Thursday, November 30, 2023

Dignity for the aged

We are now grappling with the challenge of a burgeoning elderly population. The demographic shift, driven by improved living standards and evolving healthcare, is undeniable. With the decadal growth rate of the elderly population of India currently estimated to be at 41%, and the percentage of elderly population in the country projected to double to over 20% of total population by 2050, the United Nations Population Fund, India (UNFPA) in its 2023 India Ageing Report has said that by 2046 it is likely that elderly population will have surpassed the population of children (aged 0 to 15 years) in the country. The report, released on September 27 in Delhi, projected that the population of people aged 80+ years will grow at a rate of around 279% between 2022 and 2050 with a “predominance of widowed and highly dependent very old women” ~ a finding in line with the pattern across several nations. It also reported that more than 40% of the elderly in India are in the poorest wealth quintile, with about 18.7% of them living without an income ~ adding that such levels of poverty may affect their quality of life and healthcare utilisation. Thus, the ageing of our society is not just a demographic statistic; it’s a social responsibility that we must address promptly. The United Nations has designated the years between 2021 and 2030 as the Decade of Healthy Ageing. Yet, as the elderly population in India continues to grow, the country is unprepared to provide them with the care and support they need. According to the 2023 India Ageing Report, challenges facing India’s ageing population are the feminisation and ‘ruralisation’ of the older population ~ and policies must be framed accordingly. Data show that women, on an average, have a higher life expectancy at the age of 60 and 80 when compared with men. The problem stems from a multitude of factors, including a rapidly changing society, the erosion of traditional family structures and inadequate geriatric care facilities. One of the most striking aspects of this issue is the preference of the elderly to age within the comforts of their homes while remaining active contributors to their communities. However, this ideal is often hampered by the absence of adequate support systems. Unlike many developed countries, India lags behind in integrating the private sector into community and home-based care models, leaving elderly citizens to face the challenges of ageing alone. The weakening of the traditional ties often results in feelings of powerlessness, loneliness and isolation among the elderly. Negligence by children towards their ageing parents, disillusionment due to retirement and the feeling of ‘uselessness’ are said to be pervasive issues. Financial dependence on children for basic necessities and sudden out-of-pocket expenses for healthcare create additional burdens. The migration of young working-age individuals from rural areas can exacerbate poverty and distress among the elderly living alone or with only a spouse. A study conducted by HelpAge India indicates that 47% of elderly people are economically dependent on their families for income, while 34% rely on pensions and cash transfers. This underscores the urgent need to address the financial well-being of the elderly. Health issues are a major concern, with conditions like blindness, locomotor disabilities, deafness and mental illness arising from senility and neurosis becoming increasingly prevalent. Despite the growing need for geriatric care facilities, rural areas lack sufficient resources, compounding the challenges faced by the elderly. The current state of social security pensions for the elderly in India is disheartening. The central contribution to old-age pensions under the National Social Assistance Programme (NSAP) has remained at a meagre Rs 200 per month since 2006, with slightly higher but still insufficient amounts for widows. While some States have stepped up with their own schemes, the coverage remains far from universal. As we embark on the ‘Decade of Healthy Ageing’, let it not be just another empty slogan. It’s time for the Government, private sector, and civil society to come together to ensure that our elderly population can age with dignity, security and happiness.