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Old Age Problems in Agra

Contents
 Background  Methodology  Findings

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Introduction
In India, around 2/3rd of the population is below or close to 30, so does talking about old age problems (which exist) sound awkward?

Consider this, out of every 10 elderly couples in India, more than 6 are forced by their children to leave their homes. With no place to go and all hopes lost, the elderly have to resort to old age homes, which do not guarantee first class treatment. In India, unlike USA, parents do not leave their children on their own after they turn 18 (of course there are exceptions), but children find it hard to accept the fact that there are times when parents want to feel the love that they once shared with them. There are times when parents just want to relax and want their children to reciprocate their care. Every parents wants to see their child grow and be successful but no parent wants their child to treat them like an unnecessary load on their responsibilities.

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Every other day, we see news of parents being beaten up by their children, parents and in laws being forced to do the house hold chores, being made to live in small dungeon like rooms, their property being forcefully taken over by over ambitious children.

There are 81million older people in India-11 lakh in Delhi itself. According to an estimate nearly 40% of senior citizens living with their families are reportedly facing abuse of one kind or another, but only 1 in 6 cases actually comes to light. Although the President has given her assent to the Maintenance and Welfare of Parents and Senior Citizens Act which punishes children who abandon parents with a prison term of three months or a fine, situation is grim for elderly people in India.

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According to NGOs incidences of elderly couples being forced to sell their houses are very high. Some elderly people have also complained that in case of a property dispute they feel more helpless when their wives side with their children. Many of them suffer in silence as they fear humiliation or are too scared to speak up. According to them a phenomenon called „grand dumping‟ is becoming common in urban areas these days as children are being increasingly intolerant of their parents‟ health problems.

After a certain age health problems begin to crop up leading to losing control over one‟s body, even not recognizing own family owing to Alzheimer are common in old age. It is then children began to see their parents as burden. It is these parents who at times wander out of their homes or are thrown out. Some dump their old parents or grand parents in old-age homes and don‟t even come to visit them anymore. Delhi has nearly 11 lakh senior citizens but there are only 4 governments‟ run

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to reciprocate the love. the reason we studied is our parents. Think on moral grounds. we back out. The facilities are lacking in government run homes. private agencies and charitable trusts. When we were kids we never thought of it but we knew that no matter what. to show our gratitude.homes for them and 31 by NGOs. the reason we survived all the diseases is our mother‟s care. Why do we tend to forget that the reason we are in this world is our parents. Forget the rights that the elderly enjoy in India. our parents will be by our side. But when our time came to show our respect. But the truth is that even when they are counting their last breath. The hands who made us walk is our parents‟. the reason we were alive all this while is our parents. they are still thinking of us! 5 . Just forget about the action that they can take.

stand up against such injustice. the rapid growth in the number of older population present issues. and the non-availability of opportunities for creative use of free time. For a developing country like India. These problems range from absence of ensured and sufficient income to support themselves and their dependents. Given the trend of population ageing in India.Is the youth too insensitive to the elder? Passing comments at an old man walking slowly on the road and disturbing the flow of the traffic are our ethics? Come on youth. loss of social role and recognition. Gore (1993) opined that in developed countries population ageing has resulted in a substantial shift in emphasis between social programmes causing a significant change in the share of social programmes going to older age groups. to ill-health. But in developing society these transfers will take place informally and will be 6 . the elderly face a number of problems and adjust to them in varying degrees. barely perceived as yet. absence of social security. that must be addressed if social and economic development is to proceed effectively.

The illness of the elderly are multiple and chronic in nature. arthritis. As age advances. heart problems and high blood pressure are the most prevalent chronic diseases affecting the people. due to deteriorating physiological conditions. rheumatism. The idea that old age is an age of ailments and physical infirmities is deeply rooted in the Indian mind. the body becomes more prone to illness. health problems and medical care are the major concern among a large majority of the elderly. Some of the health problems of the elderly can be attributed to social values also. Among the problems of elderly.accompanied by high social and psychological costs by way of intrafamilial misunderstanding and strife. physical disabilities and mental incapacities in their old age. 7 . This is based on a comprehensive review of the studies conducted on the elderly in India and also suggests measures to improve their health status. In the later years of life. The present paper focuses on the health of the elderly in India. Health Conditions of the Elderly It is obvious that people become more and more susceptible to chronic diseases.

breathlessness / asthma. If so. the poor countries and the poorer 8 . like chest pain. tiredness and teeth problems. heart attacks. 2002) that while the poor elderly largely attribute their health problems. it was found (Siva Raju. difficulty in movements. and diabetes which are largely diagnosed through clinical examination. in view of their greater knowledge of illnesses. mentioned blood pressure. Regarding the health problems of the elderly. it could be assumed that the nutritional and clinical care needs of the elderly were better met with adequate income than without it. on the basis of easily identifiable symptoms. having different socioeconomic status. concluded that. the upper class elderly. eye problems. Gore (1990). while there were no data showing direct relationship between income level and health of elderly individuals. shortness of breath. prolonged cough.and many of the sufferings and physical troubles within curable limitations are accepted as natural and inevitable by the elderly. by analyzing the social factors affecting the health of the elderly.

hypertension. Joshi (1971). partial or complete blindness. digestive troubles. Deonar. partial deafness and difficulty in moving some joints. Unit for Urban Studies. Tata institute of Social Sciences. and many of the sufferings and physical troubles within curable limitations are accepted as natural and inevitable by the elderly Some clinical studies have found that multiplicity of diseases was normal among the elderly and that a majority of the old were often ill with chronic bronchitis. scabies and fever. opined that the differential ageing phenomena. Mumbai-400088. rheumatism. appear to depend on environmental and social 9 . through his clinical study of the elderly. The idea that old age is an age of ailments and physical infirmities is deeply rooted in the Indian mind. were difficulty in walking and standing. anemia. Some of the cases of disability among the elderly. as reported by a few medical studies. indigestion and mild breathlessness. both physical and mental. Professor. India segments of the elderly population within each country would experience problems of health and well being.

and consumption of tobacco and alcohol. observed that males werereported to have more ailments (average: 4. The study of the Medical Research Centre of the Bombay Hospital Trust (Pathak.07) than females (average: 3.factors such as diet.678 patients admitted in the Bombay Trust Hospital during the years of 1970 and 1971. they also found that the older patients had under-reported the incidents of diseases during the survey and that some of the serious and significant ailments were revealed only on closer examination. inferred that if a retired person keeps himself/herself fit before and immediately after his/ her retirement. Purohit and Sharma (1972). but once an illness starts. Further. Desai and Naik (1972) by comparing the pre-and postretirement situation of health of the retired persons in Greater Bombay. based on the post-treatment analysis of the records of 1. type of education. before or just after the retirement period. 1975). he / she continues to face it during the post-retirement period too. The 10 .85). revealed that a good number of patients had gone through more than one major illness in the past. he/she continues to be free from illness during the postretirement period. adjustment to family and professional life. in their clinical study.

Pathak (1982) found that 62. 19.author expected that there was a higher incidence of disease in the subjects than mentioned in the records since the patients mentioned only such symptoms that they considered serious. 32. 4. Gupta and Vohra (1987) observed that only a few elderly with psychiatric disorders were being cared for in the inpatient-wards in hospitals or as 11 . Out of these. 67.2 per cent had respiratory problems.1 per cent were sick at the time of the survey. 42. al (1987) carried out a study of older persons in various slums scattered in and around the city of Hissar.2 per cent had ear and eye problems.6 per cent of the elderly patients had cardiovascular ailments.8 per cent had nervous breakdowns.6 per cent had lymphatic problems.7 per cent were suffering from chronic illness. 73.8 per cent had orthopedic. In another study of the hospital data. 19. 7 per cent had high or low blood pressure. 11. Darshan et. Among the 85 subjects interviewed by them.5 per cent had urogenital problems. 5. 11.3 per cent of the elderly had problems with all their systems.4 per cent had gastrointestinal problems.7 per cent had surgical problems while 37.

12 . There is a general perception in the community that since the old lead a sedentary life. addictions. compulsions to continue in labour force. a majority of elderly change their living habits. 1997) has revealed that the influence of the factors like. have more rest and develop more religious interest to occupy them. absence of a work routine. and the resultant stress. A more recently conducted medico-social study of the urban elderly in Mumbai (Siva Raju. perception on living status. due to restricted physical activity. At an advanced age. on both the perceived and actual health status of the elderly is found to be significant and vary considerably across different classes and sexes of the elderly. ill-health. especially their dietary intake and duration of sleep. age. type of health centre visited and whether or not taking medicines. which the male elderly mostly face. Several factors like lack of physical movement. anxieties and worries. they should eat less food. marital status. educational status. degree of feeling idle. Such a wide sex difference in this stratum is probably due to greater prevalence of health problems. and worries about unfinished tasks. economic status.residents of homes.

often. It is noticed (Siva Raju. Mental health of the elderly is another important area in understanding their overall health situation. inadequate living space. unfinished familial tasks. 1972. marriage of daughter(s). the unfinished familial tasks like education of children. etc. Some of the earlier research works (Purohit and Sharma. inadequate facilities in the household go against resting or sleeping during the day. But. Pathak. 1997) that the worries among the poor are probably about inadequate economic support. Sati. 1975. Besides. lack of recreational facilities and the problem of spending time. The allocation of less time to sleep among the lower strata of the elderly. 1988) had reported that there was a 13 .etc. It is generally expected that the elderly should be free from mental worries since they have already completed their share of tasks and should lead a peaceful life. 1987. 1997). loss of respect. are observed to be responsible for irregularity in the sleeping schedule of the elderly (Siva Raju. Mishra. probably indicate the compulsions for them to work. becomes a source of worry over a period of time. poor health.

do not enjoy any social security benefits. in reality. because with higher education and income they would have greater access to health/ medical information and services. However. a large number of the elderly in India. Although the retired persons enjoy pension benefits. most of their diseases are minor in nature and curable at the initial stage itself. There is a general perception among the elderly that they are prone to illnesses mainly due to their advanced age and that it is natural to suffer from such health problems at that age.considerable difference in the perception of old people of their health status and the reality. due to neglect of timely medication. category. It was presumed that such differences narrow down as socio-economic status of elderly increases. the health problems become aggravated and sometimes lead to death. who do not belong to the 'employed'. During the service period. Thus retired 14 . Most of them neglect the illnesses and postpone seeking medical aid. But these facilities may not be available after retirement when the old people are really in need of such subsidies. certain medical facilities such as free treatment and supply of medicines from the government hospitals / dispensaries are provided to the employees. In some cases.

prevalence of various types of physical disabilities was found to be quite high among the elderly. There appears to be a significant difference in the health situation of the elderly living in rural areas when compared to urban areas. Further. The elderly people living in rural areas appear to be much healthier as compared to those residing in urban areas. All types of disabilities were also found to be more prevalent in rural areas as compared to those in urban areas. Utilization of Health Care Services by the Elderly As the physiological condition deteriorates and responds only slowly to medication. 2000). Interestingly the prevalence of chronic disease among females is higher than among males in the case of urban areas while reverse is the case in rural areas (CSO. 15 . the elderly need medical advice and treatment regularly to minimize their health problems.government servants face a hard time after retirement if they are the victims of any serious illness.

seeking medical aid is a costly affair. medicines and the necessary medical equipment. human power.However. in view of the general perception in society that not much can be done about the health problems of old age. The advantages cited by those who utilize private source(s) of 16 . Majority of the well. the old have to compete with the other segments of our population in getting the public health care facilities. The poor strata utilize public health centres mainly because of free treatment facilities and its nearness to their residences. Health care system at various levels in our country is designed for the general population and no special provision preferences are so far provided in the system to take care of the elderly in our society. Further. But most of the public health care centres are plagued with many problems like improper hygiene. At present. overcrowding and inadequate infrastructure in terms of health.to-do and to a certain extent the MIG elderly utilize mostly the private health care facilities. unless it is from a public hospital. generally the elderly are the last segment in a household to seek or to demand the medical aid.

the paradox. Majority of studies conducted so far. adequate interest shown by doctor.medical care mainly include: good treatment. 1963. convenient time and nearness of its location (Siva Raju. faith healers and other private practitioners who live and work among them (Siva Raju. 1976). however. Instead. though rests on a well-conceived infrastructure to make health available to its people. less waiting time to see a doctor. is that inspite of the availability of the facilities. The problem is more acute in the remote areas. who are not qualified. their utilization is very meager hardly 10 to 20 per cent (Griffith. where. quick relief. cleanliness of the hospital premises. 1986). people go to practitioners of indigenous methods. they are not optimally utilized by the people. whatever meager facilities have been made available. 17 . John Hopkins University. on the utilization of existing health care services in India have revealed the very poor image the government health centres have among the people. India's health system. 1997). such as traditional birth attendants.

whatever be the illness its prevalence increases as socio-economic status goes down.Among the small proportion of villagers who use the facilities. A fact that has been found universally valid is the relationship between poverty and ill health. 18 . a majority are dissatisfied with the services. The same trend is seen in case of disabilities and handicaps too. These indications from the above facts clearly indicate that poor people are more vulnerable than the rich. Many of the communicable diseases. It is seen that in both cases morbidity shows a steady pattern. In the case of both acute and chronic diseases the lower socioeconomic status groups fare very badly compared to the higher socioeconomic status groups. especially debilitating diseases like fever and diarrhoea. mainly because of the nonavailability of medicines and the impersonal behaviour of the health functionaries. take a heavy toll on the poor. Health care system at various levels in our country is designed for the general population and no special provision preferences are so far provided in the system to take care of the elderly in our society.

Since medicines and consultations are very expensive. and those who stay in villages have a higher incidence of diseases than men and urban people. Bakshi (1987) was of the view that geriatric wards.women. expressed his doubts as to whether India would be able to afford health services for the elderly population. Getting proper medical aid was found to be beyond the reach of the elderly. most of the leading ailments become chronic in nature. Pathak (1982) suggested that aids 19 . which may have been due to their poverty. illiteracy. Also poor people spend larger proportion of their income on medical bills than the rich. and as a result. general backwardness and adherence to superstitious beliefs for curing illnesses and diseases. outpatient units and special counters need to be setup in hospitals. Bose (1988) suggested creating mobile geriatric units and special counters or days in the general hospitals for attending to the elderly population. Upadhyay as early as in 1960. Sahni (1982) is of the view that the health policy should be included as an integral part of health services of the elderly population. they take medicines only until the symptoms go away.

to the organization and provision of health care.such as dentistry. spectacles and hearing aids need to be given to the needy old. (b) legal protection and (c) health education to take care of medical and health problems of the aged. Darshan et. 20 . The pattern of various inputs for developing the appropriate social policy for the welfare of the elderly may have to be suitably modified in view of the diversity of the factors and their differential influence on the living conditions of the elderly. It is clear from the above review of earlier studies on health of the elderly that the health and well-being of the elderly are affected by many interwoven aspects of their social and physical environment. (1987) stressed the need for frequent medical camps for the benefit of the rural old population.al. Mehta (1987) has suggested a three pronged approach for care of the elderly being: (a) provision of curative services. These range from their lifestyle and family structure to social and economic support systems.

The following are some of the measures suggested to improve the health status of the elderly in India: health care so that they could learn certain do's and don'ts related to the different diseases and inculcate these in their behavioral patterns through constant practice so as to prevent the occurrence of diseases or reduce the effects of illnesses. it is high time suitable policy measures to minimize the problems of elderly in the country were adopted. thic doctors to handle the specific illnesses associated with aging. 21 . Therefore.Conclusion The trend in the size and growth rate of the elderly population in the country reveals that aging will become a major social challenge in the future when vast resources will need to be directed towards the support. care and treatment of the old.

22 .special units in hospitals and with free or highly subsidized medicines. Subsidized health care would also represent an indirect transfer of resources to the family. irrespective of their health status. There is a necessity to introduce community based income generating schemes for the benefit of the poor elderly. mainly to earn a living. needs to be attempted for that would be most cost effective as well as more efficient. on full time basis. special counters and geriatric out-patients units in existing hospitals will greatly help the elderly. form a part of the syllabus for medical professionals and paraprofessionals so that they could integrate health education along with the health care provided to the elderly persons.

which ultimately helps them in improving their health status.-availability of food may be a major factor responsible for reduced in-take and consequent poor health. elderly so that a greater commitment and involvement could be ensured in order to include "care for the elderly" within the purview of Primary Health Care. in spite of their requirement from health point of view. local NGOs working even on other issues of society may regularly interact with the elderly of their community and see that the benefits reach them in time. supplementary nutrition programmes targeting needy elderly in the poor localities may be considered on a priority basis. Therefore. Main problems as faced by elderly men and women Older Peoples roles within their communities Perception of what elder abuse is and what are the different kinds Perceptions of the contexts in which elder abuse 23 . In view of this. medicines among the poor elderly is almost absent.

and its perceived causes Situations where different acts of violence and/or abuse are acceptable or unacceptable Situations where it is appropriate for family members. care and prevention. neighbours or friend to intervene Whether abuse in common in the area or not Seasonal influences of abuse Perceptions of elder abuse as a health issue and an issue of concern for health care workers Identify existing/needed health and social services and community support in relation to violence and abuse Define the gaps. With life expectancy having increased from 40 years in 1951 to 64 years today. and the number is growing to grow to 177 million in another 25 years.occurs. a 24 . the needs and views for future responses to abuse. Why people do not approach help Discussion Conclusion Elder Abuse in India Background: India is growing old! The stark reality of the ageing scenario in India is that there are 77 million older persons in India today.

Increase in lifespan also results in chronic functional disabilities creating a need for assistance required by the older person to manage chores as simple as the activities of daily living. health or shelter. isolation and insecurity is felt among the older persons due to the generation gap and change in lifestyles. With more older people living longer. this is not without problems. With this kind of an ageing scenario. there is pressure on all aspects of care for the older persons – be it financial. Even where they are co residing marginalization. However. the growing security of older persons in India is very visible.person today has 20 years more to live than he would have 50 years back. With the traditional system of the lady of the house looking after the older family members at home is slowly getting changed as the women at home are also participating in activities outside home and have their own career 25 . causing stress in joint and extended families. As the twenty first century arrives. the households are getting smaller and congested.

Indian culture is automatically respectful and supportive of elders. joint family system is supposed to prevail. There is growing realisation among older persons that they are more often than not being perceived by their children as a burden. 26 . which is experienced as abnormal by the older family member but cannot however be labelled. elder abuse has never been considered as a problem in India and has always been thought of as a western problem. The aim of the study was to (1) define and identify the symptoms of elder abuse. With that background. However.ambitions. (2) create awareness about its existence to the primary health care workers and (3) develop a strategy for its prevention. the coping capacities of the younger and older family members are now being challenged and more often than not there is unwanted behaviour by the younger family members. Old Age has never been a problem for India where a value based.

These groups 27 . This is a technique widely used to gather data especially on sensitive issues wherein the subjects involved in the study cannot or for some reasonreserve their comments and one to one interviews do not seem to work. Two major groups were addressed: the older persons and the primary health care workers who interact with these persons when they approach as patients. residing in Agra.Methodology: Focus group discussions were held to gather data from the participants of the study. Sample: The sample was taken from urban society. Interaction within a group helps the participants to be able to define a problem without making an effort to measure its scope. Older Persons: Six focus groups were convened with the help of the author and an assistant facilitator in six different areas in Delhi.

Health care workers: Two groups of health care workers involved as primary health care workers in urban settings were also involved in focus group discussions regarding their perceptions of what elder abuse is.comprised of members of senior citizens associations in local of residential areas of Delhi. of participants Socio-economic status 1 Male 10 Middle 2 Male 08 Upper middle 3 Mixed 12 Low 4 Mixed 10 Upper Middle 5 Female 08 Low 6 Female 10 High The socio economic status was examined from the last income. occupation and education of the participants of the group. The details of the groups are given as under: Group number Constitution No. how rampant it is 28 .

Registration clerks were also included in the groups as they are the first contact of a patient in a health care setting. lack of facilities for utilisation of leisure time and a general feeling of loneliness “talking to walls”. in the focus groups with the older persons. Main problems as faced by elderly men and women MALES Discussions with male groups indicated that the middle income group listed “economic” problems on priority.Findings: During the introduction. care was taken about avoiding the word “Abuse”. The second male group from the upper middle class prioritised “mental health problems” focusing more on lack of work. Both the groups constituted of male and female doctors. female nurse and nursing attendents (both male as well as females). The problem here did not seem to be lack of money but lack of time by the “others” for the older persons Second to economic problem came ”lack of emotional 29 .within the Indian context and how they feel that it can be tackled. Total number of participants in both these groups was 8.

is a qualified medico trained in Homeopathic medicine. Singh. “a sense of insecurity” and feeling of “burden”. “experience of loneliness in everything”. He has 30 .support” from family members and both the groups felt that they felt a need to talk to their family who did not seem to have time for them The Words were many – ranging from “neglect” from family.e. Case study 1 Dr. He superannuated from Government service about 10 years back. and “Old Age itself was a disease” A glaring problem faced by the males group was older couple being asked to live separately when they had more than one child i. where there is only a specified area. the older woman to stay with one child and the man to stay with another – according to the convenience of their support in whatever housework /outside work they could contribute to Health problems however took a back seat coming in at the third position and linked with lack of mobility and economic problems Lack of accommodation was also a “problem” identified by the older persons who had houses of their own and were not staying in apartments. 70.

He is an early riser and goes to bed early. If at all he complains. he has to eat whatever is available. The timing of the meals and the items prepared do not suit his age and taste. He waits endlessly for the meals to be served. owned by him with his only son. He has asked his son and his family to leave as he is the owner and he can no longer live with them.been living in this apartment. MIXED 31 . His wife died two years back. At times. They do not go anywhere. daughter – in – law and two grandchildren for many years now. he is told in no uncertain terms to mind his own business. He has even suggested that would like to remarry for the sake of a companion and so they must be leaving the apartment. and continue to neglect him.If he offers any suggestions about the ways of keeping the house(which is his own). or for that matter looking after the needs of the grandchildren. it creates an unpleasant situation in the house and nothing improves.

They further voiced that if the women were widows. the problem of women surfaced as the next major issue wherein there was a general consensus was women were the worst sufferers with no income of their own and dependent on spouses for everything. as well as problems of living alone with disabilities. In the lower group. the situation was even worse because the finances then came from children for their welfare and it was the sole discretion of children to “decide whether she 32 .Health problems surfaced as being the most common problems faced by the older persons in the mixed group both in the lower and upper middle strata of society followed by financial problems. They stressed on the physical disabilities and problems of mobility. The views were similar in both the focus groups. They also tended to underplay their health problems for the sole reason of causing inconvenience to the other family members by way of escorting them to the doctor and/or spending money by way of consultation fee and medicines.

or open spaces covered now for the sake of the “elderly”. FEMALES 33 . women of the lower socio-economic class got very vocal about the fact that daughters in law were misusing the law. causing the older persons to be moving to smaller rooms. is designed to tackle dowry deaths) While the lower income group faced a very obvious problem of lack of space within the existing housing structure. leading to maltreatment by the police to the in-laws. This problem however did not get priority in the upper middle level group. (Indian Penal Code sec. “Daughters-in-law” was the next “problem” in both the groups. They felt neglected by the family members and also felt a sense of resentment against their own children at times. While both the groups stressed on the lack of caring attitude by the daughters in law.498(a). the upper middle group complained of lack of adjustment from the younger generation causing a great deal of turmoil among the older generation.needed medical assistance or not” even if she said she did. by reporting harassment by in-laws to the police.

Case Study 2 34 .Economic Hardships became very prominent in the women of the lower socioeconomic group while the higher socio economic category put loneliness as the primary problem affecting the older persons today. humiliation and complete neglect from family members. she had power or else she had to be dependent on children for financial support and also ”illtreatment”. This mental agony also led to various mental health problems some of which could not even be described. The lower socio economic group felt that if the woman has money.

the mother was totally ignored to the extent that the two guests on her either side were served while she just looked! 35 . mother of two sons.35/. with no finances or pension to fall back upon. On the pursuance of his friends and other members of the community. The lady survived by sitting outside a temple and serving water to the devotees and earned Rs. and generally did well in life. when refreshments were being served. She stays with the second son and his family. 75. widowed for 50 years (at least).per month (less than 1 US$) and some other income generation activities to make both ends meet. who continue to “support” her. After the inauguration. got married. Her first son (staying separately) decided to open a community water cooler in his locality. SHANTI. he invited his mother to inaugurate it. The younger of the two sons was 3 months old when the husband died. Her sons grew up. One ofthem did better than the other and moved away from the mother and brother‟s family and stopped all contact with them. in the memory of his father.Mrs.

They all were willing to contribute monetarily towards her welfare but could/did not provide emotional/moral support that she required the most. Case Study 3 Mrs Kamlesh Gupta. 65. She is mother of 5 well educated and well earning children. she appeared agitated. For fifteen long years she took care of her bedridden husband single handedly. 36 . Some in the group also felt that there was economic exploitation by the hands of the children who wanted their share in the property before the older parents‟ death and expressed concern because they felt that parents gave in to such demands as they did not want conflict.The higher socio-economic strata focus group prioritised health and mobility as the second major problem following loneliness and stressed on other issues like lack of utilisation of productive potential of older persons as well as lack of recreation facilities within the community. Some of them live in the vicinity. angry and practically furious with the callous attitude of the younger generation. During the course of discussion. belonged to an extremely rich family.

She had also suffered bouts of severe mental depression. To keep herself occupied she had started teaching adolescent girls in the neighbouhood. However, she still felt lonely and neglected.She wanted to get quick solution to her complicated problems. When the discussion was halfway, she promptly got up and walked out saying that the focus group was incapable of arriving at a solution for her problems. Older people‟s role within their communities Since we are dealing with people who have largely been professionals, (both male and female) there is a definite age of retirement from the professional life. Earlier, these people could use their energy/potential in taking care of household activities e.g. buying provisions, looking after grandchildren etc. With the change in the perception of family, these roles are now played by domestic helps. There are no clearly defined roles of older persons with in their families. Women in the lower middle class who largely had been housewives all their lives faced a different problem of being marginalized from the kind of housekeeping that they were used to. This work was now being
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performed by the daughter in law who felt that the household chores be done according to her style of functioning. Perceptions of what abuse is and what are different kinds. The groups linked the word “Abuse” to extreme behaviour of violence. Neglect/ abandonment that was clearly felt by the majority in all the three groups was not defined as abuse. Disrespect was another acknowledged form of “maltreatment” meted to the older persons Lack of dignified living was also cited as a form of “maltreatment” On explaining different types of abuse through vignettes, there was a general uneasiness among the groups and a genuine attempt was made to evade the issue. On being forceful about the specific issues of physical abuse and seasonal abuse, the groups denied the existence of such happenings in the community. Verbal abuse seemed to exist however, the older people were not very vocal about it. There seemed to be some talk about “some daughters -in38

law” speaking very rudely” to their old in-laws. No major details were provided but a glaring fact was of a woman who talked about “someone she knew” who was constantly called a “bloody bitch” by her daughter in law, even while crossing her bed, or wherever the she used to be sitting. The narrator had tears in her eyes, and within a matter of a few minutes after this was frankly crying.Economic abuse was

acknowledged, especially by way of dispossession of property. This seemed also to be linked to neglect. Cases were cited by the groups themselves wherein the children took over the property while the older parent was alive and then confined them/him to one corner of the house. Disrespect was yet another form of abuse that got acknowledged (refer to the case study 2 of Mrs. Shanti Gupta) Old parents staying separately became yet another perception of what maltreatment was. One parent was made to stay with one child while the other stayed with the other child. This adjustment was made as one child could not take the burden of looking after both the parents. There were also cases of “rotation” wherein the parents stayed with one child for a
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particular period of time and then moved over to the other child to stay with him for the same period of time. In women especially, by way of financial dependency and no access to money whenever required especially for health problems and buying of medicines. Even among the health care workers, physical cases of violence were the only ones that got acknowledged as abuse but they did not report physical violence as being seen by them. They however, did acknowledge symptoms of mental illness and frank pathological mental illness in older men and women who reported to have “family problems” Perceptions of the contexts in which elder abuse occurs, and its perceived causes Virtually the entire community in all the focus groups believed that lack of value system and negative attitude of the younger generation was the most obvious cause of “maltreatment” in the present day scenario. Lack of adequate housing leading to a lack of physical and emotional space or basic necessities, that make the older parent shift to one corner
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It was only in abnormal cases that it was heard but by and large this did not exist. There was however a passive acceptance of abuse by way of disrespect.Situations where different acts of violence and/or abuse are acceptable or unacceptable According to the focus groups. This point was emphasized by majority of groups pointing to the fact the growing realisation that. Caregivers became non caring or not caring enough for the older parents and subjecting them to neglect Lack of adjustment from the side of older persons.of the house was also perceived as another major cause Dependence of the older parent due to extreme physical and mental impairments. requiring a constant support of a caregiver. The point was made that this neglect to a large extent was not 41 . and economic by women of the lower strata. violence did not exist in their communities. they shall have to adjust with the younger generation. The older persons in the groups considered neglect acceptable and a genuine effort was made to justify this within the existing family structures. to survive. The “burden” was perceived both in the capacity of time and money. neglect.

Intervention was sought by nearly all however.wilful. They were afraid that if this complaint reached their children. on the contrary. There was also another view that if older people themselves came and talked about the way they were being harassed by their own children. there might be a sense of shame among their children and the end result may be a better life for the older parents. it was something that the younger generation could not help! Economic abuse was unacceptable. neighbours or friend to intervene The major problem here was sharing of the fact that they were being abused. Situations where it is appropriate for family members. they were scared to take the initiative. they would subject them to further abuse. 42 .

Economic dependence was considered a major reason for abuse. Somehow as thehealth care workers also perceived. Perceptions of elder abuse as a health issue and an issue of concern for health care workers Concern was shown by the health care workers of both the focus groups as a mental health problem rather than a physical problem. Physical weakness due to age was also another reason why abuse existed and they could not fight it. disrespect and neglect existed in all the areas and while one part of the group blamed it on westernisation of society and lack of value system in the once traditional family system in India.Seasonal influences of abuse Did not appear to exist. there were others in the group who somehow seemed to be blaming the older parents for the actions by the younger generation.Whether elder abuse is common in the area and why Emotional/psychological. they did not seem to have come across violence towards the elderly in the communities where they had worked. 43 .

Identify existing/needed health and social services and community support in relation to violence and abuse A health care worker at the primary health care level did not have the time to listen to the “tales of older persons”. sleeplessness.Physical symptoms that prevailed in the older persons were of epi gastric pain. 44 . anxiety. reflux. The medical doctors in the groups explained that they had tried to convince patients about the fact their illness was more in their minds and that the present diseased state was because they were probably” thinking too much”. The groups felt that the older people needed to talk to the doctors and other health workers rather than just get their illnesses diagnosed. Need for a counsellor was suggested by both the focus groups of health care workers. There were no facilities for the special geriatric services that could be availed at the primary or secondary health care set up. and depression. These were largely psychosomatic in nature and could not be labelled as a specific physical illness.

A need for a social worker was also felt by a few in the focus groups to handle cases of frank/existing abuse that the patients were willing to talk about. care and prevention. Sensitisation of younger persons through creative use of media Recreation centre Utilisation of productive potential of older persons 45 . However. the needs and views for future responses to abuse. Almost all problems of the older patients would get sorted with the introduction of a counsellor and also lead to lesser workload for the doctors.The groups felt that the older persons needed to be first screened by a trained counsellor for their physical ailments that largely seemed to be psychosomatic in nature. the health care workers were themselves not sure if that would work out because the older patients immediately tended to withdraw whenever there was talk about intervention by way of someone going from the community to talk to the children about the kind of emotional trauma that the older parents were being subjected to by them.Define the gaps.

through utilisation in community services Counselling of older people to adjust to the needs and changed circumstances of the younger generation Why people do not approach help. Occasional articles in newspapers hear of elder abuse but that is about all. and is within the four walls of a home. Most people in the group felt ashamed of the fact that they are being ill treated by family members. Discussion As compared to the abundance of systematic data on population ageing and statistics. A large majority also felt that the social agencies could hardly do anything to help them and the major fact was that it was emotionally satisfying to at least be able to “see” their children. This is a problem that largely gets swept under the carpet. or published data on elder abuse in India. It is grossly underreported and un-discussed as the older people themselves do not 46 . They were also afraid of retaliation by the family members if the agencies come to help. there is complete lack of research.

Concept of elder abuse as relevant to the developed world is alien to the Indian society. “maltreatment”. However. and the relatives and neighbours who are aware of this do not want to get involved.want to discuss it. not a single person was willing to label it as “abuse”. “feeling of insecurity”. Due to technical advances and migration from rural to urban areas. Defining abuse was a 47 . The participants of all the focus groups initially talked about “emotional problems”. They linked abuse to very severe acts of violence. The Indian scenario is not individualistic but a traditional family based society where the older persons still seem to be considered a respected lot. “neglect by the family members”. the roles of older people have become ill defined and too insignificant for the family. The six focus groups selected varied from lower to higher strata of society and largely service sector people who had superannuated at the age of 58 or 60 years. disrespect” by the family. “loss of dignity”. which they all seemed to agree was abnormal and “did not happen in our societies”. “lack of emotional support”.

In fact there was a general uneasiness among the groups and a genuine attempt was made to evade the issue.problem. changing value system that “existed everywhere in society”. The avoidance of the issue. On being forceful about the specific issues of physical abuse and seasonal abuse. Another major factor was the fact that the older parents themselves were trying to justify “neglect” in the existing circumstances. and not just their homes. at least within their own. they were sympathetic towards their own children.Even encouraging a discussion on abuse with the help of vignettes did not spark a discussion on the subject. The reason could either be emotional bonding with the children. One example at this point would be of Mrs. the groups denied the existence of such happenings in the community. Whatever be the cause. Kamlesh Gupta (case study 3) who walked out of the group. blaming it on the changing scenario. is very very evident which also points to the fact that whatever exists the older people are not willing to discuss it. especially the sons who traditionally co-reside with their parents and in the traditional Indian 48 .

A major cause that is usually considered to lead to elder abuse is the disability factor in the older persons that creates a need for a caregiver who cannot/does not care enough or is tired of caring for much too long that he/she (usually she) starts to neglect the older person. A previous study done by the facilitator in an outpatients department of a tertiary care hospital had revealed that about 85% of the older persons has felt “loved and wanted” by their family members while only about 10% felt that they were being “tolerated”. are supposed to be the heir and carry the “name” of the family into the next generation. 4% had felt “the need to go to 49 . the mental health problems encountered in these older persons were far too many to ignore the aspect that the psychological abuse did not hit the older parents as hard as the physical abuse. and get it out of their system.scenario. it manifested in all kinds of psychosomatic problems that to a large extent did not get cured by medicines. In fact this was even worse to quite an extent because since they felt the abuse but did not share it. Even though physical abuse was not sighted. talk about it.

then the world may not be a very nice place to live. There is a special 50 . Here.an old age home” while 1% had no comments on the issue. Sporadic research into the issue has shown that women have beenfound to be complaining more about abuse especially verbal and physical. Another glaring aspect seen in the study was use of crime as a weapon for elder abuse. with no financial independence and if she happens to be a widow that is the case of 55% of the women above the age of 60 years in India. This reveals the differences between a one to one interview and a focus group discussion where largely they were talking about “others” rather than their own selves. Verbal abuse seemed to exist however. incidence of physical abuse however was not cited. the older people were not very vocal about it. while women were definitely more vocal than men. Financial abuse was linked largely with people of the lower middle income group especially women. An older woman in the present day India scenario has traditional role given to her as a care giver in a largely patriarchal society.

Discussions with primary health care workers revealed that they do not look for elder abuse in older patients. Facilities need to be provided to older people to meet like minded people and spend their time doing some constructive social work. and not a health care issue. They do not consider this a health issue and neither do they feel the need to intervene and try to reduce elder abuse as they consider it more as a social problem. and energy could get help and therefore some extent of abuse in that direction could be solved. Counselling needs have emerged as yet another major component of solving the problem of elder abuse. so that the members of the family who can help monetarily but not with time.cell for crime against women where cases of domestic violence and dowry deaths are handled on priority. Counselling could prove to be an 51 . These are now being grossly misused by the younger daughters – in . Need for professional caregivers is also essential.law against the parents –in-law.

Elder abuse was linked to violence and was not acknowledged by the participants of the study as something that happened in their community. 2 elderly male and female groups mixed and 2 groups of primary health care workers comprising of doctors. spreading of awareness about its existence among the primary health care workers and also develop a strategy for its prevention. nurses and nursing attendants. 52 . 2 elderly female groups. Eight focus groups with roughly 10 people in each were the participants in the discussion that comprised 2 elderly male groups.important component of family therapy and the end result could be beneficial for both the younger as well as the older generation. Conclusion: This study was designed with the overall aims of defining and identifying the symptoms of elder abuse. The older persons in the focus groups were staying with their families in the community.

These were instead presented to the doctors as major psychosomatic complaints that did not get cured with medicines. and “disrespect” within their society and community. The introduction of an issue such as this was disturbing to most of the participants in the groups. It was even more difficult to first. However. they felt that the problems of abuse among older persons were more mental than physical. “neglect”.They however did acknowledge the existence of “maltreatment”. They were of the view that cases of abuse reported in the press were only aberrations and abuse did not exist in society in general. 53 . However. There were very few who initially were willing to talk about this objectively. a large part of the acknowledged “maltreatment” was accepted and efforts were made to justify the behaviour by the younger generation. identify and then tackle as the older persons were not willing to talk aboutthem. No cases of physical abuse were brought to the notice of health care workers in these settings.

Media was blamed for sensationalising the issue. The primary health care workers felt the need of introduction of counselling services for the elderly as a major problem solving method. Elder abuse could not be conceived to exist in the typical scenario. Primary Health Care workers are neither aware of their role in diagnosing elder abuse nor are they considering initiating intervention in this direction. Problems of the 54 . Acceptance of the fact that neglect. The solutions cited to handle the “problems of older persons” were in the form of a recreation centre/day care centre that the older participants felt could solve a lot of problems of the elderly. in any case would occur because of pressures of modern life styles and changes in the value pattern. There has been an attempt to accept negligence as apart of the changing social norm.

Elderly FACTS ABOUT ELDERLY IN INDIAMISSION & VISIONPROBLEMS OF THE ELDERLYPROGRA MMES AT GLANCE S. The aging process is synonymous with failing health. Problem No. Need 1 2 3 4 5 6 7 8 9 Failing Health Economic insecurity Isolation Neglect Abuse Fear Boredom (idleness) Lowered self-esteem Loss of control Lack of Preparedness Health Economic security Inclusion Care Protection Reassurance Be usefully occupied Self Confidence Respect Preparedness age for old 10 for old age Equity Issues are relevant to all the above Failing Health It has been said that “we start dying the day we are born”. While death in young people in countries such as India is 55 .

Health services should address preventive measures keeping in mind the diseases that affect – or are likely to affect – the communities in a particular geographical region. In addition. older people are mostly vulnerable to non-communicable diseases. lack of information and knowledge and/or high costs of disease management make reasonable elder care beyond the reach of older persons.mainly due to infectious diseases. it is of prime importance that good quality health care be made available and accessible to the elderly in an age-sensitive manner. health care for a large proportion of older persons in the country. especially those who are poor and disadvantaged. secondary and tertiary 56 . effective care and support is required for those elderly suffering from various diseases through primary. To address the issue of failing health. age-sensitive. poor accessibility and reach. In addition. Failing health due to advancing age is complicated by nonavailability to good quality.

in a holistic manner. Rehabilitation.health care systems. limited access to resources and lack of awareness of their rights and entitlements play significant roles in reducing the ability of 57 . Increasing competition from younger people. The cost (to the affected elderly individual or family) of health has to be addressed so that no person is denied necessary health care for financial reasons. Economic Insecurity The problem of economic insecurity is faced by the elderly when they are unable to sustain themselves financially. family and societal mind sets. to effectively address the issue to failing health among the elderly. community or home based disability support and end-of-life care should also be provided where needed. chronic malnutrition and slowing physical and mental faculties. Many older persons either lack the opportunity and/or the capacity to be as productive as they were. individual.

the elderly to remain financially productive. Economic security is as relevant for the elderly as it is for those of any other age group. Families and communities may be encouraged to support the elderly living with them through counseling and local self-governance. Those who are unable to generate an adequate income should be facilitated to do so. elderly who are capable. is a common complaint of many elderly is the feeling of being isolated. and thereby. isolation is most often 58 imposed purposefully or . or a deep sense of loneliness. While there are a few who impose it on themselves. As far as possible. Isolation Isolation. supported to be engaged in some economically productive manner. Others who are incapable of supporting themselves should be provided with partial or full social welfare grants that at least provide for their basic needs. independent. and if necessary. should be encouraged.

inadvertently by the families and/or communities where the elderly live. both in the family as well as in society. of families. Isolation is a terrible feeling that. It is important that the elderly feel included in the goingson around them. sensitization of community leaders and group awareness or group counseling sessions. Those involved in elder care. mental and emotional care and support. leads to tragic deterioration of the quality of life. they suffer from 59 . can play a significant role in facilitating this through counseling of the individual. if not addressed. especially those who are weak and/or dependent. especially NGOs in the field. Neglect The elderly. Activities centered on older persons that involve their time and skills help to inculcate a feeling of inclusion. require physical. When this is not provided. Some of these could also be directly useful for the families and the communities.

In extreme situations. The best way to address neglect of the elderly is to counsel families. a problem that occurs when a person is left uncared for and that is often linked with isolation. including the print and audio-visual media. 60 . legal action and rehabilitation may be required to reduce or prevent the serious consequences of the problem. Changing lifestyles and values. Government and non-government agencies need to take this issue up seriously at all these levels. distractions such as television. This is worsened as the elderly are less likely to demand attention than those of other age groups. Schools and work places offer opportunities where younger generations can be addressed in groups.neglect. a shift to nuclear family structures and redefined priorities have led to increased neglect of the elderly by families and communities. sensitise community leaders and address the issue at all levels in different forums. demanding jobs.

The best form of protection from abuse is to prevent it. abuse is carried out as a result of some frustration and the felt need to inflict pain and misery on others. Being relatively weak. the elderly may suffer from emotional and mental abuse for various reasons and in different ways. elderly are vulnerable to physical abuse. It is also done to emphasize authority. Information and education of groups of people from younger generations is necessary to help prevent abuse. This should be carried out through awareness generation in families and in the communities. usually by someone who is part of the family or otherwise close to the victim. In most cases.Abuse The elderly are highly vulnerable to abuse. including finances ones are also often misused. The elderly should also be made aware of 61 . In addition. to protect people from abuse. It is very important that steps be taken. whenever and wherever possible. where a person is willfully or inadvertently harmed. Their resources.

their rights in this regard. Elderly who suffer from fear need to be reassured. Elderly who are abused also require to be counseled. legal action needs be taken against those who willfully abuse elders. and if necessary rehabilitated to ensure that they are able to recover with minimum negative impact. Whether rational or irrational. In the case of those with real or rational fear. Those for whom the fear is considered to be irrational need to be counseled and. Fear Many older persons live in fear. combined with counseling of such persons so as to rehabilitate them. Where necessary. if necessary. the cause and its preventive measures needs to be identified followed by appropriate action where and when 62 . this is a relevant problem face by the elderly that needs to be carefully and effectively addressed. may be treated as per their needs.

Boredom (Idleness) Boredom is a result of being poorly motivated to be useful or productive and occurs when a person is unwilling or unable to do something meaningful with his/her time. The problem occurs due to forced inactivity. Many elderly can be trained to carry out productive 63 . Identifying these skills would be a relatively easy task. Most people who have reached the age of 60 years or more have previously led productive lives and would have gained several skills during their life-time. Motivating them and enabling them to use these skills is a far more challenging process that requires determination and consistent effort by dedicated people working in the same environment as the affected elders.possible. A person who is not usefully occupied tends to physically and mentally decline and this in turn has a negative emotional impact. withdrawal from responsibilities and lack of personal goals.

self-worth and value can be improved by encouraging the elderly to take part in family and community activities. learning to use their skills. For others. activities that others would often be unable or unwilling to do. developing new ones or otherwise keeping themselves productively occupied. recreational activities can be devised and encouraged at little or no additional cost. many of the elderly can be taught to keep boredom away. 64 . To restore self-confidence. neglect. communities or environment. While isolation and neglect have been discussed above. reduced responsibilities and decrease in value or worth by oneself. Being meaningfully occupied. one needs to identify and address the cause and remove it. family and/or the society. Lowered Self-esteem Lowered self-esteem among older persons has a complex etiology that includes isolation. In serious situations.activities that would be useful to them or benefit their families.

Finally. When the feeling is severe. is needed to prevent a negative feeling to inevitable loss of control.individuals – and their families – may require counseling and/or treatment. through education and awareness generation. It is also important for society – and individuals – to learn to respect people for what they are instead of who they are and how much they are worth. motivating 65 . Early intervention. finances (income). Loss of Control This problem of older persons has many facets. social or designated status and decision making powers. body systems. Improving the health of the elderly through various levels of health care can also help to improve control. While self-realization and the reality of the situation is acceptable to some. there are others for whom life becomes insecure when they begin to lose control of their resources – physical strength. individuals and their families may be counseled to deal with this.

awareness of what this entails. old age sets in quietly. there is almost no formal awareness program – even at higher level institutions or organizations – for people to prepare for old age. For each person. While demographically. and not consider. there is no such clear indicator available to the individual. Most people living busy lives during the young and middle age periods may prefer to turn away from. the possible realities of their own impending old 66 . but suddenly. we acknowledge that a person is considered to be old when (s)he attains the age of 60 years. Unfortunately. in India. This event could take place at any age before or after the age of 60. or no. and few are prepared to deal with its issues.the elderly to use their skills and training them to be productive will help gain respect and appreciation. there is a turning point after which (s)he feels physiologically or functionally „old‟. Lack of Preparedness for Old Age A large number of people enter „old age‟ with little. For the vast majority of people.

generated including through farmers. For the majority who have unregulated occupations and for those who are selfemployed. the media awareness and also can be through government offices and by NGOs in the field. The majority of Indians are unaware of the rights and entitlements of older persons. old age. Awareness generation through the work place is a good beginning with HR departments taking an active role in preparing employees to face retirement and facing old age issues. 67 . Older people who have faced and addressed these issues can be „recruited‟ to address groups at various forums to help people prepare for. The problem of not being prepared for old age can only be prevented.age. or cope with.

and social networks provided an appropriate environment in which the elderly spent their lives. Although family support and 68 . commonly the joint family type. urbanization.Economic Issue of Elderly in India Introduction The traditional norms and values of Indian society laid stress on showing respect and providing care for the elderly. education. industrialization. Consequently. occupational differentiation. These have led to defiance and decline of respect for elders among members of younger generation. The family. and growth of individual philosophy have eroded the traditional values that vested authority with elderly. the older members of the family were normally taken care of in the family itself. The advent of modernization.

where there is dominant negative effect of modernization and urbanization of family. that must be addressed if social and economic development is to proceed effectively.2002. For a developing country like India. which widely differs from society to society.care of the elderly are unlikely to disappear in the near future. 2000. In spite of several economic and social problems. Though the young generation takes care of their elders in traditional societies. 69 . barely perceived as yet. the rapid growth in the number of older population presents issues. Unlike in the western countries. family care of the elderly seems likely to decrease as the nation develop economically -and modernize in other respects. 2004). the younger generation generally looks after their elderly relatives. the situation in the developing countries like India is in favour of continuing the family as a unit for performing various activities (Siva Raju. it is their living conditions and the quality of care.

Both for men and women. is projected to become 1031 by the year 2016 as compared to 935 in the total population. reinforced by steady increase in the life expectancy has produced fundamental changes in the age structure of the population.7 million in 1991. which in turn leads to the aging population. those who live in rural areas constitute 78 percent. is 72 million in 2001 and is expected to grow to 137 million by 2021. The analysis of historical patterns of mortality and fertility decline in India indicates that the process of population aging intensified only in the 1990's. Both the absolute and relative size of the population of the elderly in India will gain in strength in future. Today India is home to one out of every ten senior citizens of the world. The data on old age dependency ratio is slowly increasing in both rural and urban areas. which was 928 as compared to 927 in total population in the year 1996. Among the total elderly population. Sex ratio in elderly population.Population Aging in India The reduction in fertility level. The older population of India. this 70 . which was 56.

Problems of Older Persons 71 . In 1991. Since women's economic position depends largely on marital status. 78 percent of the males and 84 percent of the females were in the agricultural sector. 64 percent were women as compared to 19 percent of men. women who are widowed and living alone are found to be the worst among the poor and vulnerable. Among the old-old (70 years and above). More than half of the elderly populations were married and among those who were widowed. Men compared to women are found to be economically more active.figure is quite higher in rural areas when compared with that of urban areas. 60 percent of the males were main workers whereas only 11 percent of the females were main workers. Out of the main workers in the 60+ age group. 80 percent were widows compared to 27 percent widowers.

Given the trend of population aging in the country. health. the older population faces a number of problems and adjusts to them in varying degrees. which in turn may increase financial stress in the family. loss of social role and recognition and to the non-availability of opportunities for creative use of free time. living status and other such background characteristics. The needs and problems of the elderly vary significantly according to their age. The Ministry of Social Justice and Empowerment. Mass poverty is the Indian reality and the vast majority of the families have income far below the level. These problems range from absence of ensured and sufficient income to support themselves and their dependents to ill health. Among the several problems of the elderly in our society. absence of social security. As people live longer and into much advanced age (say 75 years and over). Government of India (1999) in its 72 . economic problems occupy an important position. which would ensure a reasonable standard of living. socio-economic status. they need more intensive and long term care.

For elders living with their 73 . and are not taken care of by their children. while another 20 percent are partially so (NSSO. Though this figure may be understated from the older persons point of view. has relied on the figure of 33 percent of the general population below poverty line and has concluded that one-third of the population in 60 plus age group is also below that level. have little or no savings or income from investments made earlier. 2002). The most vulnerable are those who do not own productive assets. still accepting this figure. have no pension or retirement benefits. which in turn may increase financial stress in the family. Inadequate income is a major problem of elderly in India (Siva Raju. the number of poor older persons comes to about 23 millions.document on the National Policy for Older Persons. As people live longer and into much advanced age (say 75 years and over). or they live in families that have low and uncertain incomes and a large number of dependents Nearly half of the elderly are fully dependent on others. 1998). they need more intensive and long term care.

) constitute approximately 30 million workers and nearly one in every 10 members of the total Indian workforce of 314 million (Vijay Kumar. 2000). of local government bodies. and of major enterprises in basic industries (e.families-still the dominant living arrangement-their economic security and well being are largely contingent on the economic capacity of the family unit. The participation is high in rural areas compared to urban areas. The work participation rate among the elderly was around 40 percent. The organized sector workforce who includes the employees of the Central and State governments. manufacturing. Nearly 90 percent of the total workforces are employed in the unorganised sector. More elderly men participate in the economic activities compared to women. as their occupations do not produce income throughout the year. The bulk of the 60 plus workers were engaged in 74 . mining etc. They retire from their gainful employment without any financial security like pension and other post retirement benefits. families suffer from economic crisis. Particularly in rural areas.g.

artisans in the informal sector. Women are more likely to dependent on others. casual or contract basis. while another 20% are partially so (NSSO. and are not taken care of by their children. Economic Security Schemes for Elderly 75 . and domestic workers deserve mention here. given lower literacy and higher incidence of widowhood among them. 1998). Vulnerable groups like the disabled. unskilled labourers on daily. 1996). The most vulnerable are those who do not own productive assets have little or no savings or income from investments made earlier. fragile older persons. and those who work outside the organized sector of employment like landless agricultural workers. migrant labourers. informal self-employed or wage workers in the urban sector.agriculture. have no pension or retirement benefits. or they live in families that have low and uncertain incomes and a large number of dependents (Bose. Nearly half of the elderly are fully dependent on others. small and marginal farmers.

Though little evidence is available on poverty among the elderly and the impact of cash transfers. administrative efficiency and other such issues. the increase in the labour force coverage has barely risen from 1 percent to 5 percent. there needs serious thinking on the part of planners to evolve suitable programmes and schemes and bring reforms in the existing pension programmes. economic security benefits for those in the unorganised sector and old age pension for rural elderly. The government pension bill in 2001 was more than 1 percent of GDP or 15 percent of the revenues. As per the National Policy on Aging (1999). Given high growth rate among the elderly and also high longevity. The employees provident funds. though gradually extended from 5 to 179 industries.Government under standardized economic security policy is covering retirement benefits for those in the organized sector. several studies have raised concerns about target population. one-third of the elderly population (1993-94) is below the poverty line and about one-third are 76 .

The NOAP scheme is in operation all over India and the reports indicate that the most vulnerable sections of Indian society like. All State Government and Union Territories have their own schemes for old age pension and the criterion of eligibility and the quantum of pension amount vary among these States. but belonging to lower income group. NOAP scheme (National Old Age Pension Scheme) which is initiated by the Central Government provides for a pension of Rs.75/.76 million (as on January 1997) will be significantly expanded with the ultimate objective of covering all older persons below the poverty line. The policy document also states that the coverage under the Old Age Pension Scheme for poor persons. and lower caste individuals have been benefited from this scheme.465 crores in 2002. women. The budgetary allocation for NOAP scheme.150 per month was below the average per capita 77 . The average old age pension which is nearly Rs. which was Rs. has been increased to Rs.per month to the old people living in the conditions of destitution. which is 2.450 crores in 1999.above it.

3 percent to 68 percent.76 lakh beneficiaries would be eligible for coverage under 78 . Under the programme.6 percent only as compared to 6 percent of Central Government revenue expended on pension for its employees (Irudaya Rajan. a total amount of Rs. The total number of beneficiaries during 2000-2001 for National Old Age Pension Scheme in the country is worked out as approximately 68. through the existing public distribution system and the expected beneficiaries for the programme are estimated to be 6. This would imply that 13.227 millions were spent to benefit 49 lakh beneficiaries among the elderly. 2001). all older persons who are eligible for the NOAPS are given 10 kg. As on 1999. The Central government has announced in the year 1999 another social security programme called 'Annapurna Programme'for the elderly destitutes. The percent of elderly who benefited from the old age pension scheme varies across states. free of cost. rice / wheat monthly.income per Indian.81 lakh. The combined national budget allocation for the NOAPS comes to 0.6 millions. with the minimum of 0.

shopkeepers.) out of the total 370 million workers in India.the "Annapurna" Scheme. casual/ contract labourers etc. The need for this arose because of lack of adequate instrument to enable workers in the unorganized sector to provide for their future old age. every young worker can build up enough savings during his/her working life. According to this project. especially for the 330 million young workers in the unorganized sector (including farmers. taxi-drivers. 79 .100 crores has been provided in the budget for 2000-2001 for the Scheme. which would serve as a shield against poverty in old age. The Ministry realizes that poverty alleviation programmes directed at the aged alone cannot provide a solution to the income and social security problems of the elderly and has so commissioned the National Project tilted OASIS (Old Age Social & Income Security) as a result of growing concern for old age social & income security. An amount of Rs. professional.

This will involve an optimal combination of promotional and protective policies with the latter being based on an appropriate blend of social insurance. economic factors and diminishing value system are likely to make welfare of the elderly as the most critical area for intervention. social security has to be integrated with anti-poverty programmes. social assistance and social welfare effort. given the level of urbanization and industrialization of India. There is need to protect and strengthen the institution of the family and provide such support services as would enable the family to cope with its responsibilities of taking care of the elderly. In Indian context. Along with proper and effective professional welfare services that need to be evolved to provide counseling services both to the elderly and their 80 . Further.Conclusions The beneficiaries among the older persons for various schemes and programmes initiated by the government are very insignificant when compared to the very high size of their population and the growth rate among them.

L. it is also important to provide financial support to low income family groups having one or more elderly persons.S. Based on the existing diversities in the ageing process. In view of this. economic and cultural changes into consideration is needed to effectively solve the emerging problems of the elderly. Sharma and 81 . it may be stated that there is a need to pay greater attention to the increasing awareness on the ageing issues and its socio-economic effects and to promote the development of policies and programmes for dealing with an ageing society.. The rapid population ageing will necessarily bring social change and economic transformation. In M.family members. H.1987 An Approach to Support Services for the Elderly. References Bakshi. a holistic approach to population ageing taking social.

M.P. S. Bose.L. Darshan.) Ageing in India: Challenge Jar the Society.T. In A. New Delhi.) Ageing in India: Challenge to the Society.Bose and K. R. Desai. New Delhi:Abhinav Publications. 228-231. Bombay: Tata Institute of Social Sciences. Central Statistical Organisation.. Sharma. 1988 Policies and Programmes for the Ageing in India. 207-213. 2000 Elderly in India: Profile and Programmes.M. In M. and Naik. S. Delhi: Ajanta.M. 1972 Problems of Retired People in Greater Bombay. 1987 Health Needs of Senior Citizens. Government of India. Ministry of Statistics and Programme Implementation. A. 82 . D. KG.) The Ageing in India:Problems and Potentialities.B. Dak (Eds.Sharma and T. Gangrade (Eds. Delhi: Ajanta Publications.L and Singh.D.B.Dak (Eds.

S. Griffith. 83 .Kane. Joshi. Gore. M.Dak (Eds. &Vohra. A. Andhra Pradesh: WHO Project. Contributed to Volume IV of Encyclopedia on Ageing.J. 1987 Pattern of Psychiatric Morbidity. Delhi: Ajanta. 1963. C. John Hopkins University. New York: Oxford University Press.K 1971 Medical Problems of Old Age.L.Japan.Gore.S. In R. 214-221. Gupta. New York: Asia Publishing House. 1990 Social Factors Affecting the Health of the Elderly.G. Indian Journal of Gerontology. A.) Improving the Health of Older People: A World View. Functional Analysis of Health Needs and Services.S. M. 4 (3 & 4). 1993 The Elderly in an Ageing Society.) Ageing in India: Challenge for the Society.L. "Final Report on Public Health Programmes". D.Evans and Macfadyen (Eds. SEA/PHA/30.M. 1976. In M. P.H.Sharma & T.

In KG. Mishra.) Ageing in India-Bombay: Tata Institute of Social Sciences. 1987: Social Adjustment in Old Age. Desai (Ed. R. Delhi: Mittal Publications. In KG. Purohit. Sati. Pathak. Delhi: B.D.D. J.R.Mehta. S. C.N.K & Sharma. 1982 Health Problems of the Aged in India. 43-53. Pathak. A. Bombay: Tata Institute of Social Sciences. In M. 1988 Retired And Ageing People-A Study of Their Problems. 1975 Inquiry into Disorders of the Old. 84 . S. P. R. 1972 A Study of Aged 60 Years and Above in Social Profile. 1982 Health Services for the Aged in India: An International Perspective.) Ageing in India: Challenge for the Society. Delhi: Ajanta Publications. Sahni. Bombay Hospital Trust. 4 (3&4). Indian Journal of Gerontology. Dak (Eds. Publishing Co. 1987 Strategy for Health and Medical Care of the Aged. J.Desai (Ed.222-227. 71-83.K Sharma &T.M. Part I Bombay: Medical Research Centre.) Ageing in India.

S.Social Study on the Assessment of Health Status of the Urban Elderly". Siva Raju. Vol.B. Siva Raju. A. 2003: "Economic Security for the Elderly in 85 . S. R. 561-563. pp. S. Tata Institute of Social Sciences. 80-89. Health and Population. S. 35 (12). (Mimeo).2. 1997 "Medico. 1986. "Evaluation of Health Care System: Some Guidelines".K 1960 Geriatrics: Its Need in India. cited in Vijay Kumar.Perspectives and Issues. S. 9. B.) Upadhyay.Siva Raju. New Delhi (in Press. No. Bombay. Bangkok: ESCAP. Bose. 2002 "Health Status of the Urban Elderly: A MedicoSocial Study". Publications. Implications of Asia's population future for older people in the family (ESCAP Asian Population Studies Series # 145). with a Special Focus on Women: Needs and Capabilities of the Elderly. 1996: Economic and Social Conditions of the Elderly. Journal of Indian Medical Association.

1995. An Aging India: Perspectives. Ministry of Social Justice and Empowerment. Government of India 1999 National Policy on Older Persons. (2001. 441.India: An Overview". National Sample Survey Organisation 1998 Morbidity and Treatment of Ailments July. Government of India. 1996 (NSS 52nd Round) Report No. February 24): Social Assistance for Poor Elderly: How Effective? Economic and Political Weekly. S.45-65. Irudaya Rajan. 86 . New Delhi. New York. Prospects and Policies.June. 613-617. New Delhi. The Haworth Press p.

Publishing Co. Publishing Co. S. S. cited in Vijay Kumar. R. R. 2002: "Health Status of the Urban Elderly: A MedicoSocial Study". B. 2. 2003: "Economic Security for the Elderly in 87 . S. Delhi. Siva Raju. The Older Poor and Excluded in South Africa and India. 2000: "Ageing in India: An Overview". Murli Desai and Siva Raju (Eds. 2000: "Social Security in Indian Context". S.Siva Raju.). 2002: "Meeting the Needs of the Poor and Excluded in India". S. B. Situation and Voices. UNFPA. Mumbai (Mimeo) Vijay Kumar. No. Siva Raju. in 'Gerontological Social Work in India'. 93-110. S. Family Welfare Agency. Population and Development Strategies. Siva Raju. 2004: "Profile of Elderly and Organisations Working for their Care: A Study in Mumbai". Delhi.

Prospects and Policies. Tata Institute of Social Sciences. Unit for Urban Studies. Deonar.400 088 S.45-65. Vijay Kumar. S.45-65. The Haworth Press p. New York.html For publication in the Harmony Magazine. The Haworth Press p. New York. Siva Raju** 88 . 2003: "Economic Security for the Elderly in India: An Overview".nic. Prospects and Policies. An Aging India: Perspectives. An Aging India: Perspectives.India: An Overview". http://pib.in/infonug/infyr2000/infoaug2000/i010820001. Mumbai .Mumbai 2004 **Professor.