Social factors are
increasingly being recognized as important determinants of health for the young
and the old alike. These factors relate to the conditions of life and
occupation and are therefore called social determinants of health. According to
the World Health Organization (WHO), social determinants of health are the
conditions in which people are born, grow, live, work and age.
The elderly or senior citizens
have their unique social needs. These are people who have led active productive
lives until their retirement, following which their social circle tends to
decrease. Some people may perceive retired life as loss of status and respect
in the society.
Loneliness, neglect, loss of
self-esteem, loss of control, fear, abuse, financial insecurity, food
insecurity, decreased mobility due to either disability or physical illness or
lack of suitable transportation are some of the factors tied in to their
health, which can lead to mental and physical illnesses and also worsen health
outcomes. They increase non-compliance to treatment; consequently, the patient
may present to the doctor’s clinic very frequently for chronic complaints that
don’t seem to resolve.
Social isolation or exclusion
is a very important problem in this age group, because of which they feel
rejected by the society and sometimes, unfortunately by their own family.
Herein lies the significance
of a good support system. While a good social support or a positive social
environment has a beneficial effect on health and enhances quality of life
acting as a ‘stress-buffer’, the effect can be quite the opposite when social
support is either present but the quality of support is poor or support is
totally lacking.
All these factors add on to
each other and the net result is a poor quality of life as well as poor mental
and physical health.
Loneliness and social
isolation have been recognized as risk factors for coronary heart disease and
stroke. So, while the doctor may be treating the heart disease and stroke with
medicines, he/she could be missing out on these underlying ‘causes’ that caused
the disease – “the causes of the causes”.
In a recent judgement, the
Bombay High Court has ruled that elderly parents can take back property gifted
to a son if he fails to look after them or harasses them. Citing the special
law for the maintenance of senior citizens ‘The Maintenance and Welfare of
Parents and Senior Citizens Act, 2007’, a division bench of Justices Ranjit
More and Anuja Prabhudesai upheld a tribunal's order that had cancelled a gift
deed given by an elderly Andheri resident by which he had granted 50% share in
his flat to his son, reports TOI.
The Maintenance and Welfare of
Parents and Senior Citizens Act, 2007 provides for the maintenance and welfare
of parents and senior citizens. Maintenance includes provisions for food,
clothing, residence and medical attendance and treatment. As per this Act, any
senior citizen, after 2007, who have “transferred by way of gift or
otherwise, his property, subject to the condition that the transferee shall
provide the basic amenities and basic physical needs to the transferor and such
transferee refuses or fails to provide such amenities and physical needs, the
said transfer of property shall be deemed to have been made by fraud or
coercion or under undue influence and shall at the option of the transferor be
declared void by the Tribunal.”
It is therefore important for
the treating doctor to be aware of the unmet social needs of the elderly,
beyond their immediate presenting complaint, when they seek help and identify
them and address them. This is important for healthy aging. They should also
help the elderly patients be aware of their rights.
Dr KK
Aggarwal
Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP
Publications
President Heart Care Foundation of
India
Immediate Past National President
IMA
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