Market Principles Will not Help in Mitigating the Problems of Elder Population

International Day for Older Persons is October 1. The theme for 2023 is “Fulfilling the Promises of the Universal Declaration of Human Rights for Older Persons: Across Generations.”

UN General Secretary Antonio Guterres stated, “Older persons are invaluable sources of knowledge and experience and have much to contribute towards peace, sustainable development, and protecting our planet.”

A retired senior bureaucrat, while commenting on the plight of the market-driven principles, said that in the US, it is believed that if an average (economically) senior citizen dies in their country, a sum of USD 5,93,000 is released in the economy in terms of various benefits that accrue out of such a death. Unfortunately, this is how the older people are seen, no different from the ‘productive labour force’ category in a different order.

In such a background, the rights of older persons are basic human rights that must be ensured in a civil society. However, the bedrock of development is based on the principles of market fundamentalism, where the value of an individual is measured on the capacity to perform; older people are the most vulnerable in such a scenario. Their basic needs of pension, proper care, health-related issues, etc., also become a wasteful expenditure from the market principle.

The theme for this year, carrying forward the Universal Declaration of Human Rights, is quintessential for a secure and habitable future for older people.

The Indian Story

As we enter the Amrit Kaal of our development mode, it seems that the ‘vish’ coming out of Amrit Kaal will be borne by the older people. Let us see through the statistics how older people are placed in India.

• India’s elderly population: 138 million
• 53 million live below the poverty line
• 11 million going blind without treatment
• 96 million must work to survive
• No pension, PF, gratuity, or medical coverage
• By 2031, the elderly population will reach around 194 million; by 2050, the elderly population will reach 340 million.

The United Nations Survey Report in India (2018) is a severe indictment of the current dispensation. The UN report said, “India is no Country for the Elderly.”

Why is it that the UN passed such a castigating comment? The above statistics do, of course, reveal some of the startling realities when it comes to the condition of older people. However, the UN report adds more to it. According to the report, 62.1% of older people in India did not get long-term and palliative care; 52.4% primarily lack family support; over 75% of the elderly limit social interactions; 67.6% of the elderly being taken care of by their family members have to babysit children.

Of the poor older people, 90% are from the unorganised sector, 20 million are destitute widows, and just 10% have pension or financial support.

The health care of the older people is in dire straits. Around 25% cannot access or afford healthcare and are left to the mercy of either family or neighbours. Their neglect and isolation also grow with time, as around 11% live alone. It is estimated that by 2025, just two years from now, 25% of the 60+ age population & 40% of the 75+ population will be living alone.

According to various reports and primary surveys conducted across the country, it is estimated that 12% feel no one cares that they even exist; 13% feel trapped within their own homes; 21% feel alone, with no social circle/support, not even from family members.

The older people are also subject to abuse and crime. Around 25% have reported that they have been physically abused by their kin.

Such is the dilemma of humanity as we enter into Amrit Kaal in India. The reasons are apparent -social, economic, and cultural.

Himachal, the Land of Deities

The state of Himachal Pradesh, considered the land of deities and culturally peaceful, should be treating its older people with respect and grandeur. However, very few know that underneath this veneer of ‘land of deities, ’ the worst form of caste segregation is practised in the state. So, how does the state treat its older people?

In a panel discussion where the author was also a participant, some shocking and heart-rending stories and reports were placed by the Helpage Himachal chapter. It was reported that around 70% of the older women had been abused at least once. Quite shockingly, around 50% of cases were reported of sons abusing their mothers in the family. And around half of such abuses have been physical. This small report is enough to convey the status of older people in Himachal Pradesh.

The state, however, has an advantage over other states in the country. This pertains to a high population of retired government employees who get pension benefits and have a higher social status in the family and social groups.

However, there is a lot that needs to be done by the state for older people.

The state has nearly 700,000 older people, constituting 10.2% of its total population, which is higher than the national average of 8.6%. By 2026, the figure is estimated to reach 1.1 million. Around 92% of the elderly are currently living in rural areas. Around 42% of the elderly in the state do not have any personal income. This means that the only source of their income is the old age pension that the state government provides them. 

Around 71% of elders live with their family members. Out of that, 27% live without spouses, and 44% of elders live with spouses and children in the family.

The health and economic needs are very pressing. Around 65% of the elderly suffer from some chronic disease, 36% suffer from psychological distress, and the proportion is higher among women, widows and the rural elderly. Nearly 8% of older people need assistance for activities of daily living (feeding, bathing, etc.). This is slightly higher at 10% among elderly women.

Paradigm Shift in Understanding and Effective Implementation is the Need

The universal coverage of social security schemes for all elderly must be the immediate intervention point. Apart from this, considering the older people as a non-progressive labour entity and burden on the society must be shed aside. There has to be a home care programme for older people. A policy-level intervention is required in this regard that various civil society groups can also support. Intergenerational programmes for the elderly, which value education curriculum at the school level and training for family caregivers for the elderly, are a must. 

The healthcare system must be strengthened, and the focus should be on preventive, curative and rehabilitative care systems. It is high time that every state has at least one geriatric specialist in every hospital; likewise, palliative care needs to be promoted, and social groups should also be mobilised in this direction.

Universalisation of social pension and health insurance coverage for all the elders is necessary. Opening new nursing homes and day-care centres for the elderly in each district should be the way forward.

The writer is former Deputy Mayor of Shimla, Himachal Pradesh. The views are personal.