Elderly age group needs special mention and special care always because that is the phase of a transition from a healthy , financially stable human being to a person who along with the physiology is also at a loss of emotional well being, mental well being, financial well being and spiritual well being..It is this time that he needs the aid and presence of a society which can think and act on his behalf.

1. NATIONAL POLICY FOR OLDER
PERSONS
Dr. Meely Panda
Community Medicine
HIMSR, New Delhi

2. CONTENT
• DEFINITIONS
• SCENARIO IN INDIA
• PROBLEM STATEMENT
• THE POLICY
• OBJECTIVES
• SALIENT FEATURES
• INTERVENTIONS
• IMPLEMENTING MECHANISM
• NEW POLICY
• PREVENTION
• REFERENCES

3. DEFINITIONS
SENESCENCE ------
BIOLOGY OF AGEING

4. GERONTOLOGY -----
THE MEDICAL STUDY OF
THE AGING PROCESS

5. DEFINITIONS
GERIATRICS -----
STUDY OF DISEASES THAT
AFFLICT THE ELDERLY

6. DEFINITIONS
OLD AGE ≥ 60 YRS
60-75 – YOUNG OLD
75-85 – OLD OLD
>85 – VERY OLD /
INFIRM

7. SCENARIO IN INDIA
Source: Situation Analysis of The Elderly in India, 2011
Year Population
60+ in millions
life expectancy
1901 12 m 24 yrs
1951 24 m 36 yrs
1991 56 m 55 yrs
2001 70 m 64 yrs
2011 95 m 67 yrs

8. SCENARIO IN INDIA
Source: World population Ageing: 1950-2050; Department of
Economic and Social affairs, Population Division, United Nations.
Years Total
Population
(millions)
60+ percent 80+
2000 1008 70 (6.9) 6
2050 1572 324 (20.6) 48

9. DEMOGRAPHIC PROFILE
• India has thus acquired the label of “an ageing nation”
with 7.8% of its population being more than 60 years
old.
• The demographic transition is attributed to the
decreasing fertility and mortality rates due to the
availability of better health care services.
• Reduction in mortality is higher as compared to
fertility.

10. DEMOGRAPHIC PROFILE
• About 48.2% of elderly persons were women, out of whom
55% were widows.
• 75% of elderly persons were living in rural areas.
• A total of 73% of elderly persons were illiterate and
dependent on physical labor.
• One-third was reported to be living below the poverty line &
were in a vulnerable situation without adequate food,
clothing, or shelter.
• About 90% of the elderly were from the unorganized sector,
i.e., they have no regular source of income.

11. FUTURE IMPLICATIONS
• Changing social norms.
• Feminization of the elderly population
(51% elderly women by 2016)
• Increased risk of chronic and
debilitating disease.
• Strain on financial and health
infrastructure.
• Increased dependency ratio.

12. PROBLEM STATEMENT
• The rate of growth of the older population (60 and above)
has doubled in 2001-2011 as compared to 1951 -61.
• The people who would survive will be dependent during
these years & they would need economic, health and
emotional support to lead a healthy life.
• This could be a problem because of
(i) low socio-economic status; and
(ii) disappearance of traditional forms of familial support
to old age population.

13. PROBLEM STATEMENT
• The present financial, familial, social & psychological
conditions is likely to worsen. Under these circumstances,
it would be expected from the Government to provide
them subsistence.
• Since, the health needs of old people are different than
others, it is a felt need to give them due consideration
while planning health services specifically for these
people.

14. PROBLEM STATEMENT
• Quite a large number of old people will be physically
handicapped & there will also be a need to rehabilitate
these physically handicapped people.
• Therefore, the Government may have to take these
numbers into consideration while making plans for the
future years.

15. PROBLEMS FACED BY ELDERLY
• Most common – economic
problems
• Lack of emotional support or
loneliness
• Health problems

16. PROBLEMS FACED BY ELDERLY
• Reduced circulatory system function and blood flow
• Reduced lung capacity
• Reduced immune system function
• Changes in vocal cords that produce the typical "old person" voice
• Heightened risk for injury from falls
• Hearing loss.
• Diminished eyesight.
• Reduced mental and cognitive ability
• Depressed mood
• Lessening or cessation of sex
• Greater susceptibility to bone and joint diseases such
as osteoarthritis and osteoperosis
• Memory loss is common due to the decrease in speed of information
being encoded, stored, and received.

17. NATIONAL POLICY FOR OLDER PERSONS
• Launched in 1999, Ministry of Social Justice and
Empowerment.
OBJECTIVES:
1. Encourage individuals -- provision for their own as well as
their spouse’s old age
2. Encourage families -- care of their older family members

18. OBJECTIVES
3. Enable and support voluntary and non-governmental
organizations -- supplement the care provided by family
4. Care and protection to the vulnerable elderly people
5. Provide health care facility to the elderly
6. Promote research and training facilities to train geriatric
care givers and organizers of services for the elderly
7. Create awareness regarding elderly persons to develop
themselves into fully independent citizens

19. NATIONAL COUNCIL FOR OLDER PERSONS
• The Government has constituted a National Council for Older
Persons (NCOP) under the Chairmanship of MoSJE.
• Highest body to advice and coordinate with the Government in
the implementation of policy and programmes for the welfare
of the aged.
• Designated office for receiving suggestions, complaints and
grievances from older persons.
• Re-constituted in 2005.
• Consists of 39 members.

20. NATIONAL POLICY FOR OLDER PERSONS
Salient features of NPOP :
FINANCIAL
SECURITY :
SHELTER : WELFARE :
BASIC FACILITIES :
HEALTH CARE AND
NUTRITIONAL
NEEDS :

21. Financial security :
(1)Tax benefits and higher interest rates
(2) Promotion of long term savings in both rural and urban
areas
(3) Increased coverage and revision of old age pension
schemes for the elderly
(4) Prompt settlement of pension, provident fund, gratuity
and other retirement benefits

22. Health care and nutritional needs :
1. Strengthening of primary health care system.
2. Development of health insurance
3. Subsidy for the health care needs of the elderly poor and
reasonable user charges for others.
4. Mobile services and special camps.
5. Setting up geriatrics wards and running of training and
orientation programmes for geriatric care .
6. Promotion of the concept of healthy ageing.

23. 7. Assistance to societies for production and distribution of
material on geriatric care.
8. Provision of separate queues and reservation of beds for
elderly patients.
9. Tax relief, grants, land grant at concessional rates to
NGOs and private hospitals to provide economical and
specialized care for the older persons.
10. Expansion of mental health services, counselling facilities
for the elderly having mental health problems.
A national programme of health care for the elderly started at a cost of Rs
400 crore under the Rashtra Swasthya Beema Yojana.

24. Shelter :
1. Earmarking 10% of houses in private and Govt. housing
schemes.
2. Easy access to loans.
3. Layout of housing colonies sensitive to the needs of the
older persons.
4. Quick disposal of cases of property-transfer etc.

25. Welfare :
1. Identify the more vulnerable.
2. Grant in aid for old age homes, daycare centres etc.
Basic facilities :
1. Identity cards, fare concession, reservation of seats in local
public transport.

26. NGOs:
An Integrated Programme for Older Persons : financial
assistance up to 90% of the project cost is provided to NGOs .
• HelpAge India
• Silver Inning Foundation
• The Family Welfare Agency
• Harmony
• Dignity Foundation
• AISCCON (All India Senior Citizens Confederation)
• Agewell foundation

27. PROCESSES OF INTERVENTIONS
1. INCOME SECURITY IN OLD AGE
2. HEALTH CARE
3. SAFETY
4. HOUSING
5. PRODUCTIVE AGEING
6. WELFARE
7. MULTIGENERATIONAL BONDING
8. MEDIA
9. NATURAL DISASTERS/ EMERGENCIES

28. Income security in old age
1. Old age pension scheme would cover all senior citizens living
below the poverty line.
2. The oldest old would be covered under Indira Gandhi
National Old Age Pension Scheme (IGNOAPS).
3. They would be provided additional pension in case of
disability, loss of adult children and concomitant responsibility
for grand children and women.

29. Public Distribution System
4. The public distribution system would reach out to cover all
senior citizens living below the poverty line.
Income Tax
5. Taxation policies would be properly implemented.
Microfinance
6. Loans at reasonable rates of Interest would be offered to
senior citizens to start small businesses.

30. INTERVENTIONS
National Old Age Pension Scheme:
• The age of the applicant (male or female) should be 65 years
or more.
• The applicant must be a destitute in the sense that he/she
has no regular means of subsistence from his/her own source
of income or through financial support from family members
or other sources.

31. INTERVENTIONS
Old age pension amounts given by different states
• Name of the State Amount/month Age
• Andhra Pradesh 75 65
• Arunachal Pradesh 150 60
• Bihar 100 60
• Gujarat 200 60+
275 65 +
• Haryana 100 60
• Himachal Pradesh 150 60
• Jammu & Kashmir 125 60
• Karnataka 100 65
• Kerala 110 65
• Madhya Pradesh 150 60 (m) 50 (f)
• Maharashtra 100 65 60
• Mizoram 100 65 60
• Orissa 100 65
• Punjab 200 65 60

32. INTERVENTIONS
Annapurna scheme
Free food grains upto 10 kg per month will be provided to
such destitute older persons who are otherwise eligible for
old age pension under the National Old Age Pension Scheme
but are not receiving it and whose sons are not residing with
them.
Taxation
• The rebate is available in the case of a resident individual.
• Rs 10,000 or 40 per cent, whichever is less.

33. 2. HEALTH CARE
7. Healthcare needs of senior citizens will be given high priority -- A judicious mix
of public health services, health insurance, health services provided by not-for-
profit organizations including trusts and charities, and private medical care.
8. The basic structure of public healthcare would be through primary health care.
9. Twice in a year the PHC nurse or the ASHA will conduct a special screening of
the 80+ population of villages and urban areas and public/private partnerships
will be worked out for geriatric and palliative healthcare in rural areas
recognizing the increase of non-communicable diseases (NCD) in the country.
10. Efforts would be made to strengthen the family system so that it continues to
play the role of primary caregiver in old age.

34. 11. Development of health insurance will be given priority. Universal
application of health insurance – RSBY (Rashtriya Swasthya Bima
Yojana) will be promoted in all districts and senior citizens
compulsorily
12. From an early age, citizens will be encouraged to contribute to a
government created healthcare fund that will help in meeting the
increased expenses on healthcare after retirement.
13. Special programmes will be developed to increase awareness on
mental health and for early detection and care of those with
Dementia and Alzheimer‟s disease.
14. Restoration of eyesight of senior citizens will be an integral part
of the National Programme for Control of Blindness (NPCB).
15. Use of science and technology such as web based services and
devices for the well being and safety of senior citizens
16. National and regional institutes of ageing will be set up to
promote geriatric healthcare.

35. 17. The current National Programme for Health Care of
the Elderly (NPHCE) being implemented would be
expanded & scaled up to all districts of the country.
18. Public private partnership (PPP) models.
19. Services of mobile health clinics would be made
available through PHCs or a subsidy would be granted
to NGOs who offer such services.
20. Health Insurance cover would be provided to all
senior citizens through public funded schemes,
especially those over 80 years who do not pay income
tax.
21. Hospices and palliative care of the terminally ill would
be provided in all district hospitals
22. Recognize gender based attitudes towards health and
develop programmes for regular health checkups
especially for older women who tend to neglect their
problems.

36. INTERVENTIONS
• Insurance schemes
• Jeevan Dhara
• Jeevan Akshay
• Jeevan Suraksha
• Bima Nivesh
• Medical Insurance Scheme
• Group Medical Insurance Scheme
• Jan Arogya
• Senior Citizens Unit Plan (SCUP)
Senior Citizens Unit Plan is a Scheme under which one has to make
a one time investment depending on his/her age and have the
benefit of medical treatment for self and spouse at any of the
selected hospitals on completion of 58 years of age.

37. 3. SAFETY
23. Provision would be made for stringent punishment for abuse
of the elderly.
24. Abuse of the elderly and crimes against senior citizens
especially widows and those living alone and disabled would be
tackled by community awareness and policing.
25. Police would be directed to keep a friendly vigil and monitor
programmes.
26. Protective services would be established and linked to help
lines, legal aid and other measures.

38. INTERVENTIONS
Travel By Road
50% discount on fare for travel on Delhi Transport
Corporation buses to senior citizens who have
attained the age of 65 years. Discount is applicable
on Monthly Pass only.

39. INTERVENTIONS
By Train
Indian Railways provide 30 per cent concession in all
classes and trains including Rajdhani / Shatabdi trains for
citizens who have attained a minimum age of 65 years in case
of men and 60 years in case of women. No certificate is
required for booking but senior citizens must carry a
documentary proof of their age during travel.

40. INTERVENTIONS
By Air
50 per cent discount on the basic fare for travel on Indian
Airlines domestic flights to senior citizens who have attained
the age of 65 years, in case of men and 63 years in case of
women.
Cancer patients and persons suffering from 80 per cent
locomotive disability holding a valid certificate for the same
also get a 50 per cent discount on the basic fare.

41. INTERVENTIONS
• Priority is given to senior citizens while paying the
electricity/telephone bills as well as in the hospitals
in Chandigarh and Haryana.
• In Punjab, the Government provides priority to the
senior citizens in paying the electricity/telephone
bills, reservation of bus seats and separate OPD in
the hospitals.
• In Gujarat, all civil hospitals have separate counters
for registration and separate queues for elderly.
• In Delhi a separate counter has been opened to
facilitate the senior citizens for submission of
property tax bills.
• A total of 728 Old Age Homes are running in the
entire country.

42. 4. HOUSING
27. Ten percent of housing schemes for urban and rural lower income
segments will be earmarked for senior citizens. This will include the
Indira Awas Yojana and other schemes of the government.
28. Develop housing complexes for single older men and women, and for
those with need for specialized care in cities, towns and rural areas.
29. Promote age friendly facilities and standards of universal design by
Bureau of Indian Standards.
30. Housing colonies would reserve sites for establishing multi-purpose
centres for socialisation of elderly.
31. Senior citizens will be given loans for purchase of houses as well as
for major repairs, with easy repayment schedules.

43. 5. PRODUCTIVE AGEING
32. The policy will promote measures to create avenues for
continuity in employment and/or post retirement
opportunities.
33. Directorate of Employment would be created to enable
seniors find re-employment.
34. The age of retirement would be reviewed by the Ministry
due to increasing longevity.

44. 6. WELFARE
35. A welfare fund for senior citizens will be set up by the
government. The revenue generated from this would be
allocated to the states in proportion to their share of senior
citizens. States may also create similar funds.
36. Non-institutional services by voluntary organizations will
be promoted and assisted to strengthen the capacity of
senior citizens and their families to deal with problems of
the ageing.
37. All senior citizens, especially widows, single women and
the oldest old would be eligible for all schemes of
government. They would be provided universal identity
under the Aadhar scheme on priority.
38. Larger budgetary allocations would be earmarked to pay
attention to the special needs of rural and urban senior
citizens living below the poverty line.

45. INTERVENTIONS
• On the initiative and with the financial assistance of Ministry of
Social Justice & Empowerment, Agewell Foundation, an NGO of
Delhi, has started a Helpline for older persons.
Helpline telephone Nos. - 011-6836486, 011-6910484
• A centre named AADHAR is also being set up with the financial
assistance of Ministry of Social Justice & Empowerment to receive
and process the representations/petitions of older persons
pertaining to their various problems and to take follow up action
thereon.
• For the expeditious disposal of Court cases, Chief Justice of all High
Courts in the country have been advised to accord priority to cases
involving older persons and ensure their disposal.

46. INTERVENTIONS
• The Mobile Medicare Unit (MMU) Programme is the only
programme directly implemented by HelpAge India to provide basic
essential medicare at the door steps of needy and underprivileged
elderly in India.
• Indusind Bank Ltd. has launched a Senior Citizens Scheme - an
investment option that gives you high returns with the assured
security. It offers free ATM card, Telebanking, Internet banking and
has 26 branches all over India.
• Magazines for the elderly -- There are Four magazines specifically
for elderly , brought out by Dignity Foundation , Senior Heritage
Selections by Heritage Medical Centre,Harmony by Harmony India
and Happy Old Age by Premsagar Relli.

47. 7. Multigenerational bonding
39. The policy would focus on promoting bonding of
generations and multigenerational support by
incorporating relevant educational material in school
curriculum and promoting value education.
40. Value Education modules and text books promoting family
values of caring for parents would be promoted by NCERT
and State Educational Bodies.

48. 8. Media
40. Media has an important role to play in highlighting the
changing situation of senior citizens and in identifying
emerging issues and areas of action.
41. Involve mass media as well as traditional
communication channels on ageing issues.

49. 9. Natural disasters/ emergencies
42. Provide equal access to food, shelter, medical care and other
services to senior citizens during and after natural disasters
and emergencies.
43. Enhance financial grants and other relief measures to assist
senior citizens to re-establish and reconstruct their
communities and rebuild their social fabric following
emergencies.

50. SCHEMES
• ANTYODAYA SCHEME
• INTEGRATED PROGRAMME FOR OLDER PERSONS 2007
• SCHEME OF ASSISTANCE TO PANCHAYATI RAJ INSTITUTIONS
• CENTRAL GOVERNMENT HEALTH SCHEME
• THE NATIONAL MENTAL HEALTH PROGRAMME
• HEALTH INSURANCE SCHEME
• PARENTS AND SENIOR CITIZENS BILL OF 2007
• NATIONAL PROGRAMME FOR THE HEALTH CARE OF
ELDERLY” (NPHCE)s

51. IMPLEMENTATION MECHANISM
• The ADHAAR Unique identity number will be offered to the
senior citizens so that implementation of assistance schemes
of Government of India and concessions can be offered to
them easily.
1. Establishment of Department of Senior Citizens under the
Ministry of Social Justice and Empowerment
2. Establishment of Directorates of Senior Citizens in states and
union territories .
3. National/State Commission for Senior Citizens

52. 4. Establishment of National Council for Senior
Citizens
• A National Council for Senior Citizens, headed by the Minister
for Social Justice and Empowerment will be constituted by the
Ministry.
• With tenure of five years, the Council will monitor the
implementation of the policy and advise the government on
concerns of senior citizens

53. 6. Role of Block Development Offices, Panchayat Raj
Institutions and Tribal Councils/Gram Sabhas
• Block Development offices would appoint nodal officers to
serve as a one point contact for senior citizens to ease access
to pensions and handle documentation and physical presence
requirements, especially by the elderly women.
• Panchayat Raj Institutions would be directed to address local
issues and needs of the ageing population.

54. FOCUS OF NEW POLICY
In 2011, the National Policy for Senior Citizens had its main
focus on:
1. Mainstream senior citizens, especially older women, and
bring their concerns into the national development debate.
2. Promote the concept of Ageing in Place and sustain dignity in
old age.
3. Being a signatory to the Madrid Plan of action, it will work
towards an inclusive, barrier-free and age-friendly society.
4. Recognise that senior citizens are a valuable resource for the
country and create an environment that provides them with
equal opportunities, protects their rights and enables their
full participation in society.

55. 5. Long term savings and credit activities will be promoted to reach
both rural and urban areas.
6. Employment in income generating activities will be encouraged.
7. Support and assist organisations that provide counselling, career
guidance and training services.
8. States will be advised to implement the Maintenance and Welfare
of Parents and Senior Citizens Act, 2007 and set up Tribunals so
that elderly parents unable to maintain themselves are not
abandoned and neglected.
9. States will set up homes with assisted living facilities for
abandoned senior citizens in every district of the country and
there will be adequate budgetary support.

56. PREVENTION
► PRIMARY PREVENTION :
a) Promotion of healthy lifestyle
b) Balanced diet
c) Exercise
d) Avoidance of smoking and alcohol
e) Avoidance of stress
f) Blood pressure screening
g) Prevention of osteoporosis

57.  SECONDARY PREVENTION :
a) Screening and early detection of asymptomatic disease –
Ca Cervix, breast examination, DM, Cataract.
► TERTIARY PREVENTION :
a) Ensure rehabilitation and use of the remaining capacities
b) Ensuring social security, economic security and emotional
security

58. WHO promoted the concept of “active ageing makes
the difference” in year 1999, which was declared as
International year of older persons.
World Elders' Day --- 1st October

59. Vanaprastha dignity trust - Hissar
Daycare center aimed at promoting creativity
amongst the elderly.
This center shall have facilities for Yoga, computer
literacy classes, library, conferences, seminars,
short courses on contemporary issues,
philosophical & religious discourses, gardening,
painting, voluntary social services, canteen etc.
Independent living apartments besides common
facilities like a mess, dining hall, on-call vehicle and
geriatric care services.

60. • Geriatric OPD has been opened at Institutes in 5 States --
Chhattisgarh, Gujarat, Haryana, Jammu & Kashmir,
Karnataka.
• Gradually other states are being taken up.
• Bi-weekly Geriatric Clinic at CHCs started at Bilaspur,
Jashpur Nagar and Raipur (Chhattisgarh), Mewat and
Yamuna Nagar (Haryana), Leh (J&K) and Shimoga& Kola
(Karnataka).
• Weekly Geriatric Clinics at PHCs have been started at
Mewat (Haryana), Leh (J&K) and Shimoga &
Kolar (Karnataka).

61. Plan for 2013-14:
• Establishment of National Institute of Aging at AIIMS,
New Delhi and Madras Medical College, Chennai.
• Programme activities in 100 districts of 21 states and 8
Regional Geriatric Centres.
• New Regional Geriatric Centres to be set up
• Add more districts in a phased manner.

62. REFERENCES
1 . National sample survey. Report on Morbidity , October 2010 –
January 2011 . Report No. 292, Department of Statistics, New
Delhi.
2. National sample survey . Report on Survey of Disabled Persons,
July-December 2011, Report No. 305, Department of Statistics,
New Delhi.
3. Expert committee on population projetions. All
India Projections for 1991-2001, Registrar General Office, New
Delhi.
4. Registrar general of india. General Population Tables,
Part ll-A Census of India, Series 1, India.
5. Psychological Gerontology: Training material for mental health
professionals; Dr Indira Jai Prakash, Bangalore University,
Bangalore.
6. Maneeta Sawhney, Institute of Economic Growth; University
Enclave, Delhi – 110 007, E-mail: system@ieg.ernet.in

63. THANK YOU