Life could have been amusing if it were like F Scott Fitzgerald’s short story The Curious Case of Benjamin Button. Imagine coming out of the womb an infant but with the features of a 70-year-old, gradually heading towards blissful youth and then dying as a newborn. Growing young rather than old. It would be an intriguing life cycle that would have no place for the age-old problems of old age. In the last lap before death, your memories, too, would have faded and so the hurt associated with those memories would no longer feel as sharp as it once did. You take your last breath just like a baby taking her first.
Fantastic inversions such as this may soothe our dread of growing old and dependent once again on others even for the basic rituals of survival, but they do nothing to eradicate the problems of old age. In India, too, like in many parts of the globe, elderly people find the going anything but easy.
Take octogenarian Kaushalya Devi, for instance. Abandoned by her family, she has spent the past eight months as an inmate of the Vishram Vriddha Ashram, an old age home in Gautampuri, New Delhi. “My son and daughter-in-law threw me out of my own house,” she says. “They were only interested in my savings and used to beat me up sometimes.”
Located along a narrow lane, Vishram Vriddha Ashram is home to 200-odd old men and women, most of whom struggle with one or the other physical or mental disability. And in the majority of cases, they had been found alone and abandoned in public places such as railway stations, bus stands and markets. “Almost 90 percent of the inmates are from West Bengal, Bihar, Uttar Pradesh and Punjab, who were found abandoned in Delhi,” says the ashram founder GB Bhagat. “When we found them, many of them were in a terrible condition. Some of them had maggots crawling through the flesh of their limbs and we had to get them amputated. There is hardly any institution in the city to take proper care of the elderly who are physically or mentally disabled.”
An MPhil in computer science from Jawaharlal Nehru University, New Delhi, Bhagat has been running this old age home since 2003. “In the past 12 years we have given shelter to more than 2,000 elderly people. Most of them were afflicted by dementia or paralysis of some part of the body. There are two reasons why their families wanted to get rid of them. Nobody wants to spend money on their medicines or change their clothes if they get soiled by faeces or urine.”
Bhagat says that for the first four years after setting up the old age home he was the only one who used to clean the excreta of the inmates. “Even today, I only have three attendants for the task. From family members to outsiders, everyone is reluctant to take care of the old,” he says.
Cases of inmates being taken back by their families are rare. “In our institution, only two or three inmates suffering from dementia were lucky to be taken back by their kin, who came looking for them,” says Bhagat.
While Bhagat takes care of the elderly who are in dire straits, many financially independent senior citizens prefer “retirement homes”. A popular concept in some Western countries, the idea is finding growing acceptance in India, too. For instance, Ashiana Housing owns three such complexes in Bhiwadi and Jaipur in Rajasthan and Lavasa near Pune.
These complexes are unlike the houses we are used to seeing. Constructed as per the requirements of old people, these have floors that prevent slipping, shelves at lower heights and other features that make daily chores a little easier. Also, medical care is available round the clock.
The facilities, though, don’t address the crux of the problems faced by the elderly — lack of emotional support from the family. Changing social norms have led to a situation where old people find themselves abandoned on the streets or forced to live alone. Another factor that adds to the numbers is the rising life expectancy, which simply means that there are more elderly people among us than ever before.
According to the 2014 State of the Elderly Report released by HelpAge India, a non-profit working for the old, the number of the elderly in the country will touch 143 million by 2021. The report also projects that the number in 2050 will be 270 percent more than what it was in 2006.
The survey also brought to light some other startling figures. For instance, 80.6 percent of the respondents claimed to have faced verbal abuse and neglect from their family members.
While rising life expectancy is largely an outcome of better access to healthcare, it hides a saddening paradox: even as the number of the elderly has grown, so has the number of diseases specifically or mostly afflicting the elderly, such as Alzheimer’s, dementia, paralysis, cancer and other terminal illnesses.
Moreover, senior citizens, often lonely or poor, are especially vulnerable to the psychological impact of being ill, including extremes such as suicidal behaviour. Between 2003 and 2013, 8,357 men and 3,092 women in the age group of 60 years and above committed suicide. The number of those who decided to give up on life but failed to die is even more. As per World Health Organisation (WHO) data, until 2011 only one in seven persons who tried to commit suicide succeeded.
Chittaranjan Behera, associate professor of forensic science and toxicology at the All India Institute of Medical Sciences (AIIMS), New Delhi, agrees that illness is the major cause of suicide. Referring to his study on suicides among the elderly in south Delhi from 1996 to 2005, Behera says, “Case studies reveal that most of them were suffering from cancer or depression. Other triggers were financial or family problems and death of near and dear ones. They killed themselves by hanging, burning, poisoning or jumping from a height.”
Given this appalling picture of the state of the elderly in India, the State has much to answer for. It shows the inadequacy of our healthcare policies, medical facilities and provisions for insurance and subsidies for the elderly. This failure is driven partly by a mindset fostered by what critics of economic liberalisation and corporate globalisation call “neoliberal economics”, whose doctrine of “efficiency is everything” finds spending on the “unproductive” elderly a sheer waste of resources.
With neo-liberal economics being the guiding doctrine of successive regimes at the Centre, it is no surprise that the Narendra Modi government slashed the health budget by 20 percent in its first “interim” Budget soon after coming to power last year. This is bound to affect the implementation of the National Programme for Health Care of the Elderly, which was introduced in the 11th Five Year Plan and promises to provide preventive, curative and rehabilitative services to senior citizens.
And this is how the apathy of the powers-that-be translates on the ground: In 2013, hundreds of destitute senior citizens found themselves on the street after being forced out of their old age home in Vasant Kunj, New Delhi. Later, they were shifted to another institution on the outskirts of the city. That, sadly, was just one instance of the pattern of neglect that denies old people in India the right to live a secure life with dignity.