Health and Wellbeing in Late Life Perspectives and Narratives from India


Prasun Chatterjee

Date Published

February 5, 2019



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It gives me immense pleasure to write this foreword to Dr. Prasun Chatterjee’s book
Health and Wellbeing in Late Life: Perspectives and Narratives from India. This
book will break a new ground in India as it is placed at a unique confluence of medical
knowledge and expertise and experiences of layman. Geriatric Medicine is a
relatively new discipline in India with only a few medical schools offering a postgraduate
training programme in this discipline. Dr. Prasun Chatterjee is a postgraduate
from the first department which started the programme in Madras Medical
College, Chennai. This discipline has now caught the attention of policy-makers
and planners in the health system. Geriatric Medicine post-graduation is now a
mandate of the National Programme for the Health Care for the Elderly, a flagship
programme of the Government of India.
Childhood and old age are two extreme stages of one’s lifespan where one
behaves differently from adulthood in terms of health status, profile of illness, management
strategies and response to the treatment. Sixty years ago, a similar debate
was going on as to how paediatrics was different from the adult medicine. But now
it is an established specialty of medicine, even though most of the illnesses are similar.
This development of paediatrics as a separate department and discipline was
also a response to a changed population structure. Geriatric Medicine is a response
to the rapid change in population structure towards an ageing population.
The inevitable structural and functional changes in the body increase the vulnerability
of the individual to multiple chronic diseases which are mostly noncommunicable
in nature. Altered drug handling and high risk of adverse drug reaction, functional decline to the extent of dependence on another individual, greater vulnerability to life-ending infections, etc. make an older individual’s health needs different from that of an adult. The complexity of health problems makes Geriatric Medicine the most difficult branch of medicine. Physical and socioeconomic dependence of older persons raises the issue of long-term care, which is a medico-social issue like infant and childhood mortality. In the face of rapid changes in function and structure of families in India, long-term care of older family members has become an epidemic-like situation. Long-term care is beyond the realms of curative adult medicine.