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

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.