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India Today
    CURRENT ISSUE JULY 16, 2007
 
  COVER STORY: AGEING PARENTS
 

Home Alone

The old feel isolated and uncared for as India greys. An agonising life crisis grips families as the younger generation struggles to look after ageing parents. New adjustments and equations are being forged. but the disquiet remains.

 
  PICTURE SPEAK
“I have seen a lot of life. Today the rosary is my only companion. I pray for myself and for everyone around me.”
FERDINAND FIDELIS MOVED INTO the old-age home, run by the Little Sisters of the Poor in Chennai, 10 years ago. His three daughters and grandchildren live in and around the city.
27 million elderly are ill, need specialised care.
Do I know you?” asks her dad. They are sitting at a table in a brasserie. She is nursing a margarita, her dad’s got a mint chocolate milk—a Sunday ritual ever since her mother died two years ago, the flat in Mumbai was sold off and dad was moved to Bangalore at age 83. But after a fall last summer, her once-workaholic father seems to have lost his bearings. He has trouble recognising faces, even his own in a mirror—a brain disorder. “Dad, it’s me, your daughter,” she thinks she can reason him out of this. But his eyes—clouded by cataracts—stare forlornly back. He looks sad, confused. All around them there are happy faces—the messy, charming chaos of family life—men and women lounging, a toddler crying. She sets the drink down and stares blindly at the back of his beloved, weathered hands.

She’s hardly the only one. It has become this generation’s latest, and in some ways most agonising, life crisis: what to do when the parents who once took care of you can no longer look after themselves? The age-wave is mounting. With one elderly in every 12, India is poised to become the second largest hub of seniors in the world. There are eight million aged over 80, 29 million 70-plus and 77 million above 60. In urban areas, 64 per cent elderly women and 46 per cent men are fully dependent—for food, clothing and healthcare—on others. About 10 per cent do not have anyone to take care of them. The number of elderly, ill and in need of care, is over 27 million.

  PICTURE SPEAK
“All my life I cared for everyone. At 86, I was terrified of being left alone. My third child gave me back a home.”
HUSBAND’S DEATH AND FAILING eyesight have not dampened Satyavati Suri’s spirit. She enjoys every moment of her new life with daughter Neelam Rallan in Mumbai.

Consider Delhi’s Daljit Singh and Swarn Mongia. Their three daughters live in the US and e-mails have become a way of life. At least, ever since their parents decided to return the Green Cards, sell off the Panchsheel Park flat and settle down in a home for the aged at Dwarka. They were upset (“Why do you have to go and settle down in an ashram?”). But after 10 years of toing and froing between India and the US, enough was enough for them.

“We didn’t want a life of total dependence on children,” says Mongia, 82. “There, we had no friends our age, too,” adds his wife, 78. There is no dearth of companionship now. At dusk, as fellow residents gather in their comfortable room, the children, too, keep them company—from the massive guilded photo collage on the wall capturing every landmark in their 59 years of togetherness.

The age CRISIS
Isn’t India a youthful nation in a fast-ageing world? New research bursts the bubble. Urban India and the South are greying fast.

Life expectancy has shot up. With one grey in every 12, India is the second largest global hub of seniors.

The rapid greying is working on an “astonishingly low” per capita GDP. Over 70 per cent elders are fully dependent.

Lives are busy, women are working. Personal choice and privacy are the buzzwords. This generation is less inclined or able to care for parents.

With young people migrating in search of better prospects, caring for the old has become an elusive ideal. Over 7 per cent of elderly couples live on their own.

11% have no young people staying with them.

50% elderly widows are living alone in India.

Caring COUNTRIES

CANADA: Take care of your old parents, get a tax rebate. You can also get a six-week compassionate leave.

DENMARK: Do-it-yourself retirement communities, with shared facilities, are all the rage here.

NORWAY: Thousands are taking cures at a growing number of geriatric centres off the Spanish coast, run by Norwegian municipalities.

JAPAN: An array of gadgets. Say, an ‘online’ kettle that automatically sends e-mails to three recipients when it is switched on. Or a robotic talking doll that tells its elderly owner: “I love you.”

US: Need Help? Ask your employer. Companies are adding elder-care benefits to stop absenteeism and workdays lost due to ailing parents.

64% urban elderly women are fully dependent.

30% of seniors seek medical help of some sort.

 

  PICTURE SPEAK
“I am chasing a dream. The plan is to build a spot for the seniors where they can celebrate old age.”
SARASA VASUDEVAN HAS PULLED together the combined energies of her mother, mother-in-law and her teenage daughter to build a multi-facility old-age home near Bangalore.

“In a country famous for taking care of its old, there is an urgent talk of the greying of India,” stresses economist C.P. Chandrasekhar of Jawaharlal Nehru University (JNU). Life expectancy has shot up, from 23 at the turn of the century to 65 years and death rates have fallen, from 25 per thousand to eight. But, he adds, “The elderly forms one of the most vulnerable groups in the economy.” Police files report skyrocketing crime rates against them. Hardly a day goes by without a horror story in the media about the plight of elderly parents—abandoned or abused. The Government is sitting up and taking note. The Maintenance and Welfare of Parents and Senior Citizens Bill, 2007, which makes neglect of parents above age 60 punishable, is waiting in the wings. The Reverse Mortgage system, an ideal way for senior citizens to extract value out of their property, has just come into force.

But isn’t India one of the most youthful nations in a fast-ageing world? New research bursts the bubble. Age-wise there are “two Indias”: one that’ll stay youthful over the next 20 years; the other that has already embarked on rapid greying, points out Nicholas Eberstadt in the latest issue of Policy Review, one of America’s leading journals. India’s huge urban centres and much of south India are facing an old-age wave, add P.N. Mari Bhat of Delhi University and Tim Dyson of the London School of Economics. What’s more, India is facing the onset of rapid greying on a per capita GDP that is “astonishingly low” by any international or historical benchmark. “There’s no well thought-out policy for them,” reports S. Irudaya Rajan of the Centre for Development Studies, Thiruvananthapuram—a theme he explores in India’s Elderly: Burden or Challenge.

  PICTURE SPEAK
I keep telling myself, it is payback time. I am where I am because of them all.
IT’S ROUGHER FOR THE SANDWICH generation. With a blooming career, growing children and ailing parents-in-law, Geeta Vemuganti (left) of Hyderabad has too many balls to juggle.
We did not want total dependence on children. In the US, they have busy lives. We had no friends our age.
AFTER 10 YEARS OF TOING AND FROING between India and the US, Daljit Singh and Swarn Mongia settled down in an old-age home in Delhi. They certainly don’t lack friends now.

No wonder, the elderly are talking. Listen to their voice in the 2002 World Health Organisation’s (who) country report. They are talking about their lack of access to money, work, health, mobility and leisure. They are narrating how it feels to “talk to walls”, “be a burden on children”, of disrespect and neglect that make “old age a disease”. They are telling tales about the younger generation: of children splitting responsibility by separating mom and dad, taking care of parents “by rotation”, pushing parents to smaller rooms. And they blame it all on the “changing scenario and value system” that “exist everywhere” and not just their homes.

Old age BLUES
What do the affluent lot fear the most? Time— loneliness, lack of work and poor leisure hours.

Insufficient economic resources and dependence on children hurt middle classes the most.

Lower classes fret about poor health, disease, lack of mobility and living alone with disability.

Disrespect, neglect, abuse and humiliation make old age a ‘disease’, feel all seniors.
Source: Elder Abuse In India, WHO Country Report by HelpAge, 2002

That poses a problem for the younger generation. From office canteens to well-appointed drawing rooms to cyber space, they are talking, too: how to take care of mom and dad. “The post-globalisation generation hasn’t really experienced a great deal of hardship,” says sociologist Manas Ray, fellow at the Centre for Studies in Social Sciences in Kolkata. “They haven’t faced the trauma of the Partition or the economic crunch of the post-Independence era. For most, this is the first really rough patch in their lives.” They belong to a New India, where Gandhian frugality is passé. They shop in malls, patronise private schools and hospitals, and relax in gyms and spas. “They want to be rich, live rich, and they are willing to work hard for it,” he adds. Careers—especially, women’s—are blooming. As lives become busier, there is less time to look after the home. Ambereen Ali Shah, a pr professional who is also doing her PhD at JNU, agrees: “Whenever we meet up, my friends talk about sibling squabbles and accusations of who’s not spending enough time with mom and dad. And we all end up feeling guilty.”

It can be rougher for those who are facing the dual pressures of the “sandwich generation”—raising young children and caring for ageing parents. When Geeta Vemuganti began working at the L.V. Prasad Eye Institute in Hyderabad, her biggest worry was if her 10-year-old daughter would manage to braid up her hair for school on her own. “I had to be at work by 7 a.m. most days,” she recalls. Today, she heads ophthalmic pathology and her daughter is an independent teenager, but reaching office by seven is still a hassle: “My father-in-law needs me the most in the mornings—to check his blood pressure or pulse rate or just to talk.” With growing children, a demanding career, parents-in-law at home, a widowed mother staying close-by and constant travel, her life is more than full. “Sometimes, I feel, I have too many balls to juggle,” she smiles. “I keep telling myself, it’s payback time. I am where I am because of them all.”

FACING THE BIG EMPTY
What does it mean to grow old? Seniors talk about loneliness...

Why do you feel lonely?

26%
Retirement

41%
Spouse died

33%
Children moved away

Can you avoid loneliness?

50%
Plan life in advance

15%
Unavoidable

35%
Partially Avoidable

How do you deal with loneliness?

65% Maintain an active social life

9%
Start an enterprise

26%
Community activities

Source: HelpAge survey, 2004, on 500 seniors, age 70-85, in Delhi and Mumbai

71% men own assets, lack self-reliance.

70% of the elderly are supported by their children.

Ever since her father passed away in 1987, Monmoyee Basu wanted her mother to find home with her and her bureaucrat husband in Delhi. “Although she didn’t really like living by herself,” says the 40-something historian with Hansraj College, “my mother didn’t have the emotional strength to deal with a life-swap on top of her grief.” (Basu may not know, but that decision put her mother in Census 2001 as one of the 50 per cent elderly widows living alone.) Over the years, they have been inviting her to move in with them. “But she misses the familiarity of her neighbourhood, the quiet pace of her life, and feels isolated here.” The daughter manages to spend summer vacations with her mother. Rest of the time, she suffers spikes of anxiety and banks on the telephone to stay tuned to her mom’s wellbeing and needs.

Police records reveal, her anxiety is not unfounded. The number of elderly seeking protection in Delhi has jumped three times in the last 18 months. They fear goons, builders and even their own children. The Mumbai police helpline for senior folks gets over 80 calls a day—from medical and travel information, simple advice to friendly chats to ease loneliness. In Hyderabad, constables are doing the rounds with newspaper hawkers each morning to keep a tab on the elderly. In Bangalore and Chennai, the police are busy locating senior citizens living alone. Delhi and Kolkata have launched police verification schemes for domestic help in right earnest. In Chennai, the police have revived bicycle patrolling in the evenings, while in Pune they are dropping by once a week to lend the elderly an empathetic ear.

“We are getting increasing reports of neglect and abuse of the old,” says Mathew Cherian, CEO, HelpAge India. The helplines it runs get hundreds of calls from seniors suffering serious neglect or seeking relief from abusive children. “Often they report that children have turned against them once family property has been signed over,” Cherian says. Families where everyone works lock up Alzheimer’s patients and leave for the day, he says, lest they get lost. Neighbours sometimes call in to report about well-dressed old people suddenly living in the neighbourhood park after being tossed out of home.

Take the case of a 70-year-old widower in Delhi. A retired government servant, he is economically self-reliant with his budding homeopathy practice. He owns the flat where he lives with his only son and his family. Still he has to wait endlessly for meals, which rarely suit his age, taste or timings. If he complains, it creates disharmony without serving any purpose. If he comments on any household issue, he is told to mind his own business. In disgust, he has asked his son to leave the house, but to no avail. The who report says, it upsets parents to admit to ‘abuse’.

Failing health is the other major concern that now-generation worries over. Soon after her father passed away in March 2006, it became clear to Neelam Rallan of Mumbai that her mother, Satyavati Suri, 86, would need a new home. Ever since the family migrated from Lahore in 1944, Delhi was home—even during those difficult years when her husband was ailing. But being alone is just not an option: Suri is losing her vision. The Census shows that one out of every two elderly suffers from at least one chronic disease that requires lifelong medication. Check out the range: nearly 50 per cent report arthritis, 40 per cent hypertension, 30 per cent hearing impairment, 40 per cent defective vision, 10 per cent diabetes; 89 out of every 1,000 are mentally ill (No wonder, cases of suicide among the elderly living alone are reported so often). “In developed countries, utilisation of healthcare by elders is on the rise,” reports Satyajit Chakraborty, who studied health-seeking behaviour of the elderly at the Achutha Menon Centre for Health Science Studies at Thiruvananthapuram. “But here most are economically dependent and the cost of treatment often proves to be a burden on the household.” Only 30 per cent seniors seek treatment in India.

Health, as always, is linked to wealth. And the elderly are caught in an unfair financial squeeze: the high levels of economic dependence on others, especially for women. “Of the dependent elderly, support comes mostly from the children,” points out Professor Indrani Gupta of Delhi University’s Institute of Economic Growth. The National Sample Survey (NSS) data indicates that more than 70 per cent of the elderly are supported by their children. In a country where only 11 per cent of the population has any sort of guaranteed retirement income, the number of economically active elderly has gone up from 10 million in 1950 to 26 million in 2000. But the catch lies elsewhere. “Economic dependency does not necessarily mean that the elderly owns no assets,” adds Gupta. The NSS data shows, around 71 per cent of elderly men and 40 per cent of women own some financial assets. “Mere ownership, however, doesn’t guarantee economic self-reliance,” Gupta points out. The new reverse mortgage system, which will allow a senior citizen to mortgage property based on its valuation, may stand them in good stead in the future. For instance, if the assessed value of a flat—eligible for reverse mortgage—is Rs 8 lakh, it would yield approximately Rs 5,000 per month.

  PICTURE SPEAK
“I feel comfortable in the world I am familiar with. There’s a sense of freedom in knowing the life that runs around you.”
THE PHONE IS THE LIFELINE for Geeta Ghosh of Kolkata. She has not relented so far to her daughter’s invitation to find home with her family in Delhi.

Two decades ago, caring for the elderly was hardly an issue. “Joint family was a good place to be very old and very young,” says Professor N.K. Chadha of Delhi University, who specialises in gerontology. But in a globalised world, joint households are falling by the wayside. The great Indian family—large, noisy, with parents, children, uncles, aunts, cousins and grandparents, all living together under a single roof, squabbling but presenting a united front to the world—is more of a Bollywood reality now. Urban sprawl and spiralling cost of living do not allow three generations to live together. And modernity is kicking in. “There’s a new premium on privacy, personal choice and less tolerance for cramped communal living,” he adds.

Add to it, the pull of migration. With young people moving out in search of better prospects, caring for the old has become an elusive ideal. Mumbai and Kolkata are witnessing a rapid migration, says the just-published UNFPA report, State of the World Population. One-third of the population in India—350 million—no longer lives in their place of birth, says the Census, and 7 per cent of elderly couples live on their own. Kerala has the largest population of seniors and the highest number of migrants. The Need Assessment Study, 2002, of the elderly by the Department of Economics and Statistics shows 50,000 households in Kerala have 60-plus people living alone; over 10 per cent have children working abroad and 21.7 per cent households are headed by aged people.

Solitude is Sujata Menon’s main companion these days. The 69-year-old lives in Anna Nagar, Chennai, all by herself in a flat that her son, a doctor in the UK, bought for her. She went there recently on a six-month visa but returned after barely six weeks, unable to bear the weather. Her daughters live in her city but she gets to see them just once or twice a month—they are busy with their own lives. She feels lonely and scared: “All sorts of people try to come in and find out if I live alone.” She is yet another face among 4.9 million women who, according to the Census, live all by themselves; yet another lonely-heart out of the national total of 11 per cent; yet another solitary soul among the 33 per cent who live without their spouses. “Living arrangement is an important component of the welfare of the elderly,” says Rajan. “The most vulnerable are elderly women in urban areas.”

But seniors are fighting back too. To beat the insecurity of old age, they are moving into pay-and-stay homes that offer an honourable lifestyle. Consider the 53-odd senior citizens who live in old-age home, Godhuli, in Delhi. “Almost all our members came here on their own,” points out O.N. Gupta, once a vice-president with the Jindal Group and now a member. He lost his wife 25 years back, raised his three children single-handedly. “They are all over the world and doing very well,” he smiles. Post-retirement, he bid goodbye to his corporate lifestyle and opted for one where he would not have to face the hassles of running a household. In Tamil Nadu, Puducherry, Kerala and Karnataka, ‘day care’ centres for the elderly are turning out to be a great hit among working couples.

The younger generation is looking for inspiration. Sarasa Vasudevan, the former chief of Thai Airways in Bangalore, might just be one such. Even in college, she had enjoyed spending time with the inmates of the Little Sisters of the Poor in Langford. Now, she has milled together the combined energies of her mother, mother-in-law and her teenage daughter to think up a home for the aged, spread across 22,000 sq ft at a whopping Rs 90 lakh. The project, slated for completion in two years, will be a 60-member spot for parents to spend a few days, or the rest of their time, as they wish. “We want to make it as self-sufficient as possible,” she says.

Meanwhile, the Government is mulling over the proposed Bill. If passed, it will slap hefty fines and/or imprisonment to neglectful children. They will have to return inherited property in case of mistreatment. But not everyone is equally excited. “A relationship-based society as ours is trying to cope with changes through a rule-based Anglo-Saxon system,” says R. Vaidyanathan, professor of Finance and Control, Indian Institute of Management, Bangalore. Will parents actually complain, given various social pressures? “The government in the bedroom can be as disastrous as the government in the board room,” he adds. Such measures can at best be a palliative. “Social capital—family ties and community linkages—is still strong in India. This must be enhanced and enriched instead of deriding it in the name of modernisation.”

Till such time, it is the “empty nest” syndrome in reverse gear for the old and infirm in India. ‘Home’ is not where the heart is, ‘life’ is work and worry, ‘love’ is children’s voice on the telephone, ‘affection’ is their message on the Internet, ‘caring’ is the nurse they engage when ill and ‘responsibility’ is the money they pay through the bank account. What’s the way out for generation-now? Throwing money at the problem (better hospitals, better doctors, anything to avoid facing the alternative)? Or the other extreme of micromanaging parents’ lives (buying the groceries, doing the laundry)? The truth, that parents who nurtured them once are now the ones who need nurturing, won’t set them free, but recognising it might open up new possibilities. And unlike child-rearing, there are no Dr Spocks out there with time-tested advice. The road ahead is likely to unfold as a series of personal journeys, for which there are few reliable road maps and precious little reassurance.

-with Rahul Tewari, Stephen David, Swagata Sen and Rupesh Paul

 RELATED STORIES
Pension: Old Age Crisis

 

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India Today
CURRENT ISSUE
JULY 16, 2007
IN THIS ISSUE
  COVER STORY
Home Alone
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English Takes Centrestage

An Enchanted Past

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A Litany Of Lament

Monumental Apathy

History As Commerce

 






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