One of the deepest mysteries of today’s age are the reasons for people maintaining a healthy lifestyle. Is it to keep away signs of aging and look good or is it to make aging an easier and productive process? Given that the multi-billion-dollar anti-aging cosmetic industry is about looking young and living like the young it is not hard to believe that the former reason is on top of everyone’s mind. Thus today, more than ever, age is just a number. But no matter how long one can extend the façade of youth, the fact remains that everyone is aging.
According to the United Nations, globally the population of 65 years and older is the fastest growing demographic. By 2050 one in six will be over 65, today it is one in nine. Interestingly, 2018 saw for the first time in history persons aged 65 and above outnumbering the population of children under five. According to the World Health Organisation, by ‘2020, the number of people aged 60 years and older will outnumber children younger than 5 years’.
This points towards increasing life expectancy, proof of lives enhanced and protected by the advancement of science and technology. Besides longevity, the other reasons for an aging population is declining fertility rates and migration. There are economic and social ramifications to an aging population. For example, retirement benefits must be paid to pensioners for a longer period. Also, investments have to be made to cater to the needs of the elderly. These investments are not only in infrastructure but also in education to develop skills within society to cater to the needs of an aging population and elderly.
The pace of population aging is also increasing dramatically. According to the WHO ‘France had almost 150 years to adapt to a change from 10% to 20% in the proportion of the population that was older than 60 years.’ But, today countries like India and China have only 10 to 20 years.
The 2018-19 Economic Survey of India indicates that the population of Indians over 60 will increase from 104.2 million in 2011 to 239.4 million in 2041.To deal with this changing demography the government is thinking along the lines of increasing the retirement age and remodeling the education system.
The question is, is this enough?
Earlier, it was the joint family that ensured that the elderly were taken care of. However, education and search for employment, within India and abroad, has disrupted this tradition. The joint family ensured all forms of security for the elderly – everything from financial and physical to the psychological. The vacuum created by the dissolution of the joint family has yet to be filled. Worse still there is no single institution that can do so.
The issue of the elderly has many facets – health, safety, mobility, financial independence, well-being to name a few. These are not only different from other age groups but meeting them cannot be cloned from practices for other age groups. One has to think in terms of an eco-system when looking at ways to deal with an aging population and the elderly.
Take the issue of mobility. The elderly who are not physically mobile and or who do not have access to transport may not be able to access health support. They will also find it difficult to access their bank accounts. Lack of mobility also has a psychological effect as it can breed loneliness. This also becomes a safety issue.
As per the Geriatric Society of India there are only five institutions offering an MD in Geriatrics, and only 2 offering a post graduate diploma in geriatric medicine. Interestingly one does not need to have specialized in Geriatrics to become a member of the Geriatric Society. What does this prove?
This is nothing out of the ordinary. As per Indian philosophy the last two stages of an individual – vanaprastha, and sanyasa – are where the individual retires from society, family and possessions. It finally leads to renunciation of this world in preparation for the next. That the elderly are expected to take a step back from the everyday and prepare for the afterlife has seeped into our modern consciousness. Thus the abysmal infrastructure for them. Many old age homes are nothing but halfway houses. The focus is on religious activities and not mental and physical wellbeing of the inhabitants.
But things are changing. There is a housing market catering to elderly living segmented into Senior Living and Assisted Living. These places advertise the provision of health care, activities, serene and spacious environs. There are also organizations who provide care givers. Given the dearth of trained personnel specializing in geriatrics and gerontology one wonders whether these institutions assume that training to care for the elderly is similar to taking care of those with illnesses or those of other age groups. How well does this one-size-fits-all approach serve the aged?
One of the first initiatives targeted at the elderly was from the financial markets – institutional fixed deposits and bonds gave a higher interest rate for the elderly. Now, some banks have gone a step further and have started a service for the elderly to assist them in their banking activities. Also, there are startups focused on providing services to the elderly.
Unfortunately, these work in silos and there is much to be done too. For example, police in all cities should replicate the Delhi Police model of its personnel visiting the elderly. Infrastructure – everything from transport to access to buildings and education needs to incorporate the needs of a population that is aging.
It would not be wrong to say that Indian philosophy saw the elderly as unproductive. However, today this demographic is not only productive but are still invested in living to the fullest. In the end it is the mindset that needs to change first because the elderly are more than a new market. They are a mix of resource that can be tapped and a segment that over time will need assistance to fulfill their desire to live to their fullest.
(Samir Nazareth is an author and writes on socio-economic and environmental issues)
