Home…..it’s a late Friday evening and today nostalgia was hitting hard. As I sat in my office, wrapping up some work at the end of the day, with most of my colleagues, now heading home to spend time with their families, I felt a deep longing for mine. A colleague of mine told me on her way out, that coming Monday was ‘International Day of Families’ and here I was far away from mine. Incidentally, I work in the line of agecare & elderly. Maybe that triggered the deep sense of ‘missing’ I was feeling and I was transported back in time. I could hear a faint distant voice… A voice which seems to come from a not so distant past and an integral part of me….
“Will we ever see you the next time you come visiting”? My Mum said as I ambled to hold on to my luggage and in turn my courage, to start walking away from them…
This is almost always the parting shot that I hear from one of my parents as I start to leave for my place of my work, which is another city, after a brief holiday at my native place. It has been 19 years since I have left my home – first for education and thereafter for livelihood. My different jobs have taken me almost everywhere across the country – except home. When I left home in 2004 for my studies in Mumbai, I left behind relatively middle-aged parents who were still working and happy to see their son finally take wings. 19 years hence, I have seen them slowly ageing and, in the process, losing many of the capabilities which we take for granted in our parents. Remember the ad “my daddy strongest!”… Well, how can Daddys become weak, frail and dependent… Or the ever active and bustling Mummy, balancing the professional with personal, the quintessential multi-tasker who could almost make everything work… Well almost… Now weak and a pale resemblance of the robust person she once used to be…
In India, to be in my shoes is not a unique or a special chance of fate, but the story of every other middle-class home whether in cities or smaller towns, in urban hubs or villages.. ‘Empty Nests’ / ‘Empty Nesters’ is a term which is increasingly becoming popular whereby many such homes wear a deserted look, as the children have migrated to larger cities or foreign shores, in search of better job & livelihood opportunities.
India has close to 138 million elderly which, in the next couple of decades, is slated to increase manifold (persons aged 60+ will increase by 354% and 80+ will increase by 500%) which will surpass the population of children below 14 years as compared to the overall Indian population which will increase only by 40%. There is a rise in the dependency ratio (from 10.9% in 1961 to 14.2% in 2011) amongst the elderly requiring health, care and support. Maximum elderly suffer from disability arising out of non-communicable diseases and a majority of them have functional disability (movement, vision, hearing) that require support. While the need and demand for care & support of the elderly is acute & on the rise, the breakdown in the traditional joint family system and job-related migration of the children sees many of them leading a low quality of life and suffering due to lack of proper care & support. While “Ageing in place” is an internationally recommended and best practice, it seems highly implausible for the elderly in India for the fact that, though many would like to “age in place”, the lack of a safety net of care & support is what aggravates and makes it impossible for them to adopt & adapt. Hence elderly are left in the lurch, where they are unable to lead a decent quality of life at their own place and are reluctant to stay with their children in bigger cities, which is devoid of the active and vibrant social lives that they lead in the smaller cities & villages.
On this 30th anniversary of the International Family Day, the theme could not have been more apt – “Demographic & Families”. In a country like ours, where we pride ourselves with a youthful population, the population of elderly is slowly but surely rising up to take up gigantic proportions. When the population of the elderly becomes almost double in the next 2 decades, we as a country are ill prepared to handle their need for care and support – neither from a health care or social care perspective.
There is a need to quickly act and work towards Long Term Care Policy & strategy which is holistic and comprehensive in nature, so that our public health social care and community are not burdened with the new and emerging need. Such approach requires action at a family, community and national level. The approach would firstly require, training of young unemployed youth as elderly Caregivers, which would be solving the twin problem of availability of trained Caregivers for elderly who can afford it, especially in urban India and the upskilling & employment of unemployed youth. Secondly, training the community and family members on basics of elderly caregiving, which helps them to execute it easily without depending on formal health care system. Thirdly, training and capacity budling of the health manpower on geriatric caregiving and also greater emphasis on training more doctors and healthcare team at the Regional Institutes of Geriatrics and other medical institutions, will greatly help in this matter. Fourthly, a standardisation and regulation of elderly Caregivers’ training, their certification & working, would go a long way in making such care effective and of the highest quality. Fifthly, the family Caregivers / community Caregivers should be incentivised through tax concession and “Elderly Care Leave” in-line with maternity / paternity leave, which will incentivise and facilitate elderly caregiving & support in the country. Lastly, there is a need for a Long-Term Care (LTC) policy for elder care in the country which needs to be formulated by the government. Schemes like the National Policy of Healthcare of Elderly (NPHCE), a comprehensive policy on elderly care & currently sub scale, needs to be activated and scaled up fully, to ensure it achieves its goals.
As I type out the vision for elderly care, LTC and caregiving of elderly with a focus on improvement in quality of lives of elderly; I again slip back to the small city and my home wherein reside two of my own elderly – my parents. I fondly and emotionally reminiscence my last see off with my parents as I started back for my journey to Delhi from my hometown. Coming out of my lane, as the vehicle waited on the main road, I looked back and saw my mother wobble to catch a glimpse of me, as I was about to turn the corner from where they can see me no longer… I turned back and blew a silent kiss at her and my dad, in what happened to be the last goodbye I was making before I left their home… This perfectly encapsulated the feeling that I have felt for years, a memory which I would like to hold on to, cherish and preserve, as I get back to the hustle and bustle of the busy city life, I live in a parallel universe…
A memory, a silent prayer and a deep longing which roughly translates into this emotional message “Oh dear mother, I am your child, who is not fortunate enough to lay down his head on your comforting lap, but I promise that I will steal such beautiful moments from time to time, no matter how brief and fleeting they may be, to be by your side and feel your motherly love soak me into my soul. Till then, I will keep on returning to you… Again, and again…”
This article has been written by:
Dr. Imtiaz Ahmed,
Mission Head – Agecare, HelpAge India
