GERIATRIC CARE IN INDIA : REALITIES OF POLICY AND PRACTICE

Senior citizens are one of the most vulnerable demographic groups in societies worldwide. Most of them are not able to work after they reach a certain age, and are dependent on their offspring for their survival. In India, the population of senior citizens, that is, people aged 60 years and above, was estimated to be 103 million in 2011.

Despite this small proportion compared to the entire population of the country that stood at 1.21 billion people at that time, it is important to understand them and address their concerns now because of the imminent drastic demographic shift in population.


According to the Longitudinal Ageing Study in India (LASI), conducted by the International Institute of Population Sciences, it is expected that the population of senior citizens in India (the age of 75 and above) would increase by a whopping 340% between 2011 and 2050, and by the end of 2050, senior citizens will constitute over 40% of the total Indian population. The data suggests that giving care to senior citizens is of utmost importance.


Soon after globalization, care for senior citizens has become a burden for many, especially for people who had to migrate within the country, and outside the country in search of education and jobs. A paper investigating this aspect, written by Ajay Bailey, Jyoti Hallad, and K. S. James, talks about how senior citizens live despite the absence of their offspring. In several cases, most of the families analyzed were able to find a place to live independently, but being surrounded by friends and other kith and kin. Their offspring would arrange for groceries and medicines to be delivered, and a caretaker to look after them. Children living outside were able to arrange for internet facilities to converse with their elderly parents every day.


This study highlights an important point – care for senior citizens, especially compensating for the absence of their children in their lives, heavily depends on the social and financial capital they have access to. Most of the families studied were able to afford caretakers and the other costs involved. However, this is not always the case.

This demographic is even more complex in India since senior citizens belong to different strata of society, both socially and economically. A study by Akanksha Srivastav and Sanjay K Mohanty, based on the 2004-05 data of the National Sample Survey, shows that the estimated percentage of the elderly, living in rural areas below the poverty line, is 22.17%, and that of the urban elderly is 22.4%.


They also observe that the level of poverty amongst the elderly depends on the average poverty and income levels of the states, with higher levels recorded in states of Jharkhand, Madhya Pradesh, and Chhattisgarh.

This trend of highly varying levels of poverty among senior citizens living in urban and rural areas continues even today. According to the LASI study, the monthly per-capita consumption in households with elders is higher than the national average in economically developed places like Chandigarh (Rs.5691) and is lower than the national average in economically poorer states like Chhattisgarh (Rs.1945).


Similarly, annual per capita income in elderly households is the highest in Chandigarh (Rs.1,04,387) and is the lowest in states like Bihar (Rs.26,628) and Jharkhand (Rs.34,452). This data only shows that state intervention in elderly care is important.


This intervention should not only be in terms of social and economic security, but also in terms of an overhaul in the health infrastructure of the country. This is especially because there is also a rise in cases of serious illnesses such as dementia and Alzheimer’s amongst the elderly; diseases that require constant care and attention.


In India, according to the report titled “Dementia In India 2020”, it is estimated that 5.3 million people suffered from dementia in 2020, which translates to one in 27 people, and this number is projected to increase to 14.32 million people by 2050. Taking care of people with dementia is not inexpensive either: this report observes, after surveying other literature, that the cost of direct care (hospitalization,
treatment), and the cost of caring for activities for daily living lies anywhere between Rs.20,300 – 66,025 in rural areas, and Rs.45,600 to 2,02,450 in urban areas.

“This intervention should not only be in terms of social and economic security, but also in terms of an overhaul in the health infrastructure of the country.”

Therefore, it is important for the Government to take action, such as increasing awareness of early diagnosis and care of dementia, and allocation of resources to conduct research and provide palliative and other forms of care to patients with low income.


There is a necessity for the government, nongovernmental organizations, and civil society to collaborate on a comprehensive policy that would make the transition of the population from the working youth to senior citizens less painful, more caring, and less expensive, especially to the majority of the senior citizens living in rural areas and under poverty.

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