In Nepal, family members are traditionally the primary caregivers, and older people remain highly dependent on them even when they do not have major health issues. Many older persons require reminders to take medicine, drink water, take bath, or maintain personal hygiene. When they fall sick and visit health facilities, they often do not understand the doctor’s instructions, and tend to redirect any health-related questions to their sons or daughters-in-law. This practice is still exists today.

 

But migration of young people and the shift from joint to nuclear family structures have left many older persons in vulnerable health conditions. Older persons who once felt secure believing that their children, especially sons would care for them in old age, are now facing risks of health complications and economic insecurity.

 

In this context, Ageing Nepal, with support from HelpAge International, initiated a pioneering project titled “Strengthening the Capacity of Older People and Their Concerned Stakeholders for Healthy and Active Ageing.” Under the project, 92 champions from 14 Senior Citizens Day Care Centers were trained. These day care centers are community spaces where older persons gather and spend their day in social activities.

 

Champions of different age groups were trained on self-care practices, including nutrition, hygiene, physical activity, mental well-being, disease prevention, elder abuse, and more. Each trained champion then shared their learning with their respective groups. As each group includes over 50 older persons, approximately 800 older persons benefitted from the program. Previously, most activities in these centers were limited to sitting, chatting, and religious practices. Now, older persons exercise together, discuss healthy diets, monitor water intake, and exchange health tips as part of their daily routine.

 

Additionally, Female Community Health Volunteers (FCHVs) and community nurses were trained, many for the first time, on the specific health needs of older persons. These trained health workers now conduct monthly health screenings in the day care centers. They monitor blood pressure, weight, and blood sugar levels, provide health counselling, maintain health records, and refer cases to health posts when needed.

 

In Nepal, regular health check-ups among older persons are uncommon; they typically seek medical care only after symptoms appear. This initiative has increased awareness and encouraged preventive health behaviour. Many older people are now more conscious of their health and have been able to identify and manage health conditions early, preventing them from becoming severe.

 

To ensure continuity beyond the project period, we advocated with local government bodies. We conducted orientation sessions on ageing issues for the local government. We convinced them and follow-up with older persons, FCHVs, and community nurses. As a result, all participating wards have now committed to continue the monthly health screening program using their own resources. Ageing Nepal provided brief technical facilitation during the transition phase.

 

“I had been suffering from pain in my arms and shoulders. I was wondering where to go and which doctor to consult for the treatment. When I joined this organisation and started exercising, after a week, I was completely relieved from the pain. That’s why I like the exercises we practiced here. I do it even at home. I used to visit doctor frequently, but not anymore. This kind of activity should be carried out continuously for older people”-74, older woman.

 

When I had my blood pressure and diabetes checked in the center, the community nurse insisted that I should not come here before visiting a doctor. Then, I went to see a doctor. But they said my treatment would be delayed by a month. Fearing that I would not receive treatment on time, I decided to go to India. Doctor performed pancreatic surgery.  The health screening programme helped me diagnose my disease and saved my life. - 71, older woman