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No country for old folks

In short, it is a whole host of factors from which there is no turning back. India has stepped on the modernisation/westernisation escalator and going back is not an option.

VINATI SUKHDEV | New Delhi |

In the days when travel wasn’t so frequent and exposure to the western world was limited – there used to be two stories about the strange people who inhabited foreign lands that did the rounds on the Indian circuit.

They don’t bathe everyday was one and they leave their parents to die in old age homes was the other.

They were both uttered with the eyes screwed up with contempt, nostrils flaring with anger and disbelief and followed by the hands-cupped-to-the-ears gesture which begs divine forgiveness for uttering such blasphemy.

For a culture where ritual purification and filial piety are both short-cuts to heaven, it was perhaps understandable at the time.

As the world globalised and contact with other cultures became more frequent, the language became more politically correct, but the disdain remained. Just as female foeticide, dowry deaths and heinous rapes upset foreigners looking at India from the outside, we Indians felt it was our right to be deeply offended by the West: their bathing habits, their proclivity to marry again and again, but most of all their lack of respect and love for their parents which led to neglect and abuse of old people in retirement homes.

The coronavirus pandemic sweeping across the globe has brought into sharp relief the number of elderly people in the West who live out the last years of their lives in old age homes.

The virus has ripped through these homes and resulted in many deaths, but far from being caused by uncaring children or neglect on the part of those running the home, it has been government policy, at least in the UK, which has been largely responsible.

In the early days of the pandemic, elderly patients who had been in hospital were allowed to return to retirement homes and mingle, there was lack of testing of the staff at care homes, care home staff were also allowed to work at multiple locations leading to spread of infection; all these factors contributed to the large number of deaths, coupled with the fact that this deadly virus is more lethal in the elderly and vulnerable.

However, the media focus on care homes over the last year has also brought out the concern and love of families who have a mum, dad or grandparent there.

News reports in the UK have been of people who were devastated they had lost a relative to the pandemic or worried about the welfare of someone they loved who might be exposed to the virus.

This may be at odds with the Indian stereotype of an uncaring Westerner, but it is the truth. They are just like you and me, remembering their old grandmother fondly and tearfully and regretting that she had to die alone.

My submission is therefore very simple. It is not people who put old relatives into care homes, it is economic and demographic factors. It is the dislocation of families caused by urbanisation.

It is the migration of a whole generation to towns, cities and sometimes to new countries in search of a better life. It is the breakdown of joint families. It is cramped living spaces in cities. It is people living longer lives. It is women taking up jobs outside the home instead of being caregivers.

In short, it is a whole host of factors from which there is no turning back. India has stepped on the modernisation/westernisation escalator and going back is not an option.

This leaves us in a strange flux of cultural dissonance as well as total unpreparedness for what lies ahead. The cultural dissonance is to be expected – we are after all the land of Shravan Kumar. Who hasn’t heard the tale of this heroic boy from the Ramayana? Shot down by King Dashratha’s arrow while taking his elderly and blind parents on a pilgrimage, he embodies filial piety in the Hindu tradition.

Unable to afford transport, he carried them in baskets which were attached to a bamboo pole he balanced on his shoulders.

The story goes that King Dashratha was cursed by Shravan’s parents for killing their son and hence the King also suffered the grief of losing a son when Rama was banished to the forest.

Look around modern India though and Shravan Kumars are hard to find. Popular culture – always a good index of society – is full of stories about conflict in households burdened by the elderly and struggling to keep afloat. When neither money, nor space are freely available, some strange compromises are arrived at.

The critically acclaimed 2003 film Baghban starring Amitabh and Hema showed how the sons carved up the responsibility of looking after their parents quite literally by making them live separately. Ekta Kapoor’s Saas Bahu sagas have been a commercial success not because of original storylines or scripting but because the eyeballs that are fixed on the TV screen watching the old and the young pitted against each other in a war for control and supremacy are also seeing this play out in real life – everyday.

The signs are everywhere: along the road from Coimbatore airport to Coonoor, there are hoardings advertising retirement communities.

There are many more springing up every day: in Pune, in Dehradun, in Haridwar: all places with a salubrious climate and a whole new industry of retirement homes.

There are organisations springing up to assist elderly people living on their own (something that didn’t happen a generation ago). Gurugram-based Samarth is one such organisation that focuses on the needs of parents whose children are NRIs and hence not in a position to provide support.

They provide nursing care and medical emergency call outs but also look after the social and emotional needs of the elderly with regular get-togethers and holidays. An NRI friend who is very satisfied with their service told me that the simple in-person computer guidance her mother-in-law received, helped them be in touch over Zoom calls.

There are many similar organisations catering to a new generation of parents who want to live independently and children who are either abroad or unable to have parents live with them. All this, however, assumes that both generations are financially selfsufficient. In India that is unfortunately not a norm.

Elderly parents who have lived a hand-to-mouth existence through their working lives do not have ample pensions to retire on. Their adult children meanwhile are also struggling to keep afloat.

The result: elderly abuse and neglect, dire stories of which make the newspapers often these days. A particularly heart-rending one was from the Nilgiris district in Tamil Nadu where the elderly are abandoned by families who ferry them from other districts. Disoriented and homeless, the elderly are left to die from the cold.

These are isolated and still newsworthy instances at the moment, but this brings me to the second point: total unpreparedness for what lies ahead: a population explosion of the elderly. We are used to thinking of India as a young country and demographically it is – with about 65 per cent of the population under the age of 35.

However, longevity is increasing and in India, as always it is a numbers game. A UN Report says that by 2050, 20 per cent of India’s population will be over 60. Even at a conservative population estimate of 1.5 billion, this makes it 300 million elderly people with physical, social and emotional needs requiring hospital beds, caregivers and places to live.

That is almost the entire current population of the US! A study commissioned by Tata Trusts to look at existing infrastructure for elderly people (presuming they can afford it) arrived at an estimate of around 1,150 facilities and the capacity to house around 97,000 elderly residents.

Forecasting likely demand driven by the increasing elderly population over the next 10 years, it pointed to the crying need to enhance capacity 8-10 fold. Will it take another crisis like the second wave of the pandemic where bodies were dug into shallow graves by the Ganges to shake up policy makers? Will it take many more elderly people committing suicide, or being neglected and abused or abandoned before this totally overlooked time bomb is seen for what it is: something that could destroy the social fabric of India? It is a sad fact that when the tectonic plates of a culture clash with socio-economic forces, it is the culture that changes.

Let us not kid ourselves, there will be no Shravan Kumars in the future. So the time has come to think of alternatives. Let us give our elderly some dignity and respect and perhaps some non-slip socks and a walker instead.

The writer lives in London and is the author of East or West: An NRI mother’s manual on how to bring up desi children overseas.