The Vulnerable Elderly

The Vulnerable Elderly

Sardar Rameez Sudhan

“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.”
Mark Twain.

Aging is natural, but certain problems that are more common in old age can increase vulnerability to diseases. Some of these are decreased physical strength, poor tolerance, and decreased sensory awareness. Although older people are a very diverse group, many are vulnerable to health hazards. In India, according to the Population Census 2011, there are nearly 104 million elderly persons (aged 60 years or above). As per the United Nations Population Fund (UNFPA) report in 2019, India’s population stands at 1.36 billion of which 6% is in the age group of 65 and above. This age group is projected to increase to nearly 20% in 2050. This demographic change combined with growing environmental stresses and health hazards creates special problems for the elderly, especially those who are poor.
Covid-19 has come as a blow to weak, socially isolated seniors. China and Italy have a huge percentage of elderly population. The spread of Covid-19 in Italy has hit mostly people over 50 years of age. Also, the virus claimed more lives in the age group of 70-79 years, for which the fatality rate was 20.5 %.
Older people don’t have as strong an immune system, so are more vulnerable to disease. They’re also more likely to have conditions such as heart or lung disease, diabetes or kidney disease, which weaken their body’s ability to fight infectious diseases. The elderly often remain confined inside homes and are prone to stress. They are silent sufferers witnessing loss of loved ones, isolation, and depression caused by stress. As per the Chinese Centre for Disease Control and Prevention (CCDCP), the mortality rate due to Covid-19 for people in the age group of 60 to 69 is at 3.6% and for 80 years and above is almost 15%.
The elderly might also face mobility challenges. Also, because they are isolated, they can’t get information about what to do, or they are not able to get food they need if stores are out of stock and going out become more difficult. Due to lack of support from family or society, many land in old-age homes, further adding to the chances of their getting affected. In many societies, seniors live in poverty, which makes it more difficult for them to get the things they need and to take care of themselves.
Old age comes with significant retrograde effect on memory and reasoning, which makes it difficult for old people to be aware of the happenings around them. In a crisis situation, they are unable to reach relief centres run by social organisations or the government, so they may be left with no access to life saving medicines and essential supplies.
To address these challenges, ageing issues should be taken into consideration in all development policies and programmes, including those related to disaster management. A participatory approach should be used to ensure that older people have a voice.

Any strategy for the elderly will have to focus on:
Education: To increase awareness and knowledge about disasters and how older people experience and respond to them. This includes specific training for health professionals on how to work with the elderly.
Inclusion: Ensuring that policies, programmes and decision making at all levels take into account the needs, capacities, vulnerabilities of the ailing and isolated senior citizens.
Communication: To provide timely, accurate, and practical information that is easy to understand, both before and after a calamity.
It is incumbent upon government authorities and organisations involved in disaster mitigation that prior database of the elderly, women, and children be prepared and updated periodically. Accordingly, a customised response can be generated without any delay or duplicacy of relief efforts. It was observed during Kerala floods recently that much of the relief material was unused as it didn’t match the requirements of people in affected areas.
The WHO lays stress on public health challenges vis a vis the elderly and the differently-abled. The WHO emphasises on distributing timely, understandable and reliable information, providing psychological support to front-line workers and bereaved families, continuing care and treatment of people with mental disabilities, protecting human rights, especially of the elderly, prisoners, migrants and refugees living in closed settings.

The writer is a Disaster Management professional. rameezsuden@gmail.com

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