Aging or Jara is the state of becoming debilitated, physically and psychologically as a result of old age usually after 60 years of life. It can be described as a progressive loss of adaptability with the passage of time so that an individual is less and less able to react abruptly to challenges from the external or internal environment. With time, the individual becomes progressively more frail and in need of increasing support to maintain his or her autonomy.
The world population of the elderly is increasing and by the year 2050, adults older than 65 years will comprise 1/5th of the global population. The average life span of Indian has already reached over 65 years. According to an estimate, the number of elderly people in India by 2016 was around 113 million. It has been projected that by the year 2050, the number of elderly people would rise to about 324 million. The stupendous success of conventional medicine in the management of communicable disease, especially in the West, was owing to the identification of a single cause in the form of a parasite/causative organism for all communicable diseases and a systematic plan of action was derived to counter the cause which then cured the disease. However, the biggest challenge with geriatric problems is that in most of cases, the condition cannot be attributed to a single cause or in certain conditions such as neuropsychiatric disorders (senile dementia and Alzheimer’s depression), the structural cause is unknown. In such cases, conventional medical therapy (modern medicine) fails to come out with an effective management plan and hence is severely compromised. Another challenge with conventional medical therapy is that it does not have availability for all.
Further, geriatric care is not only concerned with providing medical care to the old but includes comprehensive care including social care, financial care, legal care, spiritual care, and terminal care. This all is beyond the scope of medical institutions and workforce and thus requires a special state policy to meet the challenge. This is more important in Indian scenario with population over 1.30 billion, nuclear families, migrations of young adults from their place of dwelling, poor health infrastructure, and where many other priorities of families and state overtake the provision of recourses for old age care. Thus, society will need to grapple with issues of longevity in near future.
Over the years, the government has launched various schemes and policies for older persons. These schemes and policies are meant to promote the health, well-being, and independence of senior citizens around the country. The central government came out with the National Policy for Older Persons in 1999 to promote the health and welfare of senior citizens in India. This policy aims to encourage individuals to make provisions for their own as well as their spouse’s old age. It also strives to encourage families to take care of their older family members. The policy enables and supports voluntary and nongovernmental organizations to supplement the care provided by the family and provide care and protection to vulnerable elderly people. Health care, research, creation of awareness, and training facilities to geriatric caregivers have also been enumerated under this policy. The main objective of this policy is to make older people fully independent citizens.
Since the National Policy for Older Persons was a Policy Document of the Ministry of Social Welfare of the Government of India, it could not lay the guidelines for the health care of older persons nor any national campaign of health care of older people was launched by Union or State Government at their own. In 2008, Department of AYUSH, Ministry of Health and Family Welfare launched an ambitious “National Campaign of Geriatric Health Care through Ayurveda and Siddha” with its allocated resources. Launched with much promise, this national campaign was too stopped after few years of its initiation as it did not have a blueprint and resources for implementation throughout the country.
Ayurveda the ancient science of life with comprehensive approach for health management by promotion of health and disease management of individuals has always been looked for providing long and healthy life. Its concept of Rasayana has widely been propagated as a specialty for arresting the process of aging and assuring old age which is sickness free and productive. Various Rasayans such as Prankamya, Ayushkamya, and Medhya Rasayanas have been thought to improve the physical, immunological, psychological, and cognitive potentials of individuals the progressive loss of which is core to the ailments of old age. However, having said that we have failed to provide reliable data as evidence base of their effectivity to the scientific world of 21st century.
The 21st century is witnessing a gradual decline in fertility, and with increase in life expectancy, the cause of morbidity and mortality world over is shifting from communicable diseases a few decades ago to noncommunicable diseases. The geriatric society too is suffering on a similar spectrum. Today, the leading causes of mortality among aged people comprise respiratory problems, heart diseases, cancer, and stroke besides common age-related functional disorders such as lowered appetite, poor digestion, anemia, decreased colonic motility leading to constipation and impaction of stools, increased frequency of urine to retention, incontinency of urine, and benign prostatic hyperplasia. Decreasing musculoskeletal – power and tone lead to falls and fracture, as well as incoordination of gait. Degenerative changes in the nervous system lead to dementia, delirium and depression, termers, ataxia, and many other psychological ailments. Frequent lung infections, osteoarthritis, etc. are the other common old age-related health problems. Author feels that working with these regressing features of old age is a real impact area of Ayurveda practices than assuring the treatment of major ailments such as cancers, old age dementia, Alzheimer’s disease, diabetes, and hypertension. Further Ayurveda can also identify its impact area in social, psychological as well as spiritual care of old people. Working with old age groups and educating society and individuals about old age care for assuring healthy aging should be the campaign of the AYUSH system both its administration and workforce in this country.