Western World and the Japanese have been handling the challenges with ageing population for some time. In India, this challenge has started coming up slowly. The current generation, those who were born around India’s independence in 1947, is ageing well, trying to take care of health, and in general gung–ho about life in general. Technology is helping them in getting in touch with each other using WA, Facebook, Instagram and such apps.
India has an old tradition of handling the aged relatives in the family. In my young age, in many families there used to be one or two grannies, lovingly called aajjies! In those times most of the families were joint families. From the “post-independence” generation, people started getting better opportunities for education. A small percentage of the population went to foreign countries and stayed back there. Over a period, this percentage started increasing. Computerisation made technology more democratic; more and more people began getting opportunities to work and live abroad.
Along with this, opportunities for education and work, jobs became abundant. Pan Indian migration started in a big way. All these things resulted in the formation of nuclear families. The ladies too were not far behind. After education, ladies became career oriented in a big way. Steady and better incomes inculcated a new thought process in families. All this gave birth to a new term, space; everybody wanted their space. It has become the requirement of grandparents, parents and children. But this space created voids in the family. The effect of voids was not understood, initially. The family kept helping and supporting each other in the short term. Better medical treatments and diagnostics helped longevity. All these events together have now created a new requirement in society.
What happens when someone in the family falls ill and needs long time support. The requirement of long-term support arose when people of the golden generation became old but could not handle many things, physically; and in some cases mentally. There are two distinctive supports available. One is palliative support, and the other is like home support. Those who are seriously ill with cancer, heart issues, renal problems, chronic obstructive pulmonary issues, cerebrovascular accident need palliative care; such treatment cannot be handled at home. But general ageing related issues can be dealt under home care.
In western countries, especially in the US, palliative care facilities are available. In Japan, there is a shortage of such facilities. In India, these facilities, compared to the needs, are almost non-existent. In India, as a society, we are prepared to provide space to each other, but while this change happened, we had not budgeted for parents who can live longer due to improved longevity. The confluence of all this created turmoil in people’s mind about handling the situation. In the year 1981, Jaya and I were in Ottawa as Jaya was taking some training. During one long weekend, we went to an island on a lake with a Canadian friend of ours; he was almost twenty years senior to us.
On the way back, the friend said, “Hey folks, is it ok if I take a bit of detour?” We said, “Absolutely no issues.” When we reached a destination, the friend said, “It is an old people’s home, my mother is here. I come and meet her every 2/3 months.” We were sitting at the back-side of the car and were confused. We did not know what we were supposed to do. But our problem was solved by his wife. In the parking lot, she said, “I will wait with Jaya and Pramod; you go and see your mother.” Problem solved. In 1981, our friend was ok with the idea of meeting his mother every 2/3 months, because she was within 50 km from Ottawa. As a society, we are not mentally prepared with this idea. The older people’s homes available are not providing facilities that people have at home.
There is some progress in creating facilities. But compared to India’s population, this number is low. It is about creating facilities; it is also about young and old getting mentally prepared for such arrangements. Hospices need doctors, trained nurses, and medical facility to handle day to day critical requirements. Whereas in older people’s homes, the need is to create facilities which suit all the pockets. Some may need five–star facilities, and others may be ok with a couple of stars. But there is a significant need for affordable facilities.
Some people will ask me why am I writing about all these things. The simple reason is it is a need of times like we have schools, colleges, gardens and so on. I hope people have managed to create a corpus which will last them till they are around.
I will tell you about some facilities in India that I know. According to me, there is a world–class facility but I will explain it in the end. Please let me know if you know about such facilities in India. In Pune, there is one facility developed by Paranjape builders called Athashri. It is well developed and within Pune city limits. To my knowledge, they have a couple of locations. In these facilities, one can buy a condo or rent it from someone who has bought it. I have heard about a similar facility in Talegaon near Pune. In Lavasa near Pune, similar facilities are there. I have read something about such facilities near Dehradun, and I am sure there must be more such facilities. But they do not provide what is provided by Dignity Foundation.
The best of such facilities for me is one in Neral. It is on a hillock, with gradually sloping covered but open corridors. Golf carts are available for those who need them. The place is called Dignity foundation.
The rooms that I saw were like a standard hotel room, with a bath and toilet. It had a small cupboard and kitchenette too. They also provide round the clock nursing service if required. I know all the details because someone very close to us lived there for her last few years. They had an arrangement with Reliance Hospital if hospitalisation was required. When she needed an eye treatment, they sent their person with her for a couple of days to Mumbai for treatment. She used to paint, so they had provided her with a small room. Besides joint celebrations, they used to show movies and had many activities.
When she died, the family suggested cremation in Mumbai. But their manager suggested that if there were no specific reason to do it Mumbai, they would arrange everything in Neral. We all went to Neral for cremation. After everything was completed, the manager suggested a small tour of the facility because some of the people had never seen it before. In the end, he took us to their dining area.
He said, “Sir, it is already 1.30 pm. The management has suggested that all of you should have lunch with us and know what kind of food the residents is served.” It was a standard home type food for lunch. But what impressed all of us was the gesture they showed and took part in the cremation as if someone from their family had died! We knew her last two–three years must have passed the way she wanted. It is not the facilities but the human touch that is important. After all, people who live there are far from their family.