Ageing alone: India’s elderly face a crisis of neglect

As families shrink and intergenerational conflict rises, many seniors are stripped of property and dignity

Chennai/Hubballi: Windows, doors, and floor tiles are yet to be installed to make this modest building fully functional.  

Yet, Sumalatha (name changed) is among the five residents living in this under-construction old-age home, managed by the Samruddhi Foundation in Chabbi village, Dharwad district in Karnataka.  

Following her husband’s sudden death from a heart attack in 2019, Sumalatha’s son and daughter, who reside in an upscale area of Hubballi, seized their pre-cast wall factory, jewellery, bank accounts and a plot registered in her name.  

“My children began viewing me as a burden due to my declining health, and they started verbally abusing and physically assaulting me,” Sumalatha says, displaying photographs of her bruised eyes and shoulders. 

After several failed attempts to end her own life, Sumalatha found refuge in the old-age home, convinced that returning to her children would strip her of any dignity.  

“I refuse to live with my children, who are cruel and self-centred,” the senior citizen declares. She adds that the Karnataka government’s pledge to enforce the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, offers some hope. This law allows property transfers to be revoked if children neglect their duty to care for their parents. 

The remaining four residents at this old-age home have different tales to narrate. 66-year-old Jyothi (name changed) cannot go back to her sister, who is in penury, while Ruksana Begum (name changed) does not know how old she is and is not aware where her only brother lives. Her brother dropped her off at the home on the pretext of taking her home.  

It is fairly common in Indian cities to find elderly people sitting outside metro stations, bus stands, and other public places, seeking alms to meet their food expenses. 

The struggles of senior citizens, particularly those from economically disadvantaged backgrounds, are not new. Rapid urbanisation, shrinking family size and demographic changes have worsened conditions for India’s elderly.

The challenges on this front are set to mount as India’s elderly population (60+) is projected to grow from 10.5%  in 2022 to 20.8%  by 2050. 

A report by the United Nations Population Fund, India (UNFPA) in 2023 said it is likely that the elderly population will surpass the population of children in India by 2046. The report also mentions that over 40% of the elderly in India live in poverty. The population of people aged 80 and above will also grow at a rate of 279% between 2022 and 2050.

Southern India, which successfully implemented strict population control measures, resulting in lower Total Fertility Rates (TFR), is likely to have an ageing society faster than the rest of India. This is why states like Tamil Nadu, Karnataka, Andhra Pradesh, and Kerala are seeking funding from the Centre to invest in fulfilling the needs of the elderly.  

In March, a disclosure by the Belagavi Institute of Medical Sciences indicated that over 150 elderly individuals had been abandoned by their families over time. The disclosure underscores the failing infrastructure around elderly care in the country.  

The information also prompted Karnataka Medical Education Minister Sharan Prakash Patil to direct authorities to strictly enforce the Senior Citizens Act, 2007,  and cancel wills and property transfers in cases where children have abandoned elderly parents.

In the last couple of months, the state has registered 3,010 cases under section 23 of the 2007 Act, which allows a senior citizen to void a property transfer if the transferee fails to provide comfort to them. Of the total cases, 2,007 have been resolved, while the remaining 1,003 are in various stages of completion. 

“We are getting reports that family members are taking back the senior citizens with them (after the threat of invoking the Act). It is very unfortunate that we have to invoke the law to ensure dignity for our elders,” Patil tells DH. 

Dr Ashok Shetty, director, BIMS, said the issue was so serious that the institute was falling short of beds for emergency cases. “Relatives of abandoned patients did not take them back. Only after it was highlighted in the media that the 2007 Act would be invoked did relatives take back patients. Almost 80% of patients have been taken back by their relatives,” Shetty adds.

The fear of legal consequences and property loss is evident from such examples. With the rise of social media, many cases of elder abuse are now coming to light, and with official intervention, seniors are either reunited with their families or have their properties restored.  

“Restoring properties alone does not help. The elderly need safety and security. We, as a society, should embrace our responsibilities,” says Elango Rajarathinam, director, Elders for Elders Foundation.

D V R Seshadri, professor of Practice in the Marketing Area, Indian School of Business, Hyderabad, explains that nuclear families, stress-filled lifestyles, urbanisation, and high real estate costs have shrunk the size of homes. This may be among the reasons that force parents to seek solace in old-age facilities.

More importantly, the exponential growth of elder care homes is also an indicator of a rapidly transforming Indian society and a growing cultural distance between these generations. 

“Most parents have already burnt their bridges with their villages and towns of origin, having earlier worked in urban settings themselves. Not having anywhere else to go, homes for the elderly seem to be the only option for them,” he says. 

Edwin Babu, director, HelpAge India of Tamil Nadu and Puducherry, echoes these insights. He adds that intra- and inter-state migration of youngsters was high in Southern India, which may be another reason why there has been a spurt in the number of old age homes. Of the 537 old-age homes for which the Centre assisted in 2022-23, 204 are in Southern states alone, while the number went up to 208 in 2023-24 out of 603 projects. 

Children generally tend to abandon their parents when they become financially dependent on them or become seriously ill, Babu adds. “Unfortunately, most of the elderly in India do not have savings because they spend heavily on educating their children and getting them married,” he says.  

A prominent psychologist and rights activist, speaking to DH, offers a different perspective, suggesting that how elders are treated in old age often reflects how they treated younger family members in their prime.

“The burden should not fall unfairly on women, and it should not be made out that taking care of the elderly is the job of the daughter-in-law or the daughter alone. Men should also bear the responsibility and blame,” the psychologist says. 

“Cultural norms, expecting female subservience and constant in-law meddling, can alienate the woman, especially if her husband sides with his family. This divide widens when the couple has children,” the psychologist says, advocating for early mediation, upholding the wife’s dignity and fostering tough conversations.

“This dynamic reflects power struggles and societal pressures, where unresolved tensions lead to irreparable rifts. Taking care of the elders should be the joint responsibility of the children and their families,” she adds.

Violence 

Senior citizens in India are vulnerable to violence within a household and to external acts of aggression like burglary and theft. 

According to 2022 data from the National Crime Records Bureau, crimes against senior citizens rose by 9.3% to 28,545 cases, when compared to 26,110 cases in 2021. As many as 1,269 cases of murder, 83 cases of culpable homicides, and 431 attempted murder cases against senior citizens were registered. Tamil Nadu (198) has recorded the highest cases in these categories, followed by Maharashtra (183) and Madhya Pradesh (128).

In the late 2000s, Tamil Nadu witnessed a wave of thalaikoothals, a traditional practice of senicide.

“We alone rescued over 20 people in Virudhunagar district from the deadly practice of thalaikoothal. We found that the practice was prevalent in many villages across Southern Tamil Nadu and was not used in terminally ill patients alone,” Elango of the Elders for Elders Foundation says. 

“Over the years, people began adopting thalaikoothal to get rid of elderly people in their households. The practice seems less prevalent now, but my hunch is it is still taking place silently, especially in rural areas where the poverty rate is high,” Elango adds. 

In Andhra Pradesh, last year, an elderly man, abandoned by his children, killed his terminally-ill wife before taking his own life out of frustration. Leaving a suicide note, the couple expressed their inability to bear suffering any longer. 

Another disturbing case emerged in the state last year when a man was caught physically assaulting his parents while demanding they transfer property to him.

In Kerala’s Varkala, Sadasivan, a 79-year-old cancer patient, and his wife, Sushama (72), were abandoned by their children over a property dispute. After an intervention from the district administration, the couple were taken back by the family. Their children were asked to pay Rs 10,000 per month to them.  

Safety concerns 

Safety concerns may also drive pensioners and the affluent to seek refuge in elder community hubs sprouting across the country. 

“I get a pension of about Rs 80,000 per month, and both my children are abroad. We do not want to live alone in our independent house. We have locked up the house and now live in a home where we socialise with people of our age group,” a retired professor says. 

Seshadri says that the stark divide between the different social strata exacerbates the problem, as nearly all elder care facilities are for-profit enterprises. 

“There is no clarity on the part of key stakeholders in the country on how to address the gigantic problem of care for the country’s teeming population of elderly poor. The living conditions at the few homes for the elderly poor are abysmal and sub-human, as they do not have a sustainable business model, ” he adds.

Financial independence for elders is critical, as statistics show that over 50% of women over 60 currently lack income. Models like Self-Help Groups (SHGs) for the elderly, pioneered by HelpAge India in Tamil Nadu, could prove useful here.  

“This approach has provided them some financial independence. We have 7,800 elder SHGs with both men and women members. Based on our success, such SHGs now operate in Andhra Pradesh, Maharashtra, Gujarat, West Bengal, and Rajasthan,” Babu adds.  

Professor M Vijayabaskar of the Madras Institute of Development Studies noted that Old Age Pension (OAP) schemes implemented by various state governments benefit seniors. “The money they receive — Rs 1,000 in Tamil Nadu — may be modest, but it earns them respect within their households. Financial independence for the elderly is crucial and must be prioritised,” Vijayabaskar says.  

Babu bats for a universal pension scheme to ensure that the elderly community becomes economically independent. “The government should also help them find employment opportunities after they retire. Putting some money in their hands will be of great help to the senior citizens,” he adds.

While some governments are stepping in with initiatives like ElderLine and by supporting some NGOs, the efforts are scattered and lack focus. 

“I do not see any sign of conditions improving, as the healthcare budget for the country is less than two percent of GDP, with competing pressures for the limited funds. Moreover, healthcare is a subject that is in the purview of both Central and state governments, resulting in the ball being dropped,” he says. 

As a consequence, elderly care, especially for the poor, is likely to be the last priority “Neither do senior citizens have any voice in forums that matter,” he says. 

The sheer volume of calls to ElderLine in states like Tamil Nadu (250 to 300 daily) underscores the scale of seniors’ problems.

“A majority of calls are related to enquiries about old age homes. We first ascertain their problems, then talk to their children, and try and reunite them. Then, there are calls seeking guidance for applying for the Old Age Pension (OAP). We also rescue destitute elders with the help of one-stop centres,” N Preethi, team lead, Tamil Nadu Senior Citizen Helpline, tells DH.

The 1090 Elder Helpline, a joint operation by Bengaluru City Police and Nightingale Medical Trust, receives about 30 calls a day. “Most of them complain about the financial problems, poor health care provided by family members and property disputes with wards,” Sulekha, manager at the helpline, says. 

Opening more day-care centres and specialised healthcare treatment for the elderly are some ideas that state governments and the Centre could adopt to reassure senior citizens. For example, the Rajiv Gandhi Government General Hospital in Chennai has an exclusive rehabilitation ward with about 60 beds to treat abandoned patients. 

HelpAge India already runs day care centres known as Active Ageing Centres in Kerala, with support from local bodies. “Such centres help people who do not know how to spend their time. We teach them digital literacy and run skill enhancement programmes. We also give them income generation options and enhance their skills and ensure regular health check-ups,” Babu says.

On the health front, Vijayabaskar emphasised the need for geriatric care as part of government intervention to ensure elderly well-being.  

He also proposed involving Public Health Centres (PHCs) for periodic elderly check-ups and volunteers for medicine delivery. 

“Local anganwadis could also be enlisted to prepare meals for them. In-kind services like medicine delivery and regular check-ups are vital,” he adds. 

Premkumar Raja, secretary, Nightingales Medical Trust, said it is essential to review and strengthen the Maintenance Act to address the shortcomings in elderly care.

“However, legislation alone cannot resolve this issue. Raising awareness and establishing support systems are crucial to encouraging children to care for their parents. This may involve promoting community-based initiatives, counselling services, and resources for caregivers,” he says. 

(With inputs from Arjun Raghunath in Thiruvananthapuram and S N V Sudhir in Hyderabad)