In India, with the majority of its population aged 30 or less, the main focus of national policy till now has been directed to the basic developmental needs and welfare of its younger population -children, adolescents and young adults. Providing for the elderly population had taken a back-seat. But now, India is facing an elderly population ‘time bomb’ according to a 2013 UNFPA report which revealed its number of old people will triple by 2050.The various schemes and programmes initiated by the government for the elderly till now are very insignificant when compared to the size and growth rate of their population. The rates of urbanisation and economic and social factors such as changing family systems are likely to make welfare of the elderly an even more critical area for intervention.
Increase in the life expectancy and proportion of the elderly
The National Policy on Older Persons in January, 1999 defined a senior citizen or as a person who is of age of 60 years or above. Ageing of population is affected due to downward trends in fertility and mortality. Low birth rates coupled with long life expectancies, push up the average of the population.
With the rapid advancement in medical science and technology in India,there has been a steady increase in the life expectancy at birth which is a good health indicator . In 2012, the life expectancy in India was 66.21 year from an earlier 41.38 in 1960. If we take a look at the figure of the proportion of the elderly, we find that that this figure has risen from 5.63 per cent in 1961 to 8.3 per cent in 2012. It is projected to rise to 12.4% of population by the year 2026.
In this changed society, the elderly face a number of problems which range from absence of ensured and sufficient income to support themselves, loss of social role and security and the non-availability of adequate health programs and facilities .The government needs to implement appropriate programmes and policy interventions for the senior citizens of the country.
Financial insecurities and changes in the family system
Despite consistent economic growth, India will have a huge ageing population that may be far poorer than their counterparts in the West. In 2013, India was ranked 73rd out of the 91 poorest nations to grow old in -according to the Global Age Watch Index (GAWI), developed with the UN fund for population and development.
The Government has made efforts to deal with economic insecurity by launching schemes in support of the elderly such as the National Policy on Older Persons, the National Old Age Pension Programme and the Annapurna Programme. Most of those who have worked in organised sector get a pension and other retirement benefits between 60 -65 years. But for the rest, the National and State Governments at present have very nominal old-age pension coverage. It varies from Rs. 75 to 150 in a month and is just not enough, to say the least.
According to the“Situation Analysis of the Elderly in India” which was carried out in 2011, about 65 per cent of the elderly had to depend on others for their day-to-day maintenance and, as their medical expenses go up , so does the dependency on children or other relatives for physical, mental and economic support.Fewer than 20 percent of elderly women but the majority of elderly men were economically independent. In the rural areas, 66 percent of elderly men and above 23 per cent of elderly women were still participating in economic activity, while in urban areas these numbers were only 39 per cent and about 7 per cent respectively.
The age-old joint family system has been instrumental in safeguarding the social and economic security for many of the elderly in the country. However, with the rapid changes in the social scenario and the emerging prevalence of nuclear family set-ups in recent years, the elderly are more likely to be exposed to emotional, physical and financial insecurities in the years to come.In 2007, New Delhi passed a law – derided by critics as “legislative love” – that made it a crime for adult Indians to fail to take care of their ageing parents.
India needs a sustainable elderly care model
The developed countries have many models for care of the elderly — sheltered homes, home care with specialised nursing, and hospital admission for acute health problems and recovery or rehabilitation. With very few such facilities in India, it may be an opportunity for innovation in the healthcare system .
According to the UNFPA report, two-thirds of India’s 100 million people over 60 suffered a chronic ailment in 2011. That number is expected to increase to more than 200 million by 2050.Prevalence of heart diseases among elderly population was much higher in urban areas than in rural parts. About 64 per thousand elderly persons in rural areas and 55 per thousand in urban areas suffer from one or more disabilities.The report also warned that India’s current hospital and welfare services are insufficient as the pace of population ageing increases. Geriatric health care services with qualified professionals are mostly city-based. Currently, the general health care system is poorly sensitised to the needs of elderly.
Traditionally, ideas of old age homes or assisted living facilities –evoked fear among elderly Indians, who equate them to abandonment. But increasingly they are also seen as practical solutions to difficult problems.The last decade has witnessed the mushrooming of old-age homes but are not enough meet the demands .
The Ministry of Health and Family Welfare has formulated a National Programme for the Health Care of Elderly. NPHCE envisages dedicated healthcare facilities at all levels of the health delivery system with provision for long-term and short-term training of health professionals to address problems of the elderly. In the first phase, NPHCE is proposed to be implemented in 21 States with eight medical institutions. It will take time to build up before the impact of this ambitious project of elder care reaches the population.
Help Age India,a voluntary organisation working for to help the abandoned elderly in India, feels that discounted price urban land for senior housing in cities, universal pensions and better health insurance, are urgently needed to meet the growing challenge of caring for India’s elderly population. “We need to put in certain systems for this demographic shift that will take place, otherwise it’s going to be quite disastrous,” says Matthew Cherian.He is chief executive officer of Help Age India.
There is a need for greater attention to ageing-related issues and to promote holistic policies and programmes for dealing with the ageing society in India.