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AGE is just a



Tamarapu Sampath Kumaran

About the Author: Mr T Sampath Kumaran is a freelance writer. He regularly contributes articles on Management, Business, Ancient Temples, and Temple Architecture to many leading Dailies and Magazines. His articles are, popular in The Young World section of THE HINDU His e-books and articles on nature, and different cultures of people around the world are educative and of special interest to the young. He was associated in the production of two Documentary films on Nava Tirupathi Temples, and Tirukkurungudi Temple in Tamilnadu.

Acknowledgement to: Mrs. Savithri Vaithi, whose dedicated service to the cause of the aged has inspired me to publish this e-book. Google for the photographs and for hosting my e-books. - Tamarapu Sampath Kumaran

Aging, an irreversible biological change that occur in all living things and with the passage of time, eventually resulting in death. Old age consists of ages nearing or surpassing the average life span of human beings. and thus the end of the human Life circle. Old Age and the aging process are of course biological happenings. It has its exclusive purpose, often beyond our control. Old age cannot be avoided. It is a phase of life, which will arrive and stay till death takes its toll. Problems of old age come in two forms: emotional and physical . Seniors are more vulnerable to chronic pain for a number of reasons including greater joint and muscle wear and tear, the presence of other medical conditions, and a general decrease in activity levels. Remember no two people are alike, and everyone has a unique approach to growing older. Caring for a loved one is a rewarding experience but the physical and emotional consequenes can be exhausting without some support. The ten Ways to Age successfully are: 1. Use it or lose it. As with any skill or capability we have learned, our physical, mental and social abilities will deteriorate if not challenged. This is intuitive, yet somehow as we age we attribute lost ability to getting old, rather than being out of shape or out of practice. 2. Keep moving. Physical activity is the closest thing we know to a fountain of youth. Staying active, even just 30 minutes most days can reduce the risk of developing heart disease, diabetes, osteoporosis, cancer, depression and even dementia. The best results come from three types of activity: endurance (walking, running, bicycling, rowing); flexibility and balance (stretching, yoga, tai chi); and strength. Strength training produces results that surprise both older adults and physicians. Just a few basic strength exercises twice weekly can work wonders to keep us totally independent for decades. 3. Challenge your mind. A great deal of the mental ability lost with age can be attributed to lack of use. Our mental function depends on neural highways, which like neglected roads eventually become unavailable for use. But we can continue to learn and grow new connections (or highways) in our brains throughout our lives. Courses, conversations with friends, learning a language, or even word games can

keep us mentally sharp. By keeping physically and mentally active, we are two times less likely to suffer from dementia. 4. Stay connected. We are social creatures and need human interaction to thrive. We can cherish family, rebuild neglected friendships, join clubs and stay open to meeting new people. 5. Never act your age. Our society equates aging with decline and expects little from older adults. If we follow our hearts, rather than obsolete expectations of aging, we will stay colorful, creative and engaged in life. And we will continue to contribute and give back to society. 6. Beware of the threats. Most of us are at high risk for certain diseases or conditions. By identifying these risks and working with our doctors, we can lower these threats and stay well and functioning at high levels for decades. Choosing to have immunizations, cancer screenings and physical exams can help protect our health, as can choosing life over the high risk of cancer or heart disease associated with smoking. 7. Eat for the long haul. Like machines, our bodies must have proper fuel to function. We need to drink lots of water, eat at least two helpings of fruits and five vegetables daily, take a multivitamin, and talk to our doctors about additional supplements we may need. Above all, we should not go long periods without eating: low glucose levels in the blood may be responsible for some dementia in later life. We can stay lean with physical activity and balanced eating, rather than dieting. 8. Have children in your life. We may value the relative peace and absence of responsibility in our lives since our children left home, but we will have a difficult time finding meaning in life or giving back without children involved. Those of us not blessed with grandchildren can look into other opportunities in the community, such as mentoring, storytelling at schools or libraries, or daycare. Organizations that work for the benefit of children, such as the Big Brothers and Big Sisters programs, also welcome volunteers. 9. Be needed. There are many opportunities to work for the betterment of the community or of those less fortunate. We took care of others when we were younger. Now, more than ever, there is a need for us to reach out. Any activity that gives us a sense of nurturing the world around us will help us, as we help others. Even plants and pets can offer us the kinds of relationships that help us stay engaged in life.

10. Laugh. The most common trait seen in people ages 100 years or older is a sense of humor and optimism. Humor is the mainstay of life. It allows us to bear discomfort, fear and loss, and still go on; it even stimulates the immune system, protecting us from disease. Humor also makes the journey more pleasant for us and for those around us Aged The Indian Scenario: Indian family is considered strong, stable, flexible and enduring. Historically the traditional perfect and beloved family in India is the joint family. Joint families consist of three to four living generations, including uncles, aunts, nieces, nephews, and grandparents living together in the same home. Indian culture is unique. It is inclusive and nurtures diversity. It treats every being, every object, as divine. Its world view is comprehensive. The age old culture of our nation remains as the bedrock of our lives and continues to guide our destiny, without many of us being aware of it. In an age filled with confusions and conflicts around the world, the time tested Indian culture remains the beacon light. Close knit families are our critical assets. They are the reason for bringing up responsible citizens, maintaining peace in the society, saving enormous amounts of money for the nation and creating new ventures. Relationship based and integrated societies are the products of our system. We have huge social capital that helps us to maintain harmony and support economic growth. Indian families and communities possess the capacity to function on their own, without depending on the state. The story of independent India reveals that much of her progress has been mostly on her own, many times in spite of the government. The head of the family is generally the senior male family member and is respected for his seniority, experience, and good judgment. The head of the family sets up rules for his family. He controls the familys finances and serves as the judge in case of family disputes. One of the important characters of the joint family is its shared nature. Family tasks like cooking, cleaning, caring for the children, and performing home maintenance are structured in a shared manner. The family members complete the tasks on a rotating basis, or else individual family members become responsible for

specific tasks. Every family member involves and participates in life-cycle events or celebration such as births, marriages, deaths, and any type of regional festival celebrations. The traditional norms and values of Indian society laid stress on showing respect and providing care for the elderly. Consequently, the older members of the family were normally taken care of in the family itself. The family, commonly the joint family type, and social networks provided an appropriate environment in which the elderly spent their lives.

The reason why Indians are proving to emerge as a prosperous lot globally, many researches claim, is because of the significance they attach to the joint family system. All working cohesively to solve a problem faced by any one or more members of the joint family, is what works magic in keeping one tension-free, happy and contended even in todays highly competitive environment. India is a country of villages, and nearly three quarters of its population is rural. Urban and rural areas provide striking contrasts in terms of living conditions, availability of resources and facilities. There are regional variations in the condition of villages but in general, most villages have poor sanitary conditions and less access to education and health facilities. Most rural folk work on their own

land or as agricultural labourers. There is neither income security nor any systematic provision for old age. Children are perceived as old age security.

Today we have a generation of people who after having lived in a joint family system have taken the plan to break out and start a nuclear family. The generation that broke out of the old joint family system did so when personal thinking began to gain predominance in the society. The advent of modernization, industrialization, urbanization, occupational differentiation, education, and the growth of individual philosophy have eroded the traditional values that vested authority with elderly. These have led to defiance and decline of respect for elders among members of younger generation. Although family support and care of the elderly are unlikely to disappear in the near future, family care of the elderly seems likely to decrease as the nation develop economically and modernize in other respects. For a developing country like India, the rapid growth in the number of older population presents issues, barely perceived as yet, that must be addressed if social and economic development is to proceed effectively. Unlike in the western countries, where there is dominant negative effect of modernization and urbanization of family, the situation in the developing countries like India is in favour of continuing the family as a unit for performing various activities. In spite of several economic and social problems, the younger generation generally looks after their elderly relatives. Though the younger generation takes care of their elders in traditional societies, it is their living conditions and the quality of care, which widely differs from society to society.

The living room, which once brimmed with incessant chatter in the evenings with family members surrounding the television, has gone silent.

Resting in his armchair, an ageing member in a family, reminisces, "Those days, evenings would be time for family reunion, when my sons would come back from work, daughters would prepare tea and snacks and all of us would sit together in front of the television to watch a popular musical show on the national television. Now, my wife and I seldom visit our children settled in different parts of the country". Indian societies are changing rapidly due to urbanisation, the steep aspirations of the youth and the increased numbers of women workforce. All these factors have led to a decline in the number of joint families and an increase in the concept of nuclear families. The direct impact of this is that the care and support of the elderly in India is getting marginalised. Rapid industrialisation in India is the main factor of the disintegration of joint family system. The joint family system was very popular among the rural people whose main occupation was agriculture. Due to the impact of industrialisation, a number of industries, factories, have been set up in India. In order to get employment people move from villages to cities. Industrialisation also affected the village and cottage industries. In ancient times duet to the lack of quick means of transportation and communication people were compelled to live together in joint family and pursue the family occupation. They could not move from one place to another easily, during those days. Due to the impact of science and technology the means of communication and transportation have expanded rapidly. It is no longer necessary for people to stay with the family and carry on their family occupation. Now-a-

days, they go to the city and take up any other occupation and establish new family. Today the Indian way of living and thinking have been very much influenced by the western culture and civilisation, because all the members get freedom and enjoy equal right and privileges in the western families. As a result of which the members who had so far been living in a joint family want to follow the living style of western pattern of single family. The decline of agriculture and cottage industries is another main factor for disintegration of the joint family in modern times. In the past agriculture and cottage industry was the main occupation of the rural people. But now the situation has changed. Today, with the establishment of factories, the goods and commodities which are produced by the village craftsmen cannot compete with the products of factories in respect of price and quality. As a result of which the village industries suffer serious loss and finally close down. Due to the closing of the village industry the workers are forced to move to the city. Similarly, agriculture which was the main occupation of rural people has now declined due to certain natural calamities such as flood, cyclone, drought, etc. All these factors lead to the disintegration of joint family. Lack of privacy and shortage of accommodation have led to the disintegration of joint family system. Since joint family does not provide adequate accommodation to its members, the newly married couple prefers to live in a nuclear family which provides necessary liberty, privacy and accommodation for a happy and better living. Traditionally, women are the worst sufferers in the joint family system. But now the spread of women education has led to the liberation of women. Educated women do not like to live under the direct control of the male members. They prefer to live an independent life in a separate small family. As a result of which joint family disintegrates.

Given the trend of population aging in the country, the older population faces a number of problems and adjusts to them in varying degrees. These problems range from absence of ensured and sufficient income to support themselves and their dependents to ill health, absence of social security, loss of social role and recognition and to the non-availability of opportunities for creative use of free time. The needs and problems of the elderly vary significantly according to their age, socio-economic status, health, living status and other such background characteristics. As people live longer and into much advanced age, say 75 years and over, they need more intensive and long term care, which in turn may increase financial stress in the family. Among the several problems of the elderly in our society, economic problems occupy an important position. Mass poverty is the Indian reality and the vast majority of the families have income far below the level, which would ensure a reasonable standard of living. The Ministry of Social Justice and Empowerment, Government of India in its document on the National Policy for Older Persons, has

relied on the figure of 33 percent of the general population below poverty line and has concluded that one-third of the population in 60 plus age group is also below that level. Though this figure may be understated from the older peoples point of view, still accepting this figure, the number of poor older persons comes to about 23 millions. As people live longer and into much advanced age they need more intensive and long term care, which in turn may increase financial stress in the family. Inadequate income is a major problem of elderly in India. The most vulnerable are those who do not own productive assets, have little or no savings or income from investments made earlier, have no pension or retirement benefits, and are not taken care of by their children; or they live in families that have low and uncertain incomes and a large number of dependents Nearly half of the elderly are fully dependent on others, while another 20 percent are partially so. For elders living with their families-still the dominant living arrangement-their economic security and wellbeing are largely contingent on the economic capacity of the family unit. Particularly in rural areas, families suffer from economic crisis, as their occupations do not produce income throughout the year. Nearly 90 percent of the total workforces are employed in the unorganised sector. They retire from their gainful employment without any financial security like pension and other post-retirement benefits. The organized sector workforce who includes the employees of the Central and State governments, of local government bodies, and of major enterprises in basic industries constitute approximately 30 million workers and nearly one in every 10 members of the total Indian workforce of 314 million. The work participation rate among the elderly was around 40 percent. More elderly men participate in the economic activities compared to women. The participation is high in rural areas compared to urban areas. The bulk of the 60 plus workers were engaged in agriculture. Nearly half of the elderly are fully dependent on others, while another 20% are partially so. Women are more likely dependent on others, given lower literacy and higher incidence of widowhood among them. Vulnerable groups like the disabled, fragile older persons, and those who work outside the organized sector of employment like landless agricultural workers, small and marginal farmers, artisans in the informal sector, unskilled labourers on daily, casual or contract basis, migrant labourers,

informal self-employed or wage workers in the urban sector, and domestic workers deserve mention here. As human life advances from childhood to youth and from youth to manhood, at every stage there is a meaningful and responsible role to play. At the same time, every stage of human life is exposed to numerous risks and hazards associated with occupation and age. In this process, as it advances from manhood to old age, new stresses and strains engulf human existence. The family has generally been. the traditional primary source of the social, economic, psychological and physical support for the aged. However, the elderly get affected due to lack of support from children who would have grown into adulthood and are in the web of fulfilling their own priorities. Due to lack of any worthwhile scheme of social insurance or social assistance these elderly become one of the marginalised and vulnerable sections of the society. Emerging changes in the demographic, social and cultural mores of the society is also one of the major causes behind the unfavourable scenario of the twilight zone of human life. The intensity of old age problems varies from rural to urban and ageing from person to person and of course from men to women. The problems of the elderly essentially concern: . Lack of Income Security . Absence of appropriate Health Care . Deprivation of Social and Emotional needs . Lack of Personal Security.

In general older people are considerably poorer than young active members in the work force. In India old age is associated with lowering of economic status, financial insecurity and at times abject poverty. Economic wellbeing of a society is often measured by dependency ratio. Persons under 15 years and above 60 are assumed to be economically inactive and depend on population aged 16-59. Dependency ratios are calculated taking these three segments of population. Inadequate income and poverty lead to dependency on bread earning/care taker group. Dependence rate is very high in India, and is around 53 percent in 2001. For every working person in the future, there will be 2 dependent persons. In turn this trend creates economic, social, health and

psychological pressure on care givers. The National Sample Survey Organisation (NSSO) studies show that nearly half of the aged persons in India are fully dependent on others. Out of these three fourths are supported by their children. Rural elderly work for longer time as agriculture labourers, while urban elderly seek re-employment. In a country with high unemployment rate, this may not be easy. At times poor health may act .as an obstacle for reemployment. Let not the statistics that two thirds of the Indian population is under 30 years lead us to believe that we don't have a problem about our elders. The situation may not be as intense as it is in Japan but it is surely creeping in. In cities, when there is only one older living spouse, many problems stem from property ownership issues. The older people bear a lot of mental harassment to transfer the property to their children's name. On the one hand, property is the only security they have; signing it away will leave them extremely insecure. On the other hand, if they don't transfer the property, their day to day existence will be a living hell. The last couple of decades have seen a great leap in life expectancy. The average age of human life has increased. This is being heralded as a marvel. This, however, means that that as people get older, unless they have had the discipline of following a healthy regimented life; they can be in for a long period of illness and suffering. The ill effects of chewing tobacco, smoking or alcoholism can catch up in old age. Due to the lack of health awareness from of the previous generations, most elderly people have unhealthy habits that lead to medical problems like cardio vascular diseases, tuberculosis, asthma etc. In addition, there is a malaise of aging problems, the physical strength diminishes, mental recall and stability deteriorates; many have memory loss. The needs of the elderly are unique and distinctive as they are vulnerable. Health, economic and psychological needs are most important. Among the medical problems, vision (cataract) and degenerative joint disease top the list, followed by neurological, cardiovascular and urinary diseases. Malignant diseases account for a sizeable extent of morbidity. Other problems of concern are malnutrition, frequent falls and cognitive dysfunction. To compound this, the aged often have more than one illness. Geriatrics, a branch of medicine that deals with the diagnosis and treatment of illness among the elderly is getting more challenging as the incidences of impaired vision and hearing loss is increasing. A simple trip and small fall can lead to a fracture or breaking of the already fragile bones. Loss of memory and

other associated diseases such as Alzheimer, Parkinson cause additional demands on the old age. The biggest disquiet is the negligence from the younger generation. Lifestyles in modern India have driven the younger generation in a race of economics. The 57 million populations of elderly above the age of 60 years are learning to deal with loneliness, craving for companionship and a sympathetic ear to listen to their melancholy. In India, the lack of a social security system is wanting where the government machinery pays for the food and medication of the old and needy, compared to the system of America keeping nearly 40% of the elderly beyond the ages of 65years, out of poverty. A western trend is for the affording elderly to hire an investment banker to look after their savings and to check into a well-established home of the aged. In India, however, since the social grapevine and social scandal is such a deterrent, most older people prefer to live with their children and grandchildren, rather than live in an old age home, whether they are well tended for or not. In modern India, retirement age is fixed at 58 in most Government jobs, and 60 years in the Universities. There is a move to increase the retirement age by another two to five years. For all practical purposes people above 60 are considered to be senior citizens. In academic research, retirement age is often taken as an index of aged status. Chronological age of 58 or 60 is considered as the beginning of old age. The Indian aged population is currently the second largest in the world. The absolute number of the over 60 population in India will increase from 76 million in 2001 to 137 million by 2021. There is also considerable discrepancy in provision between urban and rural areas in availability and access to health care resources. Rural poor and those living in tribal areas have little access to modern, high cost, urban based medical care. It is well documented that as people live longer, medical expenses will consume a major share of their savings. When people are already poor, living longer may ultimately mean living with unattended medical problems as health services cannot be readily purchased. The idea that old age is an age of ailments and physical infirmities is deeply rooted in the Indian mind, and many of the sufferings and physical troubles within curable

limitations are accepted as natural and inevitable by the elderly There is a general perception among the elderly that they are prone to illnesses mainly due to their advanced age and that it is natural to suffer from such health problems at that age. However, in reality, most of their diseases are minor in nature and curable at the initial stage itself. Most of them neglect the illnesses and postpone seeking medical aid. In some cases, due to neglect of timely medication, the health problems become aggravated and sometimes lead to death. The idea of institutionalisation of the aged has been largely borrowed from the western societies, whose values and norms are quite different from that of India.

Old Age homes are, generally, the last resort for the aged. In the absence of joint family system, nuclearisation of families, the old parents are left with no other alternative than joining the old age homes. According to a study conducted in the old age homes of Maharashtra almost 64 per cent of inmates had nobody to take care of them, and among them 45 per cent had no money. Economic consideration is one of the main reasons for choosing old age homes and even if there is family to support, the domestic environment and poor interpersonal relationships also push the aged to old age homes. There has been a growing market for retirement homes in India in recent years. With an increasing number of older adults living independently, this trend is likely to continue. In large cities relatively well-to-do people are considering living in special condominiums built for older people. In metropolitan cities, senior housing projects with medical and recreational facilities are being promoted by construction companies. Integrated housing schemes where older people can live in their own apartments in a building complex that also houses orphanage, hospital, bank and other services, are also being introduced.

Retirement homes, a popular concept in the West, are beginning to find a market in India. Changing social dimension fading joint families and financial independence are some factors that are contributing to the trend. It offers independence, community and security. The retirement homes idea was born when the doctors found that many of their elderly patients who seemed to have no particular physical ailments suffered from the 'Empty nest' syndrome - almost all of them had children who had moved away to other countries or cities. And with the joint-family system not a feature of urban living any more, the effects of that syndrome had become even more acute. Hence, the doctors brought out the idea of setting up retirement homes. In India and many other less-developed countries, federal and local governments provide a variety of public services in areas of health and education. However, these services are often inadequately provided and why these services do not reach the poor has been unclear as per several studies made. Simply informing the poor about government-provided health, educational, and social services they are entitled to could empower them to take greater advantage of free or low-cost public services. Japan is today the only country with more than 30 per cent of its population aged 60 or above. By 2050, there will be 64 countries where older people make up more than 30 per cent of the population. In simple terms, within a decade there will be one billion older persons worldwide. And by 2050, nearly 80 per cent of the worlds older persons will live in developing countries with China and India contributing to over one-third that numbers. According to United Nations Population Fund, by 2050, India will be home to one out of every six of the worlds older persons, and only China will have a larger number of elderly people. The report says the number of elderly women is more than that of elderly men. Nearly three out of five single older women are very poor, and two out of three

rural elderly women are fully dependents. There is also an increasing proportion of elderly at 80-plus ages, and this pattern is more pronounced among women. A study, undertaken by HelpAge in Kerala, Tamil Nadu, Maharashtra, Orissa, West Bengal, Punjab and Himachal Pradesh, suggests that one-fifth of the elderly live alone. This proportion has registered a sharp increase in the past two decades and is more evident in the case of elderly women. Across the States, there is a substantial variation in the type of living arrangement, particularly in the proportion of elderly persons living alone. The percentage of those living alone or with spouse is as high as 45 per cent in Tamil Nadu, Goa, Himachal Pradesh, Maharashtra, Punjab and Kerala. This indicates that with a demographic transition under way and youth migrating out for economic reasons, there will be a drastic change in the living arrangements of the elderly in rural and urban areas. The large segment of the elderly, those living alone or with spouse only, and the widowed who are illiterate, poor and particularly those from the Scheduled Caste and Scheduled Tribe families, low wealth quintiles will definitely require various kinds of support: economic, social and psychological. These, at present, are woefully lacking The Ministry of Social Justice and Empowerment put in place the National Policy on Older Persons in 1999 with a view to addressing issues relating to aging in a comprehensive manner. But the programme failed at the implementation level. The Ministry is now formulating a new policy that is expected to address the concerns of the elderly. The idea is to help them live a productive and dignified life. There is a scheme of grant-in-aid of the Integrated Programme for Older Persons, under which financial assistance is provided to voluntary organisations for running and maintaining projects. These include old-age homes, day-care centers and physiotherapy clinics. While the scheme, indeed the concept, is still alien to India, the Ministry is considering the revision of cost norms for these projects, keeping in view the rising cost of living. The most recent intervention has been the introduction of the National Programme for Health Care for Elderly in 2010, with the basic aim to provide separate and specialised comprehensive health care to senior citizens. The major components of this programme are establishing geriatric departments in eight regional geriatric centers and strengthening health care facilities for the elderly at various levels in 100 districts. Though the scheme is proposed to be expanded during the Twelfth Five Year Plan, the regional geriatric centers are yet to take off because of lack of space in the identified institutions.

The enactment of the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, was a legislative milestone. However, its implementation has been poor. With poor social security arrangements for the elderly, it is not surprising that around 37 million elderly in India are engaged in productive work, according to NSSO data for 2004-05. A majority of these workers are illiterate or have limited levels of education. Half the women elderly workers are from the two poorest consumption quintiles. This indicates that illiteracy and poverty push them to undertake work outside as a survival strategy, or out of compulsion Although in general the majority of businesses are still in the early stages of developing collaborations with NGOs, a wave of companies both new and longstanding are taking the lead I bringing business financial and human resources as well as a systems approach to the job of bridging Indias wide gap between rich and poor Drawing on a historical precedent, these businesses recognise the pivotal role of businesses in nation building and are building relationships with NGOs to create real change. However, sectoral stereotypes, a fierce short-term business climate and an under capacity NGO sector are obstacles to greater scale and impact. A vital opportunity exists to achieve a step-change in Indias inclusive growth and prosperous development by companies working much more extensively in partnership with civil society, NGOs and government. CARE has been working in India for over 60 years, focusing on ending poverty and social injustice. We do this through well-planned and comprehensive programmes in health, education, livelihoods and disaster preparedness and response. Our overall goal is the empowerment of women and girls from poor and marginalised communities leading to improvement in their lives and livelihoods. We are part of the CARE International Confederation working in 84 countries for a world where all people live in dignity and security. In India CARE focuses on the empowerment of women and girls because they are disproportionately affected by poverty and discrimination; and suffer abuse and violations in the realisation of their rights, entitlements and access and control over resources. Also experience shows that, when equipped with the proper resources, women have the power to help whole families and entire communities overcome poverty, marginalisation and social injustice. HelpAge India a, non-profit organisation registered under the Societies' Registration Act of 1860, were set up in 1978, and since then have been raising

resources to protect the rights of Indias elderly and provide relief to them through various interventions. Several NGOs with support from Business houses are running Homes for the poor and voice the needs of India's 100 million (current estimate) "grey" population, and directly impact the lives of lakhs of elders through their services.

A study of older persons in various slums at an advanced age reflects that due to restricted physical activity, a majority of elderly change their living habits, especially in their dietary intake and duration of sleep.

Mental health of the elderly is another important area in understanding their overall health situation. It is generally expected that the elderly should be free from mental worries since they have already completed their share of tasks and should lead a peaceful life. But, often, the unfinished familial tasks like education of children, marriage of daughters, etc., becomes a source of worry over a period of time. It is noticed that the worries among the poor are probably about inadequate economic support, poor health, inadequate living space, loss of respect, unfinished familial tasks, lack of recreational facilities and the problem of spending time. There is a general perception among the elderly that they are prone to illnesses mainly due to their advanced age and that it is natural to suffer from such health problems at that age. However, in reality, most of their diseases are minor in nature

and curable at the initial stage itself. Most of them neglect the illnesses and postpone seeking medical aid. In some cases, due to neglect of timely medication, the health problems become aggravated and sometimes lead to death. There appears to be a significant difference in the health situation of the elderly living in rural areas when compared to urban areas. The elderly people living in rural areas appear to be much healthier as compared to those residing in urban areas. Health care system at various levels in our country is designed for the general population and no special provision preferences are so far provided in the system to take care of the elderly in our society. A fact that has been found universally valid is the relationship between poverty and ill health. Many of the communicable diseases, especially debilitating diseases like fever and diarrhea, take a heavy toll on the poor. In the case of both acute and chronic diseases the lower socio-economic status group fare very badly compared to the higher socioeconomic status groups. The same trend is seen in case of disabilities and handicaps too. It is seen that in both cases morbidity shows a steady pattern; whatever be the illness its prevalence increases as socio-economic status goes down. These indications from the above facts clearly indicate that poor people are more vulnerable than the rich; women; and those who stay in villages have a higher incidence of diseases than men and urban people. Also poor people spend larger proportion of their income on medical bills than the rich. Since medicines and consultations are very expensive, they take medicines only until the symptoms go away, and as a result, most of the leading ailments become chronic in nature. Getting proper medical aid was found to be beyond the reach of the elderly, which may have been due to their poverty, illiteracy, general backwardness and adherence to superstitious beliefs for curing illnesses and diseases.


The trend in the size and growth rate of the elderly population in the country reveals that aging will become a major social challenge in the future when vast resources will need to be directed towards the support, care and treatment of the old. Therefore, it is high time suitable policy measures to minimize the problems of elderly in the country were adopted. The following are some of the measures suggested to improve the health status of the elderly in India: Health education of the elderly should form an important aspect of the health

Care, so that they could learn certain do's and don'ts related to the different diseases and inculcate these in their behavioral patterns through constant practice so as to prevent the occurrence of diseases or reduce the effects of Illness. There is a necessity to train both indigenous and allopathic doctors to handle the specific illnesses associated with aging. It is necessary to set up subsidized health care for the elderly with special units in hospitals and with free or highly subsidized medicines. Subsidized health care would also represent an indirect transfer of resources to the family. Society should construct and provide shelters for the poor and the sick. Government should institute a national heathcare insurance policy that every one could buy into. The poor should be subsidized for the premium and deductibles. The aim should be to stabilize costs and make medical care available and affordable for all people. Once the system gets stable, free market care can be slowly introduced back again after 10 years.