Elder Care beyond Policy

The window of opportunity opened by India’s demographic dividend will be closing with new social realities of a burgeoning population of elderly citizens in the coming decades. Demographers estimate that the population of senior citizens in the country will increase to about 20% (over 30 crore) by 2050. The demographic shift demands that the government and the society prepare for guaranteeing the senior citizens a dignified life free from all worries and build the capacity of the state to support them as their population steadily grows over the next two and a half decades. The current National Policy on Older Persons (NPOP) is ill-equipped to meet the new challenges of ageing in the days of rapidly spreading digital media and weakening of family bonds on account of economic compulsion. Critically examining the policy is essential to develop the framework of a new forward-looking policy to overcome the shortcomings. The NPOP envisages state support for financial and food security, healthcare, shelter, protection, and other needs of senior citizens to improve the quality of their lives. However, inflation and weakened family bonds have rendered it outdated and insufficient. The old age pension beneficiaries belonging to below poverty line households receive a monthly pension of Rs 1000, on average, in several states. Such tokenism is no match for rising inflation and is too little for an elderly couple who live in isolation due to the growing number of nuclear families on account of urbanization and new economic growth driven by a young migrant workforce. For migrant workers, who are not well paid and have children to raise, fund their education, and pay rent for their own accommodation to live away from their parents, cannot save much for remittance to their parents. The elderly members of such households not only suffer from financial crises but also suffer isolation and loneliness due to shrinking emotional bonds, addressing which should be a priority in the new policy. Ironically, the issues of senior citizens and the creation of age-friendly spaces figure quite less in public discourse notwithstanding the reality that nearly one in five Indians will be above 60 years of age in another 25 years. The umbrella scheme of the Ministry of Social Justice and Empowerment—Atal Vayo Abhyudaya Yojana (AVYAY)—includes an important component of training of geriatric carers. The main objective of this component is to bridge the gap between supply and andincreasing demand in the field of geriatric caregivers so as to provide more professional services to the senior citizens and also to create a cadre of professional caregivers in the field of geriatrics. Private and professional geriatric care comes with a cost, and what percentage of the elderly population will be able to avail it given their dependence on the monthly pension payout scheme and limited family income is the pertinent question the new policy will have to answer. The Maintenance and Welfare of Parents and Senior Citizens (MWPSC) Act, 2007, to ensure need-based maintenance for parents and senior citizens and their welfare, is a progressive act enacted to provide a legal shield to senior citizens against neglect by relatives. The Act provides for maintenance of parents/senior citizens by children/relatives made obligatory and justiciable through tribunals, revocation of transfer of property by senior citizens in case of neglect by relatives, penal provision for abandonment of senior citizens, establishment of old age homes for poor and needy senior citizens who lack resources to sustain themselves, adequate medical facilities, and security for senior citizens. Recurring incidents of abandonment of parents and senior citizens by their children or relatives across states paint a gloomy picture of the inadequacy of the Act and weak implementation and enforcement, as well as poor awareness about it in society. Persisting and widening rural-urban divide in accessibility and availability of geriatric care despite the fact that senior citizens in rural areas account for more than 70 percent of the elderly population also highlight the inadequacy of the NPOP. Weakening of family bonds is urban-centric alone, but due to large-scale migration of young members of farm households in rural areas in regions like the Northeast, which is grappling with agricultural crises, the vulnerability of senior citizens in rural areas has increased. Revisiting the welfare schemes in view of their changing socio-economic realities has become an urgent need of the hour, and the new policy must ensure that such schemes and programmes aimed at protecting senior citizens from such vulnerabilities are formulated in such a manner that they evolve with fast-changing realities. A paradigm shift in approach towards the challenges of senior citizens is necessary to reorient the core policy objective and replace the welfare-based framework with a rights-based framework that recognises the dignity and empowerment of senior citizens. Caring for the elderly people is not the responsibility of government alone; the society being sensitive and compassionate towards them is a moral obligation.