Context: October is the month that hosts both World Elders Day (1st) and Mental Health Day (10th). The article discusses the state of India's ageing population and related issues.

Data on elderly population

• Worldwide: There are more older people on the globe now than ever before in the history of humanity.

• In 2022, the number above 60 was 1.1 billion, comprising 13.9 % of the population. By 2050, the number of older people is expected to increase to 2.1 billion, constituting 22%. 

• In India: India is not far behind.

• It had 149 million older adults (10.5%) in 2022, this figure will grow to 347 million (20.8%) by 2050 according to projections. 

Challenges faced by elderly population 

Dependencies & vulnerabilities: Increased dependency, social isolation, poverty, ageism, pessimism, and nihilism are significant social challenges our elders face.

• They are vulnerable to emotional, physical, sexual, and financial abuse by others. Often, the perpetrators are known to them, commonly a family member. 

Many towns and cities in India are not “elder-friendly“: Many public buildings are inaccessible without ramps or handrails, pavements are non-existent, uneven, or used for parking, and public transport is limited.

• These make access to health care services difficult . 

• Many interventions, such as psychosocial treatments, day centres, and particular medicines, are available only to a limited extent in cities.

Psychological issues: Roughly 15% of elders (22 million in India) have serious mental illness.

• Common mental health problems elders face are depression, anxiety, dementia, and substance use disorders.

• Many elders struggle to accept the changes accompanying ageing. 

• Many elderly men especially feel lost and become unproductive after retirement. 

Lack of awareness: Often, elders with mental illness do not seek treatment and the “treatment gap“ is a staggering 90% in India.

• A lack of awareness among the public and healthcare professionals is the main reason for this vast gap. 

Stigmas: Elders with mental illness face the double whammy of stigma associated with ageing and mental illness. 

Government initiatives for the protection of Elderly population in India

• The National Policy on Older Persons, 1999:  The policy envisages State support to ensure financial and food security, health care, shelter, protection and other needs of older persons to improve quality of their lives.

• The Maintenance and Welfare of Parents and Senior Citizens Act: It was enacted in 2007 to ensure need based maintenance of parents and senior citizens and their welfare including shelter, healthcare, protection of life and property, against abandonment etc.

• “National Programme for the Health Care of Elderly”: Ministry of Health and Family Welfare is implementing the “National Programme for the Health Care of Elderly”.

Atal VayoAbhyudayYojana (AVYAY): The Department of Social Justice and Empowerment is implementing AVYAY for senior citizens.

• It has following components for providing different services to senior citizens:

• RashtriyaVayoshriYojana (RVY): For bringing near normalcy in the bodily functions of those BPL senior citizens who suffer from age related disabilities/ infirmities, by providing them with free of cost assisted living devices.

• Special items like wheelchairs with commode, silicon foam cushion etc. are also provided under the Scheme, besides generic items like walking sticks, elbow crutches, hearing aid etc.

Able Citizens for Re-Employment in Dignity (SACRED) Portal: Many senior citizens have experience, time and energy which can be used by the business enterprises looking for stable employees with experience.

• The Human resources cells of many private enterprises seek experienced but stable persons in certain positions. 

• The portal allows bringing these people together by virtual matching of preferences.

Promoting Silver Economy: To encourage the entrepreneurs to think about the problems of the elderly and come out with innovative solutions, by providing uptoRs. 1 crore as financial assistance in the form of maximum 49% equity participation, through an open invitation on a portal namely Seniorcare Ageing Growth Engine (SAGE).

Key Suggestion

Protection from Destitution

• The first step towards a dignified life for the elderly is to protect them from destitution and all the deprivations that may come with it.

• Cash in the form of a pension can help to cope with many health issues and avoid loneliness as well.

• That is why old-age pensions are a vital part of social security systems around the world.

Emulating the Frontrunners

• The southern States and India’s poorer States such as Odisha and Rajasthan have achieved near-universal social security pensions. Their actions are worth emulating.

• It would be much easier for all States to do the same if the central government were to revamp the NSAP.

Focus on Revamping Pension Schemes

• Another critical area would be bringing reforms in the social security pensions.

• They also need other support and facilities such as health care, disability aids, assistance with daily tasks, recreation opportunities and a good social life.

Transparent “Exclusion Criteria”

• A better approach is to consider all widows and elderly or disabled persons as eligible, subject to simple and transparent “exclusion criteria”.

• Eligibility can even be self-declared, with the burden of time-bound verification being placed on the local administration or gram panchayat.

• Although there are chances of privileged households taking the advantage, it is much preferable to accommodate some inclusion errors than to perpetuate the massive exclusion errors as is the case today.

Road Ahead

• The government must frame policies for elders with mental illness, allocate resources, and implement services. We must remember that caring for our elders is everyone’s responsibility.