The data from the NFHS-5 shows that Life expectancy in India has increased from 50 (1970-75) to 70 years (2014-18). As a result, the number of elderly people in India (over 60 years) is already 137 million, and is expected to increase by 40% to 195 million in 2031 and 300 million by 2050.
Thus, there is a need to relook at problems of the elderly, and their contribution to the society.
Who are elderly?
- Conventionally, “elderly” has been defined as a chronological age of 65 years old or older, while those from 65 through 74 years old are referred to as “early elderly” and those over 75 years old as “late elderly.
- In India and in most countries, at present, the retirement age of a working person is 60 years.
The numbers
- There are nearly 138 million elderly persons in India in 2021, including 67 million men and 71 million women, according to the report.
- An increase of nearly 34 million elderly persons was seen in 2021 over the population census of 2011. This number is expected to increase by 56 million by 2031.
- Kerala currently has the highest elderly population (16.5 per cent), followed by Tamil Nadu (13.6 per cent), Himachal Pradesh (13.1 per cent), Punjab (12.6 per cent) and Andhra Pradesh (12.4 per cent) in 2021.
- Bihar, Uttar Pradesh and Assam have the least proportion with 7.7 per cent, 8.1 per cent and 8.2 per cent, respectively.
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Policy challenges posed by increased population
- Ensuring income security for the elderly
- Mitigating the fiscal costs that arise from a high old-age dependency ratio
- Lack of dedicated service and product outlets
- Isolation of seniors in a changing society
- Increasing healthcare costs
- Mental health issues
- Lack of financial support
- In addition, most of the aged are not accorded the dignity of care they deserve in later life.
Why Elderly should be considered assets?
The elderly are assets not only for the family, but also for the society and nation. It can be seen from their knowledge and experience in various domains as below-
- Economic aspects-
- Many private and government companies retain retired person to harness their knowledge and experience. Similarly, government retains civil servants and many politicians continue to serve and get re-elected for long time beyond retirement age. Thus, there is a need to recognise and replicate this model in other areas of economic relevance.
- Personal life experience-
- Elder people have faced many aspects of life in comparison to children and adults.The joint family system for generations has seen the passage of knowledge from generation to generation. It has benefitted adults to understand the social change, become more Emotionally Intelligent to tackle problems of life, and understand the significance of many aspects like health and fitness.
- Traditional knowledge-
- Technology has given new aspects to life and brought many socio-economic benefits. But it is also important to realise the importance the traditional and cultural values that elderly possess. For instance, COVID pandemic has made people realise benefits of boosting immunity with traditional foods like ‘Golden milk’ and ‘Giloy’ which has gained mass acceptance.
- Focus on balanced and sustainable life-
- The greater focus on industrialisation has neglected the environmental aspects and thus leads to loss of biodiversity. But the negative consequences of reckless industrialisation have made us realise old saying, which focussed less on monetary aspects and more on social and environmental aspects to maintain intergenerational parity.
Measures for the elderly-
Considering the potential of elderly as assets, various constitutional, legislative and social steps are taken in India for the benefit of the elderly and to prevent discrimination against them.
- Constitutional Protection:
- Article- 41: Right to work, to education and to public assistance in certain cases: The State shall, within the limits of economic capacity and development, make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness and disablement, and in other cases of undeserved want.
- Article- 46: The State shall promote with special care the educational and economic interests of the weaker sections of the people and shall protect them from social injustice and all forms of exploitation.
- National Policy for Older Persons 1999- This policy included the following steps-
- Setting up of a pension fund for ensuring security for those persons who have been serving in the unorganized sector
- Construction of old age homes and day care centres for every 34 districts
- Establishment of resource centres and reemployment bureaus for people above 60 years
- Concessional rail/air fares for travel within and between cities, i.e., 30% discount in train and 50% in Indian Airlines.
- Enacting legislation for ensuring compulsory geriatric care in all the public hospitals.
- Insurance for the elderly-
- Ayushmaan Bharat Scheme- It is the government’s health insurance scheme which includes various former schemes for the elderly such as Senior Citizen Health Insurance Scheme (SCHIS) and Rashtriya Swasthya Bima Yojana (RSBY).
- Rashtriya Arogya Nidhi (RAN)- The scheme provides financial assistance to patients, living below poverty line and who are suffering from major life threatening diseases, to receive medical treatment at any of the super speciality Hospitals/Institutes or other Government hospitals.
- LIC Insuranceschemes- It has been providing several schemes for aged persons like Jeevan Dhara Yojana, Jeevan Akshay Yojana and Medical Insurance Yojana.
- Maintenance and Welfare of Parents and Senior Citizens (MWPSC) Act, 2007-
- It was enacted to provide financial security, welfare and protection for senior citizens. It requires children to provide maintenance for their parents, and the government to provide old age homes and ensure medical care for senior citizens.
- Other steps-
- Tax benefits to elderly persons under Section- 88B, 88D and 88DDB of Income Tax Act.
- Government also proposed to allot 10% of the houses constructed under government schemes for the urban and rural lower income segments to the older persons on easy loan.
Challenges in utilising the full potential of elderly-
Despite the steps taken, there are certain challenges faced by the elderly which prevent them from utilising their full potential. It not only multiplies their problems, but also reflects elderly as liabilities not assets. Some challenges are-
- Economic problems-
- It includes problems such as loss of employment, income deficiency and economic insecurity. It makes them dependent than being as asset.
- Psychological problems-
- It includes problems related with their psychological and social maladjustment as well as the problem of elder abuse.
- The social isolation and alienation, felling of restlessness and absence of a daily schedule after retirement further accentuates this problem.
- Physical and physiological problems- It includes health and medical problems, nutritional deficiency, and the problem of adequate housing etc. It can be further seen in following aspects-
- Poor Health infrastructure-
- The challenge is to provide a quality, affordable and accessible health care facility. They need at home services like tele or home counselling, physiotherapy and rehabilitation services as well as mental health counselling.
- According to the 2016 Healthcare Access and Quality Index (HAQ), India improved its HAQ score from 24.7 in 1990 to 41.2 in 2016. However, it is still well below the global average of 54 points. The issue is worse in small towns and rural areas where the basic health care services are also inadequate.
- A 2007 law requires states to ensure designated facilities for the elderly in each district hospital, led by doctors with experience in geriatric care. Yet, a status report filed by the government in the Supreme Court in 2019 states that 16 states and union territories do not have a single ward/bed dedicated to the elderly
- Lack of health insurance-
- Health care for the elderly, unfortunately, has been greatly neglected. Further, the inability to earn and unaffordability of health services leads to a vicious life cycle of poor health and poverty. The government schemes that cover the elderly are largely inadequate.
- Despite Ayushman Bharat, the government’s health insurance scheme for the underprivileged and private health insurance, a NITI Aayog report suggests that 400 million Indians have no financial cover for health expenses, which includes a large number of elderly people. Both the Centre and the states have pension plans for the elderly, but they offer a nominal amount as low as ?350 to ?400 per month in some states. It is also not universal.
- Change in social value system-
- The changing institution of family, rise in nuclear families has made them more vulnerable, dependent on themselves and government.
- Factors such as family neglect, low education levels, socio-cultural beliefs and stigma, low trust and affordability in institutional health care services exacerbate problems for the elderly.
- Greater focus on young population-
- Due to large demographic dividend, the focus of government schemes is more on young population like promoting entrepreneurs, unemployment and poverty. While the COVID pandemic has brought elderly and children in the limelight, there is a lack of sustained focus on their needs.
Suggestive measures
The multiple strategies at different levels of policy making, planning and programming should be adopted to harness this vast human resource for promoting the involvement and participation of senior citizens in socio-economic development process on a larger scale. Some steps can be-
- Strengthened pension system: The need of the hour is to strengthen the pension systems through better funding and coverage.
- Holistic health infrastructure- Affordable and accessible health care with special health facilities for elderly at district level. Use of technology in preventive healthcare and counselling through telemedicine facilities can be of great use.
- Inclusion in economic development- There can be increase in retirement age based of performance and willingness can make them economically dependent and productive. It will also remove social isolation and alienation for the elderly.
- Social inclusion: Social inclusion through recognising their contribution in their respective fields and the society in general, can result in moral boosting and psychological benefits to the elderly.
- Awareness: Increasing awareness about laws, regulations and government schemes.