India is on the brink of a major demographic shift in the coming decades. As the gears of urban life speed up, many will find themselves overwhelmed by the demands of their career and the pressures of a packed schedule even to contemplate having children. Increasingly, there’s disinterest in having kids among the younger generation. This might shift the balance of our nation’s population and leave more older people than the young. The question looms: who will care for the ageing masses? Shadows of concern loom over an unprepared country that will soon be facing the challenges of an ageing population.
How are traditional Indian family structures changing in caring for the elderly?
The Longitudinal Aging Survey of India revealed that India is facing a demographic shift, with the elderly population rising sharply in the coming years. The joint family system, which used to be the traditional Indian family structure, has undergone tremendous changes over time. In earlier times, three generations often lived together under one roof, and old people used to get support from their children and relatives. In this respect, it was an ideal system because the elderly belonged to the wise heads of the family and played a vital role in guiding the young members of the family concerning emotional and material care.
This setup is slowly wearing off due to the increasing rate of nuclear families, urbanisation, and migration for education and job purposes. Younger generations have started leaving their hometowns in search of a better life while ageing parents are left behind to bear loneliness. Pressure to balance between personal life and careers in quite cramped spaces usually makes it impossible for them to manage care in their homes.
As a result, more care is coming to rely on external caretakers, older people’s homes, and retirement communities. Some of these facilities may be very professional but they lack the love and warmth behind family support. The elderly then often crave family and feel isolated due to their alienation.
Secondly, the continued increase in healthcare costs along with the ageing population will once more threaten the family coffers. In most cases, older adults rely on their savings, pension, or government schemes. These measures are likely not sufficient.
What is the role of joint families in elderly care today?
Even today, joint families are one of the most significant contributing factors for elderly care in India. Although, it is losing it’s earlier grip. Traditionally, joint families acted as a supportive network for the elderly. They ensured that the elderly were provided with, not only physical care but also emotional and social support. Also, living with the family ensured the best diet and exercise for them. This model is, however, gradually being lost due to the upward march of urbanisation, migration, and nuclear families.
However, despite all such changes, joint families in rural localities still can be seen and are the prime security for the aged members. Members within a joint family share the burden of care, which helps diffuse such a heavy burden. Such an arrangement with all generations remaining under one roof allows virtually always-on, hands-on care and companionship. This decreases the chances that the elderly member will isolate himself.
However, evidence does exist that even here, in joint families, financial constraints, attitude changes toward care, and the busy lifestyles of young family members are putting pressure on this traditional model. As per a study published by the International Journal of Aging & Society, joint family arrangements still play a very desirable role in old-age care. But they are increasingly dependent upon external support like healthcare services, caregivers, and old-age homes to top up care.
How can family members prepare for the ageing of parents?
Preparing for aged parents involves steps including their emotional, financial, and healthcare needs. Key areas of discussion and planning should begin with transparent talks. This must include the concerns of medical care, living preferences, and legal matters, such as wills and power of attorney.
There should also be planning on the financial front. Such as reviewing health insurance, saving some money, and being informed about one’s pension plans. There should be planning on the healthcare front by being under consistent check-ups and inquiring about possibilities for long-term care.
Dr Ubaid ur Rahman, General Physician, Holy Mission Clinic, New Delhi says, “You should keep adequate supplies of medications that are common in elderly patients. For example, hypertension, diabetes, cholesterol levels, and arthritis. Also prepare emergency prescription drugs like nitroglycerin in case of heart conditions, inhalers in case of respiratory problems, and painkillers. Many elderly people require supplements like Vitamin D and calcium that must be within reach for maintaining healthy bones and immunity. Install monitoring devices in the house, i.e., blood pressure monitors, glucose meters, and pulse oximeters, with which vital signs can be on track. Regular medical appointments for blood tests, vision checkups, hearing tests, and general health checkups should also be part of the plan. This way, early detection of any potential health issue becomes easier to track.”
A safe home and the development of a support network of family, friends, and caregivers helps manage the caregiving burden. Legal preparations like wills and healthcare directives are very important. Technology such as medical alert systems can help to remotely keep track.
Lastly, emotional preparedness and seeking support through counselling or caregiver groups can ease the transition. These ensure that parents receive the care that they need. Today, various startups such as Khyaal, Goodfellows, and Emoha are focusing on caring for ageing population.
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