India will have over 319 million elders by 2050, a 2-fold jump from year 2023

HelpAge India works towards the cause, care and dignity of the disadvantaged elderly population in rural areas, urban slums, semi-urban areas and across remote locations in India with the mission: To work for the cause and care of disadvantaged older persons and to improve their quality of life.

Speaking to Bizz Buzz exclusively, Rohit Prasad, CEO, HelpAge India explains how the organisation is helping the elderly overcome multiple challenges across health, income, livelihoods and newer ones such as digital exclusion, loneliness linked to mental well-being and ageism

What, going by your experience, are the key challenges the elderly face in the prevailing urban family systems?

The elderly face multiple challenges across , income, livelihoods and newer ones such as digital exclusion, loneliness linked to mental well-being and ageism. The motto of HelpAge is ‘Fighting isolation, poverty and neglect’. The principle challenge before HelpAge India is to reach out to as many disadvantaged elderly as possible to help them with services and empower them to live a life of dignity. There will be over 319 million elders by 2050, threefold the number identified by the Census in 2011, and about twice the number estimated currently at 138 million (second largest in the world). With 90 per cent belonging to the unorganised sector (with no or limited social security), majority have to work in order to survive. To serve such a large segment of the elderly population, throws up multiple challenges, as their needs are many, they risk being ‘last & lost’ and unfortunately are increasingly getting marginalised.

There is also the very real challenge of ageism that has seeped into the societal mindset, which often leads to discrimination and deprioritising elder needs, making it harder for an organisation like HelpAge to advocate for their cause. There is a systematic stereotyping towards the elderly population in India, who are often not considered as part of the mainstream planning towards development and growth, both at a society level as well as at a family level. The established practice has been of viewing and treating this demographic, as dependents and burdens, which needs to change.

With the joint family system under strain, especially in urban areas, and the rise in nuclear families, elders are gradually losing their pride of place in families and correspondingly, at a society at large. HelpAge India is tackling these challenges through its programmes and initiatives spread across the country, and advocacy for change.

In how many States is HelpAge India present, and how many elders are you able to provide relief to?

HelpAge India has 17 state offices and several project offices across 24 States and Union Territories in 200 plus districts and 2000 plus villages. It supports more than 2 million elders every year directly through its various programmes, and more broadly supports many through advocacy for their rights, promotes intergenerational connect and building an age friendly environment

Elder abuse has been on the rise across the country. Can you please make a comparative assessment of the condition of elders in urban and rural India?

While making such a comparative assessment is not possible due to various differentiating factors that would need to be considered, what has emerged from our recent research reports, ‘Bridge the Gap: Understanding Elder Needs’ – A HelpAge India Report (2022) and ‘Women & Ageing: Invisible or Empowered?’ (2023) is that elder abuse is on the rise across the country, an alarming fact that needs society’s immediate attention. Surveys show that elder abuse is rising - on an average, 40-60 per cent of elders perceive that abuse is happening and 10-15 per cent actually suffer. It is an important public health and social issue. When senior citizens are asked about actions required to stop abuse, several points are mentioned. The first and foremost suggestion always is to sensitise the family and children and reinforce values of care and respect. Second is to improve economic independence and participation: financial dependence rises with age and is a key factor for abuse. Third is strengthening recourse/help options—such as from community SCAs/elders’ groups, police, helplines, etc. The Government of India’s Ministry of Social Justice and Empowerment has established a pioneering Elderline (14567) across the country and HelpAge is an implementing partner in 8 States.

MHU has helped in providing relief for eldercare across the states. Please share more about your works through MHU in different states.

HelpAge’s Mobile Healthcare Unit (MHU) programme has been recognised as Asia’s largest mobile healthcare network for elders. Currently, 170 plus MHUs, often in partnership with corporates under CSR, are spread over 24 States and provide approximately 20 lakh treatments every year. It seeks to provide sustainable healthcare solutions to disadvantaged elders and their community. Each MHU is equipped with a doctor, pharmacist and a trained social worker.

These MHUs go into the interiors of rural areas and urban slums and villages, bringing healthcare virtually at the doorsteps of these destitute elders. For most elders, it saves them from the long lines at hospitals/health facilities which are often situated far from their communities and they get free medication on a monthly basis. Elders living in remote locations, do not have access to basic healthcare facilities and have to trudge long distances to healthcare centres which is often not possible due to their own mobility challenges, as well as affordability.

The MHUs often conduct specialised health camps on various diseases and free health check-ups are conducted. The MHUs have also become awareness generating sites, with the social worker empowering the disadvantaged elder with information on various diseases, along with educating them on various preventive measures that can be taken to prevent the onset of any deadly disease. HelpAge has also been able to facilitate nearly 18 lakh vaccinations during the pandemic, largely due to this large MHU network.

How does HelpAge involve and engage with its communities, and what steps does it take to ensure its programs are successful?

HelpAge India has developed a strong culture of community engagement through several of its programmes. Its volunteers’ base includes - youth, primarily students, professionals and retired people. Volunteers are involved in Mobile Healthcare Units and the Digital Literacy initiative for the elderly. We also build community engagement for our programmes related to research, data collection and social outreach on issues such as universal pension, quality healthcare, food security, action against elder abuse and many more.

With the Elder-Self-Help-Group programme pioneered by HelpAge, elders in rural areas are becoming empowered through social, financial and digital inclusion, and joining the mainstream. Community volunteers are closely involved in supporting the elders’ collectives.

In urban areas, HelpAge India works with Senior Citizen Associations (SCAs) across the country with the intent to empower the elderly population so they can live their lives with dignity and also find the power to voice their needs. For this, HelpAge India conducts awareness sessions on issues such as pensions, the Maintenance and Welfare of Parents and Senior Citizens Act, financial planning, wills and legacies etc. Another key area of work with the SCAs is to provide digital literacy and safety to senior citizens, to help them overcome the digital divide, stay safe from online fraud and stay independent as well as more connected.

Pension and free medical care for elders continue to be an issue, and HelpAge continues to advocate with the government. Please suggest a mechanism by which both- the State government and the central government can find a solution on the vexed issue.

Several important government schemes and initiatives for senior citizens are currently operational in the country. However, many are unaware or face barriers in accessing the benefits. Collective efforts and partnerships are needed to raise awareness and strive for accelerated implementation.

To enable essential healthcare for the elderly, the implementation of the National Programme for Health Care of the Elderly (NPHCE), an important initiative of Government of India, needs to be ensured at each level. Last mile healthcare delivery of agecare services can be provided through community health workers. Preventive and health promotion activities should be emphasised. Most importantly, health insurance needs to be made available to all elders covering all age-related ailments, beyond the disadvantaged segment that Ayushman Bharat PM-JAY already covers, and bringing the middle class within the fold. Non-governmental organisations and civil society can play a critical role in reaching out to the unreached elders and supporting the Government’s efforts in universal health coverage.

Old Age pension amount and coverage needs to be significantly enhanced for ensuring social protection. HelpAge has been advocating for Rs 3000 per month minimum universal pension for the poor and disadvantaged elderly, to bring a common pension floor across the country. Currently, the average pension amount across states is in the range of Rs 500 per month, with few States above Rs 2000 per month.