Senior citizens, or those over the age of 60, are projected to touch 300 million by 2050 in India, more than double the number today. While the elderly struggle to cope with loss of agency and capacity, the real burden of ageing is borne by the ‘sandwich generation’—those in their forties and fifties who are raising children while caring for elderly parents, with little support for either task. Not all of India’s seniors need 24-hour care, but ageing does limit activity and energy levels, and they need assistance with chores as simple as regular doctor visits, managing household help, or buying groceries. Such responsibilities typically fall to women (daughters or daughters-in-law), which contributes to a glaring gender imbalance in India’s workforce and takes a toll on their mental and physical health. Elder care can be more demanding on both counts than raising children, a fact that is often overlooked: Childcare has a more rewarding goal, while elder care is about managing decline, which is dispiriting and could scar the caregiver. Without apt systems in place, ageing impacts two generations—the older and younger both.
Indians are living longer, but lack enabling social support for the elderly and palliative care options for those with illnesses, both of which would ease burdens on the young and old. Palliative care, unfortunately, is seen as end-of-life care in India, while it is actually an essential service to reduce suffering and improve the quality of life of people living with life-limiting diseases, ranging from arthritis, diabetes and kidney disease to chronic respiratory and heart disorders and curable cancers. Broadly, it also covers emotional and spiritual counselling for other forms of distress, such as frustration or grief on account of losing control over one’s life, a fate that many of us are ill-prepared to confront. In India, many doctors only prescribe palliative care once “there is no option left," after other expensive medical procedures and interventions have failed. The government, too, seems to subscribe to this point of view: All references to palliative care in the revised Operational Guidelines for National Programme for Prevention and Control of Non-Communicable Diseases for 2023-2030 (NP-NCD), released this summer, are in connection with terminal cancer. However, according to the Global Atlas of Palliative Care, 2020, the greatest need for such specialized care worldwide is generated by “non-malignant conditions." In other words, non-communicable ailments other than cancer call for the devotion of palliative resources too.
The long road we need to traverse involves taking a more accommodative approach to palliative care, softening attitudes of resistance to assisted-living facilities for the elderly, and accepting that ageing could be done smoothly if we only knew how. A strong social security and pension system that upholds the right to a life of dignity; robust public-private support services for senior citizens that provide both physical and emotional assistance; encouragement and training for those taking up careers in geriatric care, gerontology and allied fields; general guidance for households at large; and a carefully crafted palliative and elderly care policy will go a long way towards helping India’s aged live well, even as women caregivers get more time to pursue careers. While we celebrate the demographic dividend of India’s youth bulge and how it can boost our economy, we must also plan for the needs of the silver generation that has contributed no less to the country.
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India?s demography demands that we talk about ageing before it?s too late
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10.11.2023
Senior citizens, or those over the age of 60, are projected to touch 300 million by 2050 in India, more than double the number today. While the elderly struggle to cope with loss of agency and capacity, the real burden of ageing is borne by the ‘sandwich generation’—those in their forties and fifties who are raising children while caring for elderly parents, with little support for either task. Not all of India’s seniors need 24-hour care, but ageing does limit activity and energy levels, and they need assistance with chores as simple as regular doctor visits, managing household help, or buying groceries. Such responsibilities typically fall to women (daughters or daughters-in-law), which contributes to a glaring gender imbalance in India’s workforce and takes a toll on their mental and physical health. Elder care can be more demanding on both counts than raising children, a fact that is often overlooked:........
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