Supporting India’s ageing population

For all the political discourse about a ‘population explosion’, the truth is that India is witnessing a sharp slowdown in its population growth and is expected to start reversing its
numbers over the next 2-3 decades. The total fertility rate (TFR) is down to 2.3, and we are very close to achieving replacement level fertility.

Replacement level fertility is the total fertility rate—the average number of children born per woman—at which a population exactly replaces itself from one generation to the next, without migration.

A slowing population automatically implies a higher number of the elderly to the number of youth.

According to the Economic Survey 2019, the country will continue to enjoy the “demographic dividend; for a few more decades but some states will start transitioning to an ageing society as early as the 2030s.”

Unfortunately, we do not seem prepared to meet the requirements of this shift. The need of the hour for India is to not only improve healthcare infrastructure for the elderly but also to create innovative social solutions to enable the elderly population to live better, happier and more productive lives.

‘Social prescribing’ is a strategy that ageing countries are considering to address the physical and mental health needs of the elderly.

In 2018, the British government initiated the new strategy of social prescribing to address the growing problem of
loneliness among the country’s elderly. Physicians will be allowed to refer people to partake in social groups and activities to combat loneliness.

This will be supplemented by creating cafes, art spaces or gardens that can become the focal points for social prescriptions for the elderly.

Currently, the societal view of the elderly as healthcare burdens can be changed to one that values them as a large experienced, wise population with immense social capital.

Healthy ageing processes will enable the elderly to optimise their physical and mental health in order to take an active part in society. Community referrals are mechanisms to create and utilise social support structures for ageing populations.

An elderly couple living alone in a city, away from their children, can enjoy a much better quality of life if they are a part of a community exercise that enables the pursuit of their passions and hobbies.

This system must become an intrinsic part of the healthcare structure of our country whereby doctors are able to refer their elderly patients to the communities suitable for them.

There is scientific evidence to believe that staying socially active and relevant not only
helps fight off depression but also improves cognitive function and helps slow down
the decline in health. Community groups can also be effective in educating people to adopt healthy lifestyles and dietary habits.

Plan of action

The following steps can help improve the situation:

1) Creating communities and social support networks to work in cohesion with hospitals and general practitioners

2) Integrated awareness and training programmes to prepare a workforce that can act as a vital link between doctors and community groups, and can play the role of counsellors for the elderly

3) Framing guidelines to help doctors recommend and refer patients to social networks

4) Laying the ground for a community-referral system at the village, town, and city levels.

5) Engaging the local population, students and volunteers to spread the activities of community groups

According to a 2017 report by the United Nations Population Fund (UNFPA) around
12.5 % of India’s population will be 60 years and older by 2030. By 2050, one-fifth of India’s population will be of this age group.

Integrating social prescription with the healthcare structure will not only result in a healthier ageing population but also has the potential to reduce the financial burden on healthcare services.

(The writer is Director and Creative Strategist, CHAI Kreative and Return of Million Smiles)