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In the latest installment of 360info’s three-part series on aging populations, S Irudaya Rajan and Nelgyn Tennyson look to India, where family care is no longer seen as the only solution. Read part one here and part two here.
The care of the elderly and the nature of the family unit is undergoing a seismic change in India.
Families are smaller, and many children leave for studies or careers. Finally, the children settle abroad or in another city, leaving behind their elders.
Just behind China, India is already home to a sizeable elderly population. By 2050, one in five Indians will be over 60: some 319 million people.
Who will take care of them?
Increased life expectancy, migration and declining fertility all lead to an aging population and with it an increased demand for care facilities for the elderly. Radical changes are needed to address the resulting societal and economic impact on everything from jobs to the value of assets.
Indians may live longer, but like aging populations elsewhere, they live with no more sickness and handicap. On average, 30 percent of Indian seniors live with at least one chronic illness, while 20 percent live with at least two. Cardiovascular disease, cancer, chronic respiratory disease, diabetes and vision problems are all on the rise.
Smoking, obesity, physical inactivity, mental illnesses and alcohol consumption are fueling the growing burden of disease. Deaths due to cardiovascular disease alone Cost India more in terms of years of healthy working life lost than any other country in the world.
More long-term care is needed, but there is a shortage of skilled caregivers; lack of quality control systems hinders regulation. Elder abuse is rampant, complaints and lawsuits are on the increase both at home and in formal elderly care facilities.
India’s national population Politics talks about providing care for the elderly but does not detail how to achieve it. India’s National Health Policy is committed to providing culturally appropriate community-based solutions to meet the health needs of the elderly. It also recognizes the growing need for palliative and rehabilitative care and advocates for continuity of care at all levels.
Health and wellness centers ” are emerging to provide comprehensive primary health care as well as training in palliative care, but other policies point to the need for more and better home care.
A national Politics for the elderly adopted in 2011 recognizes the need for long-term care facilities, but considers institutional care as a last resort. He promises to strengthen the family system so that the elderly remain a family responsibility. It recommends tax incentives for people looking after elderly family members at home. The policy also promised a cadre of affordable geriatric health care specialists and professional caregivers and to broaden and expand the current National Elderly Health Care Program (NPHCE), in partnership with civil society organizations.
India’s social and economic policy must keep pace with changes in its society, with a focus on long-term care.
Kerala, a state with the highest proportion of older people in its population, is leading the way. He delivered the country’s first pain and palliative care policy with a focus on community home care initiatives under the leadership of local self-government. The program operates at three levels: primary home care; secondary care in hospital; and main tertiary institutional care.
Today, the vast majority of palliative care services in India are located in Kerala. A State which has recognized that family care is no longer the only solution to the aging of the Indian population.
Originally published under Creative Commons by 360info ™.
S Irudaya Rajan is President of the International Institute for Migration and Development (IIMAD), Kerala, India. Nelgyn tennyson is a researcher at IIAMD.
The authors have declared no conflicts of interest with respect to this article.