Ageing is an inevitable, natural phenomenon. Every second two persons in the world complete their sixtieth birthday. By 2050, the estimated total population of India will be 1,572 million and the 60-plus segment will be 324 million including 48 million oldest old (80 and above). The proportion of persons aged 60 and above is projected to grow by 326 per cent during 2000-2050, while the rate of increase of the total population will be 56 per cent. Quite strikingly, the 80+ segment will increase by 700 per cent. The proportions of the elderly population in 12 Indian states are in excess of the national average of 7.4 per cent and Kerala is on the top with 10.5 per cent of its population.
As the number and proportion of the elderly grow faster than any other age group, there are serious concerns about the capacities of the central and state governments to address the social, economic and other challenges associated with the demographic transition. Three-quarters of the older men and women in India live in rural areas. Most of them bear the brunt of poverty and starvation. Only 8 per cent of India’s labour force of about 460 million are covered by pension, provident fund and gratuity by the employers. Others lack income security barring a meagre amount of old age pension to a section of the elderly. Kerala is the only Indian state to have social security schemes for about 70 per cent of the work force in the unorganised sector. The government of India formulated the National Policy on Older Persons in 1999 giving rise to hopes to millions of elderly in the country. But it remained almost a paper policy. So a revised one called the National Policy on Senior Citizens was framed in March 2011. But that policy is not yet notified by the government. (Vide Appendix: National Policy).
The Maintenance and Welfare of Parents and Senior Citizens Act was a major legislation. But its implementation is far from satisfactory. The National Programme for Health Care of Elderly (NPHCE) in India, launched in 2010, to be introduced in 100 districts in 21 states has not been put in place. However, the budget for 2013-14 presented in February 2013 has earmarked Rs.150 crore for NPHCE. In the developed nations, economic development preceded population ageing. But in India the reverse trend has been seen. The government does not appear to be serious about the implications of this demographic shift.
The special issue of Social Work Foot- Prints focuses on Old Age. The issue has seven articles and two case studies of elder care services. The concepts of ageing and old age are discussed in the article by T.K.Nair. The first research study on the elderly in India, perhaps, was that of H.M.Marulasiddaiah. “Old People of Makunti”, published in 1969, was based on a village study conducted five decades ago by him. Hence some extracts of the book are included in this special issue.
K.Visweswara Rao’s article on the rural elderly in India analyses the situation of the older people in Indian villages. He also reviews the relevant policies and programmes. B.Devi Prasad, as the title of the article suggests, narrates the struggles the elderly victims of abuse and neglect go through in the Indian families.
The role of traditional medicines as well as the close link between the health of the ageing population and Ayurveda are discussed by Payyappallimana Unnikrishnan. He writes “approach to elderly care should be based on the vision of reinforcing family and community-based care in a locally driven process harnessing locally available resources and knowledge”. The research priorities in the field of ageing are outlined in the paper by S.Siva Raju. He quotes from the Research Agenda on Ageing for the 21st century adopted by the Second World Assembly on Ageing at Madrid 2002 : “There is a need to assess the ‘state of the art’ of existing knowledge, as it varies across countries and regions, and to identify priority gaps in information necessary for policy development”. The paper specifies nineteen broad areas for further research. Global ageing and the role of IFA are discussed by K.R.Gangadharan in his article.
Elder care in India meant homes for the aged till 1979, when Helpage India and the Centre for the Welfare of the Aged (CEWA) pioneered non-institutional services in Madras city. K.N.Ajith presents a case study of CEWA and its contribution to a new approach in promoting participatory elder care services which can be replicated in different parts of the country with region-specific adaptations. Nightingales Medical Trust (NMT) in Bengaluru has taken initiative to “take health care to the elderly at their door”. Many family-based health support systems for the senior citizens belonging to different socio-economic groups are initiated by NMT. Of particular significance is the unit for therapy and rehabilitation of patients affected by Dementia and Alzheimer’s disease. Kalpana Sampath developed the case study of NMT based on repeated visits and discussions with the important functionaries.
Social Work Foot-Prints is an excellent initiative of a team of committed young persons led by M.H.Ramesha to promote social work practice, education and research, as well as to popularise social welfare with H.M.Marulasiddaiah as their mentor. I thank all of them for inviting me to be the Guest Editor of the special issue on Old Age.
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