Context:

This editorial is based on the news “NITI Aayog Releases Position Paper– Senior Care Reforms” which was published in the PIB. NITI Aayog recently released a position paper titled “Senior Care Reforms in India: Reimagining the Senior Care Paradigm” discussing the current trends, challenges and reforms for the ageing population. 

Ageing Population Trends: Global and India

• Global Aging Trends: According to WHO, the global population aged 60+ is expected to double from 12% in 2015 to 22% by 2050.
• Aging in India: Senior citizens in India, who currently represent over 10% of the population, are projected to grow to 158 million by 2025 and 319 million by 2050.
• Dependency Ratio Changes: India’s total dependency ratio is forecasted to decrease until 2025 due to a growing working-age population initially, then increase to 61.22 by 2050.

Impact of Ageing Population

• Lack of Support System for the Elderly: The increase in the average age of the population, shift towards smaller nuclear families and increased migration due to work, education, and marriage have left the elderly behind with scarce or practically no support system.
• Ageing-related Stereotypes: Ageing is viewed negatively with the elderly often being viewed as a burden in society, leading to social isolation and mental health issues among the elderly.
• Economic Impact: Their growing number leads to a decline in contribution to the labour force.
  • Also, the social benefits extended by the elderly population through their unpaid work, are neither recognized nor quantified.
• Digital Divide: A considerable gap in digital literacy has led to hindrances in accessing services. 

Challenges Faced By Senior Citizens Care System

• Health Domain: Fragmented approaches to Service Delivery like nursing agencies and physiotherapists, Healthcare Gaps for the Elderly like lack of availability of targeted immunization programs, mental health services, etc. Infrastructure Gap, Paucity of trained manpower and Limited financing of elderly health care. Furthermore, senior health care insurance has a very shallow penetration (18%).
• Social Domain: Narrow and inadequate social security system, Limited awareness of rights and provisions, Changing family structure and loss of social support, Social Inequality and Inadequate elderly-friendly infrastructure.
• Economic Domain: Less than 20% of the elderly population is covered with any health insurance and nearly 78% of them remain without any pension cover, Insufficient financial literacy and awareness about available financial schemes and deficient support in lifetime financial planning. 70% are dependent on family for everyday maintenance.

Action Plan For Senior Care Reforms In India and Development of Senior Citizens Care Support System

• Health Empowerment and Inclusion: 

  • Health Literacy Enhancement, Infrastructure and Workforce Development, enhancement of the Mental Health and Emergency Services and Addressing dietary needs through initiatives and integrating Ayush systems.

• Social Inclusion and Empowerment: 

  • By Community Sensitization to raise awareness about the elderly’s needs and challenges, Peer Support Groups to share experiences and support each other, Legal and Welfare Awareness for their rights, safeguards, and available welfare schemes.
  • There is a need for Legal Reforms to ensure swift resolution in maintenance tribunals, Housing and Care Homes Reform for improving elderly-friendly conditions and by developing a comprehensive online resource for the senior care economy sector.

• Economic Empowerment and Inclusion: 

• • By focusing on Reskilling programs to update the skills of the elderly for better employment opportunities, expanding the Public Fund Coverage, Savings Plans to ensure financial security, and encouraging the private sector to develop targeted health insurance products for the elderly.
  • There is a need to adjust tax and GST policies for easier adoption and financial relief, with boosting liquidity and investment in the senior care sector and by utilizing reverse mortgage mechanisms to enhance seniors’ liquidity.