“Viewed as a whole, the problem of ageing is no problem at all. It is only the pessimistic way of looking at a great triumph of civilization.” — Frank Notestein
The elderly population in India is second largest in the world, next only to China. According to Population Census 2011, there are nearly 104 million elderly persons (aged 60 years or above) in India; 53 million females and 51 million males and is projected by the UN to increase to 137 million by 2021. The old age dependency ratio is gradually increasing in both rural and urban areas. Some of the major characteristics of ageing in India are: feminization of ageing, the high growth of oldest-old (80+ years) compared to young-old (60-69 years) and increase in their vulnerability.
In spite of being the most respected segment, according to the Indian culture, Indian elderly is still in one of the worst state in the world. Due to non-availability of any effective and affordable long-term pension plan, provident funds and health insurance, Indian elderly is hugely dependent on their children and family members for living. This situation is even more horrific in rural areas where there is poor accessibility of healthcare services and economic resources for elderly. Living conditions and quality of life is highly variable across the length and breadth of India. At one end of spectrum is the elderly population living in metro cities and affluent urban areas of smaller towns where they have access to better, effective, timely and affordable healthcare and have a financial resource by the means of robust pension plans, provident funds and health insurance as well as support from their family and children. They also have better recreational facilities and support system. While, on the other end of the spectrum is elderly population from villages, small towns, slums and poor areas of metropolitans where they are not as lucky to have access to any of the above mentioned facilities by the virtue of them being a not-so-important vote-bank for political parties.
Elderly population is particularly susceptible to innumerous old-age problems and medical conditions and thus require special healthcare attention. Diseases like cataract, cardiovascular diseases, diabetes, cancer, osteoporosis, deafness and loco-motor system degeneration along with increased susceptibility to accidents are some of the medical conditions affecting elderly. Mental conditions like Alzheimer’s disease, Parkinson’s disease, dementia, emotional and sexual adjustment disorders are also specific to old age.
“Old age should be viewed from the participation of the continuity of roles and functions than from the perspective of disengagement or withdrawal.”
In the current scenario, where elderly population is going to be a major chunk of India’ population in near future with an increased demand for better health facility and economic sustainability, the government needs to devise a comprehensive care package that includes promotive, preventive, curative and rehabilitative services in the area of health needs to be worked out for holistic promotion of health among the older people.
Research and development needs to be started in the area of clinical gerontology, geriatrics, experimental gerontology, geriatric gynaecology and geriatric psychiatrics with focus on demands and solutions specific to Indian elderly. Priority areas need to be assessed with a methodical approach including multi-disciplinary and intersectoral coordination should be evolved that could cater to healthcare, economic sustainability and recreational options for the elderly. Also, public private partnership with agencies that have already gained enough experience in the field, like HelpAge India, Harmony India and The NGO Committee on Ageing, needs to be built and worked upon.
Ageism is stereotyping and discrimination on the basis of a person’s age. It is harmful for the whole community and nation when not brought into focus. As quoted by St Simon, “The golden age is before us, not behind us”, we need to care for our elderly in order to care for the future of India.
The writer, Ankit Raj, is a Final Year MBBS student at Kasturba Medical College, Manipal.
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