Caring for the old, in a young nation

Posted by: 2018-06-04 07:39:42 , By Admin

India, a young country, must worry about educating and creating enough jobs for its children. But it must also worry about its seniors who many not have the youthful appeal and voice to get heard. But they must be listened to.

It was a difficult conversation. Last summer my dad (in his early 70s) decided to move to a senior citizen home in Bhiwadi.

I somehow felt responsible for his move.

Earlier that month I had gone to Ashiana Utsav, a senior citizen home in Bhiwadi (73 km from Delhi), Rajasthan for a story and spent half a day talking to the residents there. I came away feeling good and announced at home I would want to move to a place like that when I retire. The campus was open, green, well maintained and equipped with old-friendly facilities like a mess that served good, simple meals. They had carers for people with a range of disabilities. But the most important thing I noticed was that old people seemed happy. They had lots of company. They were smiling and laughing a lot more. Around lunch, the dining hall was full of chatter reminding me of my hostel days. Loneliness is the worst when one is old. And I found that the old residents there were less lonely.

Intrigued, my parents wanted to experience it too. I booked an apartment for them for two nights. My dad loved it. So much that he finalised a place to move in right away.

I had seen this coming. Living next to my residential complex, my parents were physically close. But they were lonely. Busy with our children, jobs and domestic life, big city living is a chase. Despite the best of intentions, time is scarce, especially on weekdays, to indulge in some leisurely extended conversations.

Initially, we all had reservations about my dad’s decision. But we rationalised that since he is moving to a rented place, he can always come back if he isn’t happy. So in a sense we didn’t see this as a permanent move.

A year on, I must admit, we were all wrong. My parents are happy. Quite happy. In fact they have now bought a place there. They have made many friends and have plenty of company. They are inundated with calls whenever they come to stay with us (they mostly spend 10-15 days with us in Delhi). But there are other unexpected upsides that I hadn’t foreseen. Earlier, my parents would often talk about their old age, their weak health and their limited years with us. Surrounded by young adults, they felt old.

The zing in their life seemed missing. This changed visibly when they shifted to the senior citizen home. Amid people, many of whom much older than them, suddenly my mom (in her late 60s) especially started feeling and behaving much younger. Taking part in competitions (like walking competition), celebrating all festivals with gusto, she has become busy getting involved in a range of activities including temple management. She even enrolled for a dance class, never mind her knee replacement surgery. Every month end, the residents have a party where they sing and dance and celebrate anniversaries and birthdays.

I began reflecting on this while reading two recent pieces. One was about an old Italian couple who were crying, traumatised by their loneliness. While they seemed financially not too badly off it was their loneliness, social apathy that made them feel so miserable.

There was another comment piece in The New York Times by David Brooks This piece speaks about how affluence brings its own problems. “As we’ve gotten richer, we’ve used wealth to buy space: bigger homes, bigger yards, separate bedrooms, private cars, autonomous lifestyles. Each individual choice makes sense, but the overall atomizing trajectory sometimes seems to backfire. According to the World Health Organization, people in wealthy countries suffer depression by as much as eight times the rate as people in poor countries.

There might be a Great Affluence Fallacy going on — we want privacy in individual instances, but often this makes life generally worse.” And it is the old who feel it the most.

This is true for India as well. In a young nation, the old are often invisible. The energy, appeal and glamour of youth often overshadows the listless, frail-bodied lives of old people. At 103 million (60 plus years) – 8.6% of the total population – India has a big old-age problem. But one does not hear much about the issues they face.

Like in many other areas, India’s old will live in multiple ages simultaneously, grappling with the first world problems (like depression, loneliness) and third world problem (like poverty). Break-down of traditional households, nuclear families, longer life expectancy and advancement in medical technologies mean affluent Indians will live longer. And often those years will be lonely. Not surprisingly, senior citizen homes are mushrooming all over the country – from Bhiwadi, Dehradun to Coimbatore, Chennai catering to different income segments and needs.

The poor deserve even bigger attention. Barely able to make both ends meet while young, their old age often stares at destitution with almost no financial cushion as their bodies weaken and their children desert them.

Many developed countries like the US and Japan are thinking hard about their old age problem. Here’s what Japan does where a quarter of its population is over 65 years and rising steadily. There too as the traditional family structure broke down and women joined workforce, old people faced ignorance, abandonment and even abuse. With fewer caregivers, many seniors were sent to hospitals called social hospitalisation (an expensive affair) as the Japanese government provided free hospital care to frail senior citizens.

In 2000, the government brought in a mandatory long-term care insurance system. It is funded partly by payroll taxes and partly by individuals (40 plus) who pay additional insurance premium. There are a slew of old-age services like adult day care, home help and visiting nurses for the elderly. The government program subsidises these elder caregiving services making it easier for children to take care of their parents.

India may not have the financial bandwidth to afford some of these programs like Japan does. Poor pension coverage (about 25%), little fund allocation (just 0.32% of GDP as against Nepal’s 47% and China’s 74%), and poor health insurance coverage means India’s old will face very difficult days in their last phase of their lives. We can do lot better.

Today, we worry a lot about channelising energies of millions of young citizens to ensure that the nation’s youthful bulge is a demographic dividend and not curse. And rightly so. But equally, we must worry about India’s elders who may not have the energy or the voice to make themselves heard. But they need to be listened to.

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