A demographic transition for PH
In many countries, the demographic transition has led to what is known as the “demographic dividend.”
Additionally, elder abuse and ill-treatment have become far more frequent and unidentifiable during the pandemic.
As India moves through demographic transition, with lowering fertility rates and increasing life spans, the economic conditions and fundamental social structures like family dynamics have started to show dramatic changes. Changes such as nuclearisation of family structure and emergence of single-parent families will soon be followed by imminent greying of the country’s population. These changes are not coincidental; rather they are inevitable. They are likely to bring along unprecedented issues and challenges, requiring novel solutions.
One such issue is increasing ageism and elderly abuse, which is a crucial challenge as the elderly will soon comprise a major part of the Indian population. According to the UN Population Prospects, by 2050, almost 20 per cent of India’s population would be 60 years or above, doubling the current figure. Literature suggests that the changing family structure and evident changes in socialisation have been correlated with prevalence of elderly abuse. According to WHO, elder abuse is defined as an act of violation of human rights; physical, sexual, psychological, and emotional abuse; financial and material abuse; abandonment; neglect, and serious loss of dignity and respect.
The recent Longitudinal Ageing Study in India (LASI, 2017-18) report highlights that elderly living alone (8.2 per cent) or with children but without spouse (5.4 per cent) are more likely to experience abuse in India. A significant proportion (7 per cent) of divorced, separated and deserted elderly have faced some kind of ill-treatment in the past year. The most common perpetrators of abuse of the elderly are children/grandchildren (37.5 per cent) and son-in-law/daughter-in-law (35.9 per cent), displaying the impact of change in socialisation and evolution of social structures.
Absence or death of spouse also plays a major role in impacting the exposure to neglect. Along with that intersectional discrimination is also a contributor. Experiences of abuse are much more common among Scheduled Caste elderly members (6.7 per cent), elderly women (5.6 per cent) and elderly residing in rural areas (5.8 per cent). Ill-treatment may also be a result of ageism and associated stereotypes, reflected by the LASI report showing elderly currently working experience frequent (6 per cent) ill-treatment. Elderly with low education levels are also more susceptible to abuse and ill-treatment as they are not aware of their legal rights. Economic factors are also likely to influence outcomes. The LASI report showed that the poorest quintile according to monthly per capita expenditure has experienced far more discrimination than the rest. The elderly are also likely to face economic exploitation, specially if they are divorced, separated and deserted or living with people other than family.
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Bihar and Karnataka reported more than 10 per cent cases of elder abuse, twice the national average. Other southern states along with north-eastern states reported quite low prevalence of ill-treatment with respect to the rest of India.
Every other victim of elder abuse occasionally experiences ill-treatment, while 14 per cent frequently experience ill-treatment. Among the victims of ill-treatment, almost 77 per cent per cent of the elderly experience verbal or emotional abuse regardless of their living conditions, economic status, marital status or education. Around 24 per cent of them have faced physical ill-treatment, 27 per cent have faced some kind of economic exploitation and 53 per cent have faced some kind of neglect.
In states like Uttar Pradesh and Arunachal Pradesh, almost 45 per cent of the elderly population has faced physical ill-treatment while 65 per cent of the elderly from Bihar have experienced neglect.
On an average, one out of 20 elderly reported experiencing ill-treatment by their family members, nationally. However, while analysing these figures, we need to consider that these are highly underreported. As abuse and ill-treatment is mostly inflicted by family members, feeling of security is severely distorted, forcing victims to not even report the crime. Also, association of the family with such accusations carries a stigma, further reducing the reporting of such disturbing cases.
Additionally, elder abuse and ill-treatment have become far more frequent and unidentifiable during the pandemic. The lockdown enclosed elderly victims with the perpetrators, leading to covert abuse. While the idea of living with perpetrators of ill-treatment may be traumatic, living alone has become even more difficult due to the ongoing pandemic considering the needs of the elderly and their susceptibility to the virus.
The trends throughout the country emphasise the dire need to deal with this issue before its consequences become debilitating. The consequences of ageism and elderly abuse are not limited to mental health problems. The first consequence is obviously the severe impact on mental and physical health of the elderly who have had experiences with violence and emotional abuse. Along with this, a huge burden falls on the economy of the country. Such prejudices and discriminatory practices are also associated with premature deaths and overindulgence in unhealthy and risky behaviours, further contributing to the disease burden of the country.
Dealing with issues like ageism and other upcoming challenges due to demographic transition need to be dealt with at the grassroots level. In other developing countries, participatory action research and community building programmes have been highly successful in creating a safe and nurturing environment for all. Such programmes address issues at root level, while ensuring inclusion and reducing intersectional discrimination. India too needs a comprehensive policy and proper execution of welfare programs for economic, social as well as emotional well-being of senior citizens.
The writers are, respectively, a research scholar at the International Institute for Population Sciences, Mumbai and a final-year student of Applied Psychology, University of Delhi.
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