Old Age and disabilities of old people has never been a problem for India where a value based Joint Family system is still prevailing in many parts. The Indian culture is respectfully supportive to the elders. In the background the abuse of elders has never been considered as a problem in India. It has always been thought as a western problem. However, the coping capacities of the younger and older family members are now being challenged.
Rapid advancement in the field of medicine has increased the life expectancy of people all around the globe, India being no exception. The reality of the ageing scenario in India is that there are 77 million older people in India and their number is growing to grow to 177 million in another 25 yrs.( As per Help Age India news letter).as per our knowledge, 2001 census, That there are 21.9 million disabled in the country, according to Census data released by the Registrar-General of India. This is about 2.13 per cent of the total population.
Of this 1.03 per cent is visually impaired, 0.16 per cent speech impaired, 0.12 per cent `hearing' impaired, 0.59 per cent `movement' impaired and 0.22 per cent `mentally' disabled.
The 2001 Census figures show that the highest percentage (48.5) of disabled is in the visual impairment category followed by the disability in `movement' (27.9 percent). The lowest percentage (5.8) has been reported for hearing disability.
A higher percentage of disabled women are in the visually impaired and hearing impaired categories. In the case of males a higher percentage has been reported in the `movement' and `mental' categories.
The number of disabled is increasing across all age groups. Disability has afflicted a higher percentage of males than females.
Three out of five children in the age group of 0-9 years have been reported to be visually impaired. This declines initially and increases with age to reach a high of 51.9 per cent among those aged 60 years and above. Speech disability afflicts the younger population more whereas hearing disability is more of an `old age' phenomenon. However this is not without problems with this kind of a ageing scenario there is pressure on all aspects of care for the older persons-be it financial health or shelter with more older people living longer the households are getting smaller and congested, causing stress in joint and extended families even where they are co residing isolations, insecurity, is felt among the older persons due to generation gap and change in life styles.
Generally increase in life span resulted in chronic functional disabilities creating a need for assistance required by the older person to manage simple activities of daily living.
With the tradition of India makes the lady of the household to look after the older members of the family. This is slowly changing. The women of the house hold are also participating in activities out side home and have their own career ambitions. Hence, the old people are being treated as a burden by their children.
Now we can understand that if this is what seniors undergo at home then what about their disabilities in old age? The thought it self is painful.
In our (All India Institute of Physical Medicine and Rehabilitation) Institute when we interview 10 old people above 50-70 both male and female we found many problems---Mainly in the areas of Health, finance, family, acceptance in society/community, along with architecture barriers. By and large they tend to be neglected because of socio-economic conditions or loss of spouse or mainly disabilities. etc.
Majority of the elderly disabled are economically non-productive and many of them will be socially isolated.
Main problems as faced by elderly males and female are,
Male:- Discussion with male group indicated that the middle income group listed economic problems on priority. The second group form the upper middle class prioritized mental health problems focusing more on non acceptance by there kith and kins. Difficulties in performing daily living activities, lack of facilities for utilization of leisure time and general feelings of loneliness and “taking to walls”.
The problem here did not seem to be lack of money and disability but lack of love and affection by members of there family. Both the groups felt that they felt a need to talk to their family who did not seem to have time for them. The words were many-ranging form “neglect” because of disability with old age from family.
“ Experience of loneliness in everything” ,
“ a sense of insecurity and feeling” or “burden”
and “old age itself was a disability.” Lack of accommodation was also a problem identified by the older persons.
Females:- Economic hardships along with disability became very prominent in the women of the lower socioeconomic group while the higher socio-economic category put loneliness as the primary problem. The lower economic group felt that if the women has money she had power or else she had to be dependent on children for financial support, health, taking care of her disability and also ill treatment and complete neglect form family problems This situation leads lot of mental health problems lot of mental health problems some of which could not even be described.
Case – 1 :- Ambubai a 70 yrs. Old lady diagnosis as Rt Amuptation. Staying at Govandi a slum area in Mumbai. Since last 40yrs.
Ambubai when she was in her 40 s she met with an road accident were she lost her right leg and come to Institute for fitting of artificial limbs. After some time she lost her husband. Then alone with disability she taken care of her 2 children one 10yrs boy and 13 yrs girl. She worked very hard as casual worker. And she some how manage with his bread and butter with her children responsibility. During the year passes and the completed her duty to upbringing her children. Her daughter married with a nice man and she settled with her husband. Then Her son Married and he is working as Driver after the Marriage of his new bride come to home and the happiness and her desire and hope of betterment of her life goes down. Family problems starts with son and daughter in laws Even she help to her daughter in laws in her day to day work still she can’t mange with her livings with them. Often times when he takes alcohol and Drugs he ill treats her; many times she can’t get the food.
Case-2:- Mr.Kelkar 75 yrs old man and he has been advised by the doctor to replace both the Knees. Staying at Mumbai. A financially well of. Mr. Kelkar is staying with his wife in big apartment of 1500 sq ft in the heart of the mumbai is having two sons, both are well educated settled in life. Now Mr. Kelkar is having disability, can’t walk both the knees has to be replaced he also can’t hear and vision effected money is not issue at once . But today he is full dependent on his wife who is also 70+ for his physical mobility. He and his wife is fully neglected by his children. Both the son and daughter in laws fights with old disabled coupes for property handover, they don’t give them meals, no other households facilities are not permitted the old couple to use like phone/ A/c, fans etc. In one small room they both cook for themselves. Emotional disturbances in adding there problems.
Health problems surfaced as being the most common problem faced by the older persons in the mixed group both in the lower and upper middle class strata of society followed by financial problems. The views were similar in both the focus groups. They stressed on the physical disabilities and problems of mobility, as well as problems of living alone with disabilities.
We can safely conclude that those who are all working for elderly (ie GO’s and NGO’s) have to co-ordinate among themselves and implements plan’s in to actions. Making Policies, Rules, Old Age Homes are not only answer for all these problem. Awareness among children, youth and family members and the society’s equally important. Creating elderly disabled friendly Community is the need of the time:
- intervention aimed at promoting health and disability should be better late then never.
- Negative life style in younger people be avoided and this is ever more desirable in older disabled.
- Careful planning of health promoting and disability prevention is essential for older disabled people.
Mrs. Anjana Neglur ( MSW)
Mr. Kailas Goswami ( Lect. MSW)
(All India Institute of Physical Medicine and Rehabilitation. K. Khadye Marg, Haji Ali Park, Mahalexmi Mumbai – 34.)
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