How the second wave devastated the elderly in India
One evening, in late-May, Neeta Malhotra, a senior citizen, needed help to cremate her elderly mother, in a South Delhi colony.
In March, just before the number of Covid-19 cases started increasing and spiralling out of control, her family had four living members. Towards the end of May, Sharma found herself all alone. Her husband, an able-bodied ex-army officer contracted the virus and never made it back from hospital. Her mother-in-law and mother died of old age. They were both 94.
That evening in May, she was bereft. The doctors advised her to go through with the cremation as soon as possible. It was already 6pm. She picked up her phone and called Gaurav Khosla, the president of the resident welfare association, who in turn, quickly called the local member of the legislative assembly, Somnath Bharti.
“My sorrow is mine and I am learning to deal with it but one must never forget the acts of kindness,” she says, narrating how Bharti reached her home, arranged for a hearse and accompanied her for the cremation. For a while at least, she forgot that the family had been reduced from four members to one. Malhotra acknowledges the help and is grateful for it. She now spends her mornings teaching her support staff’s children.
Twenty kilometers away, in a slum colony in east Delhi, Shokat Ali, 73, who has three daughters and two sons, is confronting another set of challenges. He is dependent on help from Agewell Foundation, a non-governmental organisation (NGO) that works with the elderly. Their offices are shut but their services are not.
Through a network of 80,000 volunteers, across states, Himanshu Rath, the organisation’s founder, is working overtime to help the elderly destitute, including Ali who worked as a plumber but can work no more. He gets dry rations and one of his daughter comes by with food, once in a while. What do you do when you’re hungry? “I can cook Maggi (instant noodles),’’ he says.
Covid-19 has changed Ali’s life completely. He cannot stir out of his jhuggi. There are no parks in the neighbourhood and everyone around him is trying to survive and subsist. “If 10 out of 100 are suffering from Covid, the remaining are suffering from the fear of Covid. We work for a better tomorrow but the elderly are at a loss. They don’t know if they will survive,” says Rath.
The living abandoned, the abandoned dead
At 140 million, India has the second largest population of old people in the world, as per the 2011 census. Several NGOs working with the elderly are finding themselves totally stretched. From providing dry rations to cooked meals, medicines to hospital beds, psychological counselling to physical hand holding in homes for those with dementia and Alzheimer’s, social workers are also helping rescue the “living abandoned” and the “abandoned dead”. Most of them work with the police and social welfare departments and receive urgent calls for help.
HelpAge India, an NGO that is focusing on the elderly, has 176 mobile health units, each equipped with a doctor, a pharmacist and a social protection officer. Says Imtiaz Ahmed, Mission head, AgeCare division, “The units, which take health care to the interiors and to the doorsteps of the bed-ridden, are now doubling up as ambulances. The saddest aspect of this pandemic is that the elderly are being abandoned.”
AgeCare’s statistics speak volumes of how cruel the second wave has been on India’s senior citizens. The total number of calls for help in the January to May period for 2020 and 2021 has shot up by 36%. Distress calls that include pleas for rescue of the abandoned elderly are up by 82.7% and information pertaining to the missing or the dead are also up by 60%. There is a 65% rise in those seeking medical assistance. Those reporting abuse, domestic violence and property dispute issues are also up by 19%.
The mental health impact
Agewell Foundation’s Rath has received several calls from the elderly complaining that they are being pressured into writing their wills. When written, family disputes break out, on why a particular son has been given more of the share of the property or jewellery. “There have been cases where the elderly have been denied food. That’s the family’s way of punishing the parent for writing the will a particular way. This adds to the insecurity of the senior citizens who, already isolated, are then denied food and medicines,” says Rath.
Senior psychologist Suresh Kumar, who counsels Agewell’s client base, is dealing with a host of issues. “We are providing a confidential space to the elderly who are grappling with property issues, post-retirement blues, job losses, the fear of dying and a deep sense of loss. There was less panic during the first wave. This time, the fear of death has become real.” says Kumar.
An Agewell survey, based on 5,000 respondents, found the elderly complaining of depression, anxiety, fear and a sense of loneliness and isolation. According to the study, released last month, there has been an over 50% rise in the number of older people seeking help for psychological issues.
The elderly are grappling with innumerable questions.
“Will I get a hospital bed if I get Covid?”
“Will I die?”
“Will our children die before us?”
“Will our children lose their jobs?”
“What kind of world are we leaving behind for our grandchildren?”
The answers are not easy.
Some of the elderly don’t have enough food to eat and many more are dependent on the network of NGOs for medicines and vaccines.
As part of its medical kit, Agewell is also distributing adult diapers for the severely ill, who are bed-ridden. Says Rath, “They also suffer humiliation and a loss of basic human dignity. They are totally dependent on family members, some of who are understanding while many are not. They too are grappling with the sheer grind of life.”
The care infrastructure
Some of the elderly are in a position to afford care giving services. Samvedna is one such organisation which provides senior care service for a price. “The children find us,” says its founder, Archana Sharma. Packages can cost up to ₹30,000 a month and include a “care at home” model.
“While last year’s lockdown saw us providing groceries and medication, this time, mental health issues have surfaced. It has gotten closer to home for all of us and the elderly are scared of losing family members.”
Jayashree Dasgupta, Co-Founder, Samvedna, is catering to the psychological aspects of elderly clients who have children living far away in different cities. “We are seeing an increase in clients but we also lose a lot of clients due to mortality. The elderly under our care can’t visit their children and relatives; they can’t go for the last rites of members they’ve lost and they struggle with this a lot. The pandemic has turned lives upside down.”
Caring for the elderly is a constant firefighting operation and Mumbai-based Silver Innings is trying to focus on engagement with the elderly. Its founder president, Sailesh Mishra, has tied up with Tata Trust and the All India Senior Citizen Confederation to devise quiz programmes and art and music therapy sessions. “We have co-opted the grandchildren to help grandparents get online through WhatsApp and Facetime calls,’’ says Mishra.
He points to a crucial fault line that is affecting the elderly: Old age care is not yet an essential service. He also has a problem – like many of his colleagues across the NGO network – with the concept of social distancing. “Physical distancing is important but how do you distance yourself socially when loneliness lies at the heart of this fight?’’ he asks.
It is not an easy ride for the NGOs. Sonali Sharma, HelpAge’s communication head points to a basic problem. “The able-bodied run faster than the elderly when our teams are out distributing ration. How do you differentiate between a hungry child and a hungry elder?”
The government has now devised a policy for children orphaned by the pandemic. It needs to do the same for the elderly.
Agewell has submitted a proposal to the Ministry of Social Justice and Empowerment. The primary objective of the proposal, titled, “National Initiative for Emotional Empowerment of Older Persons,” is to inculcate a sense of belief for a better tomorrow, to help the older people deal with Covid-19.
That is key. The ill, the fearful, the hungry, the abused, rich and poor, are living in the hope of a better tomorrow.
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