No country for old folks

On most days, Uma Balachander drags her cane chair to sit outside her house on the verandah and watches the world hurry by. The area she lives in, once a quiet residential area, is now filled with high-end restaurants, fancy boutiques and deafening vehicles. Wary of stepping out onto the streets, she usually walks about in her carefully cultivated garden. Her eyes sparkle whenever she talks about her plants, the way they do when she receives a phone call from her children settled abroad. But now, at 78, she can no longer do the gardening herself.

Since the last 25 years, Uma has been living by herself. She has long been separated from her husband. Tired of the roar of the traffic outside her house and the silence inside, Uma recently decided to move into a senior citizens’ home by the end of this year. “At least there’ll be someone to talk to, and round-the-clock help,” says Uma.

But it’s only over the past few years, after she got physically weaker, that she’s been feeling as lonely. Earlier, she would spend her time painting, teaching children, volunteering at an orphanage, gardening, cooking, going for walks and meeting friends. “Now, my friends are also getting older. Transport is a nightmare. So everyone hesitates to go out,” she says, sighing.

Uma’s close friend Lily Thomas lives alone too, in an apartment. At 77, Lily isn’t married. An employee at an NGO, she isn’t at home for most of the day. And once she returns home after work, where she works with “plenty of youngsters,” she usually prefers to be on her own. “But I do wish that my neighbours were friendlier,” she says, ruefully.

As much as Lily feels safer living in an apartment, she feels that it’s easier to get to know neighbours while living in a house. It’s hard not to be curious about her single-status. “Well, I didn’t want to have an arranged marriage. And when we grew up, it wasn’t easy for us to meet many men, and if at all we did, they’d already be married,” she says. Has she any regrets about it? “Sometimes I do wish I had a companion,” she admits. But she seems fairly at ease with her past choices. 

With family patterns altering constantly (fragmentation of the joint family system, more working women, increasing migration to cities, etc) and the inevitable effects of urbanisation, many senior citizens are now left feeling increasingly isolated. And it is for them that organisations like the Dignity Foundation and Nightingale Services have opened up their medical and non-medical services.

Changing family patterns
In India, traditionally, the elders in the family were considered as the heads of the family. Their views were held in high regard and their decisions seldom questioned. But today, with most families, the focus has  shifted to the children. Unlike in rural setups where there is a higher likelihood of living with your extended family and more leisure time, in cities, there are fewer caregivers and very little time for leisure. Ridden with the guilt of not being able to make time for their elderly parents, some even try to make it up to them through gifts or money. But what their parents probably need is emotional support. After all, of what use can a flat screen television be when all you want is someone to reassure you?

Often, the elders also find it difficult to adjust to their children’s or grandchildren’s lifestyles. Take for instance Indhira Karthik, a 75-year-old who lives with her daughter in Chennai. She confesses, “I feel like a permanent fixture in my daughter’s house, especially when they throw parties and I’m served dinner in my room.”

Another major factor is that because of better medical facilities, the average longevity has shot up, which implies that the care-giver could also be a senior citizen. In such cases, looking after an old person ends up being a strain. According to Dr Radha Murthy, the founder of Nightingale Services, a feasible solution in most cases is to create accessible and affordable support systems for the senior citizen. Since most of them find it inconvenient to go to hospitals where they might have to wait in queues, Nightingale provides medical services at their doorstep. “Daycare centres are also a good option for senior citizens as their emotional and psychological needs are taken care of. Most elders in India prefer not to move to old-age homes,” opines Murthy.

Although recent times have witnessed the burgeoning of many old-age homes, the stigma surrounding it has hardly diminished. It is still largely perceived as the ‘gloomy place where neglected senior citizens go’. Also, contrary to the popular belief that senior citizens enjoy the company of peers, they most often prefer interaction with youngsters.

Productive ageing
Sheilu Sreenivasan, the founder of Dignity Foundation, feels that as a society, we are yet to recognise the need for special services to be provided to senior citizens. Although NGOs are addressing some of these issues, she believes that it is urgent for the government to step in and make policy-level changes. “NGOs can reach out to smaller groups. But what is the government doing for our senior citizens?” she asks.

But she’s also of the view that it’s important for senior citizens to learn to fend for themselves and not blame their families or society at large. “The question is — did you take care of your body, did you save enough for your later life? And I’m talking largely about the middle class,” she says. Dignity Foundation, which has about 24 non-medical services (finding jobs for retired people, monthly magazine, basic computer literacy, etc), helps senior citizens to age productively.

In fact, a lot of senior citizens are prone to feelings of emptiness and low self-esteem, which is why it is essential for them to have something to look forward to. Dr Chittranjan Andrade, a psychiatrist at NIMHANS, suggests that a good way to rehabilitate senior citizens is to get them involved in local self-help groups and NGOs which have funds but require people with time.

Laughter clubs are also popular among senior citizens. Even on bittercold mornings, I’ve seen them arrive in parks, cheerfully, and quickly slip into position. All just to break into laughter, together. But that’s what seems to matter eventually, that sense of belonging.
But nothing quite prepared me for what I was to witness at the Nightingale Elders Enrichment Centre in Malleshwaram, Bangalore, on a muggy Friday evening. I walked into a bunch of wide-eyed, bespectacled senior citizens listening intently to a man holding a slippery mass of flesh in his gloved-hands.

Every Friday, Nightingale Services organises a talk (by experts from various fields) for its members. The man who had them captivated was a neurologist who had come to talk about the brain and how we make sense of the world. The elders shot questions eagerly: Could they borrow the brain, what keeps them alive — the brain, the heart or the spirit, what is the link between autism and the brain, etc. For its members, Nightingale Services also arranges book review sessions, book readings, music performances, political and religious discussions et al.

Choosing independence
For Damle, a Nightingale member, the centre has been like a second home. He spends around 25 minutes walking to the centre which he visits a few times a week. Like many others, Damle, an 86-year-old widower, often gets away from Bangalore to spend time with his daughter in Baroda and son in the United States. In the US though, he tends to get lonely.
“In my son’s house, it gets a little difficult. They go to work, so there’s no one to talk to. Only the walls!” he says. But Damle prefers not to move in with his children. “I like my independence. Besides, my children are only a call away,” he says, slipping out a cell phone from his shirt pocket.
Remaining independent seems to be a priority for many senior citizens, as long as they are in good health of course. Jog (“Like the falls, but I’m not falling.”), aged 83, enjoys living on his own. He even prefers to do most of the domestic chores himself. “Why do you think women generally live longer than men? Because they keep working,” he says, grinning. “Of course, my children and grandchildren are all very caring and doting,” he clarifies, almost as an afterthought.

Although Uma values her independence too, she often longs for company and conversation. “Having no one to talk to, you tend to forget certain words!” she says. But why couldn’t she move in with her children? “If you live with your children, you are always conscious of being in someone else’s house, even if it’s something as small as moving a vase or fluffing a pillow,” she says animatedly.

Recently, Uma had even contemplated putting out an ad in the newspaper seeking a male companion. When I giggled awkwardly, she exclaimed, “I’m serious!” And why shouldn’t she be? “In India, once a woman’s children are married, ‘settled’, it’s as if her life is over. My life doesn’t stop because my children are married,” she says.
In December, Uma will be moving into her new home — “a quiet, clean place with lots of trees, and a nice garden.” She’s even looking forward to it. But are old-age homes the solution? Is that where we are all going to end up? Is that where we’d like to be? I’m not sure. Raising issues is most often an easy task, and finding solutions always the hardest. I’m beginning to sound awfully idealistic now, in a silly sort of way. But why shouldn’t I? After all, we are all headed in the same direction!