Issues that influence the Lives of Older Persons

Class Exercise: The broad inter related categories or types into which the issues facing the older persons may be categorized are Social (demographic,
cultural, political), Health, (Mental and physical), Financial/Economic and Legal. Based on what you have been taught in this course and your
fieldwork experience so far, list out the issues under each of the domains, especially taking into consideration the Indian context.
Stakeholders working on Ageing Issues: (Older Persons, Family members, NGOs, Govt, community, academicians, employers, media, health
professionals, politicians, corporates).

Diversity and difficulty in solution provision:

Vast population and diversity in –
Gender, Class, Caste, Religion, Educational level
Marital Status, Financial Status
Place of residence (Rural/Urban/ Tribal)
Place of Stay (Living Arrangements)
Health Status, Mental Health
Childless, Conflict with Family
Non availability of family members, so on.

Each older person has one or more factors making them different from the others in the same age category
Vulnerable sections among the older persons
Therefore, finding solutions or implementing them is not easy.
Especially due to the magnitude of older population
Why suddenly this focus on Issues facing the Older Persons?
 Concerning Demographic scenario and trends of older population (numbers, women, frailty, care, living alone)
 International initiatives and the pressure put on India to work with issues of older persons
 Current Social scenario (Change in structures, erosion of values, culture of filial piety) that is not conducive for older persons
 To inform the kind of rights, care, policy, programme, legislation, social security required
 Surging number of private institutional settings for older persons & state of Govt old age homes- Good practices
 Care of older persons living in the community (family, alone, neighborhood)/ who continue to live at their home with focus on QoL and dignity
 Markets are now finding older persons as a lucrative age group (housing, medical, pharmaceutical, technology, products, loans)
 Media coverage (crimes or abuse against elderly, loneliness, mental health, dementia, abuse)
 NGOs funding and Corporate sector mandatory spending
 Increase sensitivity towards the older persons / Potential of Older Persons
 Future research directions bring in issues facing the Older Persons
 Political will
 Issues
Social
 Eroding values & filial obligation/ rise in conflicts with the family
 Decrease in decision making roles/ loss of roles /poor routine/leisure activities
 Poor intergenerational relationships / transfer of resources
 Stereotypes/ Discrimination based on age- ageism
 Elder abuse/ neglect
 Lack of privacy
 Non availability of adult children/ Changes & Shifts in Living arrangements
 Rural- Urban migration in Old age- children or elderly
 Sexuality and sexual orientation
 Friendships and relationships in later years
 Lack of elder friendly housing design, transportation, public spaces and attitudes
 Poor social support networks for older persons (emotional support, help, backing up)
 Lack of social settings for older persons (Day care/community centers/employment or
marriage bureau)
 Poor treatment in institutional settings- Govt and Pvt
 No variety in leisure activities
 Crimes against OPs (thefts, murders, battering, rape, poisoning, property)
 Unable to participate politically (distance, access, whom to vote, demands)
 Older women and their concerns
Health
PHYSICAL
 Greater incidence of Acute and Chronic Morbidity (Extended life expectancy)/ more
prone
 Lifestyle related illnesses/ Terminal illnesses/ Lack of palliative care services for
elderly
 Low functional status (inability to do activities of daily living /instrumental activities)
 Restricted mobility due to frailty/disability and dependency
 Risk for injuries and falls
 Sleep disorders and Malnourishment
 Medicine compliance
 Increase in Risky Health behaviors (smoking/tobacco chewing/substances)
 Poor health seeking behavior /their health is not a priority
 Rising health expenditures (medicines, consultation, transport, hospitalization,
Implications/Effects/Consequences
 Feeling that they are obsolete & a burden- Older person/ stakeholders
 Abandonment by family
 Older persons who have so much to share/contribute, cannot
 Generation gap and non transmission of values and resources
 Negative attitudes, images and stereotypes will impact OPs lives
 Live with spouse only or alone are the modern LAs- safety net ?
 Adjustment becomes difficult for the older persons (migration)
 Self awareness, building and maintaining relationships in old age are
difficult and need guidance
 Cannot move freely and participate in social settings
 In absence of family members and relatives, who will the older person seek
help from? Loneliness, accidents, finances
 Vulnerable targets for crimes
 Political system does not recognize their needs
 Cannot age actively/successfully and mental health is impacted
 Health spending would be a huge burden on older persons and families
 Poor health effects mobility, social participation and quality of life
 Stress due to health conditions is chronic and lead to mental health
conditions and vice versa
 Need primary care giver or trained attendant
 Health needs would not be met as they should be
 diagnostic tests, surgery)
 Health care system is not elder friendly
 Health budget provision for older persons is negligible
MENTAL
 Common mental health disorders- depression, anxiety, mood disorders, suicide
 Emotional disorders (due to anger, fear, poor adjustment, loss of control, helplessness)
 Emotional instability and loneliness leads to other ailments (physical and mental
health)
 Lack of awareness about positive mental health
 Diagnosis and progression of Alzheimers and dementia
 Poor access to counselling and therapy
 Expensive medication
Financial/Economic
 Regular monthly income stops after retirement age  Struggle with running household and meeting their basic needs
 Only some elderly get a pension after retirement  Many elderly and families are grappling with poverty
 Inability to save for retirement/lack of financial planning  Stress due to Chronic financial issues
 Income on assets may not accrue to older persons/Loans to repay  Working after 60 due to compulsion is often stressful
 Poverty of older person/family – needs ever growing  Continue to be breadwinner/one of earners in many households
 Financial Abuse /poverty conflicts/ Forced signatures/coercion  Betrayal by adult children and families
 Compulsion to work after 60  Govt existing programs not very hopeful
 Issues of elderly working in the unorganized sector (wages/benefits)  Even Above Poverty Line Older persons may need some schemes
 Economic dependence on family members or vice versa  Older persons feel pressure to bring in money
 Poor work opportunities for elderly who want to be economically productive  No products and technological innovations to make life easier –seen as
 Poor implementation of schemes for physical/food/income security investment with poor returns
 Productivity of older persons at home is measured in economic terms only
 Are not seen as a potential & huge market
Legal
 Are not informed about importance of preparing a will and how to  Taken for granted by family members and outsiders
 Property conflicts with family asking to sign it off  May be pushed into poverty or homelessness
 Not aware they can take legal action if facing any form of abuse  Cannot seek justice where their rights have been violated
 Burglary, threats from neighbors, violence  They will be exploited by attendants, may be labelled as mentally ill
 Legal action against personal attendants  Absence of legislations (Elder abuse and Neglect, Euthanasia, standards
 Legal action if being framed as mentally ill for care in institutions) allows certain rights to be violated
 No Legislations that are actually required by elderly

What are the Causal Factors for these Issues?

  Population ageing and its demographic trends
 Globalization- privatization- Social Change- Erosion of values/norms
 Lack of awareness and sensitivity about their issues
 Poverty or financial struggles of families/society in India
 Healthcare, legal, financial systems for elderly not matching needs/issues
 No trained human resource to work with them
 Govt. wants to shift responsibility to older persons, families and communities

How may we Intervene?

Social/ Cultural/Political
 Individuals and family members become aware and sensitized about normal human ageing and older people
 Value education in schools, colleges, community and Media that creates positive attitudes towards older persons and reduced generation
gap
 Family therapy to resolve conflicts, improve communication and win-win situation for elderly and family
 Helpline for older people to reach out in case of loneliness, abuse or need for referral
 Creation of elder friendly spaces and transport and digital literacy sessions
 Break the myths and stereotypes about ageing and older people
 Build social support networks, friendships, relationships and companionship
 Set up institutional settings and services required by older people such as palliative care, respite care, dating sites, trained attendants
 Markets have to focus on creating products and technology to be used by elderly
 Media has to have older people visible and sensitively represented in all platforms
 Political engagement at all levels have to be encouraged consciously
 Institutional settings require licensing, periodic renewal of license and also follow good practices as a rule
  Legislations for elder abuse, euthanasia, violation of rights, homeless elderly
 Convention on special rights of older people
Health
 Care of diet, movement and lifestyle to prevent disease – physical or mental as much as possible
 Family has to become aware of health concerns of elderly and support them by prioritizing it and discourage health risk behaviors
 Setting up of geriatric clinics in hospital with a team trained in geriatric assessment focusing on preventive care
 Subsidized healthcare for elderly and reimbursements for medication and treatment of some common medical disorders among the
elderly (physical and mental)- Accessible, affordable and available
 Strengthen the health care systems especially keeping in mind needs of elderly – Geriatric hospitals, geriatric clinics, diagnostic facilities,
geriatric wards, counseling, palliative care, physiotherapy clinics, and so on
 Conduct of health camps from time to time and provide referrals and free treatment and therapy to the needy
 Sensitize them on difference between disease and ageing and encourage faster and sensible health seeking behaviors
 Meet different health needs of 60 +, 70+, 80+ and centenarians via special schemes
 Health component in caring for elderly in institutional settings, those living alone, those disabled, living in rural areas and so on has to be
taken care of
Financial
 Awareness about the need to save for post 60 years, and to start saving early
 Training on how to prepare and register a will
 Sessions on various investment options that are low risk and paying
 Calling out on financial abuse by family members, relatives and attendants with strict legal action
 Legislation to deter persons from financial abuse
 Increase in retirement age to 65 or beyond / decide retirement on basis of relevant criterion other than age
 Facilitate part time jobs for older people in labor sector and universal pension scheme for persons in unorganized sector
 Subsidized health care for common mental health and health disorders
 Digital literacy so they are not cheated during online payments
 Training in use of ATMs, printing pass books and depositing cheques
Legal
 Sensitization on instances that warrant legal action and protection such as teasing, harassment, defamation, abuse, torture, cheating and
so on
 Free legal advice and services for older people by Civil society and Govt
 Sensitive and aware police system who respond to concerns of older persons immediately
 In case of property issues and certifying insanity of older persons, benefit of doubt or alertness by the legal authority
 Awareness on the legal procedure to make complaint and clarity on action that will be taken
 Deterrence and speedy action in case of complaints by older persons
 Awareness about the legislations available for elderly and how to enforce the same
 Creating awareness about the special rights of older persons and ensuring they are upheld

Overall Essential Interventions with Older Persons

Attitude change- Value Education, Awareness and Sensitization sessions

Infrastructure- Homes, public spaces, institutions relevant to elderly, elder friendly transport, Markets, Media, Health care system responsive to
older people, Legal and police systems responsive to older people

Information and Skill- Sessions on Financial Literacy- Investment, Savings for retirement and Schemes & benefits they can avail, Digital
literacy, Sessions on Will and Legal Aid to older persons

Department: Dedicated to addressing issues of older persons

Policy/Legislations- Elder abuse, Euthanasia, Forced will

Rights- Convention for Rights of older people

Services- Helplines, Counseling, support groups, Sr Citizen groups, Free legal aid

Regulation- Licensing of day care centers and old age home and good practices

Social Supports and Care- Training of attendants, groups, friendships, volunteer, settings

Social Security (physical, emotional, health, nutrition, financial)/Universal pensions

 Research and Training- to aid identifying issues, for interventions and their use/conduct and Scaling of ToT programs

Community based care- Leverage resources from community for needy older persons

References:

Amrita Bagga & Anuradha Sakurkar (2011). Abuse and Violence in the Lives of Older Women: It's Impact on Their Mental Health, Helpage India: Research and Development
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Health and Development (pp. 188- 202), B.R Publishers: New Delhi.

Central Statistics Office. (2011). Report on situation analysis of the elderly in India. Ministry of Statistics and Programme Implementation. New Delhi: Government of India.

Meenu Kalia, Amrit Virk and B.P. Gupta, 2013. Morbidity Patterns among the Rural Elderly: A Health Perspective. In S Siva Raju.,U.V Somayajulu, & C.P Prakasam (Eds.),
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Momtaz, Y. A., Yahaya, N. B., & Hamid, T. A. B, 2009. Determination of psychological well-being status among older persons in north peninsular Malaysia. Indian Journal of
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Rajan, S.I. (2006). Population ageing and health in India. Mumbai: Centre for Enquiry into Health and Allied Themes (CEHAT).

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Shah, A. M. (1999). Changes in the family and the elderly. Economic and Political Weekly, 34 (20), 1179-1182.

Siva Raju, S (2013). Situational Analysis of Older Women. In Nayar, P.K. B (Ed.), Older Women in India: The Context, Issues and Concerns (pp.278-301), New Delhi: The
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Siva Raju, S., 2011. Situational Analysis of Elderly In India. In Siva Raju, S (Ed.), Voice of the Elderly in India (pp. 1-29), New Delhi: B.R.Publishing.

Sugan Bhatia (2013). Some Thoughts on Social Well-being of Older Women in India. In P.K.B Nayar (Ed.), Older Women in India: The Context, Issues and Concerns (pp.35-
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