Care missing, this is no country for elderly

Jayshree Sengupta
Senior fellow, Observer Research Foundation 

In Indian tradition, the elderly were usually protected from financial ups and downs of children on whom they were dependent through joint families in which resources were pooled together by sons and brothers. The elders were respected and given a place of importance within the family. With rapid urbanisation and globalisation, nuclear families have replaced joint families and elderly parents are dependent on the earnings of a son or daughter. It is increasingly becoming difficult for children to support parents when their own incomes are falling or they are losing their jobs in this current downturn.

India is going through a serious economic slowdown which will lead to job cuts and shutting down of factories in the course of the next few months. Many steps have been taken by the government to reverse the slowdown and push up demand, but the results are not encouraging. Unless something quick and effective is done for the economy, there will be deep repercussions on society and, directly or indirectly, all will suffer.

Every so often, there are reports in newspapers about elderly parents being mistreated by their children as looking after dependent parents is low priority compared to educating own children, when income sources dry up. On the other hand, there are also cases where the children have given up their jobs to care for the elderly parents with serious diseases and have limited means of support. The elderly need help in both cases.

The situation faced by the elderly, sixty years and above, is comparatively worse in India because they cannot earn any income and are entirely dependent on younger family members for their upkeep and welfare. Their savings which go towards acquiring a house are often passed on to sons and daughters, from which they are sometimes dispossessed. Living in smaller spaces, accommodating to the needs of growing grandchildren and without any financial security, their last years are spent in misery.

Unlike in the Western countries, the elderly people in India mostly stay with the family than on their own. Only 2.2 per cent of the elderly single persons stay on their own and 10 per cent of the old couples live on their own. Nearly 87.8 per cent of the elderly live with their children. By contrast, elderly men and women live alone in the Western countries and they manage to cater to all their needs without much help and support. Physically, they are more fit and active. With proper healthcare, preventive check-ups and other kinds of health services like physiotherapy freely available through their healthcare system, the elderly are in good health and are active. In India, the family still remains the mainstay for the elderly and as they get older and weaker, their dependence grows further. 

Unfortunately, care for the elderly is missing to a huge extent in India which has one of the weakest social security systems in the world. Only around 70 per cent of the population has any form of social security.  Economic independence of the older population is the key indicator of their well-being. Only 26.3 per cent are financially independent and 20.3 per cent are partially dependent on others, but 53.4 per cent or a majority of the elderly population is entirely dependent on children for economic security. Lack of affordable old- age homes where people can live independently, is also a problem. Most are too expensive and beyond the reach of an average middle-class Indian. 

People forget that despite the demographic dividend and young population whose median age is 27.1, India is getting old before it is getting rich. A falling fertility rate has led to faster ageing in India than before.  According to a study, Economic Independence and social security among India’s Elderly, by Srinivas Goli, Bheemeshwar Reddy A, KS James and Venkatesh Srinivasan (Economic and Political Weekly), there are many aspects of ageing in India that need to be looked at carefully and remedial action is needed to lessen the burden on the ageing population. They point out that due to decline in fertility rate in India, there has been a rapid structural transition in the age composition of the population which has resulted in an accelerated rise in the proportion of the older people. There were 103.4 million elderly in 2011. Today, the numbers must be much more. Some states have more old people than others, but on an average, they comprise around 10 per cent of the population. This will reach 15 per cent by 2040 when the bulge in the working population starts to shrink.

Care for the elderly varies from state to state. The state pensions under various schemes are a pittance in most cases. As many as 17 states give less than Rs 1,000 a month as old-age pension with a minimum contribution from the state budgets. The low income ageing population of India is living without dignity and is also afflicted by various disabilities due to poor nutrition and healthcare. 

There is need for a more generous old-age pension for the elderly from the state. There is also a need to build more and affordable homes where the old can live independently. Healthcare, which is specialised in geriatrics, is needed. Many of the older generation who can still work should be given alternative employment opportunities which will lead to less mental health issues. Elderly women are more vulnerable than men to abuse from the family. They can be helped through social workers and higher pensions. 

Income tax rebates and higher interest rates on savings for senior citizens are important for guaranteeing financial security. Other schemes favouring the elderly in their travel by railways and airlines are important for making their lives more interesting and varied. 

There is also a need for universal health insurance for the elderly who are poor. As many as 500 million marginalised people are being covered by Ayushman Bharat, among whom, hopefully, there will be many elderly. There is a need for social workers to visit people suffering from loneliness and depression and help them with daily chores like bathing, exercise and cooking. The needs of the elderly who are poor and dependent on children are enormous and they need urgent help.