Acknowledgement
Acknowledgement
Recent Development
and
Legislation
of
Old Age Homes
1.2 HYPOTHESIS:
For this research following hypothesises were formulated:
The rise in NUCLEAR FAMILIES have led to the increase in more
number of OLD AGE HOMES.
Even in joint families, aged people are exposed to somewhat emotional
neglect and a lack of physical support.
The rapid socio-economic transformation has affected the age old joint
families.
1.3 METHODOLOGY
This study is based on primary and secondary sources. I have done a sociolegal research relating to old age homes and various factors contributing to the
rise and development of old age homes. I also adopted observation method
and questionnaire method for the purpose of my study and the research
delivers.
And this information are ready but very difficult to find out
CHAPTER
NO:-2.
POLICIES
AND
Indian family, which has been predominantly joint or extended one, remained
stable despite some marked and drastic social, political, economic and
religious changes over the last few decades. It has, however, retained certain
structural forms and traditional values. The historical cultural tradition of care
and respect for the elderly within the family and the community has made the
task of caring and empowering the aged relatively smooth and easy both for
the society and the Government in India.
conventional value systems and customary place of aged and women in the
society. Thus, the society is witnessing a gradual but definite withering of the
joint family system as a result of which a section of the family, primarily the
elder, are exposed to somewhat emotional neglect and a lack of physical
support.
The gender position of the elderly reveals that the life expectancy of women is
expected to remain higher. For the period 2006-2010 the life expectancy of
female is 68.1 against 65.8 of males which will rise to 72.3 for female against
69.02 for males during the period 2011-2016. This indicates that the
population of elderly women will account for a larger chunk compared to their
male counterpart in 60+ age bracket.
6
In absolute terms, the projection for male population in 60 + age group was
35 million in 2001, projected to be 40.7 million in 2006 and 48 million in
2011 as against the female population in same age group was 36 million in
2001, 42 million in 2006 and 50.2 million in 2011. From the projected figures
for the year 2006-2011 and 2016, 2021 and 2026, it is also clear that
percentage of female population in 70 + age group will outnumber their male
counterpart in the same age group. This accounts for a larger female
population in the overall 60 + age group compared to the male population in
the years to come. Many of women in the 70 + age group would be either
widow or single without any ostensible support for themselves.
A comparison of rural elderly and the urban establish the fact that around
74.97 per cent of older persons live in rural areas and 25.02 in urban areas.
This involves planning for post retirement socio-economic security through
continued skill up-gradation, employment and participation in other creative
and gainful activities.
With the changing lifestyle of modern society the young generation are
migrating from not only rural to urban area rather one country to another as
well; leading to increase in old age dependency ratio. The old age dependency
ratio (number of old persons 60+ years) to the working age group (15-59
years) has increased from 9.8 per cent in 1981 to about 12.6 per cent by the
year 2001. (Census of India,2001)
The needs of older persons living in rural areas that accounts for about 62.5
million of them, require special attention. The Government is concerned to
provide the rural elderly access to health system, socio-economic security, the
institutional care and homes for the destitute.
twenty five years period starting 1991 the population 60+ will nearly double
itself.
Sixty three percent of the population in 1991 (36 million) is in the age group
60-69 years, often referred to as young old or not so old while 11 percent
(6 million) is in the age group 80 years and over i.e., in the older old or very
old category. In 2016, the percentages in these age groups will be almost the
same, but the numbers are expected to be 69 million and 11 million
respectively. In other words, close to six tenths of population 60-69 years can
be expected to be in reasonably good physical and mental health, free of
serious disability and capable of leading an active life. About one third of the
population 70-79 years can also be expected to be fit for a reasonably active
life. This is indicative of the huge reserve of human resource.
Men outnumber women in India even after age 60 (29 million males, 27
million females 60+ in 1991). This will continue to be the situation in 2016
when there will be an estimated 57 million males and 56 million females 60+.
Incidence of widowhood is much higher among females 60+ than among
males of the same age group because it is customary for women to get married
to men older by several years; also, they do not remarry and live longer. There
were in 1991, 14.8 million widowed females 60+ compared to 4.5 million
widowed males. In other words, there were four times as many widowed
females as widowed males.
(B) Implications
The demographic ageing of population has implications at the macro and also
at household level. The sheer magnitude of numbers is indicative both of the
huge human reserve and also of the scale of endeavours necessary to provide
social services and other benefits.
A growing number of persons 60+ in the coming decades will belong to the
middle and upper income groups, be economically better off with some degree
of financial security, have higher professional and educational qualifications,
lead an active life in their 60s and even first half of the 70s, and have a
positive frame of mind looking for opportunities for a more active, creative
and satisfying life.
Some areas of concern in the situation of older persons will also emerge, signs
of which are already evident, resulting in pressures and fissures in living
arrangements of older persons. It is true that family ties in India are very
strong and an overwhelming majority live with their sons or are supported by
them. Also, working couples find the presence of old parents emotionally
bonding and of great help in managing the household and caring for children.
However, due to the operation of several forces, the position of a large number
of older persons has become vulnerable due to which they cannot take for
granted that their children will be able to look after them when they need care
in old age, specially in view of the longer life span implying an extended
period of dependency and higher costs to meet health and other needs.
The last two decades have witnessed considerable discussion and debate on
the impact of demographic transition and of changes in society and economy
on the situation of older persons. The United Nations Principles for Older
Persons adopted by the United Nations General Assembly in 1991, the
Proclamation on Ageing and the Global Targets on Ageing for the year 2001
adopted by the General Assembly in 1992, and various other Resolutions
adopted from time to time, are intended to encourage governments to design
their own policies and programmes in this regard.
There has for several years been a demand for a Policy Statement by the State
towards its senior citizens so that they do not face an identity crisis and know
where they stand in the overall national perspective. The need has been
expressed at different forums where ageing issues have been deliberated. The
Statement, by indicating the principles underlying the policy, the directions,
the needs that will be addressed and the relative roles of governmental and
non-governmental institutions, is expected to facilitate carving out of
respective areas of operation and action in the direction of a humane age
integrated society.
12
The Policy visualizes that the State will extend support for financial security,
health care, shelter, welfare and other needs of older persons, provide
protection against abuse and exploitation, make available opportunities for
development of the potential of older persons, seek their participation, and
provide services so that they can improve the quality of their lives. The Policy
is based on some broad principles.
The Policy recognizes the need for affirmative action in favour of the elderly.
It has to be ensured that the rights of older persons are not violated and they
get opportunities and equitable share in development benefits, different sectors
of development, programmes and administrative actions will reflect sensitivity
in older persons living in rural areas. Special attention will be necessary to
older females so that they do not become victims of triple neglect and
discrimination on account of gender, widowhood and age.
The Policy views the life cycle as a continuum, of which post 60 phase of life
is an integral part. It does not view age 60 as the cut off point for beginning a
life of dependency. It considers 60+ as a phase when the individual should
have the choices and the opportunities to lead an active, creative, productive
and satisfying life. An important thrust is therefore, on active and productive
involvement of older persons and not just their care.
13
The Policy recognizes that older persons, too, are a resource. They render
useful services in the family and outside. They are not just consumers of goods
and services but also their producers. Opportunities and facilities need to be
provided so that they can continue to contribute more effectively to the family,
the community and society.
The Policy firmly believes in the empowerment of older persons so that they
can acquire better control over their lives and participate in decision making
on matters which affect them as well as on other issues as equal partners in the
development process. The decision making process will seek to involve them
to a much larger extent especially since they constitute 12 percent of the
electorate, a proportion which will rise in the coming years.
The Policy recognizes that larger budgetary allocations from the State will be
needed and the rural and urban poor will be given special attention. However,
it is neither feasible nor desirable for the State alone to attain the objectives of
the National Policy. Individuals, families, communities and institutions of civil
society have to join hands as partners.
The Policy emphasises the need for expansion of social and community
services for older persons, particularly women, and enhance their accessibility
and use by removing socio-cultural, economic and physical barriers and
making the services client oriented and user friendly. Special efforts will be
made to ensure that rural areas, where more than three-fourths of the older
population lives, are adequately covered.
14
For elderly persons below the poverty line, old age pensions provide some
succour. Coverage under the old age pension scheme for poor persons will be
significantly expanded from the January 1997 level of 2.76 million with the
ultimate objective of covering all older persons below the poverty line.
Simultaneously, it will be necessary to prevent delays and check abuses in the
matter of selection and disbursement. Rate of monthly pension will need to be
revised at intervals so that inflation does not deflate its real purchasing power.
Simultaneously, the public distribution system will reach out to cover all
persons 60+ living below the poverty line.
Pension is a much, sought after income security scheme. The base of pension
coverage needs to be considerably expanded. It would be necessary to
facilitate the establishment of pension schemes both in the private as well as in
15
Long term savings instruments will be promoted to reach both rural and urban
areas. It will be necessary for the contributors to feel assured that the payments
at the end of the stipulated period are attractive enough to take care of the
likely erosion in purchasing power due to erosion. Earners will be motivated
to save in their active working years for financial security in old age.
The primary health care system will be the basic structure of public health
care. It will be strengthened and oriented to be able to meet the health care
needs of older persons as well public health services, preventive, curative,
17
The development of health insurance will be given high priority to cater to the
needs of different income segments of the population and have provision for
varying contributions and benefits. Packages catering to the lower income
groups will be entitled to state subsidy. Various reliefs and concessions will be
given to health insurance to enlarge the base of coverage and make them
affordable.
Private medical care has expanded in recent years offering the latest medical
treatment facilities to those who can afford it. Where land and other facilities
are provided at less than market rates, bodies representing private hospitals
and nursing homes will be requested to direct their members to offer a
discount to older patients. Private general practitioners will be extended
opportunities for orientation in geriatric care.
Public hospitals will be directed to ensure that elderly patients are not
subjected to long waits and visits to different counters for medical tests and
treatment. They will endeavour to provide separate counters and convenient
timings on specified days. Geriatric wards will be set up.
For the old who are chronically ill and are deprived of family support,
hospices supported or assisted by the State, public charity, and voluntary
organizations will be necessary. These are also needed to cater to cases of
abandonment of chronically ill aged patients admitted to public hospitals.
Assistance will be given to geriatric care societies for the production and
distribution of instruction material on self care by older persons. Preparation
and distribution of easy to follow guidance material on health and nursing care
of older persons for the use of family care givers will also be supported.
Older persons and their families will be given access to educational material
on nutritional needs in old age. Information will be made available on the
foods to avoid and the right foods to eat. Diet recipes suiting tastes of different
regions which are nutritious, tasty, fit into the dietary pattern of the family and
the community, are affordable and can be prepared from locally available
vegetables, cereals and fruits, will be disseminated. The concept of health
ageing will be promoted. It is necessary to educate older persons and their
families that diseases are not a corollary of advancing age nor is a particular
chronological age the starting point for decline in health status. On the
contrary, preventive health care and early diagnosis can keep a person in
reasonably good health and prevent disability.
how to stay healthy for the entire life span will be given. The importance of
balanced diets, physical exercise, regular habits, reduction of stress, regular
medical check up, allocation of time for leisure and recreation, and pursuit of
hobbies will be conveyed. Programmes on yoga, meditation and methods of
relaxation will be developed and transmitted through different channels of
communication to reach diverse audiences.
(C) Shelter
Shelter is a basic human need. The stock of housing for different income
segments will be increased. Housing schemes for urban and rural lower
income segments will earmark 10 per cent of the houses/house sites for
allotment to older persons. This will include Indira Awas Yojana and other
schemes of government. Earning persons will be motivated to invest in their
housing in their earning days so that they have no problems of shelter when
they grow old. This will require speedy urban land development for housing,
time bound provision of civic services and communication links, availability
of loans at reasonable rates, easy repayment installments, time bound
construction schedules and tax reliefs. Development of housing has to be a
joint endeavour of public and private sectors and require participation of
Housing Development Boards, civic authorities, housing finance institutions
and private developers and builders. Older persons will be given easy access
to loans for purchase of housing and for major repairs, with easy repayment
schedules.
20
Layouts of housing colonies will have to respond to the life styles of the
elderly. It will have to be ensured that there are no physical barriers to
mobility, and accessibility to shopping complexes, community centres, parks
and other services is safe and easy. A multi-purpose centre for older persons is
a necessity for social interaction and to meet other needs. It will therefore, be
necessary to earmark sites for such centres in all housing colonies. Segregation
of older persons in housing colonies has to be avoided as it prevents
interaction with the rest of the community. Three or four storied houses
without lifts are unfriendly to older persons, tend to isolate them, restraints
their movement outside the home, and are a serious barrier to access to
services. Preferences will be given to older persons in the allotment of flats on
the ground floor.
Civic authorities and bodies providing public utilities will be required to give
top priority to attending complaints of older persons. Payment of civic dues
will be facilitated. Older persons will be given special consideration in
promptly dealing with matters relating to transfer of property, mutation,
property tax and other matters. Harassment and abuses in such cases will be
checked.
21
(D) Education
Education, training and information needs of older persons will be met. These
have received virtually no attention in the past. Information and educational
material specially relevant to the lives of older people will be developed and
widely disseminated using mass media and non-formal communication
channels.
programmes
will
incorporate
material
to
strengthen
22
(E) Welfare
The main thrust of welfare will be to identify the more vulnerable among the
older persons such as the poor, the disabled, the infirm, the chronically sick
and those without family support, and provide welfare services to them on a
priority basis. The policy will be to consider institutional care as the last resort
when personal circumstances are such that stay in old age homes becomes
absolutely necessary.
23
A Welfare Fund for older persons will be set up. It will obtain funding support
from government, corporate sector, trusts, charities, individual donors and
others. Contributions to the Fund will be given tax relief. States will be
expected to establish similar Funds. The need for plurality of arrangements for
welfare services is recognised. Government, voluntary organizations and
private sector agencies all have a place, the latter catering to those who have
the means and desire better standards of care.
Police will be directed to keep a friendly vigil on older couples or old single
persons living alone and promote mechanisms of interaction with
neighbourhood associations. Information and advice will be made available to
older persons on the importance of keeping contacts on phone with relatives,
friends and neighbours and on precautions to be taken on matters such as
24
will be promoted and supported in a big way and efforts made to remedy the
current uneven spread both within a state and between states. There will be
continuous dialogue and communication with NGOs on ageing issues and on
services to be provided. Networking, exchange of information and interactions
among NGOs will be facilitated. Opportunities will be provided for orientation
and training of manpower. Transparency, accountability, simplification of
procedures and timely release of grants to voluntary organizations will ensure
better services. The grant-in-aid policy will provide incentives to encourage
organization to raise their own resources and not become dependent only on
government funding for providing services on a sustainable basis. Trusts,
charities, religious and other endowments will be encouraged to expand their
areas of concern to provide services to the elderly by involving them on
ageing issues.
will be made to make family members appreciate and respect the contribution
of older persons in the running of the household specially when women, too,
are working outside the home. Special programmes will be designed and
disseminated through the media targeted at older persons so that they can
enrich and update their knowledge, integrate tradition with contemporary
needs and transmit more effectively socio-cultural heritage to the
grandchildren.
(c) Family
Family is the most cherished social institution in India and the most vital nonformal social security for the old. Most older persons stay with one or more of
their children, particularly when independent living is no longer feasible. It is
for them the most preferred living arrangement and also the most emotionally
satisfying. It is important that the familial support system continues to be
functional and the ability of the family to discharge its caring responsibilities
is strengthened through support services.
the community. Short term stay-in facilities for older persons will be
supported so that families can get some relief when they go out. Counselling
services will be strengthened to resolve inter-familial stresses.
(d) Research
The importance of a good data base on older persons is recognised. Research
activity on ageing will require to be strengthened. Universities, medical
colleges and research institutions will be assisted to set up centres for
gerontological studies and geriatrics. Corporate bodies, Banks, Trusts and
Endowments will be requested to institute Chairs in Universities and medical
colleges in gerontology and geriatrics. Funding support will be provided to
academic bodies for research projects on ageing. Superannuated scientists will
be assisted so that their professional knowledge can be utilized. An
interdisciplinary coordinating body on research will be set up. Data collecting
agencies will be requested to have a separate age category 60 years and above.
Professional associations of gerontologists will be assisted to strengthen
research activity, disseminate research findings and provide a platform for
dialogue, discussion, debate and exchange of information.
28
(f) Media
The National Policy recognizes that media have a very important role to play
in highlighting the changing situation of older persons and in identifying
emerging issues and areas of action. Creative use of media can promote the
concept of active ageing and help dispel stereotypes and negative images
about this stage of the life cycle. Media can also help to strengthen intergeneration bonds and provide individuals, families and groups with
information and educational material which will give better understanding of
the ageing process and of ways to handle problems as they arise.
The Policy aims to involve mass media as well as informal and traditional
communication channels on ageing issues. It will be necessary to provide
opportunities to media personnel to have access to information apart from
their own independent sources of information and reporting of field situations.
Their participation in orientation programmes on ageing will be facilitated.
Opportunities will be extended for greater interaction between media
personnel and persons active in the field of ageing.
29
30
Older persons who are above 65 years of age also enjoy income tax rebate
upto 15,000 of actual tax with provision for deduction of Rs.20,000 spent on
account of medical insurance premium and Rs.40,000 spent on account of
medical treatment from taxable income. Senior citizens are exempted from
Income Tax upto 1.95 lakh as per the union Annual Budget, 2007.
Banks are providing 0.5% -1% additional interest to older persons of 65 years
and above on fixed deposit. The public facilities for the elderly are initiated by
the Government which include reservation of seats for elderly in the public
transport, railways and airways etc.
The government has launched a Reverse Mortgage System for senior citizens
to extract value out of their property and lead a hassle free life by securing a
regular income as loan against their existing property.
31
to
Non-Governmental
Organizations,
Autonomous
Bodies,
32
Many of the Government and public hospitals have started Memory Clinics,
Mental Health Programmes to facilitate proper diagnosis of Dementia to
enable slowing down the process and preparing the care-givers and the family
to manage Alzheimers and Dementia Care . The National Institute of Social
Defence under the Ministry of Social Justice & Empowerment has initiated
training of care-givers and functionaries as a special initiative on the centenary
of Alzheimers .
33
36
CHAPTER NO :- 7
DESIGNING A QUESTIONNAIRE
37
CHAPTER
NO:-8.CONCLUSION
AND
SUGGESTIONS
In the consumer world of today, affection is actually dying. Families are
shattering. Human values and responsibilities are neglected. Seeking pleasure
and carefree life at any cost is the growing trend of modern life. The
increasing number of old age homes reveals clearly the death of human heart.
The fading joint family system in India and other innumerable factors have
given rise to west-inspired phenomena of old age homes. Surprising cost of
living and scanty return on savings have almost pushed these senior citizens
on roads. Such an act has triggered the security net of the helpless, which has
almost vanished in many states in India with Kerala topping the list. They
have started walking out of their own home in search of a journey that
promises peace, joy and celebration of life with a group of people who share
the same boat of life (the wrecked one). However not may rather none of them
receive it. Young people with vigor and strength forget that its not too late for
them to be in the same shoes. Its just one life that we all have,why can't we be
a support to the needy who is not a stranger? Why cant we build a world of
love that shelters all, irrespective of age? Why can't life just begin after
retirement, than end?
If we respect the one who has moulded you into a fine being, we should then
just hold their hand and lead them straight into your home. They don't need
your money or luxury, they just need a shoulder to lean. Help them lead the
last few days of their life that doesn't trigger loneliness.
38
CHAPTER NO:-9.BIBLIOGRAPHY
(A) Books Referred
Old Age Homes In India Nirupama Narayanan
Ageing and India K.C.Karthik
39