Transcript The Need for Geriatric Nursing In the Coming Years in Bangladesh

“The Need for Geriatric
Nursing In the Coming Years in
Bangladesh”
Salome A. Rahim, RN, BSN, MPH
Nursing Superintendent
TMSS Medical College and
Rafatullah Community Hospital, Bogra
Introduction
• There will be absolute numbers of elderly
people, a larger share of elderly, no longer
healthy life expectancies, and relatively fewer
numbers of working-age people.
• According to the World Health Association,
the world’s population aged 60 and over will
more than triple from 600 million to 2 billion
in the next forty years. The fastest growing
group is those over the age of 80. This
increase in population is global.
Global Status of Geriatric Population
• The number of elders will rise in
developing countries from 400 million
in 2000 to 1.7 billion by 2050, which is
about 20% of the total 9.8 billion.
• The annual rate of increase of the
elderly population of age 60 + would
be 2.5%.
Geriatric Population Status of
Bangladesh
• The older section of the population is
increasing much faster than the total
population.
• In Bangladesh, 6.9% of the population
was classified as elderly in 1950, and
is projected to increase to 8% in 2020
and 17% by 2050.
• According to 2014 statistics above 65
years of age population is 8,32,0136 and
between 55-64 years of age population
is 9,834,577.
• Also, the old-age dependency ratio
would be almost triple between 2000
and 2050 (WPP, 2008).
• According to UNFPA in 2050 Bangladesh
population will be more than 190 million
and aging population will be 32.3
million.
COMMON GERIATRIC HEALTH
PROBLEMS
• Most common problems are: Diabetes,
Arthritis, Gout, Infections, COPD (like Asthma,
Bronchitis), Cancer (prostate, breasts, colon,
rectum, skin), Indigestion, fatigue, depression,
dementia, heart attack, heart failure,
hypertension, Benign hyperplasia of prostate,
urinary incontinence etc.
Psycho-social problems affecting their
health like
• Loneliness from losing a spouse and friends
• Inability to independently manage regular
activities of living
• Difficulty coping and accepting physical
changes of aging
• Frustration with ongoing medical problems
and increasing number of medications
• Social isolation as adult children are
engaged in their own lives
• Feeling inadequate from inability to
continue to work
• Boredom from retirement and lack of
routine activities
• Financial stresses from the loss of
regular income
Geriatric Nursing – Present and
Future Challenge
• There is a growing demand for a skilled geriatric nursing
workforce to provide quality care across a wide range of
health care setting. The exponential growth in the health care
costs for older adults creates a call greater accountability.
There is mounting pressures for health care providers and
settings to demonstrate costs effectiveness and safe, quality
outcomes. Building nursing expertise in geriatric practice has
been embraced by National Nursing Organization around the
globe. From expanding geriatric education in school of
nursing, to mandating evidence based geriatric practice in
accreditation standard for health care, the push is on!
Global Demand of Geriatric Nursing
and Outlook
• Geriatric nursing is a fast-growing career, because Americans are living
longer. The post WW II “Baby Boomer” generation is just now hitting
retirement age. According to the U.S. Census by 2050 more than 20% of
Americans will be over age 65. Because of the aging population, there is
increasing demand for geriatric nurses, especially in nursing homes and
health care facilities that have a higher older patient population.
According to the U.S. Bureau of Labor Statistics (BLS), RNs earn an
average annual salary of $65,470.00 (BDT. 5,106,660.00). According to
National Council of Nurses of US about 13000 Filipino Nurses takes
NCLEX (National Council Licensure Examination) annually, so that they
can work as Registered Nurse in the USA.
• In Japan also, the percentage of the elderly population
(aged ≥65 years) reached 25% in 2013; it is expected to
exceed 30% in 2025 and reach 39.9% in 2060. To
accommodate the medical care demand changes, it is
necessary to secure a system for providing medical
care. They are changing from "hospital-centered
medical care" to "community-oriented medical care" in
correlation with nursing care and welfare. In this view,
last year Japan made an agreement with POEA
(Philippine Overseas Employment Authority) to hire
10,000 Filipino nurses (according to POEA Press
Release).
Bangladesh Perspective
• The suggested doctor-nurse ratio of 1:3
• Bangladesh has a shortage of over 60,000
doctors and 280,000 nurses.
• Maldistribution and migration: Over 75% of
the population of Bangladesh live in rural
areas, but have less than 20% of the health
workforce available to them.
NURSING WORKFORCE IN
BANGLADESH
• As of January 2011, 26,644 registered nurses
with 17,605 posts in the public nursing
services and education
• 15,086 nurses are working in the public
sector and 2,513 posts are vacant. Vacancies
in public sector posts are higher among
nurses of higher qualification, with 96% of
class 1 (senior) posts, 68% of class II (junior)
posts, and 20% of class III (aide) posts being
vacant!
• 3,000 registered nurses are employed in the
private sector
• 3000 are working abroad.
• Bangladesh has a population-nurse ratio of
5000:1, a bed-nurse ratio of 13:1, and a
doctor-nurse ratio of 2.5:1.
• These fall far short of the international
standard for bed-nurse ratio of 4:1 and
doctor-nurse ratio of 1:3.
• Faculty shortages: There is an acute shortage
of teachers, with one-third of all sanctioned
posts of nursing instructors in public NIs
vacant. The resulting teacher-student ratio is
very high at 1:57, where a ratio of 1:20 is
considered to be the standard.
Bridging the Nursing Gap
• Govt. initiations
• Private Sector initiations
Present Nursing Courses
•
•
•
•
.
Diploma in Nursing
B.Sc in Nursing
Post -Basic (In-service) Education
Diploma in Midwifery
• Specialized Course: The specialized course on
CCU; ICU and Cardiac Nursing is available in the
National Heart Foundation, Mirpur. The opportunity
is open for 20 nurses only. Rehabilitation Nursing is
available in BHPI (CRP), Savar. The scope of having
this course is limited for 20 nurses only.
• For other subspecialty nursing courses, Govt.
sending few numbers of nurses to other
countries for training. Gerontological Nursing
Training is still lacking.
Global Employment Opportunity
• There is a huge demand for qualified nurses in
Middle East, North America, Europe, Japan and
Australia. USA alone needs 1.5 million new nurses. If
Bangladesh can send only 200,000 nurses to these
countries for an average yearly salary of USD 70,000
and if these nurses send 50% of their salary to
Bangladesh, it will amount to USD 8.5 billion foreign
remittance per year. Bangladesh will move from a
low income country to a middle income country
almost overnight.
APPROACH TO A NEW SYSTEM OF HEALTH
CARE OR THE ELDERLY
• Community-oriented medical care
• Home Health Nursing
Conclusion
• The Bangladesh Govt., the NGO’s, private
sector and the Bangladeshi nurses must be
ready to take the challenge of growing aging
population in the coming years, as the birth
rate is decreasing and life expectancy is
increasing.
• It is the high time for the policy makers to
necessary step to implement diploma and
post-graduate courses on geriatric nursing.
• “A test of a people is how it behaves
toward the old. It is easy to love
children. But the affection and care for
old, the incurable, the helpless, are the
true gold mines of a culture” Abraham
Joshua Heschel, rabbi and civil rights
activists