Insights into Editorial: The elderly as a resource, not a burden
Insights into Editorial: The elderly as a resource, not a burden
04 April 2016
Since independence, India has been striving hard to improve lives of its citizens and has largely been successful in this. Increase in life expectancy at birth is the best indicator of this.
- In 1950-55, life expectancy at birth in India was 36.6 years, whereas the average in the world was 46.8 years.
- By 2010-15, life expectancy in India had almost caught up with the global average: 67.5 years in India, compared with 70.5 years globally.
- This improvement in life expectancy is a result of reduction in poverty and improvement in healthcare and general social conditions.
What’s the main concern?
Increase in life expectancy, though desirable, has posed new challenges to the modern world. The problem of ageing populations has become a matter of great concern for many countries today. Provisions for pensions and healthcare are straining budgets, leaving very little space for creating new employment opportunities for younger people.
Home to over 100 million elderly people and with numbers further expected to increase threefold in the next three decades India has many challenges to be addressed.
Challenges faced by the elderly:
They are common across social classes and cities, although there are differences between cities. The elderly are highly vulnerable to abuse, where a person is willfully or inadvertently harmed, usually by someone who is part of the family or otherwise close to the victim. Being relatively weak, elderly are vulnerable to physical abuse. Their resources, including finances ones are also often misused. In addition, the elderly may suffer from emotional and mental abuse for various reasons and in different ways.
This is identified by many as the major reason for abuse. The problem of economic insecurity is faced by the elderly when they are unable to sustain themselves financially. Many older persons either lack the opportunity and/or the capacity to be as productive as they were. Increasing competition from younger people, individual, family and societal mind sets, chronic malnutrition and slowing physical and mental faculties, limited access to resources and lack of awareness of their rights and entitlements play significant roles in reducing the ability of the elderly to remain financially productive, and thereby, independent.
It has been said that “we start dying the day we are born”. The aging process is synonymous with failing health. While death in young people in countries such as India is mainly due to infectious diseases, older people are mostly vulnerable to non-communicable diseases. Failing health due to advancing age is complicated by non-availability to good quality, age-sensitive, health care for a large proportion of older persons in the country. In addition, poor accessibility and reach, lack of information and knowledge and/or high costs of disease management make reasonable elder care beyond the reach of older persons, especially those who are poor and disadvantaged.
In today’s globalized world, people are always on the move in search of jobs. Younger people often move to cities leaving behind their elderly parents. This makes them isolated. Isolation, or a deep sense of loneliness, is a common complaint of many elderly is the feeling of being isolated. While there are a few who impose it on themselves, isolation is most often imposed purposefully or inadvertently by the families and/or communities where the elderly live. Isolation is a terrible feeling that, if not addressed, leads to tragic deterioration of the quality of life.
The elderly, especially those who are weak and/or dependent, require physical, mental and emotional care and support. When this is not provided, they suffer from neglect, a problem that occurs when a person is left uncared for and that is often linked with isolation. Changing lifestyles and values, demanding jobs, distractions such as television, a shift to nuclear family structures and redefined priorities have led to increased neglect of the elderly by families and communities. This is worsened as the elderly are less likely to demand attention than those of other age groups.
Many older persons live in fear. Whether rational or irrational, this is a relevant problem face by the elderly that needs to be carefully and effectively addressed.
Loss of Control:
This problem of older persons has many facets. 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, body systems, finances (income), social or designated status and decision making powers.
What needs to be done?
- To address the issue of failing health, it is of prime importance that good quality health care be made available and accessible to the elderly in an age-sensitive manner. 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, effective care and support is required for those elderly suffering from various diseases through primary, secondary and tertiary health care systems.
- The cost of health has to be addressed so that no person is denied necessary health care for financial reasons. Rehabilitation, community or home based disability support and end-of-life care should also be provided where needed, in a holistic manner, to effectively address the issue to failing health among the elderly.
- Economic security is as relevant for the elderly as it is for those of any other age group. Those who are unable to generate an adequate income should be facilitated to do so. As far as possible, elderly who are capable, should be encouraged, and if necessary, 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. Families and communities may be encouraged to support the elderly living with them through counseling and local self-governance.
- It is important that the elderly feel included in the goings-on around them, both in the family as well as in society. Those involved in elder care, especially NGOs in the field, can play a significant role in facilitating this through counseling of the individual, of families, sensitization of community leaders and group awareness or group counseling sessions. Activities centered on older persons that involve their time and skills help to inculcate a feeling of inclusion. Some of these could also be directly useful for the families and the communities.
- The best way to address neglect of the elderly is to counsel families, sensitise community leaders and address the issue at all levels in different forums, including the print and audio-visual media. Schools and work places offer opportunities where younger generations can be addressed in groups. Government and non-government agencies need to take this issue up seriously at all these levels. In extreme situations, legal action and rehabilitation may be required to reduce or prevent the serious consequences of the problem.
- The best form of protection from abuse is to prevent it. This should be carried out through awareness generation in families and in the communities. In most cases, abuse is carried out as a result of some frustration and the felt need to inflict pain and misery on others. It is also done to emphasize authority. Information and education of groups of people from younger generations is necessary to help prevent abuse. The elderly should also be made aware of their rights in this regard. Where necessary, legal action needs be taken against those who willfully abuse elders, combined with counseling of such persons so as to rehabilitate them. Elderly who are abused also require to be counseled, and if necessary rehabilitated to ensure that they are able to recover with minimum negative impact.
- Elderly who suffer from fear need to be reassured. Those for whom the fear is considered to be irrational need to be counseled and, if necessary, may be treated as per their needs. In the case of those with real or rational fear, the cause and its preventive measures needs to be identified followed by appropriate action where and when possible.
- Early intervention, through education and awareness generation, is needed to prevent a negative feeling to inevitable loss of control. 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. When the feeling is severe, individuals and their families may be counseled to deal with this. Improving the health of the elderly through various levels of health care can also help to improve control. Finally, motivating the elderly to use their skills and training them to be productive will help gain respect and appreciation.
Elderly as a resource:
The elderly should be seen as a blessing, not a burden. The elderly are becoming the fastest growing, but underutilized resource available to humanity. Rather than putting them aside, physically (and mentally), to be cared for separately, they should be integrated into the lives of communities where they can make a substantial contribution to improving social conditions. The benefits of turning the ‘problem’ of the elderly into a ‘solution’ for other social problems is being demonstrated in several countries.
In Vietnam, Old People’s Associations (OPAs) are improving the lives of the elderly in many parts of the country. In a country of 90 million people, as many as 8.5 million are members of OPAs in their village and town communities. The associations are democratically run by the elderly in the communities. They set their own agendas, choose what community causes to apply themselves to, which elderly persons need special assistance and assign responsibilities among themselves. They represent the needs of the community and the elderly to government agencies, who also see them as a vital support for the government’s outreach programmes into communities.
The elderly are the fastest growing, underutilized resource that humanity has to address many other problems. Re-integration of the elderly into communities may save humanity from mindlessly changing into a technology-driven ‘Industry 4.0’ which futurists are projecting: an economy of robots producing things for each other. Investing a little to engage the elderly in communities can improve the health and well-being of the elderly. It can also improve the health and well-being of communities.