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Open Access 01-12-2024 | Research

Supportive and palliative care needs among older adults in India: an estimation using a nationally representative survey

Authors: Terrymize Immanuel, Naveen Salins, Benson Thomas M, Jenifer Jeba Sundararaj, Roop Gursahani

Published in: BMC Palliative Care | Issue 1/2024

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Abstract

Background

One in five people will be older than 60 by the year 2050 in India. This demographic transition demands integration of geriatric and palliative care. The national level burden of palliative and supportive care needs of the older population is largely unknown in India. This study estimates the burden of palliative care needs among the older population in India from a nationally representative survey - Longitudinal Ageing Study of India (LASI).

Methods

The general indicators of poor or deteriorating health from the Supportive and Palliative Care Indicator Tool for Low Income Setting were used to identify older adults with palliative care needs. These indicators were compared with the LASI data and matched with the appropriate variables. Descriptive statistical analysis, chi-square tests and multivariate logistic regression were done to estimate palliative care needs and its association with other characteristics.

Results

12.2% of Indian older adults have supportive and palliative care needs. Among Indian states, highest for West Bengal (17%), Madhya Pradesh (16.9%), and Bihar (16.3%) while lowest in Arunachal Pradesh (2.2%), Nagaland (2.4%), and Mizoram (3%). High needs were found among those aged 70 years and above (AOR-1.86), females (AOR-1.33), Muslim religion (AOR-1.24), rural residents (AOR-1.72), those who experienced ill-treatment (OR-1.75), with cancer (AOR-2.84), respiratory disease (AOR-3.14), and stroke (AOR-2.58). Lower needs were observed with higher education (AOR-0.43) and health insurance (AOR-0.83).

Conclusion

This is the first study in India that estimates the need for supportive and palliative care using a nationally representative sample. One among eight older adults in India has supportive and palliative care needs. The needs are higher among female older adults, rural residents, older adults with chronic diseases, and in poorer States. Screening and early integration of palliative care with routine healthcare care is essential to meet these needs.
Literature
1.
go back to reference Voumard R, Rubli Truchard E, Benaroyo L, Borasio GD, Büla C, Jox RJ. Geriatric palliative care: a view of its concept, challenges and strategies. BMC Geriatr. 2018;18:220.PubMedPubMedCentralCrossRef Voumard R, Rubli Truchard E, Benaroyo L, Borasio GD, Büla C, Jox RJ. Geriatric palliative care: a view of its concept, challenges and strategies. BMC Geriatr. 2018;18:220.PubMedPubMedCentralCrossRef
2.
go back to reference United Nations. Department of Economic and Social Affairs: Population Division. World Population Aging 2019. S.l.: United Nations; 2021. United Nations. Department of Economic and Social Affairs: Population Division. World Population Aging 2019. S.l.: United Nations; 2021.
3.
go back to reference International Institute for Population Sciences, United Nations Population Fund. India Ageing Report 2023, caring for our elders: institutional responses. New Delhi: International Institute for Population Sciences and United Nations Population Fund; 2023. International Institute for Population Sciences, United Nations Population Fund. India Ageing Report 2023, caring for our elders: institutional responses. New Delhi: International Institute for Population Sciences and United Nations Population Fund; 2023.
4.
go back to reference Sue Hall H, Petkova AD, Tsouros M, Costantini IJ, Higginson, editors. Palliative care for older people: better practices. Copenhagen: World Health Organization, Regional Office for Europe; 2011. Sue Hall H, Petkova AD, Tsouros M, Costantini IJ, Higginson, editors. Palliative care for older people: better practices. Copenhagen: World Health Organization, Regional Office for Europe; 2011.
6.
go back to reference Chou C-Y, Chiu C-J, Chang C-M, Wu C-H, Lu F-H, Wu J-S, et al. Disease-related disability burden: a comparison of seven chronic conditions in middle-aged and older adults. BMC Geriatr. 2021;21:201.PubMedPubMedCentralCrossRef Chou C-Y, Chiu C-J, Chang C-M, Wu C-H, Lu F-H, Wu J-S, et al. Disease-related disability burden: a comparison of seven chronic conditions in middle-aged and older adults. BMC Geriatr. 2021;21:201.PubMedPubMedCentralCrossRef
7.
go back to reference Sharma P, Maurya P, Muhammad T. Number of chronic conditions and associated functional limitations among older adults: cross-sectional findings from the longitudinal aging study in India. BMC Geriatr. 2021;21:664.PubMedPubMedCentralCrossRef Sharma P, Maurya P, Muhammad T. Number of chronic conditions and associated functional limitations among older adults: cross-sectional findings from the longitudinal aging study in India. BMC Geriatr. 2021;21:664.PubMedPubMedCentralCrossRef
8.
go back to reference Klompstra L, Ekdahl AW, Krevers B, Milberg A, Eckerblad J. Factors related to health-related quality of life in older people with multimorbidity and high health care consumption over a two-year period. BMC Geriatr. 2019;19:187.PubMedPubMedCentralCrossRef Klompstra L, Ekdahl AW, Krevers B, Milberg A, Eckerblad J. Factors related to health-related quality of life in older people with multimorbidity and high health care consumption over a two-year period. BMC Geriatr. 2019;19:187.PubMedPubMedCentralCrossRef
9.
go back to reference Bortolani A, Fantin F, Giani A, Zivelonghi A, Pernice B, Bortolazzi E, et al. Predictors of hospital readmission rate in geriatric patients. Aging Clin Exp Res. 2024;36:22.PubMedPubMedCentralCrossRef Bortolani A, Fantin F, Giani A, Zivelonghi A, Pernice B, Bortolazzi E, et al. Predictors of hospital readmission rate in geriatric patients. Aging Clin Exp Res. 2024;36:22.PubMedPubMedCentralCrossRef
10.
go back to reference Dan G. Blazer. Depression in Late Life: Review and Commentary. J Gerontol. 2003;58A:249–65. Dan G. Blazer. Depression in Late Life: Review and Commentary. J Gerontol. 2003;58A:249–65.
11.
12.
go back to reference Admi H, Shadmi E, Baruch H, Zisberg A. From research to reality: minimizing the effects of hospitalization on older adults. Rambam Maimonides Med J. 2015;6:e0017.PubMedPubMedCentralCrossRef Admi H, Shadmi E, Baruch H, Zisberg A. From research to reality: minimizing the effects of hospitalization on older adults. Rambam Maimonides Med J. 2015;6:e0017.PubMedPubMedCentralCrossRef
13.
go back to reference Connor SR. Global Atlas of Palliative Care. 2nd edition. London, UK: Worldwide Palliative Care Alliance; World Health Organization; 2020. Connor SR. Global Atlas of Palliative Care. 2nd edition. London, UK: Worldwide Palliative Care Alliance; World Health Organization; 2020.
14.
go back to reference Rajagopal M. The current status of Palliative Care in India. Cancer Control. 2015;:57–62. Rajagopal M. The current status of Palliative Care in India. Cancer Control. 2015;:57–62.
15.
go back to reference Hawley P. Barriers to Access to Palliative Care. Palliat Care. 2017;10:1–6. Hawley P. Barriers to Access to Palliative Care. Palliat Care. 2017;10:1–6.
16.
go back to reference Chandra A, Bhatnagar S, Kumar R, Rai SK, Nongkynrih B. Estimating the need for Palliative Care in an Urban Resettlement Colony of New Delhi, North India. IJPC. 2022;28:434–8.CrossRef Chandra A, Bhatnagar S, Kumar R, Rai SK, Nongkynrih B. Estimating the need for Palliative Care in an Urban Resettlement Colony of New Delhi, North India. IJPC. 2022;28:434–8.CrossRef
17.
go back to reference Prasad P, Sarkar S, Dubashi B, Adinarayanan S. Estimation of need for palliative care among noncancer patients attending a tertiary care hospital. Indian J Palliat Care. 2017;23:403.PubMedPubMedCentralCrossRef Prasad P, Sarkar S, Dubashi B, Adinarayanan S. Estimation of need for palliative care among noncancer patients attending a tertiary care hospital. Indian J Palliat Care. 2017;23:403.PubMedPubMedCentralCrossRef
18.
go back to reference Daya Ap, Sarkar S, Kar S. Estimation of palliative care need in the urban community of Puducherry. Indian J Palliat Care. 2017;23:81.CrossRef Daya Ap, Sarkar S, Kar S. Estimation of palliative care need in the urban community of Puducherry. Indian J Palliat Care. 2017;23:81.CrossRef
19.
go back to reference Highet G, Crawford D, Murray SA, Boyd K. Development and evaluation of the supportive and Palliative Care indicators Tool (SPICT): a mixed-methods study. BMJ Support Palliat Care. 2014;4:285–90.PubMedCrossRef Highet G, Crawford D, Murray SA, Boyd K. Development and evaluation of the supportive and Palliative Care indicators Tool (SPICT): a mixed-methods study. BMJ Support Palliat Care. 2014;4:285–90.PubMedCrossRef
20.
go back to reference Cramp F, Bennett MI. Development of a generic working definition of ‘supportive care’. BMJ Support Palliat Care. 2013;3:53–60.PubMedCrossRef Cramp F, Bennett MI. Development of a generic working definition of ‘supportive care’. BMJ Support Palliat Care. 2013;3:53–60.PubMedCrossRef
21.
go back to reference Nicholson C, Morrow EM, Hicks A, Fitzpatrick J. Supportive care for older people with frailty in hospital: an integrative review. Int J Nurs Stud. 2017;66:60–71.PubMedCrossRef Nicholson C, Morrow EM, Hicks A, Fitzpatrick J. Supportive care for older people with frailty in hospital: an integrative review. Int J Nurs Stud. 2017;66:60–71.PubMedCrossRef
22.
go back to reference Longitudinal Ageing Study in India (LASI). Wave 1, 2017-18, India Report. Mumbai: International Institute for Population Sciences (IIPS), National Programme for Health Care of Elderly (NPHCE), MoHFW, Harvard T. H. Chan School of Public Health (HSPH) and the University of Southern California (USC) 2020; 2020. Longitudinal Ageing Study in India (LASI). Wave 1, 2017-18, India Report. Mumbai: International Institute for Population Sciences (IIPS), National Programme for Health Care of Elderly (NPHCE), MoHFW, Harvard T. H. Chan School of Public Health (HSPH) and the University of Southern California (USC) 2020; 2020.
23.
go back to reference Marusic U, Narici M, Simunic B, Pisot R, Ritzmann R. Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review. J Appl Physiol. 2021;131:194–206.PubMedPubMedCentralCrossRef Marusic U, Narici M, Simunic B, Pisot R, Ritzmann R. Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review. J Appl Physiol. 2021;131:194–206.PubMedPubMedCentralCrossRef
24.
go back to reference Sudhakaran D, Shetty RS, Mallya SD, Bidnurmath AS, Pandey AK, Singhai P, et al. Screening for palliative care needs in the community using SPICT. Med J Armed Forces India. 2023;79:213–9.PubMedCrossRef Sudhakaran D, Shetty RS, Mallya SD, Bidnurmath AS, Pandey AK, Singhai P, et al. Screening for palliative care needs in the community using SPICT. Med J Armed Forces India. 2023;79:213–9.PubMedCrossRef
25.
go back to reference Bourmorck D, De Saint-Hubert M, Desmedt M, Piers R, Flament J, De Brauwer I. SPICT as a predictive tool for risk of 1-year health degradation and death in older patients admitted to the emergency department: a bicentric cohort study in Belgium. BMC Palliat Care. 2023;22:79.PubMedPubMedCentralCrossRef Bourmorck D, De Saint-Hubert M, Desmedt M, Piers R, Flament J, De Brauwer I. SPICT as a predictive tool for risk of 1-year health degradation and death in older patients admitted to the emergency department: a bicentric cohort study in Belgium. BMC Palliat Care. 2023;22:79.PubMedPubMedCentralCrossRef
26.
go back to reference De Bock R, Van Den Noortgate N, Piers R. Validation of the supportive and Palliative Care indicators Tool in a Geriatric Population. J Palliat Med. 2018;21:220–4.PubMedCrossRef De Bock R, Van Den Noortgate N, Piers R. Validation of the supportive and Palliative Care indicators Tool in a Geriatric Population. J Palliat Med. 2018;21:220–4.PubMedCrossRef
27.
go back to reference Van Wijmen MPS, Schweitzer BPM, Pasman HR, Onwuteaka-Philipsen BD. Identifying patients who could benefit from palliative care by making use of the general practice information system: the Surprise question versus the SPICT. Fam Pract. 2020;37:641–7.PubMedPubMedCentralCrossRef Van Wijmen MPS, Schweitzer BPM, Pasman HR, Onwuteaka-Philipsen BD. Identifying patients who could benefit from palliative care by making use of the general practice information system: the Surprise question versus the SPICT. Fam Pract. 2020;37:641–7.PubMedPubMedCentralCrossRef
28.
go back to reference Yen Y-F, Hu H-Y, Lai Y-J, Chou Y-C, Chen C-C, Ho C-Y. Comparison of intuitive assessment and palliative care screening tool in the early identification of patients needing palliative care. Sci Rep. 2022;12:4955.PubMedPubMedCentralCrossRef Yen Y-F, Hu H-Y, Lai Y-J, Chou Y-C, Chen C-C, Ho C-Y. Comparison of intuitive assessment and palliative care screening tool in the early identification of patients needing palliative care. Sci Rep. 2022;12:4955.PubMedPubMedCentralCrossRef
29.
go back to reference Hiratsuka Y, Inoue A. Perspectives on screening tools to identify palliative care needs in patients with advanced cancer. Ann Palliat Med. 2023;12:13–5.PubMedCrossRef Hiratsuka Y, Inoue A. Perspectives on screening tools to identify palliative care needs in patients with advanced cancer. Ann Palliat Med. 2023;12:13–5.PubMedCrossRef
30.
go back to reference Davis MP, Bruera E, Morganstern D. Early Integration of Palliative and Supportive Care in the Cancer Continuum: Challenges and Opportunities. 2024. Davis MP, Bruera E, Morganstern D. Early Integration of Palliative and Supportive Care in the Cancer Continuum: Challenges and Opportunities. 2024.
31.
go back to reference Kingston AE, Kirkland J, Hadjimichalis A. Palliative care in non-malignant disease. Medicine. 2020;48:37–42.CrossRef Kingston AE, Kirkland J, Hadjimichalis A. Palliative care in non-malignant disease. Medicine. 2020;48:37–42.CrossRef
32.
33.
go back to reference Singh G, Sharma M, Kumar GA, Rao NG, Prasad K, Mathur P, et al. The burden of neurological disorders across the States of India: the global burden of Disease Study 1990–2019. Lancet Global Health. 2021;9:e1129–44.CrossRef Singh G, Sharma M, Kumar GA, Rao NG, Prasad K, Mathur P, et al. The burden of neurological disorders across the States of India: the global burden of Disease Study 1990–2019. Lancet Global Health. 2021;9:e1129–44.CrossRef
36.
go back to reference Kaur S, Kaur H, Komal K, Kaur P, Kaur D, Jariyal V, et al. Need of palliative care services in rural area of Northern India. Indian J Palliat Care. 2020;26:528.PubMedPubMedCentralCrossRef Kaur S, Kaur H, Komal K, Kaur P, Kaur D, Jariyal V, et al. Need of palliative care services in rural area of Northern India. Indian J Palliat Care. 2020;26:528.PubMedPubMedCentralCrossRef
37.
go back to reference Elayaperumal S, Venugopal V, Dongre A. Identifying people in need of palliative care services in rural Tamil Nadu: a survey. Indian J Palliat Care. 2018;24:393.PubMedPubMedCentralCrossRef Elayaperumal S, Venugopal V, Dongre A. Identifying people in need of palliative care services in rural Tamil Nadu: a survey. Indian J Palliat Care. 2018;24:393.PubMedPubMedCentralCrossRef
39.
go back to reference Raj PM. Local government-led community-based palliative care programmes in Kerala. Rajagiri J Social Dev. 2016;8(2):25–33. Raj PM. Local government-led community-based palliative care programmes in Kerala. Rajagiri J Social Dev. 2016;8(2):25–33.
40.
go back to reference Pai RR, Nayak MG, Serrao AJ, Salins N. Integrating palliative care into primary health care: Indian perspectives. Progress Palliat Care. 2023;31:282–6.CrossRef Pai RR, Nayak MG, Serrao AJ, Salins N. Integrating palliative care into primary health care: Indian perspectives. Progress Palliat Care. 2023;31:282–6.CrossRef
41.
go back to reference Brighton LJ, Bone AE, Maddocks M. Supportive and palliative care for people with chronic respiratory disease and frailty. Curr Opin Supportive Palliat Care. 2020;14:206–12.CrossRef Brighton LJ, Bone AE, Maddocks M. Supportive and palliative care for people with chronic respiratory disease and frailty. Curr Opin Supportive Palliat Care. 2020;14:206–12.CrossRef
42.
go back to reference Gupta N, Garg R, Kumar V, Bharati S, Mishra S, Bhatnagar S. Palliative care for patients with nonmalignant respiratory disease. Indian J Palliat Care. 2017;23:341.PubMedPubMedCentralCrossRef Gupta N, Garg R, Kumar V, Bharati S, Mishra S, Bhatnagar S. Palliative care for patients with nonmalignant respiratory disease. Indian J Palliat Care. 2017;23:341.PubMedPubMedCentralCrossRef
43.
go back to reference Robinson MT, Holloway RG. Palliative Care in Neurology. Mayo Clinic Proceedings. 2017;92:1592–601. Robinson MT, Holloway RG. Palliative Care in Neurology. Mayo Clinic Proceedings. 2017;92:1592–601.
44.
45.
go back to reference Maurya P, Chattopadhyay A, Rao S, Sharma P. Understanding elder abuse in India: contributing factors and policy suggestions. Popul Ageing. 2024;17:5–32.CrossRef Maurya P, Chattopadhyay A, Rao S, Sharma P. Understanding elder abuse in India: contributing factors and policy suggestions. Popul Ageing. 2024;17:5–32.CrossRef
46.
go back to reference Orfila F, Coma-Solé M, Cabanas M, Cegri-Lombardo F, Moleras-Serra A, Pujol-Ribera E. Family caregiver mistreatment of the elderly: prevalence of risk and associated factors. BMC Public Health. 2018;18:167.PubMedPubMedCentralCrossRef Orfila F, Coma-Solé M, Cabanas M, Cegri-Lombardo F, Moleras-Serra A, Pujol-Ribera E. Family caregiver mistreatment of the elderly: prevalence of risk and associated factors. BMC Public Health. 2018;18:167.PubMedPubMedCentralCrossRef
47.
go back to reference Wilson KG, Chochinov HM, Graham Skirko M, Allard P, Chary S, Gagnon PR, et al. Depression and anxiety disorders in Palliative Cancer Care. J Pain Symptom Manag. 2007;33:118–29.CrossRef Wilson KG, Chochinov HM, Graham Skirko M, Allard P, Chary S, Gagnon PR, et al. Depression and anxiety disorders in Palliative Cancer Care. J Pain Symptom Manag. 2007;33:118–29.CrossRef
48.
go back to reference Fisher KA, Seow H, Brazil K, Freeman S, Smith TF, Guthrie DM. Prevalence and risk factors of depressive symptoms in a Canadian palliative home care population: a cross-sectional study. BMC Palliat Care. 2014;13:10.PubMedPubMedCentralCrossRef Fisher KA, Seow H, Brazil K, Freeman S, Smith TF, Guthrie DM. Prevalence and risk factors of depressive symptoms in a Canadian palliative home care population: a cross-sectional study. BMC Palliat Care. 2014;13:10.PubMedPubMedCentralCrossRef
49.
go back to reference Rayner L, Lee W, Price A, Monroe B, Sykes N, Hansford P, et al. The clinical epidemiology of depression in palliative care and the predictive value of somatic symptoms: cross-sectional survey with four-week follow-up. Palliat Med. 2011;25:229–41.PubMedCrossRef Rayner L, Lee W, Price A, Monroe B, Sykes N, Hansford P, et al. The clinical epidemiology of depression in palliative care and the predictive value of somatic symptoms: cross-sectional survey with four-week follow-up. Palliat Med. 2011;25:229–41.PubMedCrossRef
50.
go back to reference Lauren Rayner, Irene J, Higginson A, Price. Matthew Hotopf. The management of Depression in Palliative Care: European Clinical Guideline. London: European Palliative Care Research Collaborative; 2010. Lauren Rayner, Irene J, Higginson A, Price. Matthew Hotopf. The management of Depression in Palliative Care: European Clinical Guideline. London: European Palliative Care Research Collaborative; 2010.
51.
go back to reference Sewtz C, Muscheites W, Grosse-Thie C, Kriesen U, Leithaeuser M, Glaeser D, et al. Longitudinal observation of anxiety and depression among palliative care cancer patients. Ann Palliat Med. 2021;10:3836–46.PubMedCrossRef Sewtz C, Muscheites W, Grosse-Thie C, Kriesen U, Leithaeuser M, Glaeser D, et al. Longitudinal observation of anxiety and depression among palliative care cancer patients. Ann Palliat Med. 2021;10:3836–46.PubMedCrossRef
52.
go back to reference Kozlov E, Cai A, Sirey JA, Ghesquiere A, Reid MC. Identifying Palliative Care needs among older adults in nonclinical settings. Am J Hosp Palliat Care. 2018;35:1477–82.PubMedPubMedCentralCrossRef Kozlov E, Cai A, Sirey JA, Ghesquiere A, Reid MC. Identifying Palliative Care needs among older adults in nonclinical settings. Am J Hosp Palliat Care. 2018;35:1477–82.PubMedPubMedCentralCrossRef
53.
go back to reference World Health Organization, editor. Adherence to long-therm therapies: evidence for action. Geneva: WHO; 2003. World Health Organization, editor. Adherence to long-therm therapies: evidence for action. Geneva: WHO; 2003.
Metadata
Title
Supportive and palliative care needs among older adults in India: an estimation using a nationally representative survey
Authors
Terrymize Immanuel
Naveen Salins
Benson Thomas M
Jenifer Jeba Sundararaj
Roop Gursahani
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2024
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-024-01604-2