Problems for the elderly
There are an estimated 106 million elderly in India. 90 million still need to work to survive and 55 million sleep hungry, 51 million live below poverty line. ( Source – Helpage India website)
Asha provides services to some 700,00 people and about 10% of those are elderly.
Problems they experience include visual impairment, malnutrition, joint pains, chronic physical and mental illnesses, often complicated by low health literacy, social isolation, financial constraints, and limited access to effective health care. Many elders have spent years in hard physical labor, without savings or social security.
As Dr. Kiran Martin states :
“They are constantly worried about where they will live if their homes in the slums are demolished. Elderly women are the most vulnerable. There are estrangements in family relationships, worries about repayments that are due to money lenders, worries related to unmarried or widowed daughters, and alcoholism among male members in the family.”
Asha’s interventions to support elders extends from the Clinic to the Community
Geriatric Clinic Screening
In addition to a Geriatric Care clinic, Asha’s Community Health Volunteers (CHVs) visit elders’ homes and accompany them to the Asha clinic, where they receive a complete medical check-up, and are screened for mental and physical problems including depression, anxiety, recent falls, joint pain, and hearing and vision problems.
Geriatric Clinic Treatment
Weekly geriatric clinics provide compassionate, free health care to promote healthy aging. Services include glasses and hearing aids, referrals to specialists accompanied by CHVs, medicines and vitamins.
Community Level Activities
Asha’s Reponses to Delhi Slum Elders’ Daily Needs
Asha team volunteers visit elders daily in their slum houses to talk with them about their well-being, engage them in conversation, provide companionship and help them with their day-to-day activities including personal and environmental hygiene, house cleaning, shopping and other daily chores. Having the Asha telephone number to call anytime has been especially valuable during the Covid-19 pandemic.
Asha’s Response to Abuse of Elders Living in Slums
Elder abuse, particularly verbal abuse, increased during Covid-19. Asha Advocacy Groups intervene when they observe that elders are being treated unfairly or poorly by their family members. In addition to daily visits from Asha volunteers, the women’s and children’s groups invite the elderly community members once a month to the Asha center and share lunch and refreshments – a sign of love, respect, and care for the elder members of the community. The groups also contribute money from their resources to provide items which the elderly need.
According to WHO, the geriatric population in India will be 315 million by the year 2050. In Delhi the percentage of Elderly population is 6.5%, according to the Census Data 2011. 63% of the Elderly population across the slums of Delhi do not have access to old age benefits and pensions. The old age dependency ratio climbed from 10.9% in 1961 to 13.1% in 2001 for India as a whole. For females and males, the value of the ratio was 13.8% and 12.5% in 2001.
61.7 per cent of India’s elderly population will be without any income security by 2050 going by the present coverage of Social Security Benefits for the Elderly. The overall prevalence of malnutrition according to a study conducted amongst elderly in the slums was about 51%. The proportion of elderly with mid-arm circumference and calf circumference below the cut-off of 22cm and 31cm respectively was significantly higher in slum areas. According to NSS Data 60th Round, 57% of urban male and approximately 19% of urban female elderly do not have any financial support. 19% of elderly poor males and 13% of elderly poor females in urban India are deprived of hospital care.
What old age means in the slums
An ageing population tends to have a higher prevalence of chronic diseases, physical disabilities, mental illnesses and other co-morbidities. The health needs and health related problems of elderly people cannot be viewed in isolation. A wide gamut of determinants such as social concerns (viz. children moving out of their parents’ home in search of occupation, leaving them isolated without any physical support in daily activities); maltreatment towards elderly; poor knowledge and awareness about the risk factors; food and nutritional requirements; psycho-emotional concerns (viz. isolation, mental stress, difficulty in keeping themselves occupied); financial constraints, health-care system factors (viz. lack of effective health insurance system for elderly coupled with accessibility concerns and inadequacies in the government health-care system); and physical correlates; determine the medical problems and thus cast a significant impact on the quality-of-life of the elderly.
The Story of Pushpa
Pushpa, 65 years old, is a resident of Asha’s Chanderpuri slum colony. She is alone as her husband passed away a few years back, and she has no offspring. She lives with a distant relative. To earn her living, she works as a maid in nearby colonies, which provides her with about 50 cents per month. Out of her paltry income, she has to pay monthly rent and meet her daily expenses.
The outbreak of the Covid-19 pandemic and consequent lockdown resulted in the loss of income for Pushpa as the owners of the houses where she was working asked her not to come. Presently, Pushpa has no money and no one to support and care for her. She has diabetes and high blood pressure and requires medicine. In such dire circumstances, the only beacon of hope in her life is Asha. The Asha team and the Community Health Volunteers regularly visit her home and take care of her. She attends Asha’s geriatric clinic at Chanderpuri where she receives free treatment and medicines for her blood sugar and blood pressure, Vitamin-D and Calcium supplements for her general health, and access to groceries and the governmental widow’s pension program.
Pushpa enjoys coming to the Asha center since she can meet people, talk, and be less lonely. An Asha young adult who daily visits her house provide her comfort and companionship. Pushpa is grateful for the Asha team at Chanderpuri which she sees as a critical support in the twilight years of her life.