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Sri Lanka should upgrade Long Term Care for the elderly: ADB

Image credits- HelpAge Sri Lanka

ECONOMYNEXT- Sri Lanka’s health sector needs to improve current standards of Long Term Care (LTC) in order to treat increasing numbers of patients with Non-communicable diseases (NCD), a new Asian Development Bank report says.

“The number of older people living alone has been increasing over time across all age groups 60 years and above,” the December 2019 ADB report on ageing population said.

Long Term Care for the elderly has been found lacking in Sri Lanka over the years, especially specialized care for elders with non-communicable diseases.

“In 2016, NCDs accounted for 90 per cent of deaths of people over 60 years in Sri Lanka” the report noted.

A majority, 39 per cent, of NCD deaths were from cardiovascular disease whereas 13 per cent is from cancer and 10 per cent from diabetes.

Studies have also shown that lipid levels in Sri Lanka are comparable with that of developed economies.

 A “1998–2002 survey found that total cholesterol levels were 200–236 milligrams per deciliter (mg/dl) in the Western Province (Sri Lanka Medical Association 2004), compared with 200–240 mg/dl in developed economies.”

However, it was assumed that the high levels of saturated fat in the Sri Lankan diet may be the cause of since obesity levels in the country are very low. 

Meanwhile, SLHAS 2019 data shows that one in five adults in Sri Lanka is suffering from diabetes.

“The prevalence of disabilities increases with age and difficulties in seeing, hearing, and walking also increases sharply after the age of 70 years. The prevalence of deterioration in cognition also increases sharply after 70 years, while difficulties in self-care increase sharply after 80 years,” the report says.

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UNFPA data shows that at age 60 females can live 19 more years compared to 12 more years for males.

This might suggest that Sri Lanka is on the verge of experiencing the transformation of living conditions of the elders that may require policymakers to take note and respond more substantially, ADB says.

“Unlike mothers and children, there is no system to allow older adults to obtain care on a continuous basis from the same dedicated physicians or health workers.”

 “This reflects the lack of general practitioners in the public sector.”

Subsequently, Sri Lanka has fewer community care programs to aid the elderly apart from a few like HelpAge Sri Lanka.

Records state that there are only about 25 private home nursing care services that provide trained nurses and attendants. 

These places are expensive and most cannot afford their services which then leaves fewer options for the elderly population to receive LTC facilities.

“The average monthly expenditure per resident is SLRs 4,300 in a public elder care home and SLRs7,000 in a private (not-for-profit) elder care home, while an elder at a private (for-profit) elder care home pays on average SLRs 24,000 per month.

“Financing of public eldercare homes is predominantly from public funds and only two per cent of expenditures are funded by private donations. Expenditure at private (not-for-profit) elder care homes is financed mainly by donations made by individuals and not-for-profit organizations.”

There have been reports of elders being admitted to public hospitals when they should be admitted to LTC facilities by their families because they cannot afford it.  

The need for LTC services will increase in the future with an ageing population and diminishing capacity of families to provide care, ADB says.

Steps must be taken to raise awareness among policymakers and the general public about the need for LTC in old age and the need to establish a formal LTC system for the elderly in the country. 

(Colombo/Jan29/2020)