"Geriatric care in the country Elderly or citizens above 60 years of age form asignificant part of the population in anycountry. They may be facing many hurdles healthwise which may not be meeting the rightkind of care that they need. The essay is written about one such mental health hurdle faced bythem called ‘dementia’ which in simple words mean loss of memory. We will understand thecase of one such individual in the city and then review it from various viewpoints.Rupesh Shinde – A senior citizen in urban scenarioThe survey looked at the case of Mr. RupeshShinde, 82 years of age residing at ShaktiApartments, Andheri West, Mumbai for last three decades. After having worked with anationalised bank all his life he now lives a retired life with his wife Rupali. Rupali wasworking as a school teacher and is a homemaker now. Their son Rahul is settled in the US formany years now. Rakesh and Rupali form a case for a typical upper middle-class elderlycouple residing in the city. The survey looked at several topics like their health, financialstatus and general acts of daily living. Rupesh hails from the village Nanded where he has his brother and his family.He does nothave much of family in the city as he was the only one to have shifted his base to the city toearn a better living. The Shindes have found long lasting friends in their neighbours for lastten years, another couple residing next door – Mr. and Mrs. Dutta.Mr.Dutta joined in whilethe survey was being conducted to help Rupesh as he has bouts of dementia while talking.When asked about his daily life Rupesh explains how the pace of life has slowed down.Mr.Dutta quips in that Rupesh used to be proud of his ability at number crunching for hundredsof customers but today needs assistance for simple calculation while paying the vegetablevendor. He cites the difficulty he faced at the mall when he forgot his pin number while transacting by card. Instances like these show how age makes it difficult to carry out dailytasks. As we speak Rupali joins in and narrates her daily battle with Vascular Dementia whichcauses mild memory loss. She supports Rupesh as she is slightly better off in her mentalagility and has a cheerful disposition which carries her through life’s troubles. Both Rupaliand Rupesh do not have immediate assistance in terms of family or close friends but get bywith help of neighbours and annual visit by their son.Conclusions drawn from Preliminary Cognition QuestionnaireSupport is very important for people in this age group especially those who are sufferingfrom dementia. As per the study conducted by Alzheimer & Related Disorders Society ofIndia (ARSDI) medical healthcare organisations are not equipped with the right know how tohandle people with dementia and related disorders. It points out how this inability affectsmainly older people where it intensifies every 5 years for Individuals above 65 years of age.Conclusions drawn from Demographic DataThe same report states that over 3.7 million Indian people over 60 suffer from dementiawhich makes for 2.1 million women and 1.5 million men. It predicts it would increase greatlyafter 2030 for above 75 age group.Conclusions drawn from Financial DataAs per ‘The Dementia India Report 2010’ published by ARDSI worldwide annual cost ofdementia is estimated to 604 billion dollars for the year 2010 which was 43% of 2009 andalmost double of 2005. In India, the study states average cost per person is 925 dollars whichis approximately INR 43285. At country level, it is roughly 9.4 billion dollars. Conclusions drawn from Social Support DataThe existing services for dementia in the country include day care centres, residential carefacilities, domiciliary care services, support groups, memory clinics, and help lines. Lack ofawareness proves to be the biggest barrier to providing care to the affected lives. Even amongthe literate, the social stigma against persons suffering from dementia is prevalent. Thisprevents from reaching help to the needy.Proposed Strategies for Dementia Care in the countryIt is imperative to create awareness among both urban and rural population regarding thismental illness. And likewise, awareness for need for appropriate care must be emphasised onall platforms of media be it print or television. An active role must be played by NGOs,healthcare professionals and other government bodies.Training personnel providing healthcare to people affected by dementiais the need of the hourso that they can assist the needy effectively. Doctors and nurses will have to be encouraged toprovide this training. Probably younger interns can also be part of this campaign to bring inmore energy to the idea.Institutes to train personnel in geriatric care should be established nationwide to expeditetraining in this field. Workshops and seminars will also prove beneficial in further training ofdoctors.Affordable treatment in terms of drugs and training of the care giver needs to be madeavailable to those who are below the poverty line. Community health givers or staffappointed for elderly care will suit this purpose.Community health support groups will play an effective role in creating community basedprogrammes to spread awareness among persons affected by dementia. While people might find it difficult to form such groups themselves the government must play an active role tohelp citizens in the same.Action must be taken to provide legal services to support people affected by dementia. Thiswill help discourage abuse in any form. Again, support from the government is imperative.A consolidated effort at national level will help the purpose greatly. It would be a goodstrategy to collaborate at international level with institutes / bodies abroad to bring in newerresearch and advances in the field into our country. So far, the efforts made by the government have not yielded results as they have beensporadic.Also, the care givers are not trained well enough to impart quality services to thesepatients. Geriatric care has not been a subject of importance in our country which explains thedismal state of people inflicted with this disease.So, it’s very important to commence nowbefore it gets worse for this section of the society.The aged can be a great support to the younger generation as they carry with them so manyyears of experience in diverse aspects of life. Many of them if looked after well can live ahealthy and active life even when old.While there are no direct pointers at the reasons fordementia, studies show unhealthy lifestyle and stress are definite contributors. People likeRupesh and Rupali form a large part of our city and the society. They could be a few blocksaway or they could be our neighbours …may be our own family, so dementia care for theaged is relevant to all of us.Even if we choose to ignore them today we may not be able to inthe longer run as it might affect us in the old age. As an educated and informed society, it makes sense to start as early as possible even if wecan’t make big contributions at least we can write and speak about it at as many socialplatforms as we can.Our children will learn what they see so let’s provide them a goodexample of sensitivityand intelligence. "