Specialized facilities for elderly, a neglected sector in the healthcare system

Bangladesh has made great strides in increasing the life expectancy of the population over the years and as a result a significant number of the population are over 60 years old now.

However, there are very few specialized healthcare facilities for the older population both in the public and private sectors in Bangladesh. Health experts think alongside medical care, the older segment of the population needs palliative care, which is neglected in Bangladesh.

“I would say geriatric healthcare is almost non-existent in Bangladesh. Only a few geriatric health facilities and palliative care units are operating in Bangladesh,” said Shohael Mahmud Arafat, chairman of the Department of Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU).

He told Dhaka Tribune that approximately 30% of the patients who come to the BSMMU seeking medical care are elderly citizens.

Therefore, with the growing number of elderly people in Bangladesh, the demand for geriatric medicine, a specialty that focuses on the healthcare of elderly people, has increased manifold, he added.

The average life expectancy for women in Bangladesh is 75 years and for men 71 years, according to the 2021 report of the United Nations Population Fund (UNFPA).

The report notes that the current population of Bangladesh is 167.3 million and it is increasing at a rate of 1.1% per annum. Additionally, 5.3% of the total population of the country is 65 years of age or older.

He recommended that hospitals and clinics should have some designated beds and units for older people to compensate for the shortage of geriatric healthcare facilities.

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Abul Bashar, a 70-year old patient who had to visit the same hospital for two consecutive days to complete his entire diagnosis process, which includes a bunch of pathological tests and X-Ray and MRI, said: “My journey is not complete yet. I still have to visit the doctor. Considering my age and multiple health issues I am already too fragile to go through such miseries.”

Patients like him need specialized hospitals where they can avail all types of treatment at one place.

A study, “Health status and healthcare-seeking behaviour assessment among elderly citizens in Bangladesh,” conducted by Bangladesh Institute of Development Studies has found that the health conditions of elderly people is very critical and they suffer from several diseases for a longer time.

Older citizens often feel the need for and have suggested that the government prioritize affordable elderly health-friendly care in public hospitals for the betterment of their health and wellbeing.

A total of 478 households, with at least one elderly citizen (60 years or more), were surveyed between November 2019 and January 2020.

The study found that approximately 93% of elderly people have suffered from illness in the six months preceding the survey. Most of them suffered from chronic illness (84%). The survey also found that most of the elderly citizens were suffering from hypertension (15.6%), gastric or ulcer (14.3%), pain (13.6%), diabetes (8.9%), cardiac disease (7.6%), weakness (6.8%), asthma (5%), flu/cough (3.7%), arthritis (2.9%) as well as eye-related infections (2.7%).

Bangladesh Association for the Aged and Institute of Geriatric Medicine

Abdur Rahman Sarker, social welfare officer of Bangladesh Association for the Aged and Institute of Geriatric Medicine (BAAIGM), told Dhaka Tribune that elderly people need caregivers when they suffer from diseases due to old age.

“Healthcare facilities for older people are not enough. They need palliative care because many older people are unable to take care of themselves,” he told this correspondent.

Probin Hospital, a geriatric hospital at Dhaka’s Sher-E-Bangla Nagar, has doctors specialized in geriatric medicine. On average, around 3,700 older patients visit the hospital for medical help every three months.

Of the 92 branches of the BAAIGM in the country, only 63 branches are active at present. Only the central branch at Dhaka’s Sher-E-Bangla Nagar has a full hospital set-up with indoor and outdoor facilities.

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“Many doctors provide healthcare support as a voluntary effort for the elderly,” said Ashraful Alam Masum, assistant director of the hospital.

A geriatric consultant, Aminul Haque said: “With growing age people are diagnosed with multiple chronic diseases such as blood pressure, diabetics, cancer, kidney disease, arthritis. Due to aging, the physical capabilities of a human being are reduced. The elderly cannot be treated in the same process as a young person.”

How much special attention do the elderly actually get at hospitals?

“There are elderly corners in government hospitals that provide healthcare services to the elderly on a priority basis. In fact, during Covid-19 vaccination, elderly people have been prioritized,” said Prof Dr Nasima Sultana, additional director general of the Directorate General of Health Services (DGHS).

She also mentioned facilities such as handrails, wheelchairs and disability-friendly washrooms to ease the difficulties of the aged people.

Directors at several medical college hospitals and civil surgeons said they are trying to increase the capacity of their health workers and physicians so that they can handle such patients sensitively.

The government has asked them to have an elderly corner so that they can get proper service.

“There is no geriatric unit but we had corners for the elderly and people with disabilities. We have a directive that the elderly people need no serial in ticket purchase and doctor appointments,” said Dr Abu Shahin, civil surgeon in Jessore.

Besides elderly corners, there is a geriatric unit in Dhaka Medical College, which was initiated in 2014 but at present is closed due to Covid-19. BSMMU has a Centre for Palliative Care (CPC) under the Department of Medicine where people with terminal diseases and older people can seek help. Also, there is a gerontology (study of the social, cultural, psychological, cognitive, and biological aspects of aging) unit in CMH at present.