The Senior Citizen Health Service (SCHS) was initiated at the St. Johns National Academy of Health Sciences in TWO areas - The RURAL program (2003) at Mugalur Village, Sarjapur PHC, at Anekal Taluk, the rural field practice area of St. John’s Medical College, and the URBAN program (2005), at St Johns Medical College and Hospital. The objective of the program is to promote, preserve and maintain the health of older persons in rural and urban areas in Bangalore

A. The RURAL program
1. Rural Elderly Clinics – These are conducted once a month on a fixed day in each of 10 base clinics in and around Mugalur Village, located around 30 kms from St John’s. Specialists from the Department of Community Health, trained in Geriatric Medicine examine elderly patients who seek services at these clinics. Patients have a notebook as a record of their illness and treatment. A clinic based record is also developed and maintained. Baseline investigations and quality low cost generic drugs are provided at subsidized rates. Resident Medical Faculty at Mugalur Community Health Training Centre render follow-up/ emergency treatment. A total of around 2000 elderly are registered in the 10 clinics. Around 450 elderly patients are seen/ followed up every month at the clinics.

Home Visits are made between clinics by trained Community Health Workers, who assess compliance to health intervention, motivate those not registered, identify new problems and refer seniors as required to the Mugalur Health Centre. Health Education Sessions for seniors on issues pertinent to their health are also undertaken.

2. Grama Hiriyara Kendra Programme – This is a pilot project started in 2015 in 3 villages of Anekal Taluk. Institutions exist at the village level for children 0-6 years, where they spend the day, and receive non-formal education/ growth &health monitoring/ nutritional supplementation. The SCHS wants to try this concept for the rural elderly – a “Village Senior centre”, where elderly persons come at 10 am, do physical activity, prayer, have a hot glass of milk interact with each other, do other purposive activity, have a hot meal and leave at 2 pm. Early indications show that this is well received, having around 90 elderly persons attending the 3 centres.

B. The URBAN program
1. The Division of Geriatric Medicine - The Senior Citizen Clinic – The division is run by trained Geriatric Specialists from the Department of Medicine, with assistance from the Senior Citizen Health Service. Outpatient clinics are held everyday at St. John’s Medical College Hospital, with discounted registration, laboratory tests and specialist consultations. A comprehensive assessment of the elderly is undertaken, with cross referrals if needed. The clinic currently caters to around 600 elderly patients every month.

2. Senior Citizens residing within a 3-4 kms radius of St. Johns register with the Home Health Service. Initial assessment and baseline investigations at the Senior Citizen Clinic, followed by monthly home visits by a doctor and nurse, with further investigations/ visits to hospital if needed. Patients are also assisted in case of emergencies. A total of around 90 elderly patients are currently registered with the Home Health Service.

3. Community Initiatives include Preventive education/ awareness regarding Geriatric Health issues, Medical students/ other students’ involvement, training material developed with in-house expertise and monthly checks at 3 old age homes (2 of these are destitute elderly homes) housing around 300 elderly residents. The monthly check at these homes includes a health education and lowcost generic drugs. There is also a Urban Geriatric Clinic run at the Austin Town area once a month for underprivileged elderly seeking care, which sees nearly 60 elderly patients every month.

Research: Community and Hospital based research undertaken by Undergraduates, Post Graduates, Faculty and Observers. 8 Post graduate thesis have been undertaken in Geriatrics. Several other research articles have been published in National and International Journals.

In the future, it is hoped to build the academic discipline of Geriatric Medicine at St John’s and explore alternatives to be sensitive to healthcare needs of seniors and respond appropriately.