Covid-19 should force India to think about its elderly population
In the last six months, Covid-19 has exposed the collective neglect and ignorance on how we take care of our elderly. While certain mitigating measures have been put in place, this would be an opportune time to consider a fundamental shift in re-imagining elderly care. The western model of moving older people to specialised care homes is being re-examined as such communities in the United States (US) and Europe have become epicentres of Covid-19-related fatalities. This is despite such facilities having high-grade infrastructure, trained personnel and proper safety protocols.
A recent article by Dileep Mavalankar and Jallavi Panchamia of the Indian Institute of Public Health, Gandhinagar, in these pages, focused on India’s old age homes which seem to have staved off the coronavirus so far. But, as rightly pointed out by the authors, more data-based and scientific research needs to be done to study the full impact of Covid-19 in old age homes.
The Association of Senior Living India (ASLI), an industry body representing senior care in India, has played a vital role in allowing members to share information, and learn from best practices on how the senior living industry can manage better infection control and Covid-support systems.
Of the 110 million elderly population in India, not more than a few thousand stay in senior living/old age homes. Over 99% either stay alone or with their children and most want to remain in their homes. It is important to find ways to empower older people to continue to live safe, secure, healthy and engaged lives in the place they love the most — their home.
It is now clear that even after vaccines become available, the challenges the elderly, who are more vulnerable, will face are likely to continue. The current health care system looks at the elderly as “patients” suffering from a particular disease. This disease-centric view in the health care industry often ignores the fact that most older people have multiple co-morbidities, and both they and their family members are unaware of the complex inter-relationships between disease treatments.
The increasing trend towards nuclear families, job-related migration, shifting social norms, and an increasing preference among elders to stay independent make their lives more vulnerable. In many ways, the life of an older person is disconnected — disconnected from health care, transportation, home-support systems, emergency systems, and most important, social engagement. Social distancing is something the elderly have experienced for decades now.
However, if technology and a greater understanding of their needs are interweaved, they can have the choice of remaining at home. Several neighbourhoods and resident welfare associations have recently demonstrated that there are possibilities where inter-generational teams can take the responsibility for addressing the needs of the elderly in the community.
Older people connected with offline and online communities can finally look forward to dealing with a “pandemic” they have faced all along, that of loneliness. Better technologies and sensors facilitate their staying at home and yet have the community at just a click away.
The problem lies in the perception that there is something wrong with becoming an older person. Old age is no different from other stages of evolution. But our collective imagination has stopped thinking beyond adulthood and billions of dollars are spent on the “being young” mindset.
We need a more productive dialogue among the elderly, their associations, civic bodies, urban designers and health care leaders on how we can have a long-term, partnered, inclusive and holistic care approach for the elderly. Systems for taking care of the elderly have failed across the world. The solutions call for innovation and inclusion. Perhaps India can show the way.
Saumyajit Roy is co-founder, EMOHA elder care
The views expressed are personal