With a gradual slowdown in India’s population growth, it’s imperative to cultivate ‘social prescribing’ for the elderly to better address their medical and emotional needs. Promoting healthy ageing can help reduce burden on healthcare services
For all the political discourse about a “population explosion,” the truth is that India is witnessing a slowdown in its population growth and is expected to start reversing its numbers over the next two to three decades. With the Total Fertility Rate (TFR) down to 2.3 per woman, we are inching closer to achieving replacement levels of population growth. A slowing population automatically implies a higher number of the elderly as against the young. According to the Economic Survey 2019, the country as a whole will continue to enjoy the “demographic dividend” for a few more decades but some States will start transitioning to an ageing society as early as the 2030s.
With declining fertility, reduction in mortality and increasing survival at older ages, the shift in age structure from young to the old is expected to give rise to a major public healthcare burden. Unfortunately, we do not seem prepared to meet the requirements of this shift with little emphasis on improving our elderly care structure, health structure or building a social support system to address this.
The need is not limited to improving healthcare infrastructure and availability of caregivers for the aged but also to create innovative social solutions to enable the elderly population live better, happier and more productive lives. “Social prescribing” is a strategy that ageing countries are now incorporating in their policy to address the physical and mental health needs of senior citizens and finding a way to address the problem of loneliness.
In 2018, the British Government initiated a new strategy to address the growing problem of loneliness among the country’s elderly. As part of this strategy that is expected to be fully in place by 2023, physicians will be allowed and encouraged to refer people to partake in social activities and social groups to combat loneliness. The strategy is aimed at reducing the burden on the British health service and improving patients’ quality of life. This approach will be supplemented by investing in community projects such as creating cafes, art spaces or gardens that can become the focal point of the social prescriptions for the elderly.
This approach originates from the realisation that additional and the medical needs of the elderly mean we give them a good quality of life, happiness and greater social involvement. Currently, society treats the elderly with a peculiar redundancy. However, changing this approach could help convert a large experienced and wise population into valuable social capital, rather than just a healthcare burden.
Promoting healthy ageing can help delay the onset of disease and allow us to have a more productive population in its sunset years. Healthy ageing is essentially a process through which the elderly are enabled to optimise their physical and mental health and are able to take an active part in society. Community referrals are a mechanism to create and utilise social support structures for the elderly. For example, an elderly couple living alone in a city away from their children can enjoy a much better quality of life if they are a regular part of a community exercise that allows them to pursue their passions and hobbies. This community referral system must also become an intrinsic part of the healthcare structure so doctors are able to refer their elderly patients to the communities held suitable for them.
There is scientific evidence to believe that staying socially active and relevant not only helps fight depression but also improves cognitive function and helps slow down decline in health. Joining communities and interest groups helps the elderly indulge in fruitful discussions, volunteer for social work and gives them hope and passion to live. Community groups can also be effectively leveraged to educate people to adopt healthy lifestyles that can enable them stay healthier longer.
This strategy cannot be achieved singularly by the Government. Rather, it needs active participation of innovative start-ups, social groups and volunteers to create a medical-social network requisite for social prescribing. Efforts are needed on multiple fronts to make this happen by creating community groups and social support networks to work in cohesion with doctors and hospitals. Next come integrated awareness and training programmes, to prepare a workforce that can act as a vital link between doctors and community groups and can play the role of counselors for the elderly. Guidelines would have to be framed to help doctors recommend and refer patients to social networks apart from laying grounds for coordinated and community-referral system at the levels of villages, towns and cities. Last but not the least, we would need to engage the local population, students and volunteers to spread the activities of community groups. According to a 2017 report by the United Nations Population Fund (UNFPA), around 12.5 per cent of India’s population will be 60 years and older by 2030; by 2050 this will increase to one-fifth of the population. Integrating social prescription with the healthcare structure will not only result in a healthier ageing population but also have the potential to reduce the financial burden on healthcare services.
(The writer is director and creative strategist of an advertising and consulting agency)