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Old age homes as a fact of life

A look at certain aspects of the rising number of facilities for the elderly

There have been many transformations in recent years that have had an impact on society in different sectors – societal, financial and personal. Lifestyles have changed, some for the better and a few with negative consequences. The population in general has been reaping the benefits, and mostly those from the younger generation have been able to realise many of their dreams and develop their careers in a better fashion than was possible earlier.

However, the senior citizens, referred to as elders, face certain problems as a consequence of the social transformation. This is reflected in the transition from the traditional ways of life to modern patterns, which require many compromises and adjustments. One of these involve old age homes (OAHs). What is the genesis of old age homes and how have they changed life patterns for the elders? These questions need to be examined dispassionately.

To understand the concept of OAHs, one has to go back in time five to six decades to see the life pattern of elders and chronologically trace the developments that led to the slow yet steady changes that were necessitated by circumstances. There was the much-acclaimed joint family or extended family system wherein elders lived with not only their children but also with their brothers, sisters or uncles and aunts in nearby houses, mostly in villages or in small towns. They all used to live close by, helping each other for many purposes, be it happy small events or big occasions like marriages. Everyone was close at hand for any emergencies such as health problems or deaths. Thus, the social fabric was well-woven and due respect was given to elders. This system enabled elders to lead reasonably happy lives with hardly any tension, as they had the confidence that someone would take care of them when needed. Whenever there was some health issues for an elder, the whole family would run around to attend to all needs, rendering medical to personal assistance. With perfect understanding on caring and sharing the duties, the elders did not feel let down or lonely.

Another major blessing in those days was the system of a ‘family doctor’: each family would have a friendly physician who would be ready to visit houses whenever someone was unwell. Besides medical attention, the doctor would instill confidence with pleasant words of encouragement, which would in itself often cure the illness. Thus, a close, well-knit family system served wonderfully the elders in particular and all others in times of need. In those days when most of the deliveries used to be at home, the doctor was easily available to attend to the woman members of the family.

The scenario changed slowly and steadily with the decline or disappearance of the joint family system, which was replaced by the nuclear family system. A 50-year analysis would reveal the great transformation. Many reasons may be attributed for this change, which reflected not only the whole family set-up but also the life pattern of elders, who became dependent, partially or totally. The major factor was the disintegration of families, necessitated by the migration of sons and daughters, as also relatives from their places of birth to towns and cities in search of greener pastures. This was for education, jobs, career enhancement, marriage, amenities and improved lifestyles. While the younger generation had no difficulty in moving out of the house and adjusting themselves to new environs and adapting to new ways of life, it the elderly population found the change to be a hardship. For them, to move away from their own places with attached sentiments, comforts and property holdings, and a fairly happy life, to new environs in the cities was tough. But they had to sacrifice and compromise for the sake of their children and for their own security — financial, health and social. So, the stage was set for new life pattern of life for elders. Are they all in the same life system with their children? What are the variations and problems they face?

The patterns

There are five patterns that elders today face generally, which are situation-dependent. In one, elders stay with children in the same house in the city, which ensures financial and health security. In another situation, they live alone in a separate house with children living elsewhere in the city, considering proximity to places of work or the educational needs of children. Here, the family members visit the parents once a week or when any health problems necessitate their presence. In a third scenario, elders stay alone in a town or city while the children live in faraway cities for employment; the children visit once in a few months for occasions or emergencies of health.

In a fourth pattern, elders live all alone in the city, the children having migrated to foreign countries or for higher education, jobs and so on. The children will be living settled and comfortable lives with family and children, with all material comforts. They will visit the elders once in two or three years; this situation causes health-related and emotional insecurities, though the elders will be financially sound thanks to foreign remittances. In another pattern, elders live with relatives or in old age homes, either with spouse or alone, with financial, health and emotional insecurity. Elders, both men and women, who remained single without marriage invariably landed in OAHs. Each of these situations has its own merits and demerits. While many elders accept the change, others are unable to adjust, and start grumbling and sulking, which is understandable considering the age and exposure to circumstances.

Among the estimated population of over 10 crore in the country in the age range of 65 and above, at least 10 to 20% will be above 75 who face health problems to different degrees. Due to personal compulsions many have emigrated and stay with children mostly in the United States. But some are unable to travel owing to health reasons such as immobility or other personal reasons, and go in search of OAHs.

Genesis of old age homes

Each family has its own problems, with a single child or two or many sons and daughters to look after parents. As they give priority to their own lives with a bright future, many children face the embarrassment of taking care of their parents. Here comes the question of whether to stay back in the country to provide a comfortable life for parents in their advanced age or to migrate to other countries. Attracted by advanced technologies that provide opportunities to prosper in life and by materialistic benefits, many youngsters migrate to greener pastures, leaving behind parents to take care of themselves or with relatives. In the absence of either option, the choice is to leave the elders in OAHs under the care of others who manage the system. Thus OAHs were born to help chiefly the non-resident Indians (NRIs), to relieve them of the tension of leaving behind parents under the care of someone outside the family system. So, the OAHs were a concomitant of the emergence of the nuclear family system.

Having said that, it must be admitted that there are sons and daughters in some families who do not want to leave their aged parents and prefer to take care of them until their last breath, by opting to remain in the country with the satisfaction of whatever employment and other benefits they have commensurate with their education and qualifications. Thus, the mindset of children varies widely and parents have learnt to compromise with the given situation.

Life in OAHs

Just as in the case of systems in other sectors, OAHs have also become highly commercialised. There has been a virtual mushrooming of OAHs in recent years. It has become a lucrative business, thanks to the NRIs who are prepared to shell out huge deposits to admit their helpless parents in OAHs. The cost of providing accommodation, food, comforts and medical help is high.

A cursory glance at the number of OAHs in the country reveal that there are different categories of them to cater to the needs of elders, depending on the payment capacity. While some OAHs seem to provide good facilities, others lack such comforts. It is not that all elders are taken care of well by the managements. Some of them impose restrictions. The food served is reported to be of low quality and deficient in quantity in many of them. A recent newspaper report spoke of how a poor elder in an OAH was beaten for asking for more food. So also their bedrooms and toilets are often poorly maintained. Some of the managements do not utilise payments made to them by children in India and abroad, leaving the helpless parents in the lurch.

Such abuse and misuse of OAHs come to the limelight often, but seldom is action taken to rectify the situation. There are some well-managed OAHs too, though they are very costly.

Thus, most of the elders in OAHs are not very happy, confined as they are to isolation. Unfortunately, children are unable to come on time when parents fall sick or even die in OAHs. But there are some elders who feel comfortable in OAHs for the freedom and friendly atmosphere with other elders who keep them company, enjoying the time with TV, games and gossip. They show some detachment from family members and feel more secure in OAHs and avoid a restricted life with their children.

The life of elders in the present age is full of problems, both for themselves and for the children. The fortunate few depart with satisfaction and peace of mind, while others leave with an unhappy state of mind. Meanwhile, the OAHs have come to be a part of our social system.

rajvel44@gmail.com

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Printable version | Jun 1, 2020 3:45:46 PM | https://www.thehindu.com/opinion/open-page/old-age-homes-as-a-fact-of-life/article19523768.ece

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