What it takes to be a senior citizen in India during coronavirus epidemic

There have been few reports on the reality of our elderly citizens, and even fewer on the impact of COVID-19 on a population that the state apparatus has rendered ‘useless’. Senior citizens are often thought of as liabilities considering they can no longer contribute to economic progress and scientific development. However, they remain living bodies and minds who deal with this reality every day. It’s only during a crisis that the true inadequacies of a society become clearer.

Mobility for the elderly outside their houses is crucial in terms of physical exercise as well as to continue daily activities like buying groceries, socialise and visit doctors. As of 2017, 92.4% of the elderly population in India was physically mobile; only 5.5% was confined at home. So it is safe to assume that they can manage most of their day-to-day responsibilities.

Some 6% of elderly women and 2% of elderly men live alone in urban areas and 20% of elderly men and 12% elderly women live independently with their spouses – according to the 75th round of the NSS. While apps and app-based services have facilitated increased access to door-delivery of various commodities, most senior citizens are yet to adopt them.

Now, given older people are more likely to die of COVID-19 (but just as likely as those of other age groups to become infected), the ongoing pandemic has left more of them lonely and feeling vulnerable considering they are wary of stepping out. The government has done precious little to assuage these concerns. Through its responses as well as overarching public healthcare strategy, the state has made health an individual responsibility instead of a collective one. While some older people are privileged enough to be able to stay indoors without compromising on their quality of life, working class senior citizens or individuals who live alone have been forced to go out. In addition to the shortage of medical equipment and hospital beds, the elderly are likely to have internalised a sense of  redundancy.

The ageing body

The current healthcare system, inefficient and under duress, projects the idea that the ‘burden’ of life rests with the people themselves, and together with a broken social system often suggests their bodies are ‘disposable’. Poor stamina and slowness are seen as being antithetical to the utilitarian ideals of productivity, and which finds robust, energetic and well-motivated bodies to be more politically and economically.

In India, the older are more afflicted with chronic rather than acute illnesses – aside from locomotor difficulties – such as high blood-pressure, hypertension and diabetes, which require long-term medication. They are also more at risk of cancer, renal diseases and musculoskeletal disorders, particularly arthritis. Reduced mobility during this time prevents them from seeking regular medical attention, and leaves them dependent on others. To top it all off, 83% of their health expenses are out-of-pocket, leaving them financially vulnerable as well.

Since most older people are partially or entirely financially dependent on others (Since 53% and 20.3% of older people are partially and entirely dependent, respectively, on others for their finances, their social security is quite fragile, especially in the context of the ongoing pandemic.

India’s success in bringing down avoidable mortality among children and enhancing life expectancy hasn’t improved the quality of life for the population overall. With respect to the state’s outlook, the term “older population” or variations thereof didn’t feature in the 2018 Union budget, which was concerned instead with devising ways to use India’s millennials to increase economic growth. Safety nets like employer insurance and pensions are available to only a minority, and are lower still for women.

Misinformation and anxiety

Another compounding factor is information from the internet. A study published in January 2019 found that people older than 65 years were more likely to share fake news in the US. It’s not hard to imagine the situation is similar in India — and more than 200 million WhatsApp users are in India. In addition, WhatsApp use is very common in India, and is often the primary source of new information, especially news.

Because they are less familiar with technology and apps, anecdotally speaking, older people are often exposed to, and fall prey to, misinformation about ‘miracle cures’ for COVID-19 as well as overhyped claims, conspiracy theories, unscientific medical claims, etc. This in turn leads to hysteria and anxiety. Instead, we need to invest time and energy to educate our elderly family members about fake news and its ill-effects, and improve their access to culturally sensitive and affordable mental health counsellors.

There have been reports of more than 300 people dying by suicide during the lockdown period; some 80 of them have been attributed to the fear of being infected by the virus and the consequent isolation and loneliness. Loneliness is a serious concern among the elderly, and could be a result of lower economic resources, death of contemporaries or spouse, lack of an active social life and dissatisfaction with familial and social relationships. There is also the self-perceived stigma of ageing and loss of purpose.

In essence, the pandemic has precipitated sudden shifts in the lifestyle of older people, and as such, in a setting in which benefits are available only to those employed in the formal sector, the odds are stacked against India’s senior citizens.

(This article has republished with permission from The  Wire.)