Introduction:

On 28^th of March 2018, the SIIP III fellows who are supposed to work on finding innovative solutions for the wellbeing of elderly, visited a health camp organized by Janseva Foundation at Ambee village, Panshet. Ambee is located in Velhe Tahashil and it is around 40kms from Pune city. The Foundation is a Charitable Trust registered under Bombay Public Trust Act, 1950. Dr. Vinod Shah, founder-chairman of Janseva Foundation has setup various facilities such as old age homes, hospitals, residential nursing college and destitute home for the rural elderly. Janseva along with two renowned hospitals in Pune organized a free health check-up camp where around 1500 rural elderly from nearby villages gathered at Ambee. Transport facility for the elderly to come to the health camp was arranged by the foundation. Accredited Social Health Activist (ASHA), Gram Sevak (Village workers), Anganwadi Workers were present to take care of the elderly patients. Some of the Gram Panchayat officials visited the venue.

Infrastructure and setup at Ambee village:    

At Ambee village, under the guidance of Dr. Shah, Janseva foundation has invested lot of money and manpower to create cost-effecting Old Age Homes (OAHs); yet delivering good quality of services to the older adults irrespective of their socio-economic status.

There are three types of OAHs, one is for the destitute elderly and the rest of the two, both paid and unpaid ones for the elderly who are residing in the OAH with their own consent and/or choice. The best part about Janseva foundation’s this facility is that the food served is common for all the elderly, hence there is no barrier and all the elderly come and sit together to have breakfast, lunch and dinner which is prepared by the trained cook (Maharaj) maintaining the quality and quantity of food over the years.

In the campus itself, there is a hospital which was under renovation when we visited. The patients were shifted in other hospitals, some of the patients who were stable were given a space and monitored by the doctors in one of the OAHs on campus. In front of the hospital, there is a nursing training centre under Regional Resource Training Centre (RRTC) for the students from Vidarbha region of Maharashtra. The trained nursing staff is provided with the job after they complete the training and hence, the Janseva foundation is also working for the better future of the young and aspiring girls in addition to their contribution towards elderly population.

Overall response and reactions:

The health check-up camp received overwhelming response indicating the real need of the rural elderly who are unable to go to the urban areas due to various issues including accessibility and affordability of the medical services. The doctors from various renowned hospitals in Pune attended the patients and referred them to the further treatment if needed. Local politicians and the ZP members were present at the camp and they talked to few elderly and encouraged the volunteers to work in coordination and concentration.

We, the four fellows from Venture Center attended the camp and we talked to few elderly from OAHs as well as from other villages who had come to see the doctor in the camp. Some of the older residents of OAH recorded feeling of loneliness which is commonly observed among elderly even at home. All the elderly were happy with the management, they were in need of more personal attention and the company of their family members which was not practically possible to provide.

The infrastructure though well-equipped and well managed; lack of age-friendly set-up was observed which should be made to avoid the episodes of falls and pertaining disability among the elderly. Similarly, regular counselling by professional staff might help in preparing the elderly to stay at OAH with a little change in attitude to have better mental health.

ANMs, the nursing staff, the doctor were willing to work more for the elderly and the desire to work for this segment of population was more rather than worrying about the money they were making as a part of their job.

Major learnings:

1. The fellows observed the facility and studied the model of Janseva which is working efficiently and can be replicated in rural areas in Maharashtra and other states of India.
2. Engaging the elderly population in fruitful activities is a real challenge, especially when they are in an institutional setting. Few residents at OAH volunteered as a coordinator and were helping the management to manage the daily tasks involving other seniors. Such volunteers must encourage to plan memory games/indoor activities by involving their peers at OAHs to have more interactive and healthy environment.
3. The need for trained caregivers is increasing day by day. Motivation of the trained staff is very important. Counselling for this young staff is equally important. The coordination between the nursing college (supply) and other OLHs/Hospitals (Demand) should be maintained to have an efficient work system.
4. Dementia and Alzheimer’s disease are increasing day by day and hence, a parallel system to take of these patients must be created along with the OAHs.
5. Janseva Foundation has made an effort to utilize ‘charity’ they receive by developing these facilities catering to the needs of vulnerable older population. RRTC and other activities of Janseva helps the foundation to get connected to the different stakeholders and this is a good model which is doing a social good in a sustainable manner.
6. Use of CCTV, automated locks and security systems, anti-skid floors, use of grab bars, advanced wheel-chairs, smart walking sticks, open and age-friendly gym etc. are few concepts which should be made in a cost-effective way so that the use of technology would be incorporated in such set-ups (OAHs) and the objective of having independent and efficient life of the senior citizens will be fulfilled.