Saumyen's Pages
Rethink
Community Living of Senior Citizens: A perspective
(October 2023)
When I entered the premise on a sunny Sunday morning of September, it seemed to be just another day for all the forty elderly residents in this senior living facility. Four or five young boys in light blue uniform were trying to carry an old man in a stretcher from a first-floor room to an ambulance standing outside the three storied building. The place is little far from the city of Kolkata. I came to see Binota aunty – our neighbour in Saltlake for over four decades - my late mother’s best friend and a proud mother of three well established children. She has shifted here after her husband passed away a couple of years back and her younger son too shifted to Singapore on a resident permit. Her only daughter was married long back and her elder son – the brightest in our locality – migrated to US for higher studies two decades ago. She was busy with her family and bringing up her children over the last few decades and when they all were well settled, she had no engagement at home and no company in life. The children continue to support her financially well and visit her once or twice a year – but Binota aunty has shifted here to avoid living a lonely life. “Here I am not alone and not my story unique. All of us are here to spend the last few years of our otherwise hectic life.” She added “Trust me, witnessing so many cases here – reality sets in - death seems nearer but not scary anymore.”
Venkat spent half of his life in the corporate world – aspiring, working, achieving, fulfilling his career dream. As he entered his 60th birthday two years back, he and his wife Sudha decided to shift to a senior living place – far from hustle and bustle of the metropolis – in a serene, surreal environment – paying a hefty 2 Cr for a small but luxury accommodation with all support facilities. They are in a new environment – with a new group of friends – a few in their peer-age-group and some older – who did equally well in their career and family life and have shifted here to enjoy the rest of life on their own. Their only son is married and settled in Ahmedabad. Over time he realises that a person working for 33 years can’t just sit idle with no or little connect with the younger generation, long-time friends and the changing world. “I was used to hectic city life in Bangalore where I had migrated more than three decades ago – long enough to have lost touch with my roots. I have a good friend circle in the city – but that is too far now to meet them regularly and even attend a dinner party.”
Such stories of seniors exist across India – stories of enjoyment and melancholy, voluntary and not so voluntary (single, independent or destitute) situations, permanent and short stay experiences, high-end living and low-income models and the cases are only to grow and be diverse over time.
Why?
World is ageing – not only by its existence – but also by the average age of population. Across 196 countries, the average age of senior population (65+years) has increased from 5.46 percent to 9.9 percent over the last 50 years.
India is relatively young today – with 6.9% of senior population aged 65+ years. But, in line with the global trend, the country is also ageing from 3.69% of senior population in 1972. Population has also grown from 58 Cr to 142 Cr during this last half-a-century period. Thus, India’s senior population increased 4.6 times compared to 3.8 times for the world and today we have more than 9 Cr seniors in India. The recently published UNFPA “India Ageing report 2023” estimates a much higher number: 14.9 crore of persons aged 60 years and above i.e 10% of population. This is likely to increase to 15% (about 22.7 Cr) by 2036 and further to 34.7 Cr (approx. 21%) by 2050. Southern States have a higher ageing than central, north or eastern states – reflecting a positive correlation with development indices. For a 18% population increase between today and 2050, 60+ aged population growth will be 134% and 279% for 80+ citizens.
Without delving into a debate around the estimate accuracy, the fact remains that India is having and will continue to have the highest number of senior population only next to China (12% or 17 Cr of 65+ adults in 2019) and will exceed them in the next few years. Needless to say, there is a clear need to focus on this increasing group of population.
Economic growth, reducing fertility rate, better healthcare facilities, improving socio-economic parameters and the resultant increase in life expectancy (68.5 years for male and 73.4 for female) are the key factors for the growth of this group of population over time. On the other hand, urbanization (36% now vis-à-vis 20% in early 1970s) that continues to make a positive impact on standard of living has also created additional pressure on the urban infrastructure and higher cost of living for the people.
Moreover, the Indian society has undergone changes too. Nuclear family structure (not so prevalent three or four decades earlier), need and ability to migrate for studies or work, technology enabled communication and arguably change of family values in tune to the western culture – all have made a large section of senior population dependent on their own support system at old age – physically and in most cases financially – leave aside the mental support. The reflection of these changes is more identifiable in the urban or city life.
People migrate to different cities and urban areas for work and settle in nuclear family and once the professional life is over (when children are grown up and need no or limited monitoring by the parents), a section of them plan to move to senior or assisted living facilities. These facilities provide the support system that are often needed to take care of the daily lives. On the other hand, the culture of joint family still exists in rural areas – more due to social and economic reasons – and the seniors mostly live as part of the family – though the reach to medical facilities and inadequate financial support often add to their old day challenges.
Senior living or Assisted living place (old age home or ashram, as the earlier used to be known as) has been a solution for many such city dwellers - mostly middle class and above – who are ready to live with external professional support for food, lodging, housekeeping, healthcare and in some cases, club or related facilities. Most facilities are structured in an environment where senior people – even middle aged (50+ years) – stay together in leased or owned places – in luxury or semi-luxury communities – among a new group of friends who are peers – by age group, background and potentially, mindset.
Senior or assisted living is a flourishing concept in India – mostly in unorganised sector and more recently in organised (corporate) one. According to an analysis of India's senior living market, it is currently valued at $10.15 billion and is expected to continue growing (DW, 23 June 2023). An estimated 4500 senior living establishments are there in India (The Hindu, Dec 2018) and possibly similar number is under construction. Many of these establishments are registered in social sector. The demand is expected to be much more than the current and predicted supply. However, this business (organised sector) of senior living in separate infrastructure/ facility warrants large investments and is unlikely to keep pace with the demand.
Moreover, while the senior living places provide the physical support under a common infrastructure or facility, the residents may also need psychological support – especially when an older resident is surrounded by a group of peers – many of whom are suffering from age-related health or mental issues. According to WHO, about 15% of senior adults suffer from mental disorder – but the area is mostly neglected. A normal residential environment (with provision of supply of domestic needs) is likely to resolve a significant part of this mental issue that arise from an environment of melancholy of many senior living facilities.
In urban India especially in large cities or metros, there is a huge supply of gated communities (prevalence of high-rises) at places with access to urban infrastructure, transport, shopping places and in many cases, medical facilities. These high-rises have developed their own communities with security, basic infrastructure support, club and various cohorts for community activities and practising areas of interest. Senior people living in these communities may face less old-age related challenges – with different age groups, professions, areas of interest living together. These can address the issues of mental agonies or loneliness of old adults. Provision of food, medical and other support to their daily lives may help them to live their normal lives – the lives that they were used to. We have started seeing such lower-investment options of assisted living in select cities and potentially a cost-effective way to cater to the growing demand in future too.
This also helps addressing the concerns that Binota aunty and Venkat referred to.
(The views are personal)