One of the biggest changes brought about with the advent of modernization and improved standards of living is the increase in the ageing population. By 2050, the number of the elders in the country is expected to rise and surpass the population of children. The majority of elders in the country face various health problems and have no access to basic healthcare or medicines and for those who do have, face financial crisis. Therefore the elders are in a dire situation where healthcare is concerned.

Older people, especially disadvantaged older people who live alone are at a high risk of being under nourished, due to lack of a care, financial strain, fragility and a meagre diet. Looking at the increased number of geriatric health and social snags in India, the World Health Organization (WHO) in association with the Government of India carried out a cross sectional, community centered study of the aged populace of 60 years and above in 10 states in India. By using a structured questionnaire, about 1000 elders from rural and urban background were studied.  However due to the large sample size of the survey, the study was not specific to any section of the society but was representative of the entire population.

Ageing population is an international phenomenon with widespread socio and economic consequences.  Ageing of the population is a matter of great concern for the nation, for it is the nation’s responsibility to look after the aged. The number of older persons is rising at a rapid rate and unless the government takes corrective measures by providing them the best possible care it is going to be serious problem in the coming years, affecting not only the aged but the younger population as well.

If you happen to visit All India Institute of Medical Sciences (AIIMS) in the national capital in the recent times you will notice the place is struggling to cope with attending to the large number of elderly in urgent need of medical attention and care. The queue outside AIIMS to get an appointment or a token, starts from 2 am at night. While it is tough for everyone, it is worse for the elders who struggle to stand for long hours and need occasional recesses to breathe and – to the washroom. These elders, mostly who are destitute come from all corners of India to get the much needed medical attention. While some are accompanied by family members, most come alone, travelling without tickets in train because they have no money. When they arrive also, the situation doesn’t get any better as to get an appointment or a date for a simple blood test takes weeks, so they stay inside the hospital premises or outside under a tree or in a  nearby Dharamshala or Gurudwara for food and shelter. With hope they wait patiently, waiting for their turn, but most of them don’t get a chance, because the procedure is long and tedious and due to immobility and lack of immediate diagnosis and medication, most of them don’t come back or are unable to make it.

With growing prolonged existence and incapacitating prolonged sicknesses, elders require improved and better access to physical infrastructure, in their homes as well as in public. Due to the lack of proper healthcare facilities and unaffordable medicines, chronic diseases and malnutrition are on a high in India. Emphasis on the geriatric services is limited in the public space and is limited to a few dedicated geriatric services. Public health has many issues, among them are, lack of proper infrastructure, manpower, lack of proper care and hygiene and overcrowding of facilities. Most of the government services such as day care centers, old age homes, therapy and recreational facilities are urban based. The geriatric department services are mostly accessible at tertiary care hospitals.

Senior citizens in India are more vulnerable because the government does not spend enough funds on the social security systems. Insurance covers for the elders are non-existent, and in most cases pre-existing illness are not covered in insurance policies, which makes it all the more difficult for the elderly. As a result, most of the elders feel isolated and alone due to neglect and lack of elder friendly policies.

Economic restraints and financial dependence is common amongst elders living in India. The elders living with their relatives are essentially dependent on the economic capability of the family unit for their fiscal security and welfare. One factor that is an underlying challenge to the welfare of the old, is poverty, which gives rise to issues like abuse, abandonment and loneliness. It is imperative to understand the social dynamics that concern the elders as they go through the course of ageing. Rapid urbanization, increase in life expectancy and lifestyle changes, have given rise to diverse problems for the aged in India.

All-inclusive care for the elderly is likely only with the participation and co-operation of family, community and the Government. India should prepare to meet the growing challenge of caring for its elderly population. All public healthcare facilities in the country need to address the social challenges faced by the elders to improve their quality of life. There is a need to start necessary and proper social welfare programs to safeguard the life of the elders and assist them in living a life of dignity and hope.