When we take a look at the contemporary situation of Geriatric sector in India, we observe that research is one of the key areas of interest on this issue. With the ageing scenario projected to be grim, there is an urgent need to identify issues peculiar to the Indian situation. Research studies would provide for the existent and emerging needs and gaps in the areas of knowledge and services as well as help give us inputs for filling the already identified gaps. Recognizing the above situation, the Elderly Perceived Needs Assessment (EPNA) survey was done to address the role of study to know the needs of the elderly in the capital city of Uttarakhand. A community-based survey/study was conducted on the lifestyle of elderly people and their mistreatment, carried out across various communities dwelling older adults, with a total of 52 people, aged 60 and above living in 11 rural areas of Dehradun district, India. The outcome of the study was there is an imperative need for geriatric recreational and learning centers that can take care of the holistic development (physical and physiological needs) of the elderly. There is a need for sensitizing children about human values and rituals of our society which can help them in their overall development for a better future.
Failing health, economic insecurity, isolation, neglect, abuse, fear, boredom, lowered self-esteem, fall, loss of control, are the common problems of elderly people in today’s world. The ageing process is synonymous with failing health; older people are mostly vulnerable to non-communicable diseases. Failing health due to advancing age is complicated by non-availability to good quality, age-sensitive, health care for a large proportion of older persons in the country. In addition, poor accessibility and reach, lack of information and knowledge and high costs of disease management make reasonable elder care beyond the reach of older persons, especially those who are poor and disadvantaged. Another problem is of economic insecurity is faced by the elderly when they are unable to sustain themselves financially. The elderly, especially those who are weak or dependent, require physical, mental and emotional care and support. When this is not provided, they suffer from neglect, a problem that occurs when a person is left uncared for and that is often linked with isolation. Changing lifestyles and values, demanding jobs, distractions such as television, a shift to nuclear family structures and redefined priorities have led to increased neglect of the elderly by families and communities. Many older persons also live in fear of death, social status, economic security etc. Whether rational or irrational, this is a relevant problem face by the elderly that needs to be carefully and effectively addressed.
Elder mistreatment is a universal phenomenon. Studies conducted in various parts of the world have shown that the prevalence rate of elder mistreatment range from 3.2% in the United States (Pillemer & Finkelhor, 1988) to 23.5% in Hong Kong (Yan & Tang, 2001). It is a consequence of demographic transition i.e., the change from high fertility and mortality rates to low fertility and mortality rates. One of the major features of the demographic transition in the world has been the considerable increase in the absolute and relative number of elderly person. This had been especially true in the case of developing countries like India. Increase in lifespan also results in chronic functional disabilities creating a need for assistance among the oldest-old to manage simple chores of the life. Population ageing is a global phenomenon. The elder persons in the society face a number of problems due to absence of assured and sufficient income to support themselves for their healthcare and other social securities. Loss of a social role and recognition, and non-availability of opportunities for creative and effective use of free time are also becoming a matter of great concern for elderly persons. The trend clearly reveals that ageing will emerge as major social challenge in the future; and vast resources will be required towards the support, service, care and treatment of the elderly persons (Ministry of statistics and Program Implementation, Govt. Of India,2016).
Traditionally in India, the most common form of family structure was the joint family, which consisted of at least two generations living together, and this arrangement was usually to the advantage of elderly, as they enjoyed a special status and power. But with growing urbanization and depending on the availability of jobs, children are moving out of the joint family setup, and establishing their own nuclear families (Shubham & A.k Joshi). A large number of people enter ‘old age’ with little, or no, awareness of what this entails. While demographically, we acknowledge that a person is considered to be old when he/she attains the age of 60 years, there is no such clear indicator available to the individual. For each person, there is turning point after which he/she feels physiologically or functionally ‘old’. This event could take place at any age before or after the age of 60. Unfortunately, in India, there is almost no formal awareness program – even at higher level institutions or organizations- for people to prepare foe old age. Most people living busy lives during the young and middle age periods may prefer to turn away from, and not consider, the possible realities of their own impending old age. The majority of Indians are unaware of the rights and entitlements of older persons (Help age India).
In India, elderly population consists of 7% of the total population, in which two third resides in villages and almost half of them live in poor conditions. There is rapid growth in number of older population in India that present issues that need to be taken care of if economic and social development is to proceed effectively. It is affected by the change in socio-economic condition of the elderly that adversely affects the individual’s way of life after retirement. Economic loss comes from a change that is due to transformation from salaried to pensioner or unemployment leading to economic dependency on children or closed ones i.e., from independency to dependency. A feeling of low self-worth creeps in that is due to the loss of social recognition and earning power. Traditionally, elderly had occupied the position of power and prestige but now they are becoming inactive, dependent, sick and weak. All these phenomena lead to many physical, psychological and sociological problems (Dr. Ranjita Singh,2015). After retirement, many elderly people are forced to live a life of humiliation, abuses and isolation. Denial of food, abuse, physical and emotional violence, restricted social life, forced to do household chores are common challenges they have to face (The Hindu 2016).
The increasingly ageing population poses a host of challenges for example work status, dependency status, living arrangements, gender and ageing, health and disability status, family and kinship relationships and availability of social security provisions for the elderly. Policy for the elderly should cover all sections of the population to tackle the complicated problems of the elderly, the increasing stress and strains on the primary caregiver, the fast pace of social change that is affecting traditional care giving mechanisms for the elderly, as well as the need for a dynamic action plan to utilize the knowledge and wisdom and of course physical resources of the elderly and enhance their social status (D. Jamuna).
According to Population Census 2011 there are nearly 104 million elderly persons (aged 60 years or above) in India; 53 million females and 51 million males. As regards rural and urban areas, 71% of elderly population resides in rural areas while 29 % is in urban areas. The old-age dependency ratio climbed from 10.9% in 1961 to 14.2% in 2011 for India as a whole. For females and males, the value of the ratio was 14.9% and 13.6% in 2011. In rural areas, 66% of elderly men and 28% of elderly women were working, while in urban areas only 46% of elderly men and about 11% of elderly women were working. The percent of literates among elderly persons increased from 27% in 1991 to 44% in 2011.The literacy rates among elderly females (28%) is less than half of the literacy rate among elderly males (59%).
In the age-group of 60-64 years, 76% persons were married while 22% were widowed. Remaining 2% were either never married or divorced. (Census,2011). According to World population Ageing,2015, DESA, US, the population of elders in India will be increased from 104 million to 324 million in 2050.
Dehradun is the capital of newly formed State, Uttarakhand and is a military and education hub. The population is 1.1 million and the district is densely populated with 414 people living in a square kilometer. Literacy levels at 77%. The development indicators are much better than the national average with MMR at 51 and IMR at 42. The district is situated at the foot of the Himalayas and therefore is a favorite retirement destination. However, the public health system will have to build capacity to address the needs of the ever-increasing geriatric population. Both the health and social welfare departments have woken up to the needs and are trying to build a system which is sensitive to elders. A 6.9% of elders in Dehradun are staying alone and another 19% live with only their spouse for company.
Changing lifestyle and migration are considered as a major reason behind the loneliness of elders. Due to shortage of space in urban areas with higher rents, migrants prefer to leave their parents in their native places. Daughter-in-laws generally don’t want to live with parents for their privacy and changing lifestyles. (Rahul Prakash et…al, 2003) In a study, it has been founded that with the exception of financial abuse, a significantly greater number of women experienced verbal and physical abuse as well as neglect compared to men (Srinivasan Chokkanathan & Alex E. Y. Lee, 2015).
The benefits of government’s various social welfare schemes are there but the numbers who are benefitted by it are insignificant when compared to the very high size of their population and the growth rate among them. With rapid industrialization and urbanization in addition to rapid decline of social order it is becoming a critical area that needed a more concrete intervention.
Himalayan Environmental Studies and Conservation organization (HESCO) working in rural area of Himalaya region helps in identify and get entry into the villages of Dehradun district. With the help of HESCO, 11 villages were chosen from Dehradun district for study and all the available elder people (60/60+ years old) at that time in the village were considered as a sample for study. The above 11 villages were-
From the above selected villages 52 elder people were identified as sample for study. The data collection method in this study involved face-to-face interview on the basis of Elderly’s Perceived Needs Assessment Survey Instrument (EPNA). All the interviews were conducted with their kind permission and keeping all social work research ethics and guidelines in the mind. Google forms used to collect the data online to save the paper, but in 2 villages data collected in written form because of unavailability of proper connectivity on the mountains.
63.5% of the respondents were in the age group of 60-70 years old and 34.6% were in the age group of 71-80 years old and only 1 respondent was above 80 years old. Males were 53.8% and females were 46.2%. Study find the 52 elders people in which 2 elder people were incapacitated. 46.2% (24) were widow/widower and others were living with spouse. 58.8% were those who living with their family means with spouse, son, daughter, children & only 2 elders were living alone without any support from children. 70.6% were illiterate and others were educated at primary level only. 65.38% (34 out of 51) are currently working either part time or full time. Some are involved in farm work or animal husbandry and some are work as laborers. 45.1% (23 out of 51) were agreed that they take any kind of tobacco product like bidi/tobacco and 30.76% agreed that they take alcohol occasionally or weekly. It came to know from them that 25 out of 52 having a visual disability and 18 out of 52 having a hearing disability. Major of them were agreed that they feel boredom, loneliness, unsecured, disrespected and sadness occasionally. 18 people were get injured in last 1 year and in which 12 were reason to fall accidentally. Major of them were not aware of their legal laws and rights. 14 out of 50 were response that they have no participation in decision making and many of them share that they have to do domestic work, or farm work, to live smoothly in home.
63.5% of the respondents were in the age group of 60-70 years old and 34.6% were in the age group of 71-80 years old and only one respondent was above 80 years old.
Above pie chart represent the sex ration, that males were 53.8% and females were 46.2%.
Responses of the questions asked in interview schedule were presented below-
From the analysis of above data, it came to know that most of them are not aware from their legal laws and policies, which are necessary to know so that they can enjoyed the life with dignity. There is a recommendation for running legal awareness program through government, civil society organization.
Major of them were using tobacco products, so proper counselling is required to stop them using these products, which are not good for health.
Major of them feel boredom, loneliness, unsecured, disrespected and sadness, so it is important to provide a space in their community, where all the old age person can meet, sit, play and share their feeling to each other, because sometime youngster do not able to understand the feelings and problems of old age but by providing this space, they can understand their each other feelings.
Many are working in the fields to earn some livelihood, and government only providing 1000 INR which is not enough to run their livelihood, so government should provide some occupation opportunities for elder people where they feel safer then fields and can earn some money. It also helps in meet them with the people of their own age, which help in reducing the loneliness
It also came to seen that old age values in our Indian society are falling down day by day, so it is also important to teach old age values to children and youngsters through different medium of socialization like school, social media, etc.
Many of the respondents were injured because of fall, so proper care is required in this age and try to avoid extreme places.
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