The vision of Dr. Aniruddha Dhairyadhar Joshi (Sadguru Shree Aniruddha Bapu) of having a comprehensive facility that will tend to the old, aged and infirm, who do not have the sound financial means to support their expensive medical needs, is gradually taking shape and will come to fruition in the coming months. The origin of the process of realizing this vision can be traced back to the year 1993, when a charitable trust named Dilasa Medical and Rehabilitation Centre was formed by Bapu. The word ‘Dilasa’ means to give assurance and support with utmost compassion. It is in that same spirit that the Institute of Geriatrics & Research Centre is being set up under the guidance of Dr. Aniruddha.
Yet another facet of Bapu’s vision for this Institute is that he inspired and guided his son Pauras in pursuing a post graduate degree in Geriatrics and consequently Dr. Pauras Aniruddha Joshi at a very young age of 24 years became Geriatrician with a Master’s degree from University of Australia.
Geriatrics, as a subject, as well as its application is relatively new to India. A majority of the research and studies in the field of Geriatric Medicine has so far been confined to the Western World. The research on Geriatrics in India is in a very nascent stage. The need of the hour is to develop Research data specific to the conditions in the Sub-Continent. It is for this very purpose that the proposed facility will house a Research Centre whose broad aim would be to collect data and evidence, in order to ensure better Health Care for the Geriatric Population of our country.
One of the foremost Aims of establishing such a facility is to provide excellent end of life care to all patients needing it. Death is unavoidable, but need not always be a harrowing experience. The end-of-life care endeavours to create an environment wherein death seems more of a natural progression rather than a disaster. When all active treatment options are ruled out, it become the responsibility of the health personnel to ensure a suffering free period for the patient and this is what the Institute will work towards achieving.
The world Population is on the rise is a fact known to one and all, the maximum increase, occurring, in what are labelled as the “Developing Countries”. One of the foremost reasons for this population spurt has been attributed quite correctly to the exponential progress in the field of Health Sciences across the world, over the last century, In the past few decades the mortality rates in India have reduced quite drastically and life expectancy has risen remarkably. The latest life expectancy has been projected as 67-68 years for males and 68-69 years in females as per the provisional details released by the Government of India census report 2011. While the overall level of health facilities has improved, the same cannot, however, be said about the facilities available to all age groups, especially the Geriatric age group. The population aged above 55 years is considered as the Geriatric age group.
The total population of India is a staggering 1.2 billion and according to available statistics, it is projected to rise even further in the next few years. The 2001 census report states that already, the population above 60 years of age [Geriatric Population> is 7.5% of the total population of India. This translates to over 7.5 crore people out of a total population of a 100 crores 10 years ago. India’s population in 1901 was about 238.4 million, which has increased by more than four times in 110 years to reach a population of 1,210 million in 2011.
The overall ratio of health personnel to patients in India is, as it is, drastically low; but the ratio of specialised geriatric heath personnel to the geriatric population is virtually next to nothing. In and around Mumbai, we find a number of tertiary health facilities catering to the public, but we hardly come across any facilities that cater specifically to the needs of the geriatric population.
First and foremost, it must be appreciated that the needs of the geriatric population drastically vary from those of the younger patients. The diseases commonly encountered in this age group are rarer and hence there are chances of missing a diagnosis if the specialised protocols for diagnosis are not followed. As far as these patients are concerned, it is the need of the hour for us to provide them the necessary time and space in order for them to maintain good health.
Successful ageing is a concept which needs to be promoted, keeping in mind the increasing geriatric population. Many of the complaints of the geriatric population which are currently attributed to their ageing, have actually been proven to be of an organic origin and, therefore, to a certain extent, potentially curable. Treating these ailments in a proper manner has been found to restore the physical and mental capabilities of these individuals. Had the degeneration in the capacities been attributed solely to ageing, the treatment would never commence, as ageing is universally accepted as an irreversible process.
There has been a great amount of apathy shown towards the needs of the geriatric population, with the current trend being of getting these persons admitted to OLD AGE homes. Often it is observed that a potentially treatable condition in these persons is considered as an incurable degenerative disease and they are condemned to a future of life long dependency.
Another aspect of Geriatric Patients is that invariably they have more than one type of morbidity and, therefore, it becomes a real challenge for the treating physician to ensure the wholesome treatment of all the maladies at the same time. In the normal set-up, it is common to find a Geriatric Patient running around to many specialists, separately, in order to get the required treatment for his many problems. This is a grave but unavoidable injustice to the age of the person in the current scenario of health care. In this sense it is actually the need of the hour to envisage a facility where all Geriatric Patients receive a wholesome Health Care under a single roof. To achieve this, a separate specialised care facility is necessary, which the Institute of Geriatrics and Research Centre endeavours to provide.
Moreover, due to the conditions commonly affecting Geriatric patients, Rehabilitation is another important aspect of geriatric care. More often than not, a combination of physical, mental and social rehabilitation is necessary for these patients. Specialised Physiotherapy and Occupational therapy sessions are required more often than not. As Health has been defined by the WHO as a state of complete physical, mental, social and spiritual well being and not merely the absence of a disease, it is quite clear that major social interactions between community representatives and patients or sometimes even the various patients themselves are necessary to achieve the social well being of these geriatric patients. Certain complementary therapies such as music therapy, Naturopathy and Acupuncture have been shown to have a respectable efficacy in dealing with Geriatric Problems and these facilities are hardly available in the current set-up of Health Care Centres.
A major aim of establishing a separate Geriatric Care Facility is also to deal with the unavoidable scenario of Palliative care. The fact that the Incidence rate of Chronic diseases in the Geriatric Population is higher than in any other age group is a fact very widely acknowledged. Palliative care is a specialized area of healthcare that focuses on relieving and preventing the suffering of patients. There are occasions wherein active treatment cannot benefit the patients any further, a scenario very commonly seen with end-stage diseases, Cancer being a more common causative factor. Such patients need proper symptomatic care in order to sustain a good quality of life and in unavoidable circumstances, achieve a respectable Death rather than a painful one. Specialised Palliative care needs to be administered along with a proper Symptomatic relief to all such patients.
Along with the Palliative Care another specialised aspect of Geriatric Care is Pain Management. It has been shown that adequate pain relief in Geriatric patients has reduced the intensity of quite a few co-morbidities. To cite an example pain is one of the most important causes of Delirium in patients, which in turn fetches them a label of Mentally unsound patient. We must remember here that adequate pain relief can cause an absolute remission in the delirium and ensure a proper recovery for these patients. The threshold of pain also is known to decrease as one ages and therefore we must be able to provide the right kind of Symptomatic Pain Relief to these patients too.
Quality of life is a major indicator of the heath status of any individual. By establishing a Multi-Disciplinary Geriatric Care Facility we shall strive to provide the Highest possible Quality of Life to all patients. Therefore a facility wherein a Geriatric patient gets proper Consultation facilities under one roof, a Multi-disciplinary approach whilst taking the treatment decisions, Proper Diagnostic facilities, good residential care facilities, Exhaustive Rehabilitation Regimes, adequate Pain and Palliative Care services and Alternative therapy options known to of benefit for the Geriatric Population would most definitely go a long way in obtaining the goal of providing an Excellent Quality of Life to all Geriatric Patients.
In the Consultation and Care facilities we propose to provide the following services:
- Geriatric Consultancy:
- Oncology Consultancy:
- Orthopaedic Consultancy:
- Ophthalmology Consultancy:
- ENT Consultancy:
- Cardiology Consultancy:
- Psychiatry Consultancy:
- General Physicians:
- Ayurvedic Consultant:
- Occupation Therapy
In the area of Navi Mumbai, an area fast becoming a hub of activity rather than remaining just a satellite township, such a day care facility with the sole focus on the Geriatric Population would definitely make a difference to the Health Status of the area. The said plot is situated very close to the Juinagar Railway Station and has a fair share of auto-rickshaws and buses connecting the area with the station. Also the area is accessible by road with equal ease, both from the Highway as well as the Palm Beach road and so its location is extremely appropriate for the convenience of the patients. Also the presence of major roads on two sides of the plot ensures that in emergency situations the Ambulance entry can be kept freely accessible. The said plot offers a great deal of promise for us in order to be able to serve the society in a manner hitherto relatively unknown to the Health Sciences in India. I am sure the benefits of such a Geriatric Care establishment shall be quite evident to all persons interested in the further improvement of the health status of Navi Mumbai, as this is sure to cause a revolution in the awareness of Geriatric Health Care in India.