The ageing phenomenon is the most notable experience of this century with remarkable improvement in human longevity complemented by the lowest levels of reproduction. While its magnitude and multiplication may appear threatening, there are attempts at redefining this domain not merely in terms of age but other related functioning conditioned by the evolving expansion in longevity on one hand and evolving scenario of vulnerabilities on the other.
In Indian conditions, in particular, the four vulnerabilities of later ages in life course are in terms of restrictions in activities of daily living, multi-morbidity, poverty and absence of any income. On these counts, the Longitudinal Ageing Survey of India (LASI, 2017-18) reports that about 20% of the elderly population experience each of these vulnerabilities with widespread variation across the States. The remedial approach to address these vulnerabilities requires a multi-pronged approach involving the principles of inclusion and adoption of social security measures. Viewing these vulnerabilities as a life course phenomenon, promotion of life preparatory measures has to be put in place; this need not be limited to financial or economic independence per se but also means to ensure healthy active and productive years given the elongated life span owing to increased longevity. Most attempts at evaluation of the ageing phenomenon have maintained an individual focus, wherein the attributes and characteristics of the aged are counted more than circumstances and conditioning of later life.
The rising count of the elderly population need not be seen in isolation as the population transition is occurring along with a familial transition. While the familial transition is apparent in the reduction in average household size, this needs to be read in consideration of the household compositions and the accommodation pattern of the elderly within them. While there are households without elderly and households with multiple elderly, there are frequent instances of elderly living with elderly within the household. Not only is this living arrangement becoming more and more frequent but there are other features of dependence, care provisioning as well as social security and financial protection assuming prominence in households with elderly compared with those without them. This points to a persistence of vulnerabilities stated above in individual elderly arising simply out of the household features more than individual characteristics.
Contrasting today’s elderly with tomorrow’s elderly, there is every possibility of characteristic advantage in terms of education, life preparation and economic dependence on one hand but adversities in health and quality of living owing to rising longevity and emergence of long-term chronic ailments. In this context, the slogan of healthy ageing need not focus on the elderly population but the prospective elderly to a large extent. Limitations as regards activities of daily living (ADL) do show a worsening trend over age even among the elderly population but one wonders as to whether that pattern of rising intensity in this limitation will be moderated down among the future elderly and be postponed to much later ages of life. Health promotional measures among late-age adults need particular emphasis to ensure healthy ageing in future that would facilitate mainstreaming the elderly population in multiple productive spheres of activities.
The projected magnitude of the elderly population is estimated at 319 million by mid-century, growing by around 3% a year. This group will be feminine with a sex ratio of 1,065 females per thousand males; further, 54% of elderly women will be widows. While 6% of the elderly men live alone against 9% of their female counterparts, 70% of them are to be found in rural areas. These statistics can be of great use in terms of targeting welfare measures for this population.
The most disturbing feature relates to the health status that is reported to be poor by a quarter of the elderly as against about 20% among the population aged 45 and above. This trend is not encouraging as more and more are experiencing poor health early in life. While 75% of the elderly population are victims of one or more chronic diseases and 40% of those aged 45 and above have one or the other disability, there is a burden which by all means needs to be brought down in future. With the advent of the global burden of disease, it is apparent that the two threatening forces are diabetes and cancer which appear to be frequent among India’s elderly.
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Additionally, the new emerging concern relates to mental health with 20% of those aged above 45 self-reporting some ailment, primarily associated with depression; this is reasonably higher compared with the self-reported extent among the elderly.
There also appears to be food insecurity among India’s elderly where 6% of those above 45 years of age ate smaller portions or skipped meals and 5.3% of them did not eat despite being hungry. This phenomenon may look minimal but has its bearing on nutrition and consequential morbidities.
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Recognising these adversities, protection measures are in place in terms of welfare provisioning, legal recourse as well as concessional measures for this group of population. However, there is very little awareness regarding the welfare provisioning. Hardly 12% are aware of the Maintenance and Welfare of Parents and Senior Citizens Act, 2007 and 28% are aware of various concessions offered to the elderly. Schemes like IGNOAPS, IGNWPS and Annapurna have also limited awareness.
On the whole, there are very few expectations from life among India’s elderly in general and their insecurities and vulnerabilities make them victims of varied forms of abuse in the hands of family, community and society at large. While 5% of them report abuse, they are quite frequent, particularly for women in rural areas where they remain the most neglected. A movement towards creating social agency for this vulnerable group is the need of the hour. Innovative forms of institutions can be brought in place to alter their valuation from liability to an asset. With the transformation that is under way with youth mobility, digitalisation in all spheres of service delivery and visible exclusion in the social space, there needs to be a focus on ensuring an active life course for the future elderly. The elderly should qualify for the acronym Equip Life with Dreams Energy Renewal Longing and Yearn.
S. Irudaya Rajan is Chair at the International Institute of Migration and Development (IIMAD), Kerala. U. S. Mishra is Honorary Visiting Professor at the International Institute of Migration and Development (IIMAD), Kerala
