GERIATRIC CARE IN INDIA:

GERIATRIC CARE IN INDIA:      M.V.Ruparelia.

There is a general impression that diseases and disability are part of old age. This is not very true. According to Dr Deepak Chopra, body is ageless. Medical Science is progressing towards very long life span! WHO defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The concept of Active and Healthy Ageing needs to be promoted among the elderly, which includes promotional, preventive and rehabilitative aspects of health. Although one cannot reverse the aging process, one can find effective ways to cope with it.  The promotion of “aging well” and improved well-being may reduce lifetime health care expenditure. People who get the right start in life, follow healthy lifestyles and take good care of their health can expect to remain active during their eighth, ninth and even tenth decade of life," said Dr Margaret Chan, director-general of WHO.

According to the World Health Organization, India has just 6.5 physicians to every 10,000 patients. By comparison, China has 14.2 doctors, while Britain has 27.4 physicians for the same
number of patients. At present, more than half of the elderly have one or more chronic disease and disability. The ten most common diseases are:  hypertension, cataract, osteoarthritis, chronic obstructive pulmonary disease, ischemic heart disease, diabetes, benign prosthetic hypertrophy, dyspepsia, constipation and depression. The five most frequent causes of death in the elderly are bronchitis and pneumonia, ischemic heart disease, stroke, cancer and tuberculosis. There is special need for health care of oldest old (80+); Elderly Women and Rural Poor Elders. One-third of Indian women are tobacco users. Nearly 14 percent of older Indians are suffering from depression. The Health ministry's own data says that one out of every four elderly persons in India is depressed; one in three suffers from arthritis while one in five cannot hear. While one in three suffers from hypertension, almost half have poor vision. The elderly population will increase to 12% of the total population by 2025, 10% of which would be bedridden, requiring utmost care. According to the 2006 World Population Prospects, by 2050, the number of Indians aged above 80 will increase more than six times from existing 78 lakh to about 5.14 crore.

The United Nations Office on Ageing and the International Association of Gerontology have jointly developed the Research Agenda on Ageing for the 21st Century. Initiated mainly to support the implementation of the International Plan for Action on Ageing, the research agenda was adopted by the Second World Assembly on Ageing at Madrid, Spain, in 2002. It aimed to elaborate and implement public policies on ageing and influence the direction and priorities for scientific gerontology in the coming decades. This was built on the substantial body of knowledge and expertise regarding gerontology and related fields accumulated over time.

An ideal preventive geriatric scheme should include various components such as knowledge and awareness about disease conditions and steps for their prevention and management; good nutrition and balanced diet and physical exercise. For the promotion of a positive mindset and to create a feeling of well being, meditation, prayer, and strategies for motivation should also be included. Home service is very important for senior citizens. Unless a problem is serious and calls for hospitalization, the elderly are best treated at home. India was among the first countries to ratify UN Convention on the Rights of Persons with Disabilities (UNCRPD) which have come into effect from 3rd May, 2008. As per the provisions under Article 25 of UNCRPD, the health services needed by persons with disabilities should be provided as close to people’s own communities, including in rural areas. In addition, at present there is huge shortage of manpower of doctors in geriatrics in the country. At present, elderly health care is part of the general health care system. As the elderly suffer from multiple chronic and disabling diseases, it becomes difficult for them to run from pillar to post to get appropriate health care. Moreover the general health care system is not adequately sensitized to the health needs of elderly.

At a recent seminar organized by the World Health Organization, Dr Giridhara R Babu, associate professor, Public Health Foundation of India, pointed out that 40 per cent of hospitalized persons borrowed money, mortgaged property or sold assets to bear hospital expenses annually. Dr Babu feels insufficient funds and lack of accountability in the public health sector drive millions of Indians into poverty every year.

The need of the hour therefore is to set up geriatric wards that would fulfill the specific needs of the geriatric population. Professional training in Geriatrics and Gerontology needs to be promoted. Research in Geriatrics and Gerontology needs is to be encouraged. Improving the quality of life of the elderly calls for a holistic approach and concerted efforts are required to be made by the health and health-related sectors. Government has come up with a very comprehensive scheme to meet all health requirements of senior citizens. The National Programme for the Health Care for the Elderly (NPHCE) is an articulation of the International and national commitments of the Government as envisaged under the UN Convention on the Rights of Persons with Disabilities (UNCRPD), National Policy on Older Persons (NPOP) adopted by the Government of India in 1999 & Section 20 of “The Maintenance and Welfare of Parents and Senior Citizens Act, 2007” dealing with provisions for medical care of Senior Citizen. The Vision of the NPHCE is:

i)                To provide accessible, affordable, and high-quality long-term, comprehensive and dedicated care services to an Ageing population;

ii)               Creating a new "architecture" for Ageing;

iii)             To build a framework to create an enabling environment for "a Society for all Ages";

iv)              To promote the concept of Active and Healthy Ageing;

v)                Convergence with National Rural Health Mission, AYUSH and other line departments like Ministry of Social Justice and Empowerment.

The NPHCE expects to have 20 institutions with strength to produce 40 post-graduates in geriatric medicine per year, additional 6,400 beds in district hospitals and 1,000 beds in medical colleges for the elderly by 2017. India recently joined 10 other south-east Asian countries to adopt the Yogyakarta Declaration on Ageing and Health, committing to improving national response to the health of ageing population.

At District level, NPHCE is presently being implemented in 100 selected districts of 21 states and at tertiary level, 8 Regional Geriatric Centres (RGCs) are being developed at identified major medical institutions at various regions of the country for referral treatment, research and man power development etc. As regards progress at district level, most of the districts have started Geriatric OPDs with 10 beded geriatric wards. Bi-weekly clinics & Weekly Geriatric Clinics have been started at various CHCs & PHCs respectively. In addition, many districts have reported opening of daily geriatric physiotherapy clinics. At the RGCs, Geriatric OPDs have been started in all 8 RGCs-Regional Geriatric Centres  viz: 1. All India Institute of Medical Science, New Delhi. 2. Madras Medical College, Chennai.  3. Grant Medical College & J.J. Hospital, Mumbai. 4. Sher-I- Kashmir Institute of Medical Sciences, (SKIMS), J&K. 5.  Government Medical College, Thiruvanthapuram. 6. Guwahati Medical College, Assam. 7. Dr S N Medical College, Jodhpur.8. Banaras Hindu University, U.P.

Indoor services with 30 bedded wards have also been established in most of the Regional Geriatric Centres.

Since inception of NPHCE in 2010-11, expenditure incurred is Rs 4115.46 lakh during 2010-11, Rs 7170.27 lakh during 2011-12 and Rs 6855.84 during 2012-13. The provision made for 2013-14 is Rs 15000 lakh.

NCD cell will sensitize public about the Health Care of the Elderly promotion of healthy life style and services made available under the programme. Mass media through Radio, Television, Print media will be used for public awareness using the most effective channels that have reach to the community. Mid media and locally prevalent folk media may also be used to reach the targeted. Recently “Swasth Bharat Programme” has been launched which is being telecast from 30 Regional Centres of Doordarshan and 28 Regional Centres of All India Radio respectively five days a week on Non-Communicable Diseases (NCDs) and other diseases in India including chronic kidney disease. 

Other measures needed are: i) Supervision of the elderly health facilities available in their areas by Active Senior Citizens and their Associations and to connect elderly to such healthcare system. ii) Training of local supervisors by health and social experts.iii) Provide orientation and guidance to families of elderly. iv) Incorporate  group activities and foster capable leaders as local supervisors amongst elderly community and encourage social networking.

A review conducted by the Union health ministry before some time has however found that most states have failed to honour or execute the much-touted National Programme for Healthcare of Elderly (NPHCE). Of the 91 districts expected to start a geriatric clinic by now, only 22 have managed to do so. Worse, just a dozen districts have set up a 10-bed geriatric ward. Only three districts — Mewat and Yamunanagar in Haryana and Leh in Jammu & Kashmir — have started running a bi-weekly geriatric clinic in a community health centre. And, only two districts - Mewat and Leh — have started a weekly geriatric clinic in a primary health centre. In Punjab, a geriatric clinic and geriatric ward will come up in Bhatinda, Gurdaspur and Hoshiarpur soon. Ministry officials say none of the steps - setting up of a geriatric clinic, ward or holding bi-weekly clinics — have been rolled out in states like Andhra Pradesh, Assam, Bihar, Tamil Nadu, West Bengal, Kerala, Karnataka, Jharkhand and Chhattisgarh. A ministry official said, "We have released funds under the NPHCE for creating the stipulated wards and running the clinics in 91 districts across 21 states. Initially, we sent the funds to 30 districts by March, 2011, and then to the rest by March, 2012. However very few states have done any work. In the 12th Plan, we intend to take NPHCE to all the districts in the country. Our target is to reach 100 districts every year." This position may change, if Active Senior Citizens and their Associations continuously represent and agitate to get these facilities provided in their areas for which funds are available from Ministry of Health and Planning Commission.

Education and Recognition of 12 crore Elders as Resource & Think-Tank of the Country. Ref: Various Provisions in

M.V.Ruparelia, A503 Rashmi Utsav, Near Jangid Estate & Vijay Park, Mira Road (E). District Thane, Maharashtra. 401 107.  M.09821732855. E/Mail: mvrup@yahoo.co.in

To                                              Date: 25-8-13.

Shri Shashi Tharoor, Hon. Minister of State for Human Resource Development,

Government of India, Shastri Bhawan, New Delhi 110001.

Dear Sir, 

Sub:  Education and Recognition of 12 crore Elders as Resource & Think-Tank of the Country.

Ref: Various Provisions in National Policy of Older Persons, 1999 and our representation dt. 24-7-12 to Shri Kapil Sibalji, the then Minister, followed by RTI Application dt 1-9-12, 1^st Appeal dt 15-10-12 and letters to Shri Ashok Thakur, Secretary, Higher Education on 20-12-12 & 17-2-13 and letter dt  27-3-13 to DR. M. MANGAPATI PALLAM RAJU, Hon. Minister  to which no replies are received.

We were very much impressed by your charm, wit, eloquence, good work at UNO and continuous presence on Social Media brought out in your Interview by Srilekha Pillai published in Smt Tina Ambani`s popular Magazine- Harmony, Celebrate Age for August, 2013.We have noted your burning desire to fulfill the potential of India to give decent life to all its citizens. We are happy to note your self confidence for your realization that your personal interventions made a huge amount of difference and things, you have done at UNO has made a real difference to people`s lives. United Nation has proclaimed its policy for Elders in General Assembly in 1992 and has been encouraging governments to design & implement their policies for Elders from time to time. The theme for International Day of Older Persons, 1st October 2013 is ``THE FUTURE WE WANT -WHAT OLDER PERSONS ARE SAYING.``

2.As you have stated that you do not know enough about policies for Elders, we may state that our Government has notified National Policy for Older Persons, 99 with the approval of Cabinet on 13-2-99, covering all aspects required to be taken into account for real welfare of Older Persons. It is really a very comprehensive and extraordinary document leaving not a single aspect affecting the lives of Senior Citizens with clear directives for implementation. You, being prolific and quick reader, we request you to go through this very well presented Policy.  It has been provided in its Mandate & Policy Statement to take effective steps to improve the quality of life of all Elders, strengthen their legitimate place in society and help them to live their last spell of life with purpose, dignity and peace. Para 18 of the Policy provides that age 60+ is a phase, when individual should have chances and opportunities to lead an active, creative, productive and satisfying life. Ministry of HRD is one of the the apex authorities of Government of India at the national level to formulate policies, sponsor and support programmes of the Government. It is regretted that Ministry of HRD has not taken any steps to act as per these provisions in Mandate & Policy Statement and various provisions of the Policy, 99 pertaining to HRD Ministry even after 14 full years. The essence of Human Resource Development is education, which plays a significant and remedial role in balancing the socio-economic fabric of the Country. Motto of Human Resource Development Ministry is ``All for Knowledge & Knowledge for All.``

3. 12 crore Elders of the Country (10% of total population, 13% of electorate and 21% of effective voters) are declared  as huge untapped resource by Government of India with approval of Cabinet on 13-2-99 in National Policy, 99 (Para 78) for which facilities are to be made available to use their potentiality as per their choice. We request our sincere, thinker, philosopher and enlightened Minister to prepare a detailed Scheme to develop this untapped resource of the Country for last spell of their life and provide avenues for utilization of this experienced vast human force of 12 crore Elders. Special programmes are required to be designed, so that they can enrich and update their knowledge, integrate tradition with contemporary needs and transmit more effectively the Socio-Cultural heritage to school children and youths. As per para 81 of Policy, 99, programmes are also to be developed to promote family values, sensitize the young on the necessity & desirability of inter-generational bonding and continuity of meeting filial obligations of children. Paras 55 to 58 of Policy lay down detailed guidelines and directives to meet the education, training and information needs of Elders. Open Universities are expected to develop packages using distance education learning techniques. Educational curriculums at all stages of formal and non-formal education have to incorporate material to strengthen inter-generational bonds etc.  Let Good Institutes open their doors and give as many facilities as possible to Senior Citizens for passing time usefully in their crucial phase of life. They will be useful to the Institute & the Society with their varied experience in various fields. As per para 83, Medical colleges and research institutions are required to set up centres of gerontology studies and geriatrics. An inter-disciplinary coordinating body with national status for research for gerontological issues, sensitization programmes on ageing etc is to be established. There are large number of paras in which HRD Ministry has to take initiative and take very early action.

4.We request you to create vast avenues for useful utilization of this ever increasing vast resource of Senior Citizens as laid down in Policy. As you know, idle mind is devil`s workshop and having no such avenues for utilization, large number of Senior Citizens abuse themselves. A person retires from service, he feels he has done a lot and now deserves rest! He rests and does not remain active, resulting in deteriorating health & connected problems! He abuses himself!! He develops inertia of doing nothing. He feels, he need not waste his energy, which requires to be preserved at this age! He forgets that we have unlimited energy and even in active life, we have used a very small % of our energy. He forgets that majority of our Ministers are Senior Citizens working enthusiastically for welfare of masses. In old age also, we have unlimited energy and the Principle is ``USE IT OR LOOSE IT. As older persons constitute an ever-increasing proportion of the total population, they have the potential to become more influential politically, economically and socially. Fulfilling this potential would be in line with the objectives of the Madrid International Plan of Action on Ageing, which is to ensure that people age with security and dignity and continue to participate fully in their societies as citizens with full rights. We have to provide some honorary or paid work to all as per their qualification, inclination and timings etc. We have to lay down an humane Policy for utilization of very large portion of our citizens, who will be 20% of the population shortly by 2050 and if allowed to idle for long life of 30-40 years after retirement, there would be insurmountable problem for the Society & Country.

5.We have large number of intelligent officers and staff in your Ministry and thinker like you can make out a Scheme with their experience for avenues for utilization and education & training of our Elders. You may consider part time jobs like (i) monitoring some 5 schools by a senior citizen in his near about  area for moral lessons to students etc (ii) Appointments on Advisory Committees of Schools, Colleges, Municipality for supervising civic facilities, gardens, gyms, temples, encroachment on footpaths etc (iii) Looking after welfare activities of Corporate Houses under CSR funds utilization (iv) Government programmes like teaching adults, street children, Family Planning, polio drops, drug abuse, respect for women, census, elections, help in law and order situations etc  (v) Visits to schools, colleges, Hospitals, Old Men Homes. (vi)  Counseling & helping needy Senior Citizens etc.

6.With your dynamic personality & tact of handling all situations very efficiently and expertly, we are sure that you will do needful quickly, sincerely and give to the States/UTs a detailed Scheme on 1^st October, 13- the International Day of Older Persons for early implementation with targets.

Thanking You,

Yours Sincerely,

(M.V.Ruparelia)

Pursue Your Municipalities to provide this:

Pursue Your Municipalities to provide this:                                M.V.Ruparelia.              

1.    Government of India had announced National Policy on Older Persons, 1999 on 13-2-99 with the approval of Cabinet. This document is masterpiece containing all aspects of Elders` life. Para 97 lays down that Panchayati Raj Institutions will be encouraged to participate in implementation of this Policy, address local level issues and needs of Elders and implement various programmes for them. They will provide Forums for discussing concerns of Elders & activities required to be provided. In para 54, it is laid down that Civic Authorities & Bodies providing Public Utilities will be required to give priority to attending to representations/complaints of Elders. Payment of Civic Dues will be facilitated. Elders will be given special considerations in promptly dealing with matters relating to transfer of property, mutation, property tax & other matters, harassments & abuses in such cases will be checked. Working Group on ``Social Welfare``(October, 2011) for XIIth Five Year Plan has laid down that all Panchayats/Municipalities must come forward & take advantage of financial assistance for various projects under the Scheme of Integrated Programme and provide various schemes in their areas. Each Civic Body must earmark at least 5% fund from their untied funds for welfare activities of senior citizens. Every Civic Body must play a lead role in disbursement of various welfare programmes/schemes for senior citizens. They should create Single Window for all benefits to senior citizens. They should provide Recreation Facilities like Community Centres with television, library, yoga centre etc. They should actively initiate awareness generation & sensitization programme regarding need for well being, safety & rights of senior citizens in schools & colleges.

2.      Forums for discussion: Para 97 provides that Municipalities will provide Forums for discussing concerns of Older Persons & Activities that need to be taken. Such Forums will be encouraged at Panchayat, Municipal, Block & District level. They will have adequate representation of older women. Civic Bodies will mobilize the talents & skills of older persons & draw up plans for utilizing them at local level. District Councils laid down in Rules framed by States under Maintenance & Welfare of Parents & Senior Citizens Act, 2007 are also not established. Arrangements are required to be made to obtain details of all Registered Associations/Organizations working for senior Citizens in their areas and instructions should be issued to all Departments concerned in main office of Municipality and Ward Officers to hold regular consultations with local Associations of Senior Citizens and endorse copy of all circulars/instructions affecting elders to these Organizations. Similar list should be available with each Ward Officer for their jurisdiction. Meetings, Seminars etc should be held for inter action with elders periodically.

3.     Integrated Programmes for Older Persons (IPOP)- Revised Scheme effective from 1-4-2008: This programme for Elders is in respect of providing 16 schemes like Day Care Centres etc. Para 6 of the Revised Scheme has made Panchayati Raj Institutions & Local Bodies as main implementing Agencies. Each Local Body must make out a time bound programme for each ward to provide these Welfare Schemes, as 90% of recurring & non-recurring expenditure will be borne by Ministry of Social Justice, Delhi.

4.     Celebrating International Day of Older Persons (IDOP):  All Local Bodies must observe this Day on 1^st October every year. ``World Awareness Day of Abuse of Older Persons`` on 15^th June is also required to be celebrated. These celebrations will create proper atmosphere of Respect for Elders in the Society.

5.     Vayoshestha Sanmans:  Nodal Ministry has given a list of 10 Sanmans given by them every year, which they give in celebration of IDOP. All Local Bodies should also give similar Sanmans on World Elders Day to Senior Citizens of their areas.

6.     Policy provides that Local Bodies will lay down model instructions for builders for providing various facilities keeping in view ageing & lifestyle requirements of elders in all buildings, specially to ensure that no physical barriers to their mobility exist, Easy accessibility to shopping complexes, reservation of 10% of houses in big colonies and Housing Boards for elders, Group Housing for elders (paras 48 to 54 of Policy).

7.     Local Bodies must provide more Nana-Nani Parks and separate earmarking for seniors in existing gardens with sufficient benches, zoolas & other facilities.

8.     Each Ward Officer to be made Friend, Philosopher & Family Member of all elders in their area, making it obligatory to have full details of all elders staying in their jurisdiction and visit them occasionally.

9.      Creating awareness amongst elders of each ward about facilities given and available by all agencies-govt, municipalities as well as corporate & private bodies, NGOs etc.

10.  Concessions in Municipal buses fares with free travel for very elder ladies, toll tax etc should also be considered.

11.   Footpaths with handles, Zebra Crossings etc should be provided in all areas also.

12.   Hospitals: As many Hospitals are under Municipalities, the following should be provided:

i)                 Separate ques at present are formed in Municipal Hospitals only for taking out case paper and senior citizens have to be in common que for going to Doctor of Faculty concerned. Instructions are required to be issued for separate ques for going to Dr and getting medicines also. Such instructions are necessary to Shopping Malls for Payment Counters and all other organizations providing public utility under licensing control of Local Bodies.

ii)               Separate Health Care Units for Senior Citizens are required to be provided, as envisaged by Ministry of Health & F.W. in National Programme for Health Care of Elderly (NPHCE).

iii)                Geriatric Units in Hospitals attached to Municipal Medical Colleges as per NPHCE and Physiotherapy Units at CHE as per NPHCE should be provided.

iv)              Instructions to Private Charitable Hospitals/Clinics/Pathological units etc to provide separate ques, free treatment to poor & at concessional rate to others and various actions as per paras 33 to 54 of NPOP, 99 for Health & Nutrition and Public Trust Acts.

v)                As all Old Men Homes do not keep immobile seniors, Local Bodies may consider providing Old Men Homes exclusively for immobile elders, just as they provide Night Shelters for homeless citizens.

vi)              Counseling Centres for Elders are very much necessary.

vii)           Provide free medical facilities in all Municipal Hospitals to Elders.

Demands for International Day of Older Persons, 2013

Reply received from Ministry of Social Justice, Delhi.

On Tuesday, 8 October 2013 11:35 AM, surendra rawat wrote:

Dear Shri Ruperalia,

Reference is invited to your e-mail dated 22.8.2013 on various issues related to senior citizens.  The points raised therein have been examined and replies thereon duly approved by Hon'ble Minister, SJ&E  is attached herewith for kind perusal.

With regards

Surendra Rawat

Dear Shri Ruparelia,              

                       

Subject:-         With reference to your E. Mail dated 22.8.2013  to Hon'ble Minister  for Social Justice & Empowerment        

           

1.                         It is informed that instructions have already been issued vide D.O. No.15-39(57)/12-13/AG-II dated 20.08.2013 from Addl. Secretary, SJ&E to all Principal Secretary/Secretary of the concerned states for celebration of International Day of Older Persons on 1st October,2013 in a befitting manner. (copyplaced at Annexure – 'A').  Besides the Hon'ble Minister of Social Justice & Empowerment has also requested to all the Chief Minister of the respective states vide D.O. No. 15-39(57)/2012-13/AG-II (Pt.I) dated 26.08.2013 (copy placed at Annexure-B) to commemorate International Day of Older Persons on 1st October,2013 by organizing functions, workshops, seminars, awareness camps etc. and to give suitable instructions in this regard, so that, this year, the day is observed in befitting manner right up to the Block Level and with full involvement of the concerned Department like Education (including their NSS Units), Health Youth Welfare (including Nehru Yuvakendras) etc.  Besides the State Govts. have also been requested to organize these programmes with active involvement of Panchayats/Panchayati Raj Institutions and Municipal Bodies. Besides draft letters have been prepared and submitted for approval which will be issued to the States/UT from Minister, SJ&E, MOS (MG), Secy, SJ&E with request to celebrate the Day for one week.

   2.            Implement Important Provisions of Declared and Notified National Policy, 99:

                  It is informed that the draft National New Policy for Senior Citizens, 2011 is under preparation, which will be placed before the Cabinet for approval shortly.

  3.          It is informed that separate Bureau has already been established in the Ministry for looking after/dealing with the Welfare of Senior Citizens on various issues. At present there is no proposal to set up a separate Ministry/Department for Senior Citizens.

4.       The Govt. has taken the following action in pursuance to provisions contained in the NPOP, 1999:

(i)  National Council of Older Persons under the   Chairmanship of Hon'ble Minister, SJ&E was constituted in 1999.  Which has again been reconstituted in 2012 with a more definite structure.

  (ii) The Maintenance and Welfare of Parents and Senior Citizens Act,    2007 has been enacted by the Parliament of India and has been brought into force by all States & UTs except J&K to which the Act does not extend and Himachal Pradesh which has its own maintenance Act.

(iii)        The Ministry of Health and Family Welfare has launched the   National Programme for Health Care for the Elderly (NPHCE) in 2010.

(iv)        Central Sector Scheme of International Programme for Older Persons (IPOP) has been revised with effect from 1.4.2008 under which Voluntary Organizations, Panchayati Raj Institutes etc. are given grants for implementing various programmes for the Welfare of Senior Citizens.

   5.    As already stated that separate Bureau has been established for dealing   with and looking after the Welfare of Senior Citizens and details of activities of the Bureau are available in the Ministries Website separately.

 

   6.     Create in the Society & Govt. and strengthen the legitimate place of elders in the society.

 The Ministry every year on 1st October organizes International Day of Older Persons.  As part of the celebration an Inter Generational Walkathon is organized in the morning in the National Capital and Vayoshreshta Samman is given to Institutions/Individuals in recognition of their outstanding contribution towards in cause of Senior Citizens.  The Ministry also organizes similar Inter Generational Walkathon in to State Capitals.

 In this regards necessary instructions/ have been issued to the Central Ministries/State Govts./U.Ts. from time to time.

                  7.   Implement Maintenance & Welfare of Parents & Senior   Citizens Act, 2007 fully:-

                       

   In this regard, it is informed that suitable instructions have already been issued to all Central Ministries/State Govts./UTs from time to time to take necessary action in the subject.  So far, all States and UTs have notified the Act.  The Act does not extend to the State of J&K and Himachal Pradesh as

   they are having their own Maintenance Act.  A National Conference on Ageing was held on 6-7 November, 2012 in New Delhi. A review of implementation of this Act was taken up with the State Government representatives during the first half of the day.

            

                       8.   The Ministry on the occasion of IDOP give wide publicity of the features of MWPSC Act and the benefits/concessions given to Senior Citizens by various central Govt. Ministries/Departments through advertisements in Print and Electronics Media.

   9.  The Hon'ble Minister of Social Justice & Empowerment vide D.O. letter dated 9th Jaunary,2013 has requested the Hon'ble Minister for Rural Development for enhancement of Pension Indira Gandhi National Old Age Pension(IGNOAPS) to Rs. 500/- from Rs. 200/- (Years 60-79) and to Rs. 1,000/- from Rs. 500/- ( 80 years and above).

  10. The Ministry of Social Justice and Empowerment is implementing the Central Sector Scheme of Integrated Programme for Older Persons (IPOP) since 1992 with the objective of improving the quality of life of Senior Citizens by providing basic amenities like shelter, food, medical care and recreation opportunities etc. through providing support for capacity building of Government/Non-Governmental Organizations/Panchayati Raj Institutions/local bodies etc.  The Scheme was last revised with effect from 01.04.2008.  At present no Panchayat is receiving grant under the scheme as State Govts. have not sent any recommendation for grant to Panchayati Raj Institutions.

Yours faithfully,

(Surendra Rawat )

  Deputy Secretary & CPIO

To                                                                                          Date: 22-8-2013.
President Of India.    Prime Minister Of India.  Minister Of Social Justice. Minister of Finance.  Minister of H R D.  Minister of I & B. Minister of Rural Development. Minister of Urban Development.  Minister for Panchayati Raj.
                            Sub: International Day of Older Persons, 2013.    
The theme for International Day of Older Persons, 1st October 2013 is ``THE FUTURE WE WANT ‐WHAT OLDER PERSONS ARE SAYING.`` During this year, attention is to be drawn to the efforts of older persons, civil society organizations,  United Nations  organizations  and  Member  States  to  place  the  issue  of  ageing  on  the international development agenda. 
In India, Senior Citizens want the following during 2013 and request you to get us these:
1.     Celebrate This International Day in a befitting way. Please, issue elaborate instructions to each Stake Holder to celebrate this day with sincerity, vigor and fun fare like Valentine’s Day. Let each Ministry, PSU, Corporate, State/UT at District and Municipal/Panchayat level and Media celebrate and involve all citizens including their serving employees, children etc. In some Countries, this is declared as holiday. All must be encouraged to visit Elders, take them for treat, picnic, film, give presents etc and make this day memorable for them. These Elders have achieved Independence and Present Economic Prosperity for the Nation. Today is an opportunity for us all to show our gratitude for the contributions of older people - by spending time with an elderly neighbor, volunteering at a retirement home etc.
2.     Implement Important Provisions of Declared and Notified National Policy, 99: National Policy of Older Persons, 1999 was announced on 13-2-99 with the approval of Cabinet, covering all aspects required to be taken into account for real welfare of Older Persons. It is really a very comprehensive and extraordinary document leaving not a single aspect affecting the lives of Senior Citizens with clear directives for implementation. It is provided in its Mandate & Policy Statement (Paras 12 to 21) to take effective steps to improve the quality of life of all Elders, strengthen their legitimate place in society and help them to live their last spell of life with purpose, dignity and peace. Para 18 of the Policy provides that age 60+ is a phase, when individual should have chances and opportunities to lead an active, creative, productive and satisfying life. The Policy declares the Older Persons as respected Citizens requiring strengthening of their legitimate place in the Society. It recognizes the Older Persons as a Resource of the Country.Make each Ministry work towards this.
3.     Provide Separate Ministry/Department/Commission for 12 crore Senior Citizens & Pensioners (10% of total population, 13% of electorate and 21% of effective voters).
4.     Provide Avenues of Utilization of Elders: Even after 14 years of formation of the Policy for overall upliftment of Senior Citizens in paras 20, 21, 31, 55, 78, 79 etc, nothing is done for their proper utilization. Many pensioners and Senior Citizens feel lonely and require some avenues of passing their time usefully.

5.     Provide Negotiating Machinery: Negotiation & Dissemination of Information to Elders is completely neglected by Nodal Ministry. Separate Negotiating Machinery by recognizing existing registered Federations of Senior Citizens and separate Web Site for Senior Citizens is what we need immediately.

6.     Create respect for Elders in the Society & Government and strengthen the legitimate place of Elders in the Society.

7.     Implement Maintenance & Welfare of Parents & Senior Citizens Act, 2007 fully by providing Old Age Home in each District, making District Magistrates give wide publicity to the Act and about Government Programmes for welfare of Elders; by establishing State Councils; District Committees; preparing up to date lists of all senior citizens living in jurisdiction of each Police Station and forming of Volunteers` Committees for each Police Station.

8.     Get Cooperation of all Newspapers, private TV Channels and Bollywood etc: This  is absolutely necessary for creative use of entire Media for highlighting continuously the changing situations of Elders, active ageing, intergeneration bonds etc

9.      Increase Indira Gandhi National Old Age Pension (IGNOAPS): At present, amount of Rs 300 is given by Central Government for paying to less than 1 crore senior citizens belonging to BPL Family out of 4 crore BPL Senior Citizens in the Country. This is a mockery of Elders of the Country. Financial Constrains are for only helpless, ailing BPL Elders of a Highly Advanced & Financially Prosperous Country, which boasts in the ENTIRE WORLD for having RESPECT for their ELDERS!! Government spends Rs 20000 p.a. (more than Rs 1600 p.m.) for one Under Trial Prisoner and much more for convicts. Even alcoholic & drug addicts are granted Rs 900 p.m. by same Govt for food during their remaining in Anti-addict Centres!  Kindly, look in to this mockery of Elders and increase the amount to Rs 2000 p.m., as demanded by Pension Parishad. For Rashtriya Swasthya Bima Yojna (RSBY), Para 2.8.3 of Report of XII Five Year Plan (2012-17) Working Group on ``Social Welfare`-`October, 2011 recommended to provide insurance to the extent of Rs 1 lakh in place of existing Rs 30000. This is required to be implemented early. RSBY is required to be modified on lines of Schemes being implemented by Maharashtra, Andhra & Tamilnadu States, classifying those having income up to Rs 1 lakh p.a. as BPL and those between 1 to 5 lakhs as APL. Pension & Insurance should be admissible to APL also.
10.   Get Integrated Programmes for Older Persons (IPOP) Implemented fully for improving the quality of life of the Older Persons by enforcing Municipalities/Panchayats to provide 16 Schemes in each ward by time bound targets.

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Let Us Take Advantage of Facilities Given by Government.

Let Us Take Advantage of Facilities Given by Government.   M.V.Ruparelia.

National Policy, 99 recognizes our Associations (NGOs) as a very important institutional mechanism to provide user-friendly affordable services to senior citizens of their areas. Elder persons should be encouraged by our Associations for involving them to provide services to fellow senior citizens, thereby making use of their professional knowledge, expertise and contacts. All associations should sincerely work towards this goal and get benefits given by governments and local bodies reach to all elders of their areas. Each Association and active Senior Citizen should have copy of NPOP, 99; Maintenance Act, 2007 & Rules made there under by their State/UT; List of Facilities & Concessions given by Central & State Governments and Local Body of their area; Integrated Programmes of 16 Schemes by Ministry of Social Justice, Help Lines of their area; Vrudhashrams in their areas etc. (Please, see  Web Sites of Nodal Ministry & my blogs: http://rupareliasblog.blogspot.com or http://blogs.rediff.com/mvrup).They should constantly endeavor to disseminate such information amongst all senior citizens of their areas and help & guide those, who approach them. In this article, we shall see very useful but most neglected (by us) facility given by our Nodal Ministry viz Integrated Programmes to Elders of the Country.

AIMS AND OBJECTIVES of Integrated Programmes for Older Persons (IPOP) is to improve the quality of life of the Older Persons by providing basic amenities like shelter, food, medical care and entertainment opportunities and by encouraging productive and active ageing through providing support for capacity building of Our Associations(NGOs)/ Panchayati Raj Institutions / local bodies and the Community at large. Assistance under the scheme is given to our Associations (eligible Non-Governmental Voluntary Organizations with 2 years registration); the Panchayati Raj Institutions / local bodies for the following purposes:-

(i) Programmes catering to the basic needs of Older Persons particularly food, shelter and health care to the destitute elderly; (ii) Programmes to build and strengthen intergenerational relationships particularly between children / youth and Older Persons; (iii) Programmes for encouraging Active and Productive Ageing; (iv) Programmes for proving Institutional as well as Non Institutional Care / Services to Older Persons; (v) Research, Advocacy and Awareness building programmes in the field of Ageing; and (vi) Any other programmes in the best interests of Older Persons.

It would be observed from the above that government is ready to give financial assistance for above purposes. Our Registered Associations should take advantage of this for benefits of senior citizens of their areas. Some active office bearers/senior citizens, having preconceived ideas for government working, pride & prejudice avoid dealing with government machinery depriving their senior citizens of various facilities very much needed & useful for them. We may experience many difficulties for dealing with government departments but having come of our own volition in the field of social service, our inactions should not deprive our senior citizens for whom we have to work. Ministry of Social Justice and Empowerment allocates huge funds every year to your State/UT, which is not used fully. They have given details of assistance for 16 schemes and you can have any programme for your area, keeping aims & objects in view. If you study this Integrated Programmes, you will realize that how much is being done by government for us. To give one or two examples, you will be happy to know that if you arrange a Camp for about 50 senior citizens through recognized charitable hospital, nursing home, medical institutes, colleges etc for disability of hearing and providing hearing aids, dentures, knee braces etc free of cost, Ministry is giving up to Rs 1,60,000 per camp. For physiotherapy Centre, which is needed more in this age, Ministry gives Rs 7,00,000 for equipments and Rs 2,36,000 p.a. for day to day expenditure. For Day Care Centre for 50 members, it gives Rs3,74, 000 p.a. and Rs 32000 for furniture etc. For running your registered association, 90% grant to the extent of Rs 1,44,000 p.a. (12000 p.m.) is given for 5 years on various items of expenditure and Rs 50000 for non recurring expenditure for furniture, telephone, computer etc, if your membership is 1000 and above and to your Federations/Confederations, if membership is more than 20000. They have given details of grants for 16 schemes, as under, for which our Associations can get financial assistance with managerial staff etc.

(i) Maintenance of Old Age homes to provide food, care and shelter for a minimum number of 25 destitute older persons. (ii) Maintenance of Respite Care Homes and Continuous Care Homes for a minimum of 25 Older Persons who live in old age homes but are seriously ill requiring continuous nursing care and respite. (iii) Running of Multi Service Centres for Older Persons to provide daycare, educational and entertainment opportunities, healthcare, companionship to a minimum number of 50 older persons.  (iv) Maintenance of Mobile Medicare Units to provide medical care to the older persons living in rural and isolated and backward areas.  (v) Running of Day Care Centres for Alzheimer's Disease / Dementia Patients to provide specialized day-care to the Alzheimer's disease patients. (vi) Physiotherapy clinics for older persons. (vii) Disability and hearing aids for older persons.(viii) Mental health care and Specialized care for the Older Persons to provide Mental Health Care Intervention Programmes to the elderly. This scheme is also open to organizations / hospitals, which are already into mental health care. The scheme would help such organizations to integrate the component for older persons, which is hitherto neglected. (ix) Help-lines and Counseling Centres for older persons. (x) Sensitizing programmes for children particularly in Schools and Colleges. (xi) Regional Resource and Training Centres. (xii) Training of Caregivers to the older persons. (xiii) Awareness Generation Programmes for Older Persons and Care Givers like Self-care, preventive health care, disease management, preparation for old age / healthy and productive ageing; intergenerational bonding. (xiv) Multi facility care centres for destitute older widow women to provide shelter, educational, occupational and entertainment opportunities, healthcare, companionship to the widowed older women. (xv) Volunteers Bureaus for older persons. (xvi) Formation of Vridha Sanghas / Senior Citizen Associations. (xvii) Any other activity, which is considered suitable to meet the objective of the scheme.

ELIGIBILITY CRIETERIA FOR ASSISTANCE UNDER THE SCHEME for your Association is as under:-

i) The Non-governmental voluntary organization should be a registered body, under an appropriate Act so that it gets a corporate status and a legal personality and a group liability is established for its activities; ii) It should be registered either under the Societies Registration Act, 1860 or relevant State Societies Registration Act and has already been working for at least two years; or a Public Trust registered under any law for the time being in force or a charitable company licensed under Section 525 of Companies Act, 1958.iii) It should have been registered for a minimum period of two years but in the case of the North Eastern region, J&K, Desert areas and under serviced/Under-represented areas, this condition of two years will not be applicable. In other deserving cases, the condition of two years may be relaxed with the approval of the Secretary (SJ&E) on case-to-case basis. iv) The Organization shall have a properly constituted managing body with its powers, duties and responsibilities clearly defined and laid down in a written Constitution; It shall have an appropriate administrative structure and a duly constituted managing/ executive committee; v) The organization is initiated and governed by its own members on democratic principles.vi) The aims and objects of the organization and programmes in fulfillment of those aims and objects are specifically laid down; vii) The Organization shall not run for profit to any individual or a body of individuals; The Organization should possess proven credentials and capabilities to handle such projects.

These grants are substantial and likely to be increased shortly. These grants are admissible to all Registered Associations of Senior Citizens working for 2 years & above and NGOS, Municipalities (all local bodies), Trusts, Hospitals, Nursing Homes and all registered & recognized Social & Government Organizations, State Governments etc. Where Associations do not want to do themselves, they can get these done through other agencies by constant persuasion. It is better to do yourself rather than pursuing others. Details of the Scheme & procedures to be followed can be seen from their Web Site: www.socialjustice.nic.in   Our Associations of Senior Citizens are requested to work hard towards provision of these facilities in their areas by themselves or through various agencies mentioned above.

Our Associations should also work hard to get State Councils, District Committees, Volunteers Committees with Police etc under Maintenance Act, 2007 established for regular & wide publicity of Policies and continuous negotiations for effective implementation of various policies for senior citizens. Lot of facilities and monthly IGNOAPension are given to BPL senior citizens. They being illiterate, they are to be provided full assistance by our associations to get these facilities.

International Day of Older Persons, 2013.

                       International Day of Older Persons, 2013.     M.V.Ruparelia.

The theme for International Day of Older Persons, 1st October 2013 is ``THE FUTURE WE WANT ‐WHAT OLDER PERSONS ARE SAYING.`` During this year, attention is to be drawn to the efforts of older persons , civil society organizations,  United Nations  organizations  and  Member  States  to  place  the  issue  of  ageing  on  the international development agenda. 

It was before 23 years on December 14, 1990 that the United Nations General Assembly voted to establish October 1 as the International Day of Older Persons. This day is celebrated by raising awareness about issues affecting the elderly. It is also a day to appreciate the contributions that older people make to society. This was preceded by initiatives such as the Vienna International Plan of Action on Ageing - which was adopted by the 1982 World Assembly on Ageing and endorsed later that year by the UN General Assembly. In 1991, the General Assembly adopted the United Nations Principles for Older Persons. In 2002, the Second World Assembly on Ageing adopted the Madrid International Plan of Action on Ageing to respond to the opportunities and challenges of population ageing in the 21st century and to promote the development of a society for all ages.

Let us write and request our President, Prime Minister, Nodal Minister & other Ministers and Chief Minister of our States/UTs as to What We Want. The following is What 12 crore Elders of the Country are saying:

1. Implement Important Provisions of Declared and Notified National Policy, 99: National Policy of Older Persons, 1999 was announced on 13-2-99 with the approval of Cabinet, covering all aspects required to be taken into account for real welfare of Older Persons. It is really a very comprehensive and extraordinary document leaving not a single aspect affecting the lives of Senior Citizens with clear directives for implementation. It is provided in its Mandate & Policy Statement (Paras 12 to 21) to take effective steps to improve the quality of life of all Elders, strengthen their legitimate place in society and help them to live their last spell of life with purpose, dignity and peace. Para 18 of the Policy provides that age 60+ is a phase, when individual should have chances and opportunities to lead an active, creative, productive and satisfying life. The Policy declares the Older Persons as respected Citizens requiring strengthening of their legitimate place in the Society. It recognizes the Older Persons as a Resource of the Country. It lays down in clear terms that each Ministry will prepare Five Year & Annual ACTION PLANS to implement aspects which concern them (Para 93) by fixing Targets and Time Schedules to take steps to ensure flow of all benefits to older persons. Paras 16 to 18 of Policy lay down that opportunities will be made available for the development of the potential of senior citizens and services will be provided so that they can improve the quality of their lives. They should get opportunities & equitable share in development programmes & administrative actions. They should have chances & opportunities to lead an active, creative, productive & satisfying life. Para 90 lays down that National Policy will be widely disseminated for which ACTION PLAN will be prepared so that its features remain in constant PUBLIC FOCUS. Para 91 clearly mentions that Policy will make a change in the lives of senior citizens only, if implemented. It also mentions that Apex Level Organizations of Senior Citizens have special responsibility to function as WATCHDOG, energize continuing action, mobilize Public Opinion & GENERATE PRESSURE for implementation of this Policy! No machinery is laid down to listen to any Organization of Elders!! Please, get proper & prompt action taken by each Ministry at Centre, State/UT and Local Bodies during 2013.

2. Provide Separate Ministry/Department:  Ministry of Social Justice is nominated as Nodal Ministry for Welfare of Elders. This Ministry deals with many subjects other than welfare of Senior Citizens and is not able to take appropriate & prompt action for welfare of Elders of the Country. We need a separate Ministry for 12 crore Senior Citizens (10% of total population, 13% of electorate and 21% of effective voters).

i)                3.  Provide Negotiating Machinery: At present, neither Nodal Ministry nor any other Ministry even sends a copy of circular/instructions affecting Elders to any of our Associations of Senior Citizens. Recognition of various Associations, as done by Ministry of Pension for Associations of Pensioners is necessary. One of the main requirement of NPOP, 99 is wide dissemination of information to Senior Citizens and their Organizations, so that they can function as watchdog, energize continuing action, mobilize public opinion and generate pressure for implementation of Policy, as laid down in para 91. Para 72 lays down that there will be continuous dialogue and communications with NGOs on ageing issues and on services to be provided. Para 90 provides that National Policy will be widely disseminated. Negotiation & Dissemination is completely neglected by Nodal Ministry. Separate Negotiating Machinery by recognizing existing registered Federations of Senior Citizens and separate Web Site for Senior Citizens is what we need.

4. Provide Avenues of Utilization of Elders: Even after 14 years of formation of the Policy for overall upliftment of Senior Citizens in paras 20, 21, 31, 55, 78, 79 etc, nothing is done for their proper utilization. Many pensioners feel lonely and require some avenues of passing their time usefully. Ministry of Human Resource Development has to provide proper education to retired staff, which plays a significant and remedial role in balancing the socio-economic fabric of the Country. 12 crore Elders of the Country are declared as huge untapped resource (Para 78) for which facilities are to be made available to use their potentiality as per their choice.

5. Create respect for Elders in the Society & Government: It is observed that Elders of the Country are not treated well in Society, as were being treated earlier-Matru Devo Bhav-Pitru Devo Bhav. Recent Help Age Report on Elder Abuse indicates this. They are treated as ``Spent Force`` by Government, which is apparent in non implementation of various notified and declared Policies. Para 15 of Policy, 99 states that State will strengthen the legitimate place of Elders in the Society. Para 18 states that Elders should have chances and opportunities to lead an active, creative, productive and satisfying life. State has to strengthen inter generational bonds and mutually supporting relationships. State has to encourage capable Senior Citizens to provide service to other senior citizens in need of help. It is necessary that the Family Support System continues to be functional to discharge its caring responsibilities, sensitizing the young on necessity & desirability of inter generational bonding etc. Each provision in Policy is important and requires highlighting.

6. Implement Maintenance & Welfare of Parents & Senior Citizens Act, 2007 fully: 10 States and 6 UTs have not yet operationalized this Act even after 6 years! Not a single State/UT has yet provided Old Age Home. No District Magistrates give wide publicity to the Act nor about Government Programmes for welfare of Elders; No State Councils nor District Committees are formed, no up to date lists of all senior citizens living in jurisdiction of each Police Station and formation of Volunteers` Committees for each Police Station are formed, as laid down. Many States have not provided for punishments for abandoning parents; restoring right to property in cases of not taking care of parents after getting property transferred and provision of free medical care in government hospitals, as provided in Act. This is required to be done early.

7. Get Cooperation of all Newspapers, private TV Channels and Bollywood etc: This  is absolutely necessary for creative use of entire Media for highlighting continuously the changing situations of Elders, active ageing, intergeneration bonds etc as per para 88 & 89. A weekly programme of one hour duration should be introduced in Doordarshan on various issues and concerns relating senior citizens viz health care, security, need for care & maintenance etc should be started early.

8. Increase Indira Gandhi National Old Age Pension (IGNOAPS): As per para 25 of Policy, 99, BPL Senior Citizens were to be provided with Old Age Pension as succor and rates of monthly pension were to be revised at intervals so that inflation does not deflate its real purchasing power. At present, amount of Rs 300 is paid by Central Government to less than 1 crore senior citizens belonging to BPL Family out of 4 crore BPL Senior Citizens in the Country. This is a mockery of Elders of the Country. Financial Constrains are for only helpless, ailing BPL Elders of a Highly Advanced & Financially Prosperous Country, which boasts in the ENTIRE WORLD for having RESPECT for their ELDERS!! Government spends Rs 20000 p.a. (more than Rs 1600 p.m.) for one Under Trial Prisoner and much more for convicts. Even alcoholic & drug addicts are granted Rs 900 p.m. by same Govt for food during their remaining in Anti-addict Centres! Kindly, look in to this mockery of Elders and increase the amount to Rs 2000 p.m., as demanded by Pension Parishad. For Rashtriya Swasthya Bima Yojna (RSBY), Para 2.8.3 of Report of XII Five Year Plan (2012-17) Working Group on ``Social Welfare``(October, 2011 recommended to provide insurance to the extent of Rs 1 lakh in place of existing Rs 30000. This is required to be implemented early. RSBY is required to be modified on lines of Schemes being implemented by Maharashtra, Andhra & Tamilnadu States.