National program for the health care of the elderly [NPHCE] ~ Nursing Guru

National program for the health care of the elderly [NPHCE]

National program for the health care of the elderly [NPHCE]


The exceptional increase in human life span in twentieth century has brought about the marvel of population maturing everywhere throughout the world. Nations with huge population, for example, India have enormous number of individuals currently matured 60 years or more. The population beyond 60 years or more old has significantly increased in most recent 50 years in India and will persistently increment in not so distant future.


The National Program for the Health Care of the Elderly (NPHCE) is an expression of the government's international and national commitments to the UN Convention on the Rights of Persons with Disabilities (UNCRPD) and the National Policy on the Elderly (NPOP). Section 20 of the Government of India, 1999 and the "Parental Management and Welfare and Senior Citizens Act, 2007" dealing with regulations for the medical care of senior citizens. 

Need of national program for the health care of the elderly 

As indicated by 2001 census, there were 75.93 million Indians over the age of sixty years; of them 38.22 million were male and 37.71 million were females. The five census estimates for the year 2051 are: 96.30 million (2011), 133.32 million (2021), 178.59 (2031), 236.01 million (2041) and 300.96 million (2051).


The older experience the ill effects of numerous and interminable maladies. They need long term and predictable care. Their medical issues require the consideration of masters from different divisions for example Ophthalmology, Cardiovascular, Dental, Orthopedics, Urology and Psychiatry. A consideration model that gives complete well being administrations to the old at all degrees of social insurance conveyance is basic to meet the developing well being needs of the elderly. Moreover, the old with in-capacities should be kept up close and personal.

Proposition of national program for the health care of the elderly

According to the NPOP, Ministry of Health and Family Welfare was endowed with the accompanying plan to take care of the health needs of the elderly:

  1. Setting up Geriatric ward for older patients at all District level hospital
  2. Development of treatment facilities for constant, terminal and degenerative sicknesses
  3. Giving improved clinical facilities to those not ready to go to clinical focuses reinforcing of CHCs/PHCs/Mobile Clinics
  4. Consideration of geriatric care in the prospectus of medical courses including courses for nurses
  5. Reservation of beds for older in public hospitals
  6. Preparing of geriatric care givers
  7. Setting up research organizations for chronic elderly diseases, for example, Dementia and Alzheimer

Vision of national program for the health care of the elderly

  1. To provide accessible, affordable and high-quality long-term, comprehensive and dedicated care services to the aging population
  2. To create a new architecture for elderly
  3. To building a framework to create an enabling environment for society for all ages
  4. To promote the concept of active and healthy aging

Objectives of national program for the health care of the elderly

  1. To provide easy access to promotional, preventive, preventive and rehabilitative services for the elderly through a community-based primary health care approach.
  2. To identify health problems in the elderly and provide appropriate health interventions with appropriate referral backup support in the community.
  3. To enhancing the ability of medical and paramedical professionals as well as family caregivers to provide health care for the elderly
  4. To providing referral services to elderly patients through district hospitals and regional medical institutions
  5. To convergence with other line departments such as the National Rural Health Mission, AYUSH and the Ministry of Social Justice and Empowerment

Core strategies of national program for the health care of the elderly

The main strategies to achieve the goals of the program are:

  1. Community-based primary health care approach, including home visits by trained health care workers.
  2. Dedicated services at the PHC / CHC level, including machinery, equipment, training, additional human resources (CHC), IEC, etc.
  3. Special facilities at the District Hospital with 10 bed wards, additional human resources, machinery & equipment, consumables & medicines, training and IEC.
  4. Strengthen 8 regional medical institutions to provide tertiary level medical facilities dedicated to the elderly, introduce PG courses in Geriatric Medicine and train in-service health personnel at all levels.
  5. To reach the Information, Education & Communication (IEC) target community using the Information Society, Folk Media and other communication channels.
  6. Continuous monitoring and independent evaluation of the program and implementation of research and NPHCE in geriatrics.

Supplementary strategies of national program for the health care of the elderly

  1. Promoting public-private partnership in geriatric health care.
  2. Mainstreaming AYUSH - restoration and convergence of local health traditions with the programs of the Ministry of Social Justice and Empowerment geriatric field.
  3. Reversing medical education in support of geriatric issues.

Services at different levels under National program for the health care of the elderly
National program for the health care of the elderly [NPHCE]

Sub Center

  1. Health education related to healthy aging
  2. Training family care providers in residential visits and caring for people with disabilities for the care and care of the elderly / bedridden elderly at Home.
  3. Arrange to convert them into ambulatory for calipers and assistive devices suitable for the elderly from PHC.
  4. Link with other support groups and day care centers operating in the area

Primary Health Center

  1. Weekly Geriatric Clinic runs by a trained medical officer
  2. Maintain their record using the standard format on the first visit of elderly
  3. Conducting general health assessment of the elderly based on routine clinical examination of the eye, BP, blood sugar, etc.
  4. Provision of medication and proper advice on chronic diseases
  5. Public awareness on health promotion, prevention and rehabilitation on geriatric aspects during Village Sanitation Day / Camps
  6. Investigation for diseases that require further research and treatment, referral to a community health center or district hospital.

Community Health Center

CHC is the first referral unit (FRU) for PHCs and below.

  1. The geriatric clinic for the elderly twice a week.
  2. Rehabilitation wing for Counseling and Physiotherapy
  3. Rehabilitation worker's home visits for bedridden elderly and family members' advice on their home-based care.
  4. Promotion Health promotion and prevention
  5. Hospital Referral of difficult cases to District Hospital / Advanced Health Care Facility

District Hospital

  1. Elderly Geriatric Clinic for Regular Dedicated OPD Services for the Elderly.
  2. Facilities for laboratory research for diagnosis and of drugs for geriatric medical and health problems
  3. 10 bedded geriatric ward for elderly patient care
  4. Current specialties such as General Medicine; Orthopedics, Ophthalmology; ENT services etc. provide essential services to elderly patients.
  5. Provide services to elderly patients referred to CHCs / PHCs
  6. Conducting camps for geriatric services at PHCs / CHCs and other sites
  7. Case Referral services to tertiary hospitals for serious cases

Regional geriatric Center

  1. Geriatric Clinic (Specialized OPD for the Elderly)
  2. A 30-bed geriatric ward for the care of patient patients and beds dedicated to elderly patients in various specialties. Surgery, Psychiatry, Urology, Ophthalmology, Orthopedics, Neurology etc.
  3. The elderly need laboratory research with a dedicated sample collection center in the OPD block.
  4. Tertiary health care for medical colleges, district hospitals and lower level

Activities under National program for the health care of the elderly at various levels

Sub-center

The activities at the sub-center are as follows:

ANM / Male Health Worker provides information on intervention to the elderly or family / community health care providers:

  1. Health education related to healthy aging, environmental changes, nutritional needs, lifestyle and behavioral changes.
  2. They pay special attention to the elderly at home / in the bedridden and training family health care providers in caring for the elderly with disabilities.
  3. They set up appropriate calipers and assistive devices from PHC and make them as ambulatory for the elderly disabled.
  4. Linkage with other support groups and day care centers operating in the area

The following items are made available at the sub-central level:

  1. Walking sticks
  2. Calipers
  3. Infrared lamp
  4. Shoulder wheel
  5. Pulley
  6. Walker (General)

Additional contract manpower under the program at the SC level is not indicated. Joint training is provided to all health personnel at the sub-central level with training under the (NPCDCS) National Program for the Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke

Primary Health Center

The PHC Medical Officer is responsible for promoting coordination, implementation and health care for the elderly. The following activities are carried out in PHC:

  1. A weekly geriatric clinic will be set up at the PHC level by a trained medical officer.
  2. Advise on chronic diseases such as chronic obstructive lung disease, arthritis, diabetes, hypertension etc. including diet control.
  3. Conducting geriatric health assessment based on routine clinical trials related to routine research including vision, joints, hearing, chest, BP and blood sugar
  4. The provision of medicine to the elderly for their medical disorders.
  5. Health referral to Community Health Center or District Hospital for further investigation and treatment.

The following items are made available at PHC

  1. Nebulizer
  2. Glucometer
  3. Shoulder wheel
  4. Walker (General)
  5. Cervical Traction (Manual)
  6. Exercise Cycle
  7. Lumber traction
  8. Walking training tool
  9. Infrared lamp etc.

Medications for general treatment are provided from stock available in PHCs. The Medical Officer liaises with the Blindness Control Program, NPCDCS and other programs to provide diagnostics, equipment, consumables, medications and services for the Geriatric Clinic.

Community Health Center

The basic activities and role of CHC under NPHCE are as follows:

  1. First referral unit: CHC becomes the first medical referral unit for patients with and below PHCs.
  2. Geriatric Clinic: Twice a week CHC sets up special and specialized geriatric clinics for the elderly.
  3. Rehabilitation Services: Physiotherapist / Rehabilitation Worker is provided at CHC for Physiotherapist and Medical Rehabilitation. Rehabilitation worker home visits for bedridden seniors and counseling for family members for the care of such patients.
  4. Referral to District Hospitals / Medical Colleges for further research and treatment as required.
  5. Data Compilation: Compilation of data received from all PHCs under the jurisdiction of the CHCs on the elderly and forwarded to the District Program Officer (NCD)

The following items are available at CHC

  1. Nebulizer
  2. Glucometer
  3. ECG machine
  4. Pulse oximeter
  5. Defibrillator
  6. Multi-channel monitor
  7. Shortwave diathermy
  8. Cervical traction (intermittent)
  9. Walking for training walking equipment
  10. Walking sticks / calipers
  11. Shoulder wheel
  12. Pulley
  13. Walker (General)
  14. Cervical traction (manual).

District Hospital

Geriatric units will be set up in district hospitals with the following functions:

  1. Geriatric Clinic to provide regularly dedicated OPD services for the examination and management of their ailments to the elderly
  2. Geriatric ward (10 beds) for patient care for the elderly. Of the 10 beds, 2 beds are allocated in a separate room
  3. Providing facilities for laboratory research and medicines for geriatric medical and health problems
  4. Current specialties such as General Medicine; Orthopedics, ophthalmology; ENT services etc. provide essential services to elderly patients.
  5. Training of medical officers and paramedical staff of CHC and PHC
  6. Provide referral services for elderly patients with CHCs / PHCs
  7. Conducting camps for geriatric services at PHCs / CHCs and other sites
  8. Cases Referral services to tertiary hospitals / regional old age homes for serious cases

Regional Aging Centers

The program will facilitate the establishment of geriatrics centers in the medicine departments of 8 selected medical institutions in the country, known as regional geriatric centers. 

The main functions of the Regional Aging Centers are as follows:

Provide tertiary services for medical colleges, district hospitals and complex / acute geriatric cases as indicated below.

  1. Regulate postgraduate courses in Geriatric Medicine.
  2. Training of trainers of recognized district hospitals and medical colleges
  3. Develop evidence-based treatment protocols for geriatric diseases prevalent in the country.
  4. Develop and update training modules, guidelines and IEC equipment.
  5. Research on specific geriatric diseases.

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