THE REALITY OF AGEING AND GERIATRIC CARE IN THE GROWING NIGERIAN POPULACE
A wise philosopher once mused, “Ageing is not about getting old, it’s about living a full and vibrant life.”
Ageing is one of the constants of reality that humanity has inevitably had to deal with throughout its recorded history. It has shaped, in one way or another, all cultures and traditions in the globe in the present age as well as the not-so-distant past, underscored by the diverse myths and folklores each culture has devised to help explain the concept and consequences of ageing.
From the medical standpoint, ageing is defined as “the process of natural change that leads to a decline in biological function and the ability of the organism to adapt to metabolic stress. Geriatrics (the medicine of the elderly) in the nation garners more and more attention and economic importance progressively, especially as the population of Nigeria continues to grow. As of the year 2020, approximately 9.4 million Nigerians were aged 60 years or older. This was a result of an increase in the aged Nigerian demographic by about 740,000 people between the years 2018 and 2020, and the figures have only continued to grow.
As one ages, the body’s ability to adapt to stress and metabolic changes decreases as pointed out earlier. This decline that builds up over the years eventually manifests as a group of diseases called geriatric diseases. Geriatric diseases are defined as basically complex health states that occur exclusively in old age. These diseases are caused by multiple underlying factors that tend to add up as the years roll by.
Some diseases that fall under this category of health conditions include frailty, urinary and faecal incontinence, pressure ulcers, diabetes, Alzheimer’s / Dementia, osteoporosis and so on.
Whilst speaking on the issue of ageing and its link to geriatric diseases, Dr. Osi-Ogbu, Consultant Physician at the National Hospital Abuja, stated that “Ageing doesn’t begin at 60, it begins right from birth. As a person advances in age, what happens to them is highly dependent on what they have done with their health in the past. If you have been careless, by 40 you want to make sure you become careful. We find that you are a more functional, healthier older adult if you have maintained a good health practice from a younger age.”
A study of the epidemiology of dementia (which is one of the most prevalent geriatric diseases in Nigeria) in 2019 showed that the number of dementia cases increased by over 400% over a two-decade period, increasing from about 63,512 cases in 1995 to about 318,011 cases in 2015 among Nigerian citizens aged 60 years and above. Furthermore, a more disheartening conclusion gleaned from this study also showed that the Nigerian medical system has failed to adequately improve its structure to cope with the growing burden. This is due to several factors like poor funding from the government and the sector being majorly private-driven. This is seen in the 2018 appropriation bill, where the budget for advancing adolescent and elderly welfare and well-being was estimated to be a paltry sum of about 2.9 million naira.
The situation is more or less the same in other fields that deal with other geriatric diseases, as state underfunding, rising poverty levels and inflation have collectively contributed to the increasing difficulty in accessing geriatric healthcare and services in Nigeria. This also reflects in Nigeria’s position on the global age index, as it has been ranked as one of the worst countries for any older adult to live in based on indices like employment rate, health status, job security and so on.
So, what can be done to stop this worrisome trend from propagating even further?
In 2018, Former President Muhammad Buhari signed the National Senior Citizens Centre Act, which was followed by the launch of the National Senior Citizen Centre in Abuja. Such proactive actions ought to be encouraged and implemented much more frequently to ameliorate the pressure on the already limited number of geriatric medical institutions in the nation and also make healthcare more accessible to older Nigerian citizens.
Better measures and systems also need to be implemented to improve the social welfare and security of older Nigerian citizens. Health insurance needs to be better subsidized by the government and made readily available to the masses.
Hubert Humphrey (1911-1978) who was once the Vice President of the United States famously said, “The moral test of a government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.”
Ageing is a human concept that cuts across all walks of life. It is also a phenomenon that comes with a host of complex and ever-evolving challenges. Combatting the issues posed by ageing and geriatric healthcare requires a comprehensive and multi-faceted approach. By subsidizing pension and health insurance programs, strengthening critical social support systems and implementing favourable legislative policies, the state of geriatric healthcare in Nigeria can yet be greatly improved, and provide a longer and healthier life to the average elder citizen.
Adebisi Abdulateef
