About one fifth of the Oldest Old in India experience any type of abuse from those they live with. Daughters-in-law and sons emerge as the major abusers with 75 per cent and 60 per cent. In one tenth of cases, daughters and grandsons are abusers. Patna is the worst for these people with 60 per cent reporting abuses, followed by Kolkata (36 per cent) and Mumbai (23 per cent). None of the Oldest Old in Ahmedabad reported to have faced any kind of abuse.
India has a population of 80,38,718 population of 80+ of whom 20,22,345 live in urban areas. But 63 percent of the elderly are illiterate in India, which has a bearing on their economic activities. Poverty and loneliness further add to the problem of elderly care by rendering them even more vulnerable.
Traditionally, in India, the most common form of family structure was the joint family. But with growing urbanisation and depending on the availability of jobs, children are moving out of the extended family set-up, leaving the "empty nest" and establishing their own nuclear families. The elderly are now an extremely vulnerable group.
To study the status of the Oldest Old in the country, HelpAge India carried out a survey in eight cities (Delhi NCR, Mumbai, Ahmedabad, Kolkata, Bhopal, Chennai, Patna and Hyderabad). The findings have been published as 'Economic and Health Survey on India's Oldest Old (80+): Needs, Cares and Access'.
- Overall highlights
- 57 per cent of the oldest old are widows/ widower
- 70 per cent of the Oldest Old are illiterate
- Mean number of children of the Oldest Old is 4, with at least 2 sons and 2 daughters
- 71 per cent of the Oldest Old stay with sons and 10 per cent alone
- 50 per cent of the Oldest Old living in semi-Pucca house and 20 per cent in kuchcha
- 12 per cent of the Oldest Old are still engaged in economic activities
- 36 per cent of the Oldest Old have a monthly household income of less than Rs 2,500 (Sample
- Average (= Rs. 4381)
- Remittance from children are the main sources of income of the Oldest Old
- 72 per cent financially depend on others
- 79 per cent financially depend on sons
- 50-70 per cent depend on son and daughter-in-law at the time of ill
- 61 per cent Oldest Old depends on daughter-in-law for household chores
- 20 per cent Oldest Old faced abuse at household level
- 10 per cent Oldest Old reported verbal abuse and neglect
- Out of those abused, 75 per cent reported Daughter-in-law as the main abuser and 60 per cent
- reported Son
- 5 per cent Oldest Old reported physical abuse. 82 per cent of these reported Physical abuse resulting
- in a health problem
- 52 per cent of the Oldest Old have either to be poor or very poor health condition
- Only 12 per cent are aware of any government health related welfare scheme
- Only 23 per cent are aware of any health insurance schemes
- Only 5 per cent are covered under any health insurance scheme
- Only 5 per cent are aware of any Rashtriya Swasthya Bima Yojana
- Non availability of support system at community - reported by 80 per cent of the oldest
- NGO involvement in work related to Oldest Old seems to be low, only 3 per cent reported so
- Profile
- The mean age of the Oldest Old covered in the study is 83 years
- Close to three fifth of the Oldest Old (57 per cent) are widows/ widower
- Majority of the Oldest Old covered in the study (70 per cent) are illiterate
- Majority of the Oldest Old covered in the study (85 per cent) are Hindus
- Majority of the Oldest Old covered in the study are scheduled caste (38 per cent) and other backward caste (30 per cent)
- The mean number of children of the Oldest Old is more than four, with two sons and two daughters
- More than two third of the Oldest Old stay with sons, while one tenth stay alone
- Children working/living in another place is the major reason for the Oldest Old staying alone with other reasons being ‘no support from children’ and ‘having no children’
- Most of the Oldest Old live in own house, with half living in semi-pucca house and one fifth living in kuchcha house
- One tenth of the Oldest Old (12 per cent) are currently engaged in an economic activity
- One third (36 per cent) of the Oldest Old have a monthly household income of less than Rs 2,500
- Remittance from children and non contributory pension are the main sources of income of the Oldest Old
- Dependency of Oldest Old
- More than two third of the Oldest Old are financially dependent on others, mostly on son/daughter— reported by 72 per cent
- The Oldest Old depend on children to take care of them during ill health or any health related problems. However, the children don’t always take care of them as half of the Oldest Old also reported managing health problems on their own or with the help of spouse
- More than half the Oldest Old depend on daughter-in-law or children for daily routine chores
- Experience of Abuse
- One fifth of the Oldest Old reported to have experienced any type of abuse, with verbal abuse and neglect being the most common form of abuse
- The Oldest Old also feel neglected, which further creates a psychological pressure on them. The Oldest Old who participated in the qualitative study reported issues like ‘family members not spending time with them’ or ‘talking to them’ and ‘family members being least bothered about their desires and needs’
- The Oldest Old face abuse from son and daughter-in-law, who emerge as the major abusers of the Oldest Old. The qualitative findings also indicate that the son and daughter-in-law are the major abusers
- Among the abused Oldest Old, more than three fourth reported to have faced health problem due to physical and economical abuse
- Health status
- More than half of the Oldest Old interviewed consider their health status either to be poor or very poor
- The major health problems faced by the Oldest Old include body pain, eyesight, hypertension, arthritis and asthma
- More than two third and half of the Oldest Old reported availability of private doctor/clinic and private hospital respectively in their area
- Private doctor/clinic, chemist/pharmacy and district hospital are the top three health facilities being utilised by the Oldest Old for treatment of common ailments
- District hospital, private hospital and private doctor/clinic are the top three health facilities being utilised by the Oldest Old for treatment of chronic problems
- Oldest of the Old as well as the health care provider suggested that health centres should provide free of cost treatment to the people aged 80 +years
- The health care expenses are met by children and their own savings of the oldest. The Oldest Old and health care provider reported poor economic condition of the Oldest Old to be a major hindrance in availing medical care
- Support System
- As regards the support system, if both husband and wife are alive, they give support to each other. But, if the Oldest Old is alone then he/she faces a lot of problem at family level in terms of emotional and physical support
- Non-availability of support system at community level also emerges as an issue as 80 per cent of the Oldest Old reported so
- NGO involvement in work related to Oldest Old seems to be low (3 per cent)
- Welfare schemes and Health Insurance
- Awareness about the government health related welfare schemes and health insurance schemes for the Oldest Old is also an issue as only one tenth and one fifth of the Oldest Old reported awareness of the same respectively
- Only 5 per cent of Oldest Old covered under health insurance schemes Awareness of Rashtriya Swasthya Bima yojana (RSBY) is very low as 5 percent of the Oldest Old being aware of the same.
- Needs of Oldest Old
- The various needs and requirements reported by the Oldest Old include ‘free treatment’, ‘health care’, ‘financial aid’, ‘pension scheme’ and ‘separate hospital for Oldest Old’
- Health care provider strongly recommended that, people aged 80+ years need respect in family, security, emotional, mental and family support which is desirable for providing them an healthy life
- They also suggested that, actual benefit of governmental schemes are not reaching up to them, and hence there is a need for great effort to resolve this problem so as to ensure that everyone can benefited
- Government should initiate some good health related schemes specially for 80+ people and all new and existing schemes should be available at each and every hospital
- HelpAge's recommendations
- The main concern of the oldest of the old is regarding health facilities/services. Therefore, more geriatric facilities need to be provided in hospitals
- and dispensaries
- Outreach services should also be provided to the oldest of the old. Houses with oldest of the old population should be identified and registered with their health status, issues/ concerns, This can be done by the local health functionaries
- Since financial dependence on family members and others is a primary issue at this age, the oldest of the old should be provided free treatment and medicines or universal health insurance coverage that covers all types of health problems of the oldest of the old
- Mobilisation and community based support towards the Oldest of the Old also needs to be emphasised and worked upon. Efforts need to be made to sensitise the people especially the young generation towards the needs and concerns of the Oldest Old
- Abuse at family level is also an issue and the family members need to be educated about the harms of the elder abuse
The survey was carried out by Sigma Research and Consulting.
