Increasingly, Tier II cities like Tiruchi and Madurai are attracting senior citizen service providers.

A recent report by Global Age Watch Index (GAWI) ranked India as 73rd in senior care. With the UN-backed study estimating India’s over-60s population set to become the second largest in the world, the low rank only outlines the vacuum in the care and rehabilitation of the elderly.

In Tamil Nadu, facilities for senior citizens who are no longer living their families are unevenly developed — from homes for destitute elderly to upscale ‘retirement colonies’ modelled on gated community living.

Increasingly, Tier II cities like Tiruchi and Madurai are attracting senior citizen service providers, serving the age group of 60-70-year-olds.

Paid old age homes charge anywhere from Rs.3000 to Rs.12,000 depending on the facilities.

Shelter for destitute

Tiruchi has over a dozen listed old age homes, most of them allied to social service organisations. Among the oldest here is St. Anthony’s Home for the Aged in Kattur. Inaugurated in 1964, the home accepts elderly people who have been abandoned by their children or are sent in by the police or social workers.

Set right next to St. Anthony’s Nursery and Primary school, the noise of the schoolchildren contrasts the silence of the slumbering inmates within the home.

Sister Arul and her colleague Sister Thenmozhi, a medical nurse, are among the nine nuns in charge of the elderly, taking them through a daily simple routine of prayer, meals and medical care.

With a major renovation going on ahead of the home’s 50th anniversary next June, the inmates have had to move around a bit within the campus to accommodate the builders.

Many of them have psychological problems readjusting to their isolation, and often go into deep depression over their lost past, says Sister Arul. Sometimes, there is age-related mental decline. “Some will forget and take somebody else’s plate and start fighting,” she adds. “Some will refuse to take bath, so we have to keep compelling them.

“Children can be changed, and taught new values, not old people,” says Sister Arul. “All we can do is to feed them, shelter them and give them a peaceful life before they meet their God.”

The home is open to people of all faiths, but doesn’t accept those with contagious diseases as the inmates are housed in dormitories.

In the event of an inmate’s death, the home hands over the body to relatives if they are traceable or conducts the burial. “Earlier, I used to refuse to give the body to relatives who had never bothered to visit the person in the home when he or she was alive. Some people come only if there is a chance of inheriting something from the dead person. But now, I think, why should I stop someone from making peace with their relative at least in death? Besides, Kattur’s inclusion in the Tiruchi Corporation limits has increased the paperwork for getting death certificates. We cannot spare that much time, so we allow families to reclaim their relative’s body more easily now.”

The government’s assistance takes the form of food grants — 855 kg of ration rice, 40 kg of sugar and 95 kg of wheat every year. But even for this, the licence has to be renewed annually, a paper chase that takes three months to complete.

“We are depending solely on God. He knows to feed His own people. Somebody or the other comes forward to donate a sum to the home,” says Sister Arul.

Serving seniors

For Shakila Banu, starting the Happy Home for Old Age in a rented house was the culmination of a long-held desire to do something concrete for the elderly in Tiruchi.

Her four-bedroom Khaja Nagar enterprise is six months old, and for now, the married B.Sc Maths graduate doubles up as manager and care-giver to the 15 people who live in the home.

Old people with no major health problems can join up for a Rs.5000 fee (which includes laundry service), while those who are bedridden and need medical attention have to pay Rs. 10,000.

Shakila Banu employs a cook to prepare three vegetarian meals, while carrying out the other chores — bathing the residents, cleaning up and attending to administrative work — all by herself. A television and newspaper are the main source of entertainment for the inmates.

“I have learned that we should be regular in our service, and careful with how we deal with the seniors,” says Shakila Banu. “We house three members per room, and they generally take care of their areas themselves. Our oldest member is in the 80s.”

Still awaiting certification for the home, Shakila Banu says she feels sad to see people in a desperate situation in their twilight years. Of the 15 inmates, only nine have paid their fees. “We are helping the rest. We try not to turn away anyone, but it is hard to maintain a good home without adequate support.”

Planned retirement

Geared towards the more market-aware and well-travelled professional contemplating retirement are real estate projects like Ponni Delta on the banks of the Cauvery close to Srirangam.

The project, promoted by Natesan Builders, is offering 106 retirement homes and 130 apartments, with maintenance and security controlled by the management. “We cannot be compared to old age homes,” avers Mr. Hari, one of the project’s directors. “Our customers are usually people who have travelled the world and would like to settle down in a place that resembles their ancestral village, but with better infrastructure.”

So far, 68 units of the project, started in 2009, have been handed over, and another 200 are nearing completion this year. As many as 20 of the homes, priced between Rs. 40 lakhs and Rs. 60 lakhs, are occupied.

“We are moving from a phase of old age homes for the destitute to independent living facilities for senior citizens, says Mr. Hari. “And while real estate costs are high in the metros, pushing retirement colonies at least 40 km outside city limits, in Tier II cities like Tiruchi or Madurai, it is still possible to be located at the heart of the city and have easy access to healthcare providers.

“What we need now is to lose the stigma of being a retirement colony or old age home. Our customers are not here because they don’t have anyone to take care of them. They have made a conscious choice to look outside the family for support and a fruitful old age,” he says.

The breakdown of the joint family and a declining fertility rate are most commonly cited as the reasons for the abandonment of senior citizens in India.

“Even those with a low income are ready to pay a minimal amount for the old age homes that will take care of their parents,” says Mr. K.V. Vijayaprakash, Manager, HelpAge India project office in Madurai.

The non-profit organisation gives pre-retirement training to workers above the age of 45 years focusing on finance management, healthcare and even legal issues related to wills.

Senior citizens living alone are often targeted by criminals, says Mr. Vijayaprakash. For the first time in the state, Madurai District Superintendent of Police Mr.V.Balakrishnan, IPS, has appointed elderly volunteers in each and every police station of Madurai District (Rural) as per the guidance of the Tamil Nadu Maintenance and Welfare of Parents and Senior Citizens Rules, 2009, (Act-2007).

As the market for elderly care evolves in India, more people could expect a happy glow in the evening of their lives.