Worldwide elderly population is rising and Sri Lanka, as Sri Lanka is one of the fastest ageing countries in the world. The percentage of population more than 60 years was 12% in 2012, became 15% in 2015 and it is predicted to be 29% by 2050.

What is ageing? Biological ageing involves wide variety of molecular and cellular damage leading to decrease in physiological reserve. Organs and systems of body become increasingly vulnerable for diseases and eventually the death of the individual. However, there is a wide variation in the rate of this process among individuals. While some become feeble at younger age, for some others, they continue to live healthy even up to 100 years. The rate of biological changes of tissue are determined by many factors including genetics and environmental and long-term behaviour of the individual.

What is important for aged is healthy ageing. Aged population with healthy ageing is a good resource for a country. There is a need to improve the health care delivery system addressing the health needs of elderly population if elderly to be used as a good resource for the country.

There is a wide variation with regard to capacity for activities among elders. Based on capacity elderly period could be divided in to three phases: high and stable capacity, declining capacity and with significant loss of capacity.

During the high and stable capacity period, while the capacity- enhancing behaviour should be promoted, there should be attention on prevention and early detection of chronic conditions common among older people. During the declining capacity, there should be attention on slowing the capacity decline or reversing the losses. Removing barriers for participation and compensate for lost capacity become important during this period. When there is a significant loss of capacity, elderly should be ensured a dignified late life.

Physical impairments which acts as barriers for day to day functions are disabilities. Common disabilities seen among elders are problems with regard to vision and hearing, swallowing, communication, bladder and bowel functions etc., It is understandable that all these issues could not be sorted out by one individual but by a team described as a multidisciplinary team. Generally regular members of MDT consist of doctors, nurses, physiotherapists, occupational therapists, speech and language therapists, social service officers and counsellors. MDT care is the most profitable form of care required for the net outcome with a functionally independent older person.

Doctors would assess the person for specific symptoms and for disabilities, arrive at diagnosis and will prescribe specific treatment. Nurses will provide the prescribed drugs, maintain nutrition and hydration, monitor and keep the records.

Physiotherapist will carry out activities to regain body balance and coordination ensuring correct gait pattern. He should concentrate on minimizing development of spasticity and deformities and also chest complications. In Sri Lanka there are around 1000 physiotherapist who provide these services.

At the moment there are about 150 Occupational therapist in the country and they provide form of skilled treatment or adaptations that helps people become successful and independent in their activities of daily living such as eating, washing, combing the hair, use of toilet etc.

Speech and Language Therapist (SLT) helps to overcome the problems such as swallowing and speech. In Sri Lanka there are about 150 speech and language therapist who supply these services to the country.

Social Service Officers will guide and provide the necessary resources and advices to the older people living in the community to lead an independent life.

Older people who lives alone may feel isolation with depression. Trained counselors support will be helpful for them to overcome these conditions.

By providing the above mentioned multidisciplinary care let us give a fruitful, active ageing for the Sri Lankan elders.

Dr. Padma Gunaratne
MD(SL), FRCP(Edin, Glasg, Lond), FCCP, Hon FRACP, FAAN, FWSO
President
Sri Lanka Association of Geriatric Medicine