Uncertain Twilight | On ageing in India

Home is where the care is

Home alone: A resident at the Government Old Age Home run by Social Justice Department at Thevara, Kochi.

Home alone: A resident at the Government Old Age Home run by Social Justice Department at Thevara, Kochi.   | Photo Credit: H_Vibhu

Recent years have witnessed a slew of real estate projects mushrooming across the country, catering to the burgeoning demand for retirement homes. Yet the quality of accommodation options for the elderly varies significantly depending on income levels.

Victoria is able to smile, but it is no easy task for this octogenarian mother of four fated to live the last ten years with her husband George in an old age home.

Even the lack of privacy to grieve the loss of their only son to cancer hasn’t turned her spiteful. It is hardly two months since the 56-year-old died at a relief settlement a few kilometres away from the old age home.

“The separation from him was so painful. We consoled him promising to visit every now and then,” Ms. Victoria recollected as a thin film of tears betrayed the still lingering smile.

Notwithstanding that searing pain of separation, the couple had no other way but to vacate the rented house and move into the Government Old Age Home at Thevara after the burden of marrying off three daughters left them financially broke.

All 35 inmates at the Home run by the Social Justice Department have similar harrowing tales to share. Often, widowed mothers with daughters end up at the Home once the latter are married off, which in a way explains why there are 22 female inmates to 13 males, officials said.

Abandonment epidemic

With a never-ending queue of parents being abandoned by their children in this most literate State of the country, the Home with dormitories has run out of space forcing authorities to reject 10 to 12 inquiries a month.

Notwithstanding the construction of a new building with the capacity to accommodate 60 inmates, based on funding from the National Urban Livelihood Mission and running costs supported by the Corporation, residents could no longer be admitted directly after it became clear that uncaring children found it all too convenient a way to dump their ageing parents there and move on.

Now a detailed verification is made about the background of potential residents before admitting them. Besides, candidates recommended by the district collector and destitute persons brought in by police officers not below the rank of sub inspector are also admitted.

This epidemic of abandoning elderly parents in homes reflects the seriousness of the supply shortfall in affordable senior care homes.

Government provision

Public provision of housing for the elderly is on the rise, yet it has clearly been outpaced by the ageing of the population across Indian states. Data provided by Board of Control for Orphanages and other Charitable Homes in Kerala’s Department of Social Welfare suggest that the State has registered a three-fold increase in old age homes since 2011 compared to the previous three-and-a-half decades. Even from 2010-11 to 2015-16, official records suggests that the number of registered old homes has surged from nearly 391 to 574.

Of this, 228 old age homes are receiving government support. Each destitute elderly in these old age homes gets an assistance of ₹1,000 monthly.

Home is where the care is
 

Yet in a number of government-run homes, the inevitable overcrowding leads to fewer funds and facilities on offer for each resident, many of whom are quite poor to begin with, with little to no savings to lean upon.

For example, in Kerala the Ageing Survey 2014 prepared by S. Irudaya Rajan and U. S. Mishra of the Centre for Development Studies, Thiruvananthapuram, suggests that a significant number of elderly in the State who had earlier taken part in the formal activities are expected to be covered by pension and income security schemes to support themselves in their old age. However, this is not true in numerous cases, which suggests that the elderly have no option but to work in the informal sector even in their old age, a majority of whom are women.

Homes for the well-heeled

Nowhere is the starkness of income inequality more evident than in the differences between the quality of homes that the destitute elderly can access vis-à-vis the plusher, private-sector-driven accommodation available to the middle classes, mostly in five to ten acres plots in peripheral locations close to the cities.

Such units mostly consist of apartments and independent villas, typically with two bedrooms, and come with the caveat that occupants may live in these spaces as long as they wish to, yet they would not be allowed to sell or transfer it to their nominees as builders fear that it would change the objectives of a retirement home for the senior citizens and alter the ecosystem.

Although real estate prices vary considerably across India’s major metros, a typical studio apartment may require an up-front deposit somewhere in the range of ₹20 lakhs, whereas a one-bed facility would need a deposit of ₹25 lakhs.

Additionally, most of these accommodations demand a monthly rent in the range between ₹15,000 or higher, which would often include food, common utilities and preventive illness, but exclude medicine cost and unit level utilities. Of course the sky is the limit for luxury units, where monthly expenses would be in the range of ₹35,000 or considerably higher. Many builders of these homes are willing to refund around 60% to 80% of the deposit to the occupant or their nominees if they wish to move out from the project.

Mushrooming market?

According to a 2015 report by real estate consultancy Jones Lang LaSalle India, senior housing is a $60-billion industry worldwide. With Census projections suggesting that India would see a jump in the number of seniors from about 76 million in 2011 to 173 million by 2025, and about 240 million by 2050, it is quite likely that the size of real estate investments into senior housing will expand rapidly in years to come. Yet the assumption here is that the elderly in India will increasingly also seek to reside in specialised homes for senior citizens, and that is not entirely supported by the patterns of old-age dependency data that is available so far.

As per the National Sample Survey Organisation’s 60th round in 2004, nearly 3% of persons aged above 60 years were living alone, the number of elderly living with their spouse only is 9.3 %, and those living with their children amount to 35.6 %. This likely does not include those who are homeless or destitute, a cohort that could well be a sizeable proportion of the total elderly population. In that case the rise of the senior housing concept as conceived by the private sector will, if it is to gain traction and provide options for the elderly at multiple income tiers, have to focus on affordability, building social acceptance of living in care homes, creating a legal and regulatory framework to ensure that in such environments the security and dignity of the elderly is protected, and critically, ensuring that sufficiently skilled manpower, including nurses and medical professionals, are trained, certified, deployed and monitored in these institutions.

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Printable version | May 31, 2020 9:14:11 AM | https://www.thehindu.com/news/national/home-is-where-the-care-is/article17330534.ece

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