Delays to accessing healthcare for older adults with disabilities in Bengaluru, India: views of healthcare providers and older adults

Introduction: A person’s ability to live independently may be limited by physical and cognitive declines associated with ageing, including disabilities that affect mobility and self-care. This study examines the delays to accessing healthcare facilities among older adults who are frail or have disabilities, using the three-delays model. Methods: A qualitative study was conducted during March and April 2022 among 21 older adults (aged 60 or above) who were frail or disabled (using assistive devices) in Bengaluru and nine key informants, consisting of geriatricians, physiotherapists, psychologists and NGO workers. Data were analysed using NVivo 12. Results: Delays in accessing healthcare for older adults were attributed to multidimensional factors related to the individual (disability; lack of trust in healthcare workers; low/no income), the community and household (neglect/lack of awareness by the family; limited, inaccessible and unaffordable transport modes) and the health system (poor staffing; under-supplied healthcare facilities; waiting times at the hospital). Delays led to complications, hospitalisations and financial burdens for the older adults. The key informant interviews supported these findings. Conclusion: This research highlights that it is important to overcome delays in accessing healthcare for older adults to ensure better health and wellbeing among this group. A holistic approach is needed to reach out to individuals, communities and households, and the healthcare system. Providing adequate transport services to hospitals should be planned in conjunction with the health department for timely delivery of care. Providing health insurance for older adults and improving geriatric care would be highly beneficial to improving health outcomes.