Wrinkles should merely indicate where smiles have been.
— Mark Twain, in Following the Equator
Every living thing has to age, that is the raw truth of life. Ageing simply denotes one growing older, developing or maturing. The process involves progressive changes occurring in the body’s ability to generate, produce and replace healthy new cells. Over time, ageing affects every cell in every organ, structure and tissue in the body. The process varies from person to person and there isn’t an accurate way to determine or measure the rate or degree of ageing.
A National Policy on Older Persons exists but is yet to be implemented fully India. It was announced by the government in 1999 in pursuance of a UN General Assembly Resolution and in keeping with the assurances held out to older persons in the Constitution. The year 1999 was observed as the International Year of Older Persons.
The well-being of senior citizens is mandated in the Constitution of India under Article 41: “The state shall, within the limits of its economic capacity and development, make effective provision for securing the right to public assistance in cases of old age. The Right to Equality is guaranteed by the Constitution as a fundamental right. Social security is the concurrent responsibility of the central and state governments”.
The following are some questions to ponder over. Why does ageing occur? Who says old age cannot be combated? What kind of support systems or facilities is available for the elderly? How can we make the younger generation aware of the necessity to be responsive to the needs of the elderly? Who says old age is not a joy?
We seldom give much thought, at last when we are young, to growing old but it may be surprising to learn that of the many physiological effects of ageing occur much earlier than you might think. However, at some point we begin to see and feel the effects of changes, such as wrinkles and grey hairs, and some degree of physical decline, for example, aches and pains, weight issues, diabetes, high blood pressure and cardiovascular problems. It affects every aspect of our lives, physical, physiological, mental and emotional.
Ageing is a life-long process and taking proper care of ourselves and making healthy lifestyle choices at every stage of life can go a long way towards helping us live longer and reducing the risk of disability.
Health and medical facilities
The healthcare of the rural elderly is one of the biggest challenges facing the Health Ministry. With more than 70% of the elderly population living in rural areas being able to access only a low level of health facilities, mortality rates due to disease is high. Facilities for elder care in rural and urban India are still virtually non-existent in general, and many cases go unattended.
Look at the situation at the All India Institute of Medical Sciences in New Delhi. The facilities are overburdened. Rural citizens often wait for days together to get an appointment. However, let me concede that once they get the attention of the doctor they are looked after well. There are excellent physiotherapy and geriatric departments here, and easy access to the doctor.
But how many rural residents can come to such hospitals from the villages to access treatment, financially weak as they are. Building such hospitals in every village is difficult. To make things work, for the benefit of the elderly mobile clinics going to villages twice a week would be of much use. Thus, medical aid should reach their doorsteps. The need of the hour is also an emergency ambulance service, ramps in hospitals for mobility challenged and elderly patients to move about freely to access the services available and a single-window facility wherein all the services are made available.
Loneliness
Along with age often comes loneliness, a serious problem among elderly people, which is largely an urban phenomenon. Those living in rural areas generally have immediate family members who play the role of providers of social security. The feeling of being deprived of company and love makes elders reclusive. They suffer ailments that indicate depression, causing mental and physical deterioration.
Loneliness can be overcome through certain initiatives. The elderly should make efforts to make friends and meet new people, the kind one can turn to for emotional support. Volunteering time and talent can help put one’s own situation in perspective, bringing to light the positives. They could check with local senior centres and hospitals for opportunities to volunteer. Hobbies can keep them motivated and forward-thinking; they can help set goals. They could adopt a pet for company; caring for a pet can renew the meaning and purpose of one’s life. They should recall aspects of their past life, which will enhance their emotional health. This will make an individual less likely to be lonely or withdrawn.
If they are home-bound, meeting people can be particularly difficult. Continuous rapport-building and networking with non-governmental agencies in the area, or places of worship, could yield information about home visitation services. Provision of community transport facilities for the elderly will make them more mobile. Engaging in small income-generation activities will help seniors earn some pocket money.
Pension schemes
In India we have a lot of ambitious schemes, ambitious paperwork, ambitious seminars and workshops, and so on. But all these do not reach the elderly to promote their health. Schemes are often not implemented. The situation is so pathetic that out of 70% of the total elderly population only 18% have access to pension, and only a quarter of widowed elderly women benefit from the widow pension scheme, as was revealed in a report released by the United Nations Population Fund (UNFPA)
However, the tedious process of standing in long queues and filling up numerous forms makes it stressful for the elderly person. They will normally have health conditions and restricted mobility. Sometimes it takes a day’s work to get their pension amount each time. The shifting of the duly filled forms from one counter to the other is time-consuming and exhausting for the senior citizen. Can thoughts be woven around these issues to create a simple technology to access pension funds and make withdrawals without the elderly having to undergo lengthy processes?
Responsibilities of the young
In Singapore, every young person who takes care of elderly people gets a rebate in income tax. The Government of India is yet to come up with such policy initiatives.
Very few Indian parents are seen to lodge complaints about ill-treatment by children; they quietly suffer within the four walls of their home. Hence in the relevant Act a clause to ensure secrecy of proceedings should be included. The onus should not be put on the parents.
Old-age is joy
Today at 80, in spite of my immobility, I feel joy and happiness in voluntary service. Every elderly human being can make life a joyful experience by sharing and caring, trying to work for someone else — daily for some hours at least.
Nowadays virtually every home has access to TV and every elderly person can enjoy watching it for a few hours. They can have congenial relations with neighbours and interactions with them will improve morale.
The gathering in a chaupal in villages is indeed rehabilitation for the elderly. Here they can spend time together to catch up on news, play games or do something creative to keep them abreast of current developments. There should be a senior citizens’ club in every area, which is easily accessible and safe for members to take a leisurely walk and take part in activities organised for them, by them. Get-togethers in these clubs on holidays and festivals should be occasions for participation by the elderly of the area where they reside. The senior citizens’ club or community centre should have facilities and services to teach the rudiments of using a computer, arts and craft and pottery-related activities to keep minds occupied. The requirement of physical exercise will also be taken care of through these activities.
(Dr. Mohini Giri is the founder-chairperson of the Guild of Service)
