Elderly Care in India

Elderly Care in India

GS-2: Human Resources

(IAS/UPPCS)

Relevant for Prelims:

Older Population, Life Expectancy, Sex Ratio, Article 41, National Social Assistance Program (NSAP), Ministry of Health and Family Welfare (MoHFW), Ministry of Social Justice and Empowerment (MSJE) and Ministry of Skill Development and Entrepreneurship (MSDE).

Relevant for Mains:

Aging population in India, challenges, initiatives for elder care, way forward, conclusion.

30/04/2024

Context:

This article reveals important insights into elder care in India. The world's population is living longer and getting older.

  • Adapting to and planning for this massive demographic change is one of the greatest societal challenges of the 21st century.

Aging Population in India:

  • India is moving towards a future where older people will be an important part of the society, mainly due to advances in health care and increase in life expectancy.
  • The current elderly population of 153 million (aged 60 and above) is expected to reach 347 million by 2050.
  • According to the 2011 census, there are 104 million elderly people (60+ years) in India, which is 8.6% of the total population.
  • Among the elderly (60+), women outnumber men.
  • Which is likely to more than double to 230 million by the year 2036. This will be approximately 15% of the total population.
  • The sex ratio of elderly people is expected to increase to 1060 by the year 2026.
  • It is expected to increase to 319 million by the year 2050, which is about one-fifth of the total population.
  • Declining fertility rates and increasing life spans are driving this change.
  • The average family size in India has decreased from 5.94 in 2011 to 3.54 in 2021.

Challenges:

  • Socio-cultural mindsets and norms that label the elderly as a “burden”, elder abuse, as well as the lack of a comprehensive safety net increase the vulnerability of older persons manifold.
  • Homes with smaller families and an increasing number of older people who may be suffering from chronic disease
  • Caring for senior citizens at home is a growing concern as it oscillates between social care and health care.
  • Home care methods are not well defined and standardized.
  • There is no specific grievance redressal mechanism for users or caregivers.
  • Impact on women: Poverty is inherently gendered in old age when older women are more likely to be widowed, live alone, have no income and less assets and be completely dependent on family for support.
  • If India does not succeed in growing its economy at a rapid pace in the coming decades, the aging population could become a serious economic crisis.

Homecare status:

  • Smaller families and increasing numbers of older people demand changes in the health and social care system.
  • Home care of senior citizens is a growing concern as it diverges between social and health care.
  • Changing family structures are paving the way for outside help in caring for older people at home.
  • The range of services provided at home has expanded from assistance with activities of daily living to routine nursing care as well as specialized care.

Growing Homecare market:

  • Homecare is currently a private for-profit sector that provides the bulk of these services.
  • The market estimates that the home care industry will grow at a rate of 15-19% annually from approximately US$6-7 billion in 2021 to US$21 billion by 2027.

Drawbacks of Homecare:

  • Homecare rules not being well defined and standardized
  • Lack of training and sympathetic approach
  • Complaints of ill-treatment by families
  • Lack of specific grievance redressal mechanism for users
  • Recognizing the home as a place to provide care and as a workplace for caregivers
  • This has implications for the rights and security of both users and providers.
  • Home care is a different system than an institution like a hospital or old age home.

Initiatives to care for the elderly:

Constitutional Provisions:

  • Article 41 of the Indian Constitution states that the State will take measures to protect the rights of the elderly according to its economic capacity.

Government Schemes:

  • The Government of India has been formulating policies and programs to address the problems of population aging in accordance with the Madrid International Plan of Action on Aging (MIPAA), 2002.
  • The Maintenance and Welfare of Parents and Senior Citizens (Amendment) Bill, 2019, seeks to regulate home-based care for older people.
  • However, it has not been passed since it was introduced in Parliament in 2019.
  • Ministry of Health and Family Welfare (MoHFW), Ministry of Social Justice and Empowerment (MSJE) and Ministry of Skill Development and Entrepreneurship (MSDE) have important roles in this matter.
  • The Government of India has made positive progress with its visionary and inclusive policies, programs and schemes like the National Program for Health Care of the Elderly (NPHCE).
  • National Social Assistance Program (NSAP), Maintenance and Welfare of Senior Citizens Act, 2007 and (Amendment) Bill, Atal Vayo Abhyudaya Yojana (AVY), and Elderline-a national helpline, among others.
  • Health and Wellness Centers under the National Program for Health Care of the Elderly and Ayushman Bharat Program provide dedicated health care to the elderly in primary health care settings.
  • The Insurance Regulatory and Development Authority of India (IRDAI) recognizes home hospitalization in certain situations.

Way forward:

  • A comprehensive policy on home-based care should be formulated by the government so that the elderly can be given priority.
  • Aged care should include aspects such as registry of providers of such services, ensuring transparency and accountability, setting up grievance redressal mechanisms and insurance coverage.
  • Policy should also take cognizance of the fact that life expectancy of women in India is higher than that of men.
  • Women in India are generally younger than their husbands, so they spend their later years as widows.
  • The policy should especially take into account the more vulnerable and dependent older single women so that they can lead dignified and independent lives.
  • The provision of care for older people is a moral responsibility of society to respect the physical, social, emotional and economic investment made by older people in society throughout their lives.
  • It proposes to register institutions providing home care services and set minimum standards for them.
  • There is a need to streamline their professional training, nomenclature, roles and career progression to meet the growing demand for trained carers.

Conclusion:

India is currently facing an aging population which requires a comprehensive framework of homecare, new institutions, services and support to meet the needs of the elderly.

As India ages, it is important to ensure that the elderly population has access to the care and support they need to live healthy, dignified and fulfilled lives.

India can redefine the story from demographic challenge to demographic resilience, inclusivity and growth.

To achieve this, India will have to choose a transformative multi-pronged path with supporting institutions such as the private sector, academia, civil society etc.

 

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Mains Question:

Discuss the way forward to address the challenges related to elder care in India.