Ageing stands in the Way

Subhadeep Tripathi

Developing countries like India are witnessing rapid ageing of its population. According to UN Revision 2006, India has second largest aged population in the world. In 2001 census it is witnessed that population of people over 60 years of age is around 77 million which constitute nearly 7.5 percent of the total population of the country. It is estimated that the number will increase to 177.4 million in 2025. The growth rate of elderly people is higher than growth rate of overall population.

Ageing is a continuous process which is not reversible. It is a universal process by which one's productivity declines towards the society and becomes economically dependent on other person. In India, the age of 60 years and above has been adopted by the census of India for the purpose of classifying a person as old, which coincides with the age of retirement from government service. Elderly people are neglected and sometimes forced to leave their homes and stay in old age homes where they do not get proper treatment which they deserve as senior citizen. Elders are abused and neglected for which they lose hope and become depressed. When people cross sixty they need health care and emotional support. There are several health problems faced by elderly persons which may be physical or mental like Dementia, High Blood Pressure or Cardiac Problems. Government health care spending should be increased for elderly people. Rural aged populations are more vulnerable in comparison to urban, especially in terms of healthcare. Rural India lacks healthcare infrastructure and good living standards. Elders in rural India are deprived from their basic needs and the situation is worst in tribal areas. They suffer from powerlessness, social insecurity, social isolation, physical weakness etc. In India poverty is the main problem as well as a risk for aged persons which makes them more vulnerable and in some cases destitutes.

Aging is synonymous to failing health. Older people are more vulnerable to non-communicable diseases. Lack of age sensitive health care infrastructure makes them more vulnerable to diseases. Lack of accessibility and high cost is the main obstacle of rural poor people for good quality health care service. Not only health but also the other problem for which they suffer most is economic insecurity. With growing age, people lose their productivity towards society and they take retirement from job and in this stage of life they become dependent on other peoples especially their spouses. Isolation and sense of loneliness makes them depressed. They even live in isolation in their own family especially sometimes with their spouses. It leads to depression and decrease quality of life as they become neglected too. According to Tribune India "Of the about 100 million elderly in India, one in every three faces abuse, often at the hands of family members". Changing life styles and values and trend towards nuclear family have increased neglect of the elderly by family and the community. Government and non-Government organizations have to raise these issues at all levels. Legal action and rehabilitation is required to reduce and prevent these problems. Elderly are highly vulnerable to abuse. It is very necessary to take step to protect abuse of elderly whenever and wherever needed. Relatively weak elderly are more vulnerable to physical abuse. Sometimes they become victims of emotional and menial abuse. The Elderly feel low self-esteem and have lost control over their life.

In present Indian society nuclear households characterized by individuality, independence, and desire for privacy are gradually replacing the joint family. This rapid transformation is the impact of industrialization, urbanization, globalization etc. Traditional values are changing and social institutions are in process of erosion and for this adaptation of new family trend the integration of family is weakening day by day. Population pressure is the push factor and wider economic activity is the pull factor for which younger members of the family are migrating to urban areas or abroad from rural community. For this joint family structure is breaking day by day and a trend towards nuclear family is being observed everywhere. This disintegration of joint family is because of modernization and for this elderly people are neglected and are isolated in family. At the time when there was value based joint family system then care and protection of elderly was not an issue. But this oriental culture seems to have lost its appeal to new generations.

Economic factor is definitely a factor for care of elderly. Economic dependability is one of the major problems that very often affects older persons. Responsibilities of finance, business and property are transfered to the hands of children. Psychological problems which most elderly people face are feeling of inferiority, depression, reduced competence along with different social disabilities. The social disabilities trigger the feeling of psychological problem like widowhood, societal prejudice etc. Segregation increases the frustration of elderly people. Besides physical health problems older people are more likely affected by mental health problems like Neurosis. According to 2001 census 78% of elderly persons reside in rural areas. In rural areas they face major physical disabilities like blindness or deafness, cough, poor eyesight, anemia, dental problem etc. Not only this psychiatric morbidity too is prevalent among elderly population to a great extent.

Women face the problem of ageing more than men because they live longer becoming a widow. They become isolated and discriminated. Not only discrimination or economic problem but they also face an emotional void in their life. Elderly people who live below poverty line face more problems. They are mostly vulnerable to poverty and lack of care and medical facilities.

Professor Nasreen Rustomfram, chairperson of Centre for Lifelong Learning at the Tata Institute of Social Sciences (TISS) stated 'The country needs eight lakh geriatric care professionals" (Hindustan Times, August 20, 2015). According to Dr Aniruddha Malpani, (a consultant, IVF specialist and an active advocate of patient rights) this pathetic situation of the elderly is for crumbling social structure and for this elderly health care became an issue of concern, specially for destruction of the traditional joint family system (Hindustan Times, August 20, 2015). Not only physicians but also other trained geriatric care professionals are needed to deliver care and support towards elderly like geriatric psychiatrist, social workers etc. which are lacking specially in rural areas. As maximum elderly population resides in rural areas, it is mandatory to make geriatric care facility in primary health centers with trained Medical officers in geriatric medicine. The other thing which should be improved is transport system. Lack of organized transport system and dependency, delays an aged person to access the available health care facility. Health care services should be based on "felt needs" of the aged person. The felt needs may vary from urban to rural.

India has tradition of voluntary and philanthropic activities for the old, disabled, poor etc. Concept of old age homes is known to everyone. Indian old age homes mainly are charitable type. Kerala has largest number of old age homes. In recent times the number of old age homes are rising as they gradually gaining acceptance especially for those people who don't want to live in the house of their spouse. Efforts are taken by both government and non-government bodies in rehabilitating the aged in India but still this group is most vulnerable and facing multiple problems. Efforts should be made to strengthen family care because still family is the reliable and preferred source of support for the elderly. Traditional values should be reinforced in society and family especially in the younger generation. There should be effective legislation to save parents from abuse and they should be cared by children. The existing health care facility is not enough to meet the needs of elderly, specially physical and mental needs. The main task is public awareness along with intake of special trained volunteers for old age homes and community to deliver service towards the elderly. The main target group should be rural aged, specially the widows in villages.

The role of social workers has changed in recent times. Now social work profession has adopted a right based approach. Social workers have several roles like assessment, mobilizing resources, case work, counseling, community work, advocacy etc. Providing direct intervention like counseling support, especially to those elderly who are abused and neglected is one of the central roles of social workers. They can carry out social research which can examine the existing condition of elderly and the effectiveness of the interventions. They have to perform psycho social assessment to determine the level of care required. They have to monitor their client and ensure that their needs are fulfilled and their rights are protected. The other responsibility is to ensure that the elderly are protected from abuse and neglect and if the client needs further care then the social worker can refer them to specialised professionals.

Now the main task ahead of the government is to build a geriatric health infrastructure in different parts of the country. That should be within the grip of senior citizens. The elderly are the precious persons for the country and they have rich experience and wisdom. So, everyone should respect them and especially the civil society should work for their rights and protection. Policies should be designed to meet the needs of senior citizens and those should be effectively implemented. To combat elderly abuse there should be an action based plan. Elder abuse is an attack on human rights and human dignity. So, government's effective intervention is necessary.

Concerned citizens have to take the responsibility to stop elderly abuse and to make them live with dignity.

  subhadeep.tripathi@gmail.com

Frontier
Vol. 50, No.23, Dec 10 - 16, 2017