Old People’s Homes
Old People’s Homes Ageing people need differentiated living arrangements since ageing deepens the older person’s need especially designed senior citizens homes, bedrooms, toilets, food varieties and qualities geared to specific nutrition, healthcare services, nursing, wheel chairs/crutches to move. National demand for differentiated living arrangements increases with increase in ageing population. With demand, supply both as free social service and commercial enterprise also tends to increase. Such differentiated demand and supply are quite visible in developed countries where good retirement plans and pension systems work. One can see thousands of senior citizens homes of various types and qualities (free or on payment) in developed countries. Most of them are available on commercial terms. These homes are for those elderly men and women who do not have any living adult children or close relatives with whom they enjoy living. Besides, there are elderly people who do not want to live in the family with their adult children and or grand children along with wives of sons or husbands of daughters. They prefer leading independent life. They have money or they have children to pay for the cost of living in the Old Peoples Homes. Most people believe that the availability of Senior Citizen’s Home on payment is a great help to the elderly people who need or prefer independent living arrangement. But these facilities are hardly available in a developing country like Bangladesh.
All these are linked with the changes in longevity. Rapid increase in longevity due to high quality nutrition and availability of better healthcare services propelled by higher per capita income and innovative technology creates new expectation for more comfortable living arrangements and longer enjoyable life among the ageing population. Such changes in expectations usually happen in developed countries where both per capita income and life expectancy are higher. In rich developed countries of Europe, USA and Japan, with the expectation of long years after retirement and the economic security largely due to the maturity of pension funds, the older persons expect and plan for better living arrangement in Senior Citizens Homes. Particularly, older women often feel that this is their first opportunity to explore and seek self-actualisation. Hiroko Akiyama and Toni Antonucci in their paper Changing Life Style of Older Japanese- Seeking Independence and Solidarity states, For majority of men and women in Japan the exploration for a meaning of life after retirement has just began. The status of the elderly people in rich countries is much better than that in developing countries like Bangladesh.
However, there is a concern for the status of older women. This concern is not a country specific phenomenon but one of global issue. Decreasing fertility and increasing life expectancy has reshaped the age structure of population all over the world. Availability of improved healthcare services, more comfortable life-style and recreational facilities and healthy food habit has enhanced human longevity. This has led to a steep increase in the number of older people, defined by the United Nations as those over the age of 60. Globally the population of older persons is increasing at a rate of 2.6% per year (UN, 2007). This means that the demand for Old Homes, special living arrangements, traveling facilities, geriatric hospital, recreation centres for ageing population are also increasing rapidly. Bangladesh is one of the poorest and most densely populated countries in the world. A striking feature of those from low-income background is that they become older at a much earlier stage of life due to malnutrition and other effects of poverty. In recognition of this factor, government statistics consider those above 50 to fall into the elderly category. In 2009, the government started work on a detailed data bank for people aged over 50. In 2005, the total number of older people was 5.64 million and the number is estimated to increase to 14.6 in 2025, (UN 2007). An ageing population has emerged as a new demographic challenge, one that is especially difficult for a resource-constrained economy in which state provision of social safety nets is not well established. It is in this context that question of old people’s homes arises.
By old people’s homes, we usually mean institutional shelters for older men and women who have no family to support them, and who do not have the financial resources to live by themselves. While some homes provide services free, most require payment. This is a very new concept in Bangladesh where traditionally children are responsible for taking care of parents in their old age. The majority of older people live with extended families on whom they depend for food, shelter and access to healthcare. Nowadays, due to changes in social and economic structures, including increasing urbanisation, as well as broader ideological shifts, the trend has moved away from extended families to nuclear families. As a result, we find that more and more older people from all strata of society are being neglected or even rejected by their families. Even if their extended families are willing to look after them, poverty prevents a large segment of the elderly population from accessing basic health and shelter services. This is borne out by the increasing number of elderly beggars in Dhaka city and elsewhere. The government introduced old age allowances in 1998 for destitute, poor and financially hard up elderly persons. A step in the right direction, it covers primarily rural populations and is clearly inadequate. Women are stipulated to be 50% of the beneficiaries but they are usually discriminated against even here. Those from more affluent backgrounds find themselves subject to psychological neglect and social isolation, especially if they no longer have property in their own names. Once assets are divided among the children, parents find that they lose status and respect within the family. Those who receive pensions, usually men, find the sum inadequate for their survival. Older women who have depended on their husbands in the past find themselves especially marginalised once they become widows. Older women are also more vulnerable physically and face more acute exploitation. They live longer and have extremely limited income capacity. The provision of old homes for women, especially in rural areas, is therefore an urgent need.
The government has set up six free shelters as Shanti Nibash, one each in divisional headquarters providing food and shelter for residents. The Bangladesh Association for the Aged and the Institute of Geriatric Medicine with financial help of the Government has established a Senior Citizen’s home where various services are provided to elderly people.
A number of homes have been established through private initiative. There are a number of old homes located in and around Dhaka. In Gazipur, Dhaka a big old home has been established by private initiative. Some of these homes provide recreational facilities as well as basic services. A study of old homes in Dhaka shows that 47% of the residents are there because they have no one to look after and over 60% are male.
In Bangladesh the number of existing Old Peoples Homes is much lower than the demand. In addition, many living in Old Home face a considerable social stigma, primarily because this is very new concept in our culture. However, the economic and social reality is that many elderly people will have no choice but to stay in old homes. A recent survey reveals that some of the rich ageing ladies prefer to live in a quality Old Home on payment. The establishment of Old Home by government and private initiative throughout the country is a demand of the time. [Najma Siddiqi]