Elderly

• National Policy on Older Persons, 1999 certain rights of the aged & government’s responsibility towards providing economic and social security along with healthcare and protection of life and property of the aged people.
• Maintenance and Welfare of Parents and Senior Citizens Act, 2007.

Healthy Ageing

• WHO defines healthy ageing as “the process of developing and maintaining the functional ability that enables wellbeing in older age.” 
• Functional ability is having capabilities that enable all people to be and do what they have reason to value. For e.g. meeting their basic needs; make decisions; be mobile etc.
• It includes all the physical and mental capacities of an individual and their interaction with environment (home, community etc.)
• World Health Organization’s previous focus on Active ageing,2002.
• process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age
• based on Madrid International Plan of Action, 2002, three priority areas:
• older persons and development;
• advancing health and well-being into old age;
• ensuring enabling and supportive environments.

Ministry of Health and Family Welfare launched Decade of Healthy Ageing (2020-2030) on International Day for Older Persons (1st October) endorsed by World Health Assembly in August 2020.

• bring together governments, civil society, international agencies, professionals, academia, the media, and the private sector for ten years of concerted, catalytic and collaborative action to improve the lives of older people, their families, and the communities they live in.
• In India, Decade of Healthy Ageing will include evolving convergence within various national health programs and also promoting inter-sectoral coordination with other line Departments/Ministries.

Elderly Population - status in India

• Census 2011 nearly 104 million elderly persons (aged 60 years or above) in India; 53 million females and 51 million males
• United Nations Population Fund and HelpAge India report suggests that the number of elderly persons is expected to grow to 173 million by 2026
• 71% of elderly population resides in rural areas while 29 % is in urban areas.
• old - age dependency ratio climbed from 10.9% in 1961 to 14.2% in 2011 for India as a whole. For females and males, the value of the ratio was 14.9 % and 13.6% in 2011.
• age-population ratio of those typically not in the labour force (the dependent part) and those typically in the labour force (the productive part) to measure the pressure on productive population.
• Kerala has maximum proportion of elderly people 12.6 per cent, Goa (11.2 per cent) and Tamil Nadu (10.4 per cent) as per Population Census 2011.
• least proportion is in Dadra & Nagar Haveli (4.0 per cent), Arunachal Pradesh (4.6 per cent) and Daman & Diu and Meghalaya (both 4.7 per cent).

Challenges Faced by elderly population

• Social
• Ageist stereotypes: Stereotyping (how we think), prejudice (how we feel) and discrimination (how we act) towards people on the basis of their age, deleterious effects on the health and well-being of older people. This marginalizes older people within their communities, reduces their access to services, including health and social care, and limits appreciation and use of the human and social capital of older populations.
• Changing Family Structure: prevalence of nuclear family set-ups, the elderly exposed to emotional, physical and financial insecurity
• Lack of Social Support: less government spending on social security system.
• A rapidly changing world: Globalization, technological developments (e.g. in transport and communication), urbanization, migration and changing gender norms influencing lives of older people in direct and indirect ways. 
• Health
• Medical Problem: multiple illness and physical ailments. Besides physical illness, more likely to be the victims of poor mental health.
• Availability, Accessibility and Affordability of Health Care: lack access to adequate levels and quality of health care.
• Financial bankruptcy: since their assets; properties and all their wealth are legally transferred to their children so most elderly people do not have the emergency fund available to meet their basic needs
• Psychological: feeling of powerlessness, feeling of inferiority, depression, uselessness, isolation and reduced competence.

Need for amendment in the Act

• Breakdown of traditional support structures: As families become increasingly nuclear and with the gradual breakdown of joint family system, number of cases of neglect, crime, exploitation and abandonment of parents and senior citizens are on the rise. National Crime Records Bureau in 2018, crimes against the senior citizen rose by 13.7% from 2016 to 2018.
• Large Elderly population: UNESCO estimates, the number of aged is likely to double by 2025.
• Dilapidated Conditions of old-age homes and unaffordable healthcare services: including specialized geriatric facilities in hospitals, remains out of reach. Also, they cannot be a sustainable substitute for family-based care
• Violation of constitutional provisions: For example, denial of basic human rights (such as lack of medical care, food, shelter and other basis facilities) for the aged is violation of their fundamental right to life and liberty guaranteed under Article 21 of the Constitution.
• Orders by the courts: Supreme Court and Various High Courts have directing the Government to review provisions of the Act.  

Key amendments brought by the bill

• amend the Maintenance and Welfare of Parents and Senior Citizens Act, 2007.
• Definitions:
• Children: to include step-children, adoptive children, children-in-laws, and the legal guardian of minor children
• Parents: to include parent-in-laws, and grandparents
• Relative: to include minors represented by their legal guardians
• Maintenance: healthcare, safety, and security for parents and senior citizens to lead a life of dignity
• Welfare: provision of housing, clothing, safety, and other amenities necessary for the physical and mental well-being of seniors.
• Maintenance orders: removes the upper limit on the maintenance fee which is Rs. 10,000. Fixation of the amount by a Tribunal will depend on:
• standard of living and earnings of the parent or senior citizen
• earnings of the children
• reduced the number of days to deposit the maintenance amount to 15 days from earlier 30 days.
• Appeals:allows children and relatives also to appeal decisions of the Tribunal.
• Offences and penalties: increases penalty to imprisonment between three and six months, or fine of up to Rs 10,000, or both.
• Maintenance officer: (i) ensure compliance with orders on maintenance payments, and (ii) act as a liaison for parents or senior citizens.
• Establishment of care-homes: Senior citizen care homes and Multi-Service Day Care Centre by government or private organisations
• central government will prescribe minimum standards for these homes
• Healthcare:  All hospitals, including private hospitals, to provide facilities (such as separate queues, beds, and facilities for geriatric patients) for senior citizens. Further, homecare facilities will be provided for senior citizens with disabilities.
• Protection and welfare measures: Every police station to have at least one officer, not below the rank of Assistant Sub-Inspector, to deal with issues related to parents and senior citizens
• State governments must constitute a special police unit for senior citizens in every district

Issues with the bill

• No focus on mental issues: of depression, dementia and Alzheimer among older adults in India. Agewell Foundation rept one in every two elderly people suffer from loneliness leading to depression and other mental issues.
• Feminisation of elderly not addressed: sex ratio of the elderly has increased from 938 women to 1,000 men in 1971 to 1,033 in 2011 with predominance of widowed and highly dependent very old women.
• No provision to increase awareness: 55% senior citizens do not know that they can take their children or next of kin to court for negligence and exploitation.
• Issues with senior care homes: Most senior care homes follow the format of pay and stay. Elderly people with no relatives and no income or savings have no place to go.

Suggestions

• Formulating policies to retain or hire senior workers in the organisation to use their knowledge and experience.
• Promoting old age education to make old age people more aware, empowered and self sufficient as the literacy rate among elderly is around 35% only.
• Emulating the community-based care and health services found under the United Kingdom’s National Health Service.
• Banks may devise special credit schemes for the retired to begin small businesses thus making them economically secure.
• Government needs to provide some free old age homes for deprived and poor senior citizens.
• Improving the perception of old age homes in order to make them place of choice rather than the place of last resort.

Way forward

• Age Friendly Environment: Removing physical and social barriers and implementing policies, systems, services, products and technologies to:
• promote health and build and maintain physical and mental capacity throughout the life course;
• enable people, even when they lose capacity to continue to do the things they value.
• Address diversity in older age: comprehensive public health response must address this wide range of older people’s experiences and needs
• Long Term Care: essential to maintain functional ability, enjoy basic human rights and live with dignity. In addition, it is essential to support caregivers, so they can deliver proper care and also take care of their own health.
• Introduce or enhance legislation to promote equality and non-discrimination on the basis of age in the provision of health and health insurance services and in social protection policies and programming, and undertake measures to prevent multiple discrimination against older persons;
• Global Measures: Global Campaign to Combat Ageism; Enhancing the Global Network for Age-friendly Cities and Community
• Research in Geriatrics and Gerontology needs to be further encouraged.

Schemes by the Government for welfare of Senior Citizen

• Varishtha Pension Bima Yojana (VPBY) to give an assured minimum pension on a guaranteed minimum return on the subscription amount
• Vayoshreshtha Samman conferred as a National award, and given to eminent senior citizens & institutions under various categories for their contributions on International day of older persons.  
• Article 41- The state shall, within the limits of its economic capacity and development, make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness and disablement and in other cases of underserved want”.
• Integrated Programme for Older Persons (IPOP) to improve the quality of life of older persons by providing basic amenities like shelter, food, medical care and entertainment opportunities, etc. 
• National Programme for Health Care of the Elderly (NPHCE) to provide dedicated health care services to the elderly population at various levels of primary health care settings.
• Maintenance and Welfare of Parents and Senior Citizens Act to ensure need-based maintenance for parents and senior citizens and their welfare
• Indira Gandhi National Old Age Pension Scheme (IGNOAPS), earlier called as "National Old Age Pension Scheme (NOAPS)", under which Central assistance in form of Pension is given to persons
• Rashtriya Vayoshri Yojana (RVY) under which aids and assistive living devices are provided to senior citizens belonging to BPL category who suffer from age-related disabilities such as low vision, hearing impairment etc.
• Pradhan Mantri Vaya Vandana Yojana to provide social security during old age. This is a simplified version of the VPBY and is implemented by the Life Insurance Corporation (LIC) of India.