As the country’s youthful demographic curve transitions into a gerontological bulge by 2020, the plight of the aged will aggravate
India has traditionally enjoyed a robust joint family system that has taken care of the elderly. Yet, the sweeping currents of globalisation, lapping the shores of continents, and rupturing the warp and woof of social fabric, are having their baleful effect on our society. With the disintegration of the joint family system and the emergence of nuclear families, elders are increasingly neglected, uncared for and, in some cases, maltreated. As Professor Jean Dreze said: “The first thing that struck me was the immense number of elderly people and their miserable plight.... They rarely complain, at least, not in public, but if you enquire about their well being, the tales of sorrow are endless.”
As India's youthful demographic curve transitions into a gerontological bulge by 2020, the plight of the aged will only aggravate. The population of senior citizens as a percentage of the total population, which stood at 7.5 per cent during the 2001 census, is likely to increase to 12.4 per cent in 2026, as per the report of the Technical Group constituted by the National Commission on Population. According to the UN projections, by 2050, the overall population in India will grow by 55 per cent but the 60+ group will grow by 326 per cent and 80+ group by 700 per cent.
It is a matter of concern, as observed by the parliamentary panel on Social Justice and Empowerment in its recent report, that there are no holistic programmes to address the variegated needs of the elderly. The problem is most aggravated in the unorganised sector. A manual worker, a rickshaw puller or a marginal farmer become emaciated much before attaining the sobriquet of ‘senior citizen'. Our subsidy regime and direct cash transfer schemes are more likely to create indolence, lethargy and paid unemployment rather than motivate young and able-bodied people to work hard and earn their wages. Doles, subsidies and financial assistance should be given, more appropriately, to needy senior citizens in a graded scale as they advance in age and are left to fend for themselves.
Paradoxically, the National Policy for Senior Citizens recognises productive ageing as the key to the welfare of senior citizens between the age of 60 and 70 years. With increased life expectancy and relatively better health conditions of a considerable section of people, some suggest that retirement should be postponed to 62 years and recommend greater post-retirement opportunities. But any such move should not contribute to unemployment among the young.
The people in the 80+ age group are also vulnerable to a whole array of disease and infirmities, and need special care. There is a National Policy on Older Persons but, for want of a coordinating machinery, different Ministries work in silos. This policy needs a comprehensive revisit. Also, the National Council for Senior Citizens is dysfunctional. It has not met even once, though required to meet twice a year. The position of State level Councils for senior citizens is no better. There is no Directorate of Senior Citizens for over-arching policy formulation and to oversee implementation of welfare measures.
Programmes related to old age homes, day care centres and mobile medicare units have grievously suffered due to paltry allocation. There are only 296 old age homes in the country and most are concentrated in a few States. The welfare programmes may be integrated so that elders in old age homes and service apartments, for instance, are able to mentor children in orphanages and schools. No norms have been prescribed for the manpower and the expertise needed to run old age homes. Panchayati Raj institutions and local bodies seem to be disinclined to run such institutions for lack of financial support.
Mobile medicare units can play an effective role in providing much needed healthcare to the elderly in remote areas but the number of these units has gone down from 38 in 2011 to 29 in 2012. Geriatric daily clinics have been established only in 65 district hospitals and geriatric wards established in 53 district hospitals. All 640 districts must be equipped with such facilities. Super-speciality hospitals also need to be set up exclusively for geriatric care in different regions.
It is also imperative to set up a National Institute of Ageing. The health insurance scheme, on the lines of the Rashtriya Swasthya Bima Yojna, needs to cover senior citizens without any regular source of sustenance. The income tax exemption for the senior citizens should be indexed to the cost of living and healthcare. The aged destitute should be given a decent monthly pension and free medical care. The protection of the life and property of the elders is yet another emerging challenge since crimes against them have become rampant especially in urban areas. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007, needs to be enforced stringently by the States.
The right to live with dignity is part of the fundamental Right to life. The poet's promise to “grow old along with me” as the “best is yet to be” will only fructify if we are able to secure the health, care and dignity of the elderly.