The rise in old population
In the sea of young faces, there sits a wrinkled face with a body arched over. Taking the support of a stick, this shriveled figure of its earlier glory grapples to find balance as it wobbles its way through the crowds. This is the face of tomorrow, the face of an ageing country.
India has the world’s largest youth population in the world with 356 million people between the age group of 10-24 years. According to a UN report, India is set to become the world’s youngest country with 64 per cent of its population in the working age group by the year 2020. This demographic potential offers India and its economy an unprecedented edge.
The Global Age Watch Index 2014 presents a unique snapshot of the situation of older people in 96 countries of the world today.
It highlights which countries are doing best for their older populations and how this is directly linked to the policies towards pensions, health, education, employment and the social environment in which older people live.
Globally Switzerland tops the 2015 Index this year, while Afghanistan ranks lowermost on the rung. India ranks at abysmally low at the 71st rank.
What has often been overlooked is the surging population of old persons or senior citizens (who are above the age of 60). India today has more than 110 million people over the age of 60. Presently, the elderly are divided into three categories: the young old (60-70) the middle-aged old (70-80) and the oldest old (80 plus).
By 2050, India will be home to nearly double the elderly population than it has today. Only China will have a larger number of elderly people, according to estimates released by the United Nations Population Fund.
Japan is today the only country with more than 30 per cent of its population aged 60 or above. By 2050, India is expected to have around 20 per cent of its population above the age of 60.
The Census of India (2011) suggests that India had 90 million elderly persons in 2011, with the number expected to grow to 173 million by 2026. Of the 90 million seniors, 30 million are living alone, and 90 per cent work for livelihood.
The report also points out that though the share of elderly men exceeded that of elderly women, however now the roles have reversed. The variation in this chunk of the entire population of has also increased over decades from 1961 to 2011.
For a developing country like India there is a mounting pressure of maintaining pension outlays, health care expenditures, fiscal discipline, savings levels and other items on the never-ending list of geriatric care in the country. There is an emerging need to pay greater attention to ageing-related issues and to promote holistic policies and programmes for dealing with the ageing society.
This project “Being Elderly in India’ highlights the key challenges faced by Senior Citizens in India and attempts to look at the road ahead through a journalistic lens.
The need of an old age home
Manorama, 80, belonged to a small place in Bengal called Gitarishourie. After living most of her life in her hometown she was made to leave. “I slept in my bed at night and woke up on the street in the morning. I did not know where I was. The police found me eventually I was brought to this old age home through an NGO.”
An old couple is dropped off in the middle of the night at the doorstep of an old age home. An elderly man suffering from paralysis is abandoned at the hospital. An old lady tries to run away from her house to save her will and the remaining property that her husband left her. There are countless cases of abandonment, abuse and disregard. Like Manorama, there are thousands of others who are abandoned by their families and are forced to live a life of seclusion.
In the narrow cobbled streets of Badarpur in the Capital is Guru Vishram Vridh Ashram, a shelter for mentally and physically challenged senior citizens, most of whom have been abandoned by their families.
Like most other inmates, Manorama sits on her bed all day. In one corner of what was earlier known as the woman’s ward, she spends her days cooped up and has to be assisted in carrying out daily functions like bathing and eating. The old age facility has now begun accommodating women in the men’s ward due to lack of space and the increasing number of women residents.
“In the past 12 years I have picked up more than 3,000 elderly from the streets. First there wasn’t any publicity of the old age home so only 3-4 were brought in, in a month. Now we have about 30-35 people coming in every month. As and when people keep finding out about such facilities, this number is only going to increase.” said. Dr. G.P. Bhagat, the founder of the Guru Vishram Vridh Ashram.
Contrary to what many think, most of the inmates at the Ashram belong to the higher strata of the society. “95% are rich and affluent people who abandon their elderly or send them here. I get calls daily, but I don’t have the capacity to keep those people from these rich families, why? Because if I start keeping those people. Otherwise, how will I then take care of those people who are on the streets.” said Bhagat.
Life as a senior citizen
The vagaries of an old soul
What is it like to be a senior citizen in Delhi? When asked that particular question, the elderly stared back at us as if there was to be some sort of a response to that.
Abandonment of the elderly
The disregard for an older population
At 65, Tejinder Singh had no option but to be content with the facilities provided at Guru Vishram Vridh Ashram, an old age home at the outskirts of Delhi.
“They called my family, told them I was in a serious condition. The hospital was kind enough to ask them to come and visit, but no one came. I was abandoned at the hospital,” he says.
Tejinder was diagnosed with partial paralysis which left his legs (below the knees) without any sensation. The medicines only made it worse.
Tejinder’s story isn’t the only example of abandonment of families and children who do not think twice before washing their hands off the elderly in their family.
He is nor the first case of complete abandonment of the ailing elderly. According to an Agewell Study 97% of the elderly in NCR have found themselves feeling lonely or isolated, even if they were living with their family. In villages of Delhi & NCR 36% older persons were reported isolated socially as well as emotionally. While emotional isolation is only due to strained interpersonal relationships, social isolation is the most chronic with a persistent withdrawal or absence of any social interaction. Many like Tejinder find themselves socially isolated and eventually completely abandoned.
Janki Kunwar had lived all her life in Patna, but ailing health brought her to her son’s home in Delhi where she was undergoing medical treatment. A few weeks after recovery she ventured into the city. She went to Bangla Sahib Gurudwara in Delhi to pay her respects. On her way back she got off the bus at the wrong station. Her bags, which had the contact details and addresses of her children in a diary were left behind in the public transport.
Somewhere in the busy streets of Chandni Chowk, Janki found herself struggling to remember the name of her son’s locality. She asked for help and those willing to give her help only wanted one tiny detail from her: Where did her son live? Tired of searching, she spent that night on the footpath with countless other homeless people.
It has been eight years since that day and not one day passes by when she doesn’t wish that she could see the faces of her children for one more time.
Looking at India through the lens of Delhi
For many senior citizens, the sunset years of life often turn out to be traumatic. They live alone, handling rising costs, scrambling to find and pay for even the basic facilities. Senior citizens, most of whom have worked all their life, saving and scrimping in order to live a peaceful retired life, find that the changes in the economy come as a hurdle to their already difficult life.
Health is one big uncertain zone where one’s calculations can go haywire, especially if a retired person falls sick. Hospital expenses shoot up, drilling a hole into his savings. There is no national social security or health plan in place. Senior citizens in India are often dependent on their children or extended families for healthcare. With increasing urbanization and social mobility, this dependence is what brings the need of geriatric care or care for the elderly into the spotlight.
The Central government is now considering providing a health insurance cover to senior citizens. Aimed at those above 60 years of age, the scheme proposes to cover medical expenses incurred for secondary and tertiary care up to Rs.1 lac a year.
Mrs. Mohini Gopal, 80, is a retired teacher. Mohini accompanied her husband to Nigeria when he was commissioned for a project there. For 8 years she taught at the Nigerian University. When she came home, her parents had passed away and soon her husband left her too, leaving her the sole support system for her intellectually disabled sister.
With her son settled in Singapore, her daughter is not far from her facility playing the role of the Deputy Commissioner in the Ministry of Health in Delhi.
“The senior citizens are treated in India way better than any other foreign countries. There, they don’t care for their wife, how will they take care of their parents. It is much better here.” she says. From the past 14 years, Mohini has been living in a government run senior facility called Aradhana.
Delhi, much like its other counterparts, is seeing an expanding population of older people. According to HelpAge India, there are more than 1 lac older couples living on their own in the National capital alone.
The elderly are facing a hiatus from the government, as they patiently wait for it to act on some policy. The infrastructure is crumbling. Take for example the capital which is failing to support the senior citizens with 4 government run facilities, of which 2 are run by North Delhi Municipal Corporation (NDMC).
NDMC runs two old age homes (Aradhana, for women senior citizens and Sandhya for old couples) while the Municipal Corporation of Delhi does not run any old age homes.
The sorry state of the privately or NGO-run old age homes makes us wonder, what really could have been the picture had the canvas been painted with more funds from the government. More often than not the elderly are forced out of their homes. Some families are considerate enough to inquire about the housing conditions. But still their decision remains ultimate.
However, not many are half as lucky as Parvati, who had the power to choose. Nicknamed “Iron Lady” by her late son-in-law, Parvati underwent a particularly complex surgery of her hip and has been equipped with a metal rod ever since then. Just like her nickname, Parvati has proven to be a woman of great strength. She supported her daughter’s education all by herself doing small jobs after her husband passed away. She could not bear to borrow a single penny from anyone.
“I used to sell odd materials from door-to-door. It helped me raise some money. I never listened to my relatives. What would people think, everyone told me. I told them: They didn’t even spare Lord Rama, why would they spare me, one has to do what they feel should be done at that moment.”
Her daughter told her to come and live with her when Parvati’s son-in-law died young. But Mrs. Mathur was a woman of her principles. “Besides, as a Hindu, my religion does not permit me to even have even a glass of water at my daughter’s house, let alone set up camp there. I told her it was a firm no. I did not want to become a burden.” she said.
Parvati found out about the old age facility, Aradhana, all by herself. Again her daughter protested, but she was adamant. She had always wanted to be independent, never once did she wish to be a burden.
“The two government run old age homes that are there are not well-off, they are not well looked after. People are not really happy there. We did open one or two more, but they just did not take off,” reflects Sheila Dixit, former Chief Minister of Delhi.
But Dixit clearly states that not the government but the society has failed to give proper care to its senior citizens. She adds, “In Indian society, there is a tradition of looking after the old. Increasingly, the entire household is working, both the spouses are busy enough and have their hands full with the children. The elderly seem to drift away from the nuclear family. So the family system where the grandparents were respected because they were a part of the family, has been heavily dented.”
There are many reason behind India’s low ranking in the Global Age Watch Index. Comparing India with the countries of the sub-continent, reveals many shocking figures. Even countries like Sri Lanka and Bangladesh with lower GDPs (Gross Domestic Product) than India are performing better in terms of Health and Income Security Index.
Take Switzerland at one hand, the prime location to grow old and Afghanistan on the other which ranks lowest at the 96th position and among other countries of the sub-continent and you will realize where India stands.
Existing policies for the elderly
The journey so far
Ghazala Meenayi, Joint Secretary, Ministry of Social Justice and Empowerment, says, “There is a dichotomy. If we create old age homes, everyone will send their parents to old age home and that is not the Indian culture. The practicality is that there are people who are living alone, whose children are abroad, so just because of that other people will also send their children, and we cannot overlook these needy people. There are many schemes which the government is running for elderly. Elderly are not our only problem, its the issue of society.”
Ghazala went to a UNDP meeting to Madras. What she found there was a reality she could not digest. “I was told that people are killing the elders in the family by giving them oil bath and drastically cooling down their body which leads to their slow but silent death.”
The Supreme Court in August, 2015 has asked the Centre to revisit rules on rehabilitation and maintenance of old people either abandoned by their families or living in poverty.
“The National Policy on Older Persons is more than 15 years old. It is time you revisited the policy. Your affidavit does not really disclose the steps you have taken so far for the welfare of the old persons,” a social justice bench of Justices Madan B. Lokur and U.U. Lalit told the Center.
The Attorney General of India, Mukul Rohatgi, feels that the security of the senior citizens remains the primary concern.”Every day you see there are murders of elderly couples being committed in the capital because there is no security. There should be a special police force dedicated towards the senior citizens. Most of them live alone and hence security is of utmost importance.”
He stresses on the need of a social benefit scheme that is over-arching and can provide food and basic health care at their doorstep.
Rohatgi adds,”Today, what is happening is that most senior citizens, if they are not cared for by their families, they are just left alone, the states are not caring for them. Individual state care is required on the pattern of countries like the United States.”
The road ahead
The elderly constitute 8% of the population today and need support from the government for schemes and pensions that will enable them to live a life of dignity. According to HelpAge India report, India spent just 0.032% of country’s GDP on pensions. In terms of coverage, India has 25% coverage by its own records. Nepal covers 47% of its population, China 74%.
The government has formulated the Indira Gandhi National Old Age Pension, under which it provides a paltry amount of Rs.200 to the elderly belonging to poor families. It has asked state governments to share this responsibility though the level of implementation varies. “In certain states it can so happen that the pension is handed out once every six months,” reveals a report published in the Times of India.
“In India we can’t give pension to each and every person, we don’t have enough money. The universalization of pension is almost impossible, unless the states also play a role in distributing pensions and other facilities evenly.” said Ghazala Meenayi, Joint Secretary, Ministry of Social Justice and Empowerment.
The Ministry of Social Justice and Empowerment is the nodal body for formulation of policy for welfare of senior citizens on behalf of Government of India.
The improvement in the life expectancy rate along with changing family value system, economic compulsions of the children, neglect and abuse has caused elders to fall through the net of family care. In this context, homes for the elderly have become a prime need of the hour.
Senior citizens ailing with medical problems, depression, loneliness, etc. do not have any proper mechanism to deal with the lack of infrastructure in the country and hence, are left hanging by the thread of their children.
In such a scenario the increased number of abuse they face at the hands of their own kin has come to light through a Help Age India study which was conducted across 12 cities. Delhi charts worst in these cities. Financial dependence on their children has made them live at the mercy of their kin.
While at one hand a section of the society reaps benefits of their earnings, there exists a major portion of the population that struggles to find a roof over their heads.
Unless the old age homes and other geriatric facilities are built into a support system that can become the backbone for the elderly, there is a thin chance that the state of senior citizens can improve.The road ahead is dark unless India wishes to come halfway both from the side of the society as well as the government.