A society ages when there is an increase in its elderly population along with decrease in the rest of the population. It is the result of demographic transition in which a population moves from high to low fertility and mortality rates. This inevitable and irreversible process affects one's physical and psychological well-being. Besides, it is said to have social, economic and cultural implications too. Therefore, the studies on ageing are significant for understanding the problems related to elderly care, which is an urgent need in the 21st century.
Defining Ageing/Old Age
Although everyone is familiar with ageing, defining it is not so easy. Elderly or old age consists of ages nearing or surpassing the average life span of human beings. The boundary of old age cannot be defined exactly because it does not have the same meaning in all societies. However, despite a number of commonly used definitions of old age, there is no general agreement on the age at which a person becomes old. Though most countries of developed world have accepted the chronological age of 65 years as a definition of 'elderly' or older person, but like many westernized concepts, this does not adapt well to the situation in developing or underdeveloped countries. At the moment, there is no United Nations standard numerical criterion, but its agreed cutoff is 60+ years to refer to the older population
Lacking an accepted and acceptable definition, in many instances, the age at which a person becomes eligible for statutory and occupational retirement pensions has become the default definition. According to Gorman (2000), "The ageing process is of course a biological reality which has its own dynamic, largely beyond human control. However, it is also subject to the constructions by which each society makes sense of old age. In the developed world, chronological time plays a paramount role. The age of 60 or 65, roughly equivalent to retirement ages in most developed countries, is said to be the beginning of old age. In many parts of the developing world, chrono logical age has little or no importance in the meaning of old age. Other socially constructed meanings of age are more significant such as the roles assigned to older people; in some cases it is the loss of roles accompanying physical decline which is significant in defining old age. Thus, in contrast to the chronological milestones which mark life stages in the developed world, old age în many developing countries is seen to begin at the point when active contribution is no longer possible."
Indian Scenario
The population of elderly is growing everywhere in the world. In the l century, the proportion of population aged 60 and above has increased almost all the countries of the world. According to an estimate, about 6 million people were aged 60 and above at the turn of new millennium and the number is expected to further increase mainly due to substantial improvement in life expectancy throughout the world. This has become possible because of improvement in public health and medical advances in the prevention of many deadly epidemic diseases.
Percentage Share of elderly population (60-plus) in total population
Source
- Census 1961
- Census 1971
- Census 1981
- Census 1991
- Census 2001
- Census 2011
Persons
- 5.6
- 6.0
- 6.5
- 6.8
- 7.4
Female
- 5.8
- 6.0
- 6.6
- 6.8
- 7.1
Male
- 5.5
- 5.9
- 6.4
- 6.7
- 7.1
The tremendous growth of the elderly population is not unique to the industrialized or developed societies. People in the age group 65 and above i European and Asian industrialized nations now account for at least 15 to 20 percent of their nations' population. By 2025, the 60-plus world population expected to approach 1.2 billion people. In most nations, the older population is growing faster than the population as a whole.
India is also heading towards the similar demographic pattern (i.e., lov birth rate and low death rate) like other developed countries of the world. The elderly or senior citizens (aged 60 years and above) in India numbered 767 million (37.8 million males and 38.8 million females) in 2001 registering an increase of 19.9 million persons compared to their number in 1991. la percentage terms, the share of elderly population, which was 6.8 per cent of the total population in 1991, increased to 7.4 per cent in 2001, and is expected to further increase to more than 10 per cent by the year 2021. For males it was marginally lower at 7.1 per cent, while for females it was 7.8 per cent.
Problems Faced by the Aged
In general, the following problems are faced by an elderly person:
(i) Failing health: It has been rightly said that "we start dying the day we are born". The ageing process is synonymous with failing health. While death in young people in countries such as India is mainly due to infectious diseases, 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/or high costs of disease management make reasonable elder care beyond the reach of older persons, especially those who are poor and disadvantaged.
(ii) Economic insecurity: The problem of economic insecurity is faced by the elderly when they are unable to sustain themselves financially. Many olde persons either lack the opportunity and/or the capacity to be as productive they were, Increasing competition from younger people, individual, famil and societal mind sets, chronic malnutrition and slowing physical and mental faculties, limited access to resources and lack of awareness of their rights and entitlements play significant roles in reducing the ability of the elderly to remain financially productive, and thereby, independent.
(ii) Isolation: Isolation, or a deep sense of loneliness, is a common complaint of many elderly is the feeling of being isolated. While there are a few who impose it on themselves, isolation is most often imposed purpose fully or inadvertently by the families and/or communities where the elderly live. Isolation is a terrible feeling that, if not addressed, leads to tragic deterio- ration of the quality of life.
(iv) Neglect: The elderly, especially those who are weak and/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 self-neglect of the elderly by families and communities. This is worsened as the elderly are less likely to demand attention than those of other age groups.
(v) Abuse: The elderly are highly vulnerable to abuse, where a person is willfully or inadvertently harmed, usually by someone who is part of the family or otherwise close to the victim. It is very important that steps be taken, whenever and wherever possible, to protect people from abuse. Being relatively weak, elderly are vulnerable to physical abuse. Their resources, including finances ones are also often misused. In addition, the elderly may suffer from emotional and mental abuse for various reasons and in different ways. The major forms of abuse are physical, sexual, psychological and economic, which are discussed in detail in the latter part of the chapter. Where necessary, legal action needs be taken against those who willfully abuse elders, combined with counseling of such persons so as to rehabilitate them. Elderly who are abused also require to be counseled, and if necessary rehabilitated to ensure that they are able to recover with minimum negative impact.
(vi) Fear: Many older persons live in fear. Whether rational or irrational. this is a relevant problem face by the elderly that needs to be carefully and effectively addressed. Elderly who suffer from fear need to be reassured. Those for whom the fear is considered to be irrational need to be counseled and, if necessary, may be treated as per their needs. In the case of those with real or rational fear, the cause and its preventive measures needs to be identified followed by appropriate action where and when possible.
(vii) Boredom(Idleness): Boredom is a result of being poorly motivated to be useful or productive and occurs when a person is unwilling or unable to do something meaningful with his/her time. The problem occurs due to forced inactivity, withdrawal from responsibilities and lack of personal goals A person who is not usefully occupied tends to physically and mentally decline and this in turn has a negative emotional impact. Most people who ha reached the age of 60 years or more have previously led productive lives would have gained several skills during their Lifetime.
(viii) Lowered self-esteem: Lowered self-esteem among older persons has a complex etiology that includes isolation, neglect, reduced responsibilities and decrease in value or worth by oneself, family and/or the society.
(ix) Loss of control: This problem of older persons has many facets. While self-realization and the reality of the situation is acceptable to some, there are others for whom life b comes insecure when they begin to lose control of their resources-physica, strength, body systems, finances (income), social or designated status and decision making powers.
(x) Lack of preparedness for old age.: 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 (s)he attains the age of 60 years, there is no such clear indicator available to the individual. For each person, there is a turning point after which (s) he 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
Elder Abuse
Elder abuse is recognized as a continually increasing and serious problem in our society. According to World Health Organization (WHO), it is a violation of human rights and is a significant cause of illness, injury, loss of productivity, isolation and despair.
Each year, hundreds of thousands of adults over the age of 60 are abused, neglected or financially exploited. In India alone, a majority of older adults are believed to be abused or neglected at various levels. These statistics are likely an underestimate because most of the victims are unable or afraid to tell the police, family or friends about the violence.
Ageing and Elder Abuse In India