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OLD AGE- An Introduction

Kraepelin referred to old age as the darkest chapter in ones life. Everyone wants to live long but no one wants to grow old. Old age is viewed as an unavoidable, undesirable problem-ridden phase of life that we all are compelled to live, marketing time until our final exit from life itself. Perceiving old age with fear is actually a rather recent phenomenon. It seems to increase as each day passes and the world become more complex and less comprehensible. Earlier, when life was simpler and values counted for more, those who reached a ripe old age held an enviable place in society. They could really relax and enjoy their twilight years, secure in the knowledge that they still commanded attention, respect and affection, and that though they were well past their prime, all that they had given their best for was still important- and so were they.

PROBLEMS FACED BY THE ELDERLY


Physical changes There is often a general physical decline, and people become less active. Old age can cause, amongst other things:

wrinkles and liver spots on the skin change of hair color to gray or white hair loss lessened hearing diminished eyesight slower reaction times and agility reduced ability to think clearly difficulty recalling memories

lessening or cessation of sex, sometimes because of physical symptoms such as erectile dysfunction in men, but often simply a decline in libido

greater susceptibility to bone diseases such as osteoarthritis.

Psychological problems The prevalence of psychiatric disorders in the elderly population has been investigated by means of numerous recent surveys. Though differing somewhat in aims and methods, largely the findings obtained are in good agreement with one another, and testify to the high scientific quality of these investigations. Between 20 % and 30% of persons over 60 were found to be exhibiting psychiatric symptoms or psychological deviations. Of these, some 10% showed the effects of pathological brain changes, but they were seriously disabling in only 5-6%. Severe depressive or paranoid states were encountered in 1-2 %. Neurotic and character disorders of disabling severity were estimated to be present in between 5% and 9% of elderly community subjects, but in a further 10-15% minor psychological deviations were noted. Functional, especially affective, disorders predominated below the age of 70. After 75, psychorganic states accounted increasingly for the rising psychiatric morbidity. Even beyond the age of 85, however, some 70 % of community residents were found to have remained free of the more severe forms of mental deterioration. In addition to complaints of decreasing energy, most old people report increasing memory difficulties Deterioration of personality functions, such as ability to plan ahead, consideration for others, concern with personal appearance, interests

and hobbies, as well as an increase of irritability and of anxiety proneness -all these features were found to correlate strongly and positively with decline of memory and of other cognitive abilities. A gradual 'disengagement' of the ageing person should be regarded as normal and in many ways as advantageous. More severe personality changes occur in only a small proportion of old people, reaching, however, the 50% mark after the age of 80. Beyond this, once again, old women deteriorate in personality far more frequently than men. Other common problems of old age Some senior citizens find themselves in financial troubles without enough income for a shelter, while others are unable to retire. In other cases, seniors might experience mourning the death of a spouse, child, or best friend, and forced to live in poverty. Loneliness and depression can be debilitating and Despair, despondency, and discouragement follow. Help Age India conducted a survey on loneliness in later life, in Delhi and Mumbai, through questionnaires and telephonically. Help Age interacted with 500 older people in the two metros, and found that loneliness and isolation are the scourges of too many old peoples lives. The responses were received primarily from men only 8% of the respondents were women. The survey threw up some startling facts. 12% (1 out of 8) older people said no one cares they exist. 13% feel trapped within their own homes. 21% feel more or less alone and socialize with very few people, including their own children.

THE LEGISLATIONS, POLICIES AND SCHEMES BY THE GOVERNMENT FOR THE ELDERLY IN INDIA
Acts by the government for the old aged
Maintenance of Senior Citizens Act
An initiative of the Ministry of Social Justice and Empowerment, this Act accords prime responsibility for the maintenance of parents on their children, grand children or even relatives who may possibly inherit the property of a Senior Citizen. It also calls upon the State to provide facilities for poor and destitute older persons. Provisions of the Act

Parents who are unable to maintain themselves through their own earnings or out of their own property may apply for maintenance from their adult children. This maintenance includes the provision of proper food, shelter, clothing and medical treatment.

Parents include biological, adoptive and stepmothers and fathers, whether senior citizens or not. A childless Senior Citizen who is sixty years and above, can also claim maintenance from relatives who are in possession of or are likely to inherit their property.

This application for maintenance may be made by Senior Citizens themselves or they may authorize a person or voluntary organization to do so. The Tribunal may also take action on its own.

Tribunals on receiving these applications may hold an enquiry or order the children/ relatives to pay an interim monthly allowance for the maintenance of their Parents or Senior Citizen.

If the Tribunal is satisfied that children or relatives have neglected or refused to take care of their parents or Senior Citizen, it shall order them to provide a monthly maintenance amount, up to a maximum of Rs.10,000 per month.

The State Government is required to set up one or more tribunals in every sub-division. It shall also set up Appellate Tribunals in every district to hear the appeals of Senior Citizens against the decision of the Tribunals.

No legal practitioner is required or permitted for this process. Erring persons are punishable with imprisonment up to three months or a fine of up to rupees five thousand or with both. State Governments should set up at least one Old Age Home for every 150 beneficiaries in a district. These homes are to provide Senior Citizens with minimum facilities such as food, clothing and recreational activities.

All Government hospitals or those funded by the Government must provide beds for Senior Citizens as far as possible. In addition, special queues to access medical facilities should be arranged for them.

Pension Related Acts/Rules To safeguard the interests and rights of senior citizens, the Government has framed various acts and rules. It helps to have a thorough knowledge of these acts and rules to keep a track on pension matters and the process of getting hassle free payments. Another benefit of knowing about these acts is to guard against being cheated of your pension grants.

The following Rules and Acts are administered by the Department of Pension and Pensioners' Welfare

Pensioners Procedure Central Civil Services (Pension) Rules, 1972 The Pensions Act, 1871 Central Civil Services (Commutation of Pension) Rules, 1981 Central Civil Services (Extraordinary Pensions) Rules General Provident Fund (Civil Services) Rules, 1960 Contributory Provident Fund (India) Rules, 1962 All India Services (Death cum Retirement Benefits) Rules, 1958 Central Civil Services (Medical Examination) Rules, 1957

Policies/ Schemes by the Indian Government for the old aged


Over the years, the government has launched various schemes and policies for older persons. These schemes and policies are meant to promote the health, well-being and independence of senior citizens around the country. Some of these programs have been enumerated below. National Policy for Older Persons The central government came out with the National Policy for Older Persons in 1999 to promote the health and welfare of senior citizens in India. This policy aims to encourage individuals to make provision for their own as well as their spouses old age. It also strives to encourage families to take care of their older family members. The policy enables and supports voluntary and non-governmental organizations to supplement the care provided by the family and provide care and protection to vulnerable elderly people. Health care, research, creation

of awareness and training facilities to geriatric caregivers have also been enumerated under this policy. The main objective of this policy is to make older people fully independent citizens. This policy has resulted in the launch of new schemes such as1. Strengthening of primary health care system to enable it to meet the health care needs of older persons 2. Training and orientation to medical and paramedical personnel in health care of the elderly. 3. Promotion of the concept of healthy ageing. 4. Assistance to societies for production and distribution of material on geriatric care. 5. Provision of separate queues and reservation of beds for elderly patients in hospitals. 6. Extended coverage under the Antyodaya Scheme with emphasis on provision of food at subsidized rates for the benefit of older persons especially the destitute and marginalized sections.

Integrated Program for Older Persons The Integrated Program for Older Persons is a scheme that provides financial assistance up to 90 per cent of the project cost to nongovernmental organizations or NGOs as on March 31, 2007. This money is used to establish and maintain old age homes, day care centres, mobile Medicare units and to provide non-institutional services to older persons. The scheme also works towards other needs of older persons such as reinforcing and strengthening the family, generation of awareness on related issues and facilitating productive ageing.

Scheme of Assistance to Panchayati Raj Institutions Another program of the government is the Scheme of Assistance to Panchayati Raj Institutions voluntary organizations and self-help groups for the construction of old age homes and multi service centers for older persons this scheme provides a one-time construction grant. Central Government Health Scheme Senior citizens and retired personnel who have worked in Central Government bodies are assured of their health care needs through the Central Government Health Scheme . This scheme for pensioners provides medical assistance to retired central government officials along with their dependents, freedom fighters and widows of government officials. The CGHS Scheme also covers Delhi police personnel, retired judges of the Supreme Court, Parliament secretaries and their families. National Mental Health Programme The National Mental Health Programme focuses on the needs of senior citizens who are affected with Alzheimers and other dementias, Parkinsons disease, depression and psycho geriatric disorders.

Financial Assistance to Senior Citizens The assistance of Old Age Pension has been fixed at Rs.100 per month. This assistance can be availed at the death of the concerned husband/wife by their spouses if the person is deemed destitute i.e. if none of his or her relative is in a position to give him or her financial

support. A person having an income not exceeding Rs.60 per month from all sources, including income from the property owned shall also be deemed to be a destitute for the purpose of the sub rule and is incapable of doing any kinds of remunerative work for their livelihood. New Schemes The journey towards financial security does not end here. The Central Government is in the process of developing newer plans and schemes to benefit senior citizens. In the 2007-08 Budget , the Finance Minister has proposed to provide monthly income to seniors and develop new health insurance schemes. For the benefit of senior citizens, it has been proposed that

The National Housing Bank will introduce a 'reverse mortgage' scheme under which a senior citizen who owns a house can avail of a monthly stream of income against mortgage of the house.

An exclusive health insurance scheme for senior citizens is to be offered by the National Insurance Company. Three other public sector insurance companies are to offer a similar product to senior citizens.

These new developments for senior citizens are meant to get them on the path to a better, peaceful and financially sound life.