India's developing senescence landscape and its impact on the nation

In December 2021, the Sankala Foundation hosted the seminar "Ageing in India: Actionable Solutions". The event aimed to address the challenges and propose solutions for India's rapidly growing elderly population.

India's ageing population faces numerous challenges, including financial dependency, lack of affordable healthcare, shortage of geriatric care professionals, rising chronic diseases, mental health issues, social isolation, and diminished family support systems.

Economic vulnerability is a significant issue, with many seniors facing low literacy, limited financial security, and the need to work post-retirement. Healthcare gaps are marked by unaffordability, inadequate infrastructure, and a severe shortage of geriatricians. The number of geriatricians currently stands at around 300-350, while the need is predicted to reach over 59,000 by 2050.

Chronic non-communicable diseases such as hypertension, diabetes, cardiovascular diseases, and cognitive decline are on the rise, making healthcare a pressing concern. Social issues like social isolation, mental health decline, and the erosion of traditional joint family support systems also pose challenges.

However, there are proposed solutions and ongoing initiatives to address these challenges. These include increased government investment in healthcare, the expansion of national programs like the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), and the promotion of innovation in healthcare delivery.

There is a focus on developing specialized geriatric training to increase the number of geriatricians and build elder care capacity. Social protection policies are being developed to support financial independence and improve mental health, and efforts are being made to counter social isolation by fostering community support systems.

Experts have called for leveraging the "silver dividend" to ensure that elderly care becomes part of national development. The Maintenance and Welfare of Parents and Senior Citizens Act, enacted in 2007, allows the elderly "unable to maintain themselves" to take legal action against adult children or grandchildren who fail to provide them with basic necessities.

The NHRC has focused on monitoring and advocating the rights of senior citizens, ensuring all elderly prisoners are covered by health insurance schemes, and improving the functioning of old age homes. The southern states of India have the highest proportions of older adults, and in 2024, the port city of Kochi became the first city in India to be a member of WHO's Global Network for Age-friendly Cities and Communities.

In 2022, there were nearly 149 million people over the age of 60 in India, comprising 10.5% of the total population. Enforcement of the Maintenance and Welfare of Parents and Senior Citizens Act has been difficult, and many senior citizens are not even aware of such a law.

Reports of violence and abuse of elderly have been frequently reported in the media in recent years. Models followed in places like Hong Kong and Shanghai are being considered, such as training family members to care for elderly relatives and integrating old-age homes within local neighborhoods.

The elderly bring a wealth of experience, knowledge, and cultural depth that can be harnessed to enrich communities and contribute to social and economic development. The Ministry of Health and Family Welfare launched the Longitudinal Ageing Study in India (LASI) in 2017, a population-based survey investigating health, economic, and social determinants of population ageing in India.

Experts predict that by 2050, nearly 20% of the Indian population will be over the age of 60, amounting to over 347 million individuals. States like Kerala have allocated five per cent of the budget to palliative care and evolved frameworks to safeguard the autonomy of senior citizens.

The seminar was supported by the Niti Aayog, the ministry of social justice and empowerment, and the National Human Rights Commission (NHRC). Experts have recommended for the creation of an integrated National Plan on Elderly Care. A robust senior care economy focused on specialized healthcare, elder-friendly tourism, and recreational activities is being proposed.

Several experts on the issue of ageing will share their vision on how to respond to the current challenges at the national conference on "Ageing in India: Emerging Realities, Evolving Responses" later this week.

The Sankala Foundation recognized the increasing prevalence of medical conditions like chronic diseases, cancer, respiratory conditions, digestive health issues, and eye health problems in India's aging population.
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