Research Priorities in the
field of Ageing in India : Some suggestions
S. Siva Raju
Background
The large scale social, economic and technological
changes, which are taking place in the society have significantly transformed
the pattern of formal and informal support systems available to the older
people. With the growth of
“Individualization” in modern industrial life and materialistic thinking among
the younger generation, there is greater alienation and isolation of the
elderly from their family members and from society at large. Given the changes,
the elderly face a number of problems and adjust to varying degrees. These problems range from absence of ensured
and sufficient income to support themselves and their dependents, to ill
health, absence of social security, loss of social role and recognition, to the
non-availability of opportunities for creative use of free time. Given the constraint of resources, care of
elderly has received a low priority so far in planning and programming social
security provisions and services.
Issues of the
older persons
These days, due to
change in family structure, the elderly are not given adequate care and
attention by their family members. This
trend is fast emerging partly due to growth of "individualism" in
modern industrial life and due to the materialistic thinking among the younger
generation. These changes lead to
greater alienation and isolation of the elderly from their family members and
from society at large. Due to the
changes in the family structure and the value system, the respect, honour,
status and authority, which the elderly used to enjoy in the traditional
society, gradually has started declining and in the process the elderly are
relegated to an insignificant place in our society (D’ Souza, 1971). Though the young generation takes care of
their elders, in spite of several economic and social problems, it is their living
conditions and the quality of care, which widely differs from society to
society.
As older people
become aware of their incompetencies, they begin to revise their ideas about
themselves. They also have to start
coping with reduced income, change of status, loss of friends and spouse and lastly,
their waning physical health.
Psychological changes accompany the passing of years, slowness of
thinking, impairment of memory, decrease in enthusiasm, increase in cautionness
and alternation of sleep patterns.
Social pressure and inadequate resources create many dysfunctional
features of old age. Further, it is well
known that the incidence of mental illness among old people is much higher than
among the young. The psychological
problems encountered by retired persons are much wider and its impact on the
individual is entirely different as compared to those in the unorganised
sectors. Reduced health, reduced income
and a sudden break with a particular kind of professional life results in
various socio-psychological problems for the retired. The attitude of family members towards
retired persons changes and his attitude towards his family members also
changes in this period of life.
Attitudes towards old age, degradation of status in the community,
problems of isolation. loneliness and generation gap are the prominent thrust
areas resulting in socio-psychological frustration among them (Mohanty, 1989).
Most elderly are
reported to bear a negative self-image and poor self-concept (Ramamurti and
Jamuna, 1984). Changes in looks and
likeability and a feeling that others alienate the elderly greatly contribute
to the negative self-image. It was
noticed that after the age of 50, people gradually manifest more problems and
display poor adjustment and life satisfaction till the age of retirement. However, after the retirement they slowly and
gradually find adjustment and as such their life satisfaction and adjustment
show higher index until the age of 70 when the negative effects of ageing again
become more pronounced (Ramamurti, 1978). The significant determinants of
Successful Ageing, according to some studies (Ramamurti and Jamuna, 1992,
Niharika, 2004, Siva Raju, 2006), include self-acceptance of ageing changes,
self-perception of health, perceived functional ability, perception of social
support, inter-generational amity, belief in karma and after life, flexibility,
range of interests, activity level, marital satisfaction, religiosity, certain
value orientations and economic well-being.
Health problems and medical care are the major concerns
among a large majority of the elderly.
The majority of them refrain from seeking medical aid from public
hospitals due to many impediments, besides lack of money. Some of the health problems of the elderly
can be attributed to social values also.
The idea that old age is an age of ailments and physical infirmities is
deeply rooted in the Indian mind and many of the sufferings and stresses within
curable limits are accepted as natural and inevitable by the elderly.
The existing medical facilities in India are inadequate and their
utilisation by the public is very meagre.
The problem is more acute in the remote areas, where, whatever
meagre facilities have been made available, are not optimally utilised by
people (Siva Raju, 1991). Instead,
people go to private practitioners of indigenous medicine who live among them
and who may not be qualified. Getting
proper medical aid is beyond the reach of the elderly, which may be due to
their poverty, illiteracy, general backwardness and adherence to superstitious
beliefs for curing illnesses and diseases. Poor people spend larger proportion
of their income on medical bills than the rich.
Since medicines and consultations are very expensive, they take
medicines only until the symptoms go away, and as a result, most of the leading
ailments become chronic in nature.
Research on Ageing in
India
The Research Agenda on Ageing for the 21st Century which
was jointly developed by the United Nations Office on Ageing and the
International Association of Gerontology, was adopted by the Second World
Assembly on Ageing at Madrid, Spain in 2002. It aimed to elaborate and
implement public policies on ageing and influence the direction and priorities
for scientific gerontology in the coming decades. According to UN (2002), “There
is a need to assess the ‘state of the art’ of existing knowledge, as it varies
across countries and regions, and to identify priority gaps in information
necessary for policy development.” Accordingly, attempts are made recently to
review the body of knowledge in the field of ageing and to identify the
priority areas of research in the field of ageing in India (Prakash, I.J.,
2004, Ramamurti, 2005, Siva Raju, 2006).
The science of gerontology is still in its infancy in India. The
interest of social scientists and social work professionals on various ageing
issues is of recent origin. At present academic institutions like Tata
Institute of Social Sciences and SNDT University in Mumbai, International
Longevity Centre in Pune, M.S. University in Baroda, Centre for Development
Studies and Centre for Gerontological Studies in Trivandrum, Council for Social
Development in Hyderabad, Sri Venkateswara University in Tirupati and Bangalore
University in Bangalore have been actively engaged in research on ageing. The
Census, National Sample Survey Organisations, Central Statistical Organisation
and others collect and compile data on various ageing related issues like age
and sex structure, rural urban residential patterns, literacy, martial status,
work status dependency status, disability and health status and related
information. Further organizations like ICSSR, ICMR, Planning Commission,
Ministry of Social Justice and Empowerment and International Agencies like
UNFPA, UNESCO, WHO and ESCAP sponsor projects that focus on issues related to
ageing. These organizations also sponsor programmes and organize seminars
conferences and workshops on ageing related issues.
The research on Ageing in India as on today was primarily focused on
socio-economic and demographic profiles, living arrangements, problems of and
services to the aged, interpersonal relationships especially of the urban
elderly. No doubt concerted efforts made by researchers have so far led to a
better understanding of ageing issues. However the diversity that has emerged
in the ageing process necessitates our research efforts to focus on different
ageing issues in society. This in turn is expected to promote a development
of effective age-related policies and
programmes. The review of the earlier studies reveal that most of them view the
elderly as passive receivers of care. Further the problems of vulnerable
elderly like widowed females, disabled, fragile older persons and those from
the unorganized sector are inadequately covered. Most studies conducted to
assess various issues of the elderly are exploratory and descriptive. Ageing
needs a multi and inter-disciplinary perspective. The development of social
gerontology reveals that disciplines like sociology, demography, psychology,
anthropology, geography, law, social policy and administration, management,
economics, nutrition, as well as varied professional training like social work,
nursing, counseling and clinical psychology, focus on various ageing issues.
However, no single disciplinary focus gives a holistic understanding. A
combination of qualitative and quantitative approaches are also required for a
more comprehensive understanding of ageing issues. Also wide variation in
levels of development and socio-economic status of people living in different geographical
regions make national level studies on elderly essential. Analysis of both
secondary and primary data need to be attempted, wherever necessary, which in
turn will help to focus on ageing issues, both at macro and micro levels.
Research Priorities
Some of the areas of research on elderly which needs our attention
on priority basis are:
- Assessment of the impact of globalization on the living conditions of the elderly.
- Study of vulnerability of elderly women, disabled, fragile older persons and those from the unorganized sector.
- Focus on the rural and tribal elderly living conditions.
- Effect of rural - urban migration of young members on the living conditions of their elderly.
- Need assessment studies on establishment of day care and interactive centres for elderly in the community.
- Impact of health problems on the quality of life of the elderly.
- Study of linkages between nutritional and health status of the elderly.
- Primary Health Care for the rural and tribal elderly.
- Factors contributing for different forms of elder abuse.
- Determination of ‘successful’ ageing, ‘healthy’ ageing, ‘productive’ ageing and ‘active’ ageing
- Assessment of quality of life of elderly on the basis of life span approaches.
- Assessment of family relations and social networks of elderly living in different socio-economic settings.
- Issues and implications of networking of organizations working on ageing issues.
- Assessment of areas for collaboration between Public and Private sector for enhancing the living conditions of the elderly.
- Assessment of issues related to the promotion of ageing in place.
- Study of linkages between spirituality and ageing
- Study of role of technology in the quality of life of elderly.
- Assessment of voluntarism among the elderly living in different socio- economic settings
- Study of opportunities and facilities that are required for enhancing the contribution of elderly to the family, community and society.
The focus of social gerontology is not only concerned with people in
later life but also the social institutions which particularly affect that
period such as retirement, pensions and welfare policy. Given the changes in
the socio-economic profile of the elderly, there is a need to recognize them as
the resource group and to develop suitable policies and programmes for their
integration into the development process.
References
D'Souza, V.S. 1971 Changes in Social Structure and Changing Roles of
Older People in India. Sociology and
Social Research 53 (3), 297-304.
Government of India 1999 National Policy on Older Persons. Ministry of Social Justice and Empowerment,
New Delhi.
Mohanty, S.P 1989 Demographic & Socio-Cultural Aspects of Ageing
in India:Some Emerging Issues. In
R.N.Pati & B.Jena (Eds.) Aged in India: Socio-Demographic
Dimension. New Delhi: Ashish, 37-45.
Niharika, Gupta, 2004. Successful Ageing and Its Determinants, Ph.D.
thesis, TISS, Mumbai (Mimeo)
Ramamurti, P. V. 1978 The Sixth decade and
after. Tirupathi: S. V. University
Press.
Ramamurti, P.V. & Jamuna, D. 1984 Psychological Research on the
Aged in India. Journal of the
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Ramamurti, P.V.
& Jamuna, D. 1992 Markers of Successful Ageing Among Indian Sample, Basle,
Switzerland, Sandoz Project Report.
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Raju, 2006, Identify the priority areas of research in the field of ageing in
India
Siva Raju, S. 1991 "Health care system in
India: Need for comprehensive evaluation", in `Primary Health care',
Yesudian C.A.K. (ed.) Tata Institute of social Sciences, Bombay.
Siva Raju, S.
2002: “Health Status of the Urban Elderly: A Medico-Social Study”, Delhi, B. R.
Publishing Co.
Siva Raju, S. 2002: “Meeting the Needs of the Poor
and Excluded in India”, Situation and Voices, The Older Poor and Excluded in
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Siva Raju, S,
2006, Ageing in India in the 21st Century : A Research Agenda,
Mumbai: Harmony- Celebrate Age
(Dr.S.Siva Raju is
Professor and Dean, School of Development Studies,Tata Institute of Social
Sciences.)
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