1

A SITUATIONAL ANALYSIS OF ELDERLY IN PUNE CITY

PROJECT LOCATION: RAMTEKDI (PUNE)

PROF. S. SIVA RAJU

With Assistance From

Ms. Chaitra Khole

Mr. Gandharva Pednekar

TATA INSTITUTE OF SOCIAL SCIENCES, MUMBAI

MARCH 2016

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PREFACE

The emerging changes in the age and sex structure of India’s population will have a profound

impact on the demographic landscape and are expected to pose multifaceted developmental

challenges, especially for older persons. A rapid increase in the number of older persons as

well as their proportion in our population has led us to being more conscious of the many

social, economic, psychological and health problems of the older population. Several

researchers have attempted to focus on issues of the elderly from various surveys

commissioned for different purposes. However, data base focusing exclusively on the elderly

is very limited. Hence, Tata Institute of Social Sciences (TISS) in collaboration with Sanctus

Rehabilitation Care Foundation (SRCF), Pune and Tata Trusts, undertook a research project on

Situational Analysis of Elderly to initiate activities at local level, especially in urban context

by strengthening health care services. In this regard, generating scientific and systematic

information on the living conditions of the older persons in Ramtekdi was done by conducting

a situational analysis. Further, such a study is expected to help in providing information on

gaps in the existing services and also provide valuable clues for designing suitable

interventions to promote community and health care for elderly.

The review of the studies conducted so far on Situation of Elderly show that a lot of focus has

been centered on these issues in the West, while in India, negligible attempts have been made.

Given the complexities involved in understanding the issues and concerns affecting the well-

being of elderly, it is very important to initiate the process of understanding their needs and

evolve a plan of action to minimize their problems and enhance their quality of life. In this

regard, it is increasingly seen that organizations like Sanctus are focusing on various social

activities to improve the condition of the elderly within community, along with the

establishment of intervention projects in the areas of their operations.

Both quantitative and qualitative approaches were used in the study as it provides a

comprehensive and in-depth understanding of the socio-economic, demographic, housing and

health conditions of the elderly in the community. The data collection was carried out during

the period November 2015 to December 2015 and altogether 473 elderly residing in Ramtekdi

were covered in the survey.

The successful completion of the survey and this report under the title ‘Home Care for

Elderly’ would not have been possible were it not for the engagement of various individuals

and institutions that contributed at different stages of the project. We sincerely thank and

convey our deepest gratitude to all of them.

Prof. S. Parasuraman, Director, Tata Institute of Social Sciences (TISS) for granting necessary

permission to associate with this major project and for his constant encouragement.

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Ms.Sugandhi Baliga, Tata Trusts for conceptualizing the study, entrusting it to us and also for

her valuable suggestions at various stages of the study. We are thankful to Mr. Nilesh Yadav,

Programme Associate Health, Tata Trusts for his constructive and active involvement in the

implementation of this study.

We are thankful to Mr. Devashish Bharat, Director (SRCF) and Dr (Mrs) Majushree Kumar,

Senior Advisor for his co-ordination, co-operation and administrative support throughout the

study. Thanks are due to all the Sanctus officials and all the other members who are associated

with the field activities.

Our sincere thanks to Dr.Nidhi Gupta, Assistant Professor, TISS for her academic support

during the study.

We appreciate all the TISS survey team for their sense of responsibility and commitment in

successfully carrying out the various research activities in the assigned field areas. We thank

the project staff: Mr. Gandharva Pednekar, Ms. Chaitra Khole, Ms. Shweta Singh and

Ms. Rashmee Sharma for their continual involvement in the execution of the project.

Our sincere thanks to the community workers in the respective study areas, various personnel

of government and non-governmental agencies and volunteers who assisted indifferent stages

of the field work.

Last but not the least, to all the community members of the study areas, who provided us with

the requisite information.

Mumbai

Dr. S. Siva Raju

March 2016

Tata Institute of Social Sciences

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RESEARCH STAFF ASSOCIATED WITH THE SURVEY

Ms. Chaitra Khole, Project Officer

Mr. Gandharva Pednekar, Research Associate

Ms. Rashmee Sharma, Administrative Assistant

Ms. Shweta Singh, Research Assistant

Ms. Sakina Shaikh, Research Investigator

Field Investigators

Yogesh Sonawane

Amol Chavan

Mahendra Kharade

Ganesh Patil

Avijit Das

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CONTENTS CHAPTER 1. INTRODUCTION .................................................................................................................... 9

CHAPTER 2: METHODOLOGY ................................................................................................................. 12

CHAPTER 3: DEMOGRAPHIC PROFILE .................................................................................................... 15

CHAPTER 4:HOUSING CONDITIONS AND LIVING ARRANGEMENTS....................................................... 19

CHAPTER 5. ECONOMIC CONDITIONS .................................................................................................... 26

CHAPTER 6: SOCIAL PROFILE .................................................................................................................. 35

CHAPTER 7: ACITIVITES OF DAILY LIVING (ADL) AND INSTRUEMENTAL ACTIVITIES OF DAILY LIVING ... 47

CHAPTER 8: PRIMARY CAREGIVER ......................................................................................................... 52

CHAPTER 9:HEALTH AND NUTRITION .................................................................................................... 56

Conclusions ............................................................................................................................................ 67

Action points for intervention: ............................................................................................................... 68

Social Mapping of Utility Agencies in Study Areas ................................................................................. 69

REFERNECES ........................................................................................................................................... 73

ANNEXURE ............................................................................................................................................. 78

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List of Tables

Table 3.1 Distribution of Elderly by age group and gender……………………………………………………15

Table 3.2 Marital status of elderly age wise and gender wise……………………………………………….16

Table 4.1: Percentage distribution of living arrangement among the elderly household age

and gender-wise………………………………………………………………………………………………………………….19

Table 4.2: Percentage distribution of Type of dwelling…………………………………………………………20

Table 4.3: Percentage distribution of type of dwelling age wise and gender wise………………..21

Table 4.4 Percentage distribution of ownership and owner of house……………………………………21

Table 4.5: Percentage distribution of ownership of house among the elderly age wise and

gender wise…………………………………………………………………………………………………………………………22

Table 4.6: Percentage distribution of owner of the house among the elderly household age

wise and genderwise……………………………………………………………………………………………………………22

Table 4.8: Percentage distribution of elderly having a separate room age and gender wise…24

Table 4.9: Percentage distribution of elderly using toilet facilities age and gender wise……….24

Table 4.10: Percentage distribution of elderly using bathroom facilities age and gender

wise……………………………………………………………………………………………………………………………………..25

Table 5.1: Percentage distribution of chief earner of the house among the elderly

household……………………………………………………………………………………………………………………………27

Table 5.2: Percentage distribution of chief earner of the house among the elderly household

age wise and gender wise…………………………………………………………………………………………………….27

Table 5.3: Percentage distribution of elderly who have planned to meet their old age

expenses………………………………………………………………………………………………………………………………29

Table 5.4: Percentage distribution of source of income of the elderly age wise and gender

wise……………………………………………………………………………………………………………………………………..30

Table 5.5: Percentage distribution of income source of the elderly age and gender

wise……………………………………………………………………………………………………………………………….…...31

Table 5.6: Percentage distribution of income situation of the elderly age and gender wise….32

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Table 5.7: Percentage distribution of Elderlys expectation to meet their expenses age and

gender wise…………………………………………………………………………………………………………………………33

Table 5.8 Percentage distribution of reasons to find work

opportunities………….………………………………………………………………….………………………………………..37

Table 5.9: Percentage distribution of future living of the elderly age and gender wise………...35

Table 6.1: Percentage distribution of activities elderly are engaged in………………………………….35

Table 6.2: Percentage distribution of activities elderly are engaged in age and gender wise.36

Table 6.3: Percentage distribution of activities elderly spend most of the time in age and

gender wise…………………………………………………………………………………………………………………………37

Table 6.4: Percentage distribution of social activities elderly are engaged in age and gender

wise……………………………………………………………………………………………………………………………………..38

Table 6.5: Percentage distribution of elderlys involvement in decision making…………………….39

Table 6.6: Percentage distribution of Issues faced by the elderly age and gender wise…………41

Table 6.7: Percentage distribution of awareness and utilization by the elderly age and gender

wise……………………………………………………………………………………………………………………………………..44

Table 6.8: Percentage distribution of awareness and registration of schemes by the elderly..45

Table 7.1: Percentage distribution of ADL of the elderly age and gender wise……………………..48

Table 7.2: Scoring of the ADL scores………………………………………………………………………..........48

Table 7.3: Percentage distribution of IADL of the elderly age and gender wise…………………….50

Table 8.1: Percentage distribution of time spent by the caregiver age and gender wise………53

Table 9.1: Percentage distribution of type of disability of the elderly…………………………………..56

Table 9.2: Percentage distribution of self-rate health of the elderly age and gender wise…….57

Table 9.3: Percentage distribution of acute morbidities faced by the elderly age and gender

wise……………………………………………………………………………………………………………………………………..59

Table 9.4: Percentage distribution of chronic morbidities faced by the elderly age and gender

wise……………………………………………………………………………………………………………………………………..60

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Table 9.5: Percentage distribution of nutrition screening checklist among the elderly…………62

Table 9.7: Percentage distribution of total score of nutrition screening checklist among the

elderly age and gender wise…………………………………………………………………………………………………64

Table 9.8: Percentage distribution of BMI of elderly age and gender wise……………………………65

List of Figures

Figure 2.1: Map of Pune……………………………………………………………………………..13

Figure 3.1: Percentage distribution of elderly by gender………………………………………..15

Figure 4.1: Percentage according to type of dwelling……………………………………………19

Figure 5.1: Percentage distribution of chief earner of the house among the elderly household

age and genderwise…………………………………………………………………………………….29

Figure 6.1:Percentage distribution of issues faced by the elderly…………………….………...38

Figure 7.1: Distribution of ADL scores……………………………………………………………..45

Figure 9.1: Type of disability………………………………………………………………………….53

Figure 9.2: Percentage distribution of self-rated health of elderly- age and genderwise……54

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CHAPTER 1. INTRODUCTION

India, the world’s second most populous country, has experienced a dramatic demographic

transition in the past 50 years, entailing almost a tripling of the population over the age of 60

years (Government of India, 2011). This pattern is poised to continue. It is projected that the

proportion of Indians aged 60 and older will rise from 7.5 percent in 2010 to 11.1 percent in

2025 (United Nations Department of Economic and Social Affairs [UNDESA], 2008). This is

a small percentage point increase, but a remarkable figure in absolute terms. According to

UNDESA data on projected age structure of the population (2008), India had more than 91.6

million elderly in 2010 with an annual addition of 2.5 million elderly between 2005 and 2010.

The number of elderly in India is expected, by 2050, to surpass the population of children

below 14 years (Raju, 2006).

Population ageing is an important emerging demographic phenomenon in India, warranting a

strong multi-sectoral policy and programme response to deal with many significant

implications for the elderly in particular and society at large. Longevity by itself is to be

celebrated but for the increasing vulnerabilities of the elderly arising out of poverty, income

insecurity, illiteracy, age related morbidity, feminisation, dependency and decreasing support

base. In most of the western countries, advanced stages of development preceded population

ageing but the same is not true for many developing and middle-income countries, including

India. In India with majority of its population aged less than 30, the problems and issues of its

grey population has not been given serious consideration. To reap the advantage of

demographic dividend, the attention is mainly on the children and the youth and fulfillment of

their basic needs for proper development. Also the traditional Indian society and the age-old

joint family system have been instrumental in safeguarding the social and economic security

of the elderly in the country. However, with the rapid changes in the social scenario and the

emerging prevalence of nuclear family set-ups in India in recent years the elderly people are

likely to be exposed to emotional, physical and financial insecurities in the years to come.

This has drawn the attention of the policy makers and administrators at central and state

governments, voluntary organizations and civil society. Further, India is presently going

through a phase of demographic paradox wherein it has to capitalise on the demographic

window of opportunity by investing in youth and at the same time focus on an increasing

elderly population.

Ageing diminishes the capacity to work and earn. “A reduced capacity for income generation

and a growing risk of serious illness are likely to increase the vulnerability of elders to fall

into poverty, regardless of their original economic status…” (Lloyd-Sherlock.2000) The

presence of elderly make its implication on the production function within the household and

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thus on overall work effort that reflects in income and production (Schwarz, 2003). In other

words, in most of the cases, the presence of the elderly creates distortions in the production

function as they are physically unfit to work. This can have direct effect on the wellbeing of

the households that reflects in the poverty among elderly. The inability in the initial

endowment of an individual that deteriorates as they go up in the life cycle make them more

vulnerable and puts them a position in which they fail in risk management and maintenance of

a cope-up strategy in maintaining the level of living conditions (Zwi, 1993). This makes the

elderly more dependent on others for their needs resulting in higher levels of economic

insecurity and deprivation. In the West most of the elderly are under the social safety net, the

incidence and magnitude of the economic insecurity are high in the case of developing

countries (Helpage International, 2003; World Bank, 2001).

Physical and health risks are very high among the elderly. The precise implications of

population aging for future levels of health and health care utilisation depend on whether the

increases in life expectancy experienced in general are accompanied by an increase or

decrease in health problems in later life (Gruenberg, 1977; Kramer, 1980; Manton, 1982). The

increased health care expenditure in household with elderly in the developing world has lead

to deprived access to health treatment to the elderly (Helpage International, 2005). The studies

highlight high rates of deprivation of good health and lack of care in the developing and

transitional economies (Balkov, 2005; Ferrer, 2002; WHO, 2004).

A few important characteristics of the elderly population in India are noteworthy. Of the 7.5

percent of the population who are elderly, two-thirds live in villages and nearly half are of

poor socioeconomic status (SES) (Lena et al., 2009). Half of the Indian elderly are

dependents, often due to widowhood, divorce, or separation, and a majority of the elderly are

women (70 %) (Rajan, 2001). Of the minority (2.4 %) of the elderly living alone, more are

women (3.49 %) than men (1.42 %) (Rajan and Kumar, 2003). The majority of the Indian

elderly work in the informal sector with low levels of wages and deficient working conditions

and this has also put them in a state of deprivation, vulnerability and distress in old age in

terms of both health and economic security (Helpage International, 2002). Studies have shown

a gradual decline in the standard of life of the aged with high rates of dependency and lack of

basic needs (Rajan Mishra and Sarma, 1999; Rajan, 2004; Alam, 2007). The occurrence of

economic, health and social insecurities are becoming common (Dey, 2000; World Bank,

2001; Priya, 2003; Alam, 2007).

The belief that children will take care of the parents in the old age is eroding in India where

the family size has been cut down as a result of the demographic process (Dandelkar, 1996).

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The situation in the urban areas shows a rejection of older people by the next generation and

this is spreading to rural areas (Desai, 1985). In the nuclear family setting, the positions of the

aged become more vulnerable and are treated as a burden to the family (Nayar, 1992). The

social negligence of the aged occurs due to cultural, social and economic relations within the

society and its coexistence with demographic development (Achenbaum, 1978). This

changing dynamic that starts within the family and society can make the elderly insecure

(Alter G et al 1996) through intergenerational imbalance (Hareven and Adams, 1996). These

changing dynamics can affect the living arrangements and social protection system and make

the elderly more insecure.

This report is an outcome of the survey carried out in Pune from November to December 2015

by TISS for SRCF, Pune. It consists of various sections. The first section comprises of

introduction, the second explains the methods used in the study, third starts with social profile,

this is followed by analysis and concluding with conclusion and recommendations. The last

section of the report explains about Social Mapping in which various utility agencies in

Ramtekdi area are plotted in specially prepared maps with help of geographical information

system (GIS).

Objectives of the study:

A rapid increase in the number of older persons as well as their proportion in our population

has led to us to being more conscious of the many social, economic, psychological and health

problems of the older population. One such initiative is to work at locality level especially in

urban context by strengthening community care services. In this regard, generating scientific

and systematic information on the living conditions of the older persons in selected localities

by conducting a situational analysis is vital. Further, such a study helps in providing

information on gaps in the existing services and also valuable clues for designing suitable

interventions to promote care for the elderly.

The specific objectives of the study are as follows:

- Understand the living conditions of the older population in the selected locality in

Pune, in terms of social, economic, demographical, cultural and health aspects with a

view to know their expectations from various stakeholders towards their care

- Know the programmes and services for the care of the older population in the selected

locality in terms of old age homes, day care centres, senior citizen’s clubs, old age

pension schemes and other such programmes

- Develop locality level action plan to build enriching care for elderly in order to

strengthen the need based services care for them,

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- Develop strategy to enhance inclusion of senior citizens in the community in order to

increase their participation

CHAPTER 2: METHODOLOGY

About SRCF

SRCF Rehabilitation Care Foundation (SRCF) was born out of founding team’s personal

experience. The lack of proper service to patients with long term medical needs set us on a

passionate course to make a difference. SRCF works to provide quality, trained and supervised

care to patients and reduce total costs of care. SRCF is registered not for profit under Section

8 (formerly Section 25) of the Companies Act 2013.The services provided include Nursing

Care, Physiotherapy, Occupational Therapy, Speech Therapy, Diet Planning etc. They have

evolved and follow medical protocols for patient management with appropriate documentation

to monitor progress of our patients. The main are focus is on reducing the total costs of care

while focusing on prevention, infection control, identification of early warning signs, reduce

the costs repeat hospitalization and emergency care costs. Through various partners they

provide medicines, surgical and other products for use by such long term patients at

discounted pricing for both buying and renting, also developing cross subsidization in the

pricing of our services to further increase the accessibility of services. Additionally identify,

train and employ people from socially and economically weaker sections as Senior Citizen

Support Assistants, Home Care Medical Assistants and Nurses who under supervision of our

medical team provide nursing and rehab support to patients and work with foundations/

government vocational colleges to develop and deliver training to create a skilled work force.

In the current study a descriptive approach was used with both qualitative and quantitative

methods in Ramtekdi area in Pune city. All elderly members aged 60 years and above were

interviewed. The field work was carried out during the period November 2015 till December

2015 and a total of 473 elderly interviews were conducted.

The state Maharashtra is selected for this study as it ranks fifth in terms of highest numbers of

elderly in the country according to the Census 2011 Pune city was selected as the study area

which is one of the most famous and fast growing cities of India. It is the second largest city

in Maharashtra. Pune city is governed by Municipal Corporation which comes under Pune

Metropolitan Region. As per Census India, population of Pune in 2011 is 3.1 million; the rise

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in the population is due to various factors like job, work space, education, healthcare

treatment, real estate investment, suitable weather, better quality of life etc.

Figure 2.1 Map of Pune showing study area

(Source: http://maps.newkerala.com/Pune-city-map.php#.VNes9_mSwqI)

Study area: Ramtekdi

Ward No. 90

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Location:

Slum in S.No. 109 Hadapsar, Blind School, Ramtekadi Mandir, Slum in Hadapsar S.No. 110,

SRP Group l(part), Ramtekadi Industrial Estate, Nanawati nagar

North:

From the intersection of road on Eastern side of AIPT and Pune Solapur road towards East by

Pune Solapur road to meet Pune Miraj railway line

East:

From the intersection of Pune Miraj railway line and Pune-Solapur road towards South East

by Pune Miraj railway line to meet old PMC limit near Hadapsar S.No.76

South:

From the intersection of old PMC limit and Pune Miraj railway line near Hadapsar S.No.76

towards West by old PMC limit to meet nalla and then to the South by the nalla to meet

boundary between Hadapsar Mohammadwadi and then to the West by boundary between

Hadapsar Mohammadwadi to meet boundary of Wanwadi and then to the North by boundary

between Mohammadwadi Wanwadi to meet boundary between SRP group no. 1 and 2 and

then to the West by the boundary between SRP group no. 1 and 2 to meet the road on Western

side of Nanawati nagar

West:

From the intersection of road on the Western side of Nanawatinagar and boundary between

SRP group 1 and 2 towards North by the road on the Western side of Nanawatinagar and

further by the road going towards commandant residence of SRP group no. 1 to meet road on

the South side of AIPT and then to the East by the road on the Southern and further Eastern

side of AIPT to meet Pune - Solapur road.

A census approach was applied for data collection wherein all the households of the area were

covered and data was collected where the respondents were ready o participate in the study.

The tool used for conducting the survey was a close-ended interview schedule. The interviews

were administered on Tablets by a set of trained investigators using the application ‘Collect’.

‘Collect’ is a smart phone based data collection tool to capture data from the field in realtime,

monitor progress of projects and make quick decisions based on real time, accurate

data.(socialcops.com/collect)

The Schedule collected basic information on the Demographic profile, Housing conditions

and Living Arrangements of elderly, Economic Conditions, Socio-Cultural Engagement and

Subjective Health and Nutrition Assessment. An interviewer’s Manual was designed that

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contained techniques and procedures for conducting and completing the interviews. It

explained the questions and procedures for soliciting the responses and quality checks for

ensuring consistency of responses. Field investigators involved in data collection were trained

to use and administer the questionnaire on tablets. Cross-sectional analysis of data was

conducted using Software Package used for Statistical Analysis (SPSS). The collected data

was analyzed age wise and gender wise.

CHAPTER 3: DEMOGRAPHIC PROFILE

Age-gender distribution

The elderly population cannot be considered a homogenous group with similar needs and

expectations. Age specific requirements and services are just as important as the varied needs

of the males and females. Therefore, the age of the respondents were categorized into three

age groups, namely, 60-64 years, 65-69 years and those who were 70 years or above.

Table 3.1 Distribution of Elderly by age group and gender

Male Female Total

Percent Number Percent Number Percent Number

42.5 201 57.5 272 100 473

Age (in years)

60-64

12.6

60

22.1

105

34.7

165

65-69 16.4 78 15.0 71 31.4 149

70 13.3 63 20.0 96 33.3 159

Figure 3.1: Percentage distribution of elderly by gender

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Out of the total sample of 473 about 42.5 percent of them are males and 57.5 percent females.

The age distribution indicates that young old comprises of 34.7 percent followed by middle

old/ old-old of another one third (31.4 %). Those who are very old (70+ years) constituted

almost one third (33.3 %) in the sample.

Marital status

Marital status is considered important in determining psychological and emotional health of

the people in later years. Presence of spouse might be a significant source of support in later

years of life. A marriage relationship can provide affection and a sense of belonging. This

valuable support is lost upon widowhood. Table 3.2 shows percent distribution of respondents

by gender, age and marital status.

Table 3.2 Marital status of elderly age wise and gender wise

Marital

Status

60-64 age group

(n=165)

65-69 age group

(n= 149)

70+ age group

(n= 158)

Total

M

(n=60)

F

(n=

105)

T

(n=

165)

M

(n=

78)

F

(n=

71)

T

(n=

149)

M

(n=

63)

F

(n=

95)

T

(n=

158)

M F T

Married 86.7

(52)

50.5

(53)

63.6

(105)

79.5

(62)

31.0

(22)

56.4

(84)

73.0

(46)

16.7

(16)

39.0

(62)

79.6

(160)

33.4

(91)

53.0

(251)

17

Widowed 11.7

(7)

44.8

(47)

32.7

(54)

16.7

(13)

66.2

(47)

40.3

(60)

27.0

(17)

81.2

(78)

59.7

(95)

18.4

(37)

63.2

(172)

44.1

(209)

Others 1.7

(1)

4.8

(5)

3.6

(6)

3.9

(3)

2.8

(2)

3.4

(5)

0.0

(0)

2.1

(2)

1.3

(2)

2.0

(4)

3.3

(9)

2.7

(13)

Table 3.2 represents the marital status of elderly by age and gender. Out of the total sample,

over a half (53 %) of the elderly are married, followed by 44.1 percent widowed. A few (2.7

%) are separated, deserted or never married.

The marital status of 60-64 year indicates 63.6 percent of them were married followed by 32.7

percent who were widowed. When gender was taken into consideration, majority (79.5 %) of

the males are married as compared to 50.5 percent females. Opposite trend was noticed with

respect to widowhood, wherein 44.8 percent elderly women are widowed compared to males

(11.7 %). About 5 percent females were separated, deserted or single.

In the second (65-69 years) and third age group (70+ years) respectively; about 56.4 percent

and 39 percent elderly were married, 40.3 percent and 59.7 percent were widowed and 3.4

percent were separated, deserted or single. Considering only the 65-69 years age group about

79.5 percent males and 31 percent females were married, 16.7 percent males and 66.2 percent

females were widowed. In the last age group it was seen that 73 percent elderly males and 17

percent females were married. This was followed by 27 percent males and 81 percent females

were widowed.

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CHAPTER 4:HOUSING CONDITIONS AND LIVING

ARRANGEMENTS

The family life of the elderly plays a pivotal role in the quality of later life. To assess their

housing conditions and living arrangements is pertinent in order to gauge at the comfort and

support that the elderly experience. Variable such as living arrangements, type of dwelling and

owner of house, comfort using toilet and bathroom facilities, are discussed in this chapter.

Living arrangements:

Marital status has a direct bearing on the living arrangements of the elderly. This trend has

important implications for housing needs and the demand for institutional care. With the

decline in the proportion of the elderly living with relatives likely to continue, there will

probably be a greater need for the provision of social support and health services by the

community or other public sources.

Table 4.1: Percentage distribution of living arrangement among the elderly household age

and gender-wise

Living

arrangements

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

With spouse 26.7

(16)

13.3

(14)

18.2

(30)

20.5

(16)

8.5

(6)

14.8

(22)

22.2

(14)

5.2

(5)

11.9

(19)

22.8

(46)

9.1

(25)

15.0

(71)

Alone

3.3

(2)

13.3

(14)

9.7

(16)

6.4

(5)

15.5

(11)

10.7

(16)

4.8

(3)

15.6

(15)

11.3

(18)

4.9

(10)

14.7

(40)

10.5

(50)

With spouse

and children

53.3

(32)

35.2

(37)

41.8

(69)

22.5

(16)

51.3

(40)

37.6

(56)

42.9

(27)

11.5

(11)

23.9

(38)

37.3

(75)

32.3

(88)

34.4

(163)

With children 10.0

(6)

28.6

(30)

21.2

(35)

11.5

(9)

33.8

(24)

22.1

(33)

25.4

(16)

39.6

(38)

34.0

(54)

15.4

(31)

33.4

(91)

25.7

(122)

Others 8.3

(5)

8.4

(10)

8.3

(15)

10.2

(8)

19.7

(14)

14.9

(22)

4.8

(3)

21.5

(27)

13.1

(30)

7.9

(16)

18.7

(51)

14.1

(67)

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It is observed that with rise in age, the number of elderly living with their spouse decreases

gradually. Some of the elderly lived alone; this category included more females as compared

to that of males in all the three age group. Overall, about 34.4 percent elderly lived with their

spouse and children, 25.7 percent with their children, 15 percent with their spouse, 10.5

percent alone, 7 percent with their married daughter, 3 percent relatives and 4 percent with

others which all constituted to 10.9 percent which was later clubbed into Others.

In the 60-64 age group, 41.8 percent of the elderly lived with their spouse and children. This

was then followed by 21.2 percent who lived with their children, 18.2 percent with spouse and

9.7 percent alone. Gender-wise comparison showed that more males (26.7 %) lived with their

spouse alone than females (13.3 %), the reason for this can be due to higher number of

widowed women than men which also results in more number of females (13 %) staying alone

than males(3 %). About 53.3 percent and 35.2 percent elderly males and females lived with

their spouse and children and 10 percent males and 29 percent females lived with their

children respectively. A similar trend is observed in the other two age groups.

Type of Dwelling

Table 4.2: Percentage distribution of Type of dwelling

Percent Number

Independent bungalow

Flat in the building

Tenement with a common toilet

Hut in the slum

Others

2.3

23

51.6

22.4

0.6

11

109

244

106

3

Figure: 4.1Percentage distribution According to Type of Dwelling

21

More than 50 percent of the elderly lived in tenements with a common toilet. About 23 percent

lived in flats in a building and 22 percent in a hut in the slum respectively. The others

comprised of the elderly who lived on streets.

Table 4.3: Percentage distribution of type of dwelling age wise and gender wise

Type of

dwelling

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Flat in the

building

26.7

(16)

21.9

(23)

23.6

(39)

32.1

(25)

14.1

(10)

23.5

(35)

22.2

(14)

21.9

(21)

22.0

(35)

27.0

(55)

19.3

(54)

23.1

(109)

Tenement

with a

common

toilet

51.7

(31)

54.3

(57)

52.3

(88)

48.7

(38)

57.7

(41)

53

(79)

41.3

(26)

53.1

(51)

48.4

(77)

47.2

(95)

55.0

(149)

51.1

(244)

Hut in slum

locality

18.3

(11)

21.9

(23)

20.6

(34)

17.9

(14)

25.4

(18)

21.5

(32)

33.3

(21)

19.8

(19)

25.2

(40)

19.2

(46)

22.3

(60)

20.7

(106)

The locality that was selected for the situational analysis comprised of people of the middle

and low middle income group. Majority of the elderly in all the 3 age groups resided in

tenement with a common toilet (‘chawls’) i.e. 52.3 percent, 53 percent and 48.4 percent

respectively.

Ownership of household

Table 4.4 Percentage distribution of ownership and owner of house

22

Ownership of the house Percent Number

Rented

Owned

5.9

94.1

28

445

Owner of the house

Parents

Self

Son

Daughter

Grandchildren

Relatives

Others

6.1

62.8

12.5

3.2

0.6

2.7

12.1

29

297

59

15

3

13

57

The survey collected information on ownership of the household in order to gauge at the

dependency ratio of elderly for a place to live. Overall, 94.1 percent of elderly live in houses

that are owned and the remaining 5.7 percent in rented households. Most of the houses were

owned by the elderly themselves (63 %) followed by their son (12.5 %)

Table 4.5: Percentage distribution of ownership of house among the elderly age wise and

gender wise

Ownership

of the

house

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Rented 3.3

(2)

7.6

(8)

6.1

(10)

2.6

(2)

5.6

(4)

4.0

(6)

9.5

(6)

6.2

(6)

7.5

(12)

5.1

(10)

6.4

(18)

5.7

(28)

Owned 96.7

(58)

92.4

(97)

93.9

(155)

97.4

(76)

94.4

(67)

96

(143)

90.5

(57)

93.8

(90)

92.5

(147)

94.8

(191)

93.5

(254)

94.1

(445)

Table 4.6: Percentage distribution of owner of the house among the elderly household age

wise and genderwise

Owner of 60-64 years 65-69 years 70+ years TOTAL

23

the house

M F T M F T M F T M F T

Self 90.0

(54)

48.6

(51)

63.6

(105)

78.2

(61)

50.7

(36)

65.1

(97)

66.7

(42)

55.2

(53)

59.7

(95)

78.3

(157)

51.5

(140)

64.9

(297)

Son 1.7

(1)

12.4

(13)

8.5

(14)

11.5

(9)

14.1

(10)

12.8

(19)

11.1

(7)

19.8

(19)

16.4

(26)

8.1

(17)

15.4

(42)

11.7

(59)

Others 8.3

(5)

11.4

(12)

9.8

(17)

7.7

(8)

29.5

(21)

18.6

(29)

12.8

(8)

18.7

(18)

15.7

(26)

9.6

(21)

19.8

(51)

14.7

(72)

The age group classification for ownership by elderly was 63.6 percent, 65.1 percent and 59.7

percent respectively. In the first age group; 90 percent elderly males and 48.6 percent elderly

females owned the house which is a significant observation. In the second age group 78.2

percent males and 50.7 percent females owned the house whereas in the last age group 66.7

percent males and 55.2 percent females owned the house. The others category about 14.7

percent included houses owned by daughter, grandchildren or relatives.

Subjective Comfort in existing housing condition

Table 4.7: Percentage distribution of elderly according to their comfort in existing housing condition

age and gender wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Comfortable

using the

house

58.3

(35)

67.6

(71)

64.2

(106)

67.9

(53)

69.0

(49)

68.5

(102)

52.4

(33)

56.2

(54)

54.7

(87)

59.5

(121)

64.2

(174)

61.8

(295)

Considering the comfort using the current housing set-up it was seen that about 62 percent

elderly felt that the current housing condition was comfortable and 34 percent felt it wasn’t.

Sex-wise differences are observed to be marginal. The level of comfort, as expected, is

observed to decrease with increasing age.

Provision of separate room

Majority of the elderly (70 %) did not have a separate room exclusively for themselves. NA

(Not Applicable) is meant for elderly who are either homeless or living in a small hut with

larger number of people.

24

Table 4.8: Percentage distribution of elderly having a separate room age and gender wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Having a

separate

room

28.3

(17)

27.6

(29)

27.9

(46)

25.6

(20)

25.4

(18)

25.5

(38)

20.6

(13)

27.1

(26)

24.5

(39)

24.8

(50)

26.7

(73)

25.7

(123)

About 27.9 percent, 25.5 percent and 24.5 percent of the elderly from the age groups 60-64,

65-69 and 70+ respectively, had a separate room for themselves.

Toilet facilities

Table 4.9: Percentage distribution of elderly using toilet facilities age and gender wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Toilet access 56.7

(34)

61.9

(65)

60.0

(99)

69.2

(54)

57.7

(41)

63.8

(95)

57.1

(36)

56.2

(54)

56.6

(90)

57.1

(111)

58.6

(160)

57.9

(271)

Comfortable

using the

toilet

58.3

(35)

65.7

(69)

63.0

(104)

67.9

(53)

57.7

(41)

63.1

(94)

52.4

(33)

58.3

(56)

56.0

(89)

59.5

(121)

60.5

(166)

60.0

(287)

Fear of fall

in the toilet

13.3

(8)

14.3

(15)

13.9

(23)

12.8

(10)

16.9

(12)

14.8

(22)

22.2

(14)

29.2

(28)

26.4

(42)

16.1

(32)

20.1

(55)

18.0

(87)

Taking into account the toilet facilities, it was observed that 60 percent elderly have easy

access to toilet. The elderly had toilets either in their house, or a common toilet which was

located in the nearby area at a distance of upto 0.5 km.

About 40 percent of the elderly did not have toilet in their home so they had use common

toilets provided by the PMC or open spaces. About 95 percent of the elderly had an Indian

type of toilet and 61 percent were comfortable using it. About 18 percent of the elderly

witnessed fall in the toilet. The elderly who were not comfortable using the current toilet

facilities complained of unhygienic conditions, water shortage in the toilets. From the above

table it can be observed that with rise in age, fear of falling experienced by the elderly is

25

increasing. On a gender basis, it was noticed that women experienced more fall incidents

compared to that of men. Falls were experienced due to slippery floors, weakness, health

complication etc.

Bathroom facilities

Table 4.10: Percentage distribution of elderly using bathroom facilities age and gender

wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Bathroom

access

68.3

(41)

71.4

(75)

70.3

(116)

79.5

(62)

53.5

(38)

67.1

(100)

65.1

(41)

64.6

(62)

64.8

(103)

70.9

(144)

63.1

(175)

67.0

(319)

Assistance

required

in bathing

20.0

(12)

19.0

(20)

19.49

(32)

10.3

(8)

15.5

(11)

12.8

(19)

19.0

(12)

30.2

(29)

25.8

(41)

16.4

(32)

21.5

(60)

18.9

(92)

Fear of

fall in

bathroom

10.0

(6)

12.4

(13)

11.5

(19)

9.0

(7)

12.7

(9)

10.7

(16)

19.0

(12)

24.0

(23)

22.0

(35)

12.6

(25)

16.3

(45)

14.4

(70)

Bathrooms were situated within flats or were common for those residing in chawls, wherein

some of the elderly had a small section within the tenement to be used as bathroom. Those

with bathrooms situated outside the house, complained of no/improper drainage system.

Looking at the above table it can be seen that a lot of elderly required assistance in bathing.

About 67 percent elderly had easy access to bathroom; the others have constructed a small

bathing space outside the house wherein they take shower. It was observed that 19 percent

required assistance during bathing, changing clothes etc. About 14.4 percent elderly

experienced fear of fall in the bathroom owing to various issues such as slippery floor, losing

balance and vertigo.

26

CHAPTER 5. ECONOMIC CONDITIONS

Among the several problems of the elderly in our society, economic problems occupy most

important position. With advancing age and inadequate finances, the elderly start depending

on their children economically, especially on their son/s. The economic condition of their

offspring has considerable effect on the living conditions of the elderly. The following

variables such as current and most recent occupation, planning of old age expenses, source of

income, perceived income situation and work participation, aim to throw light on the

economic conditions of the elderly in the sample so as to develop suitable schemes and

services for improving the quality of later life.

Occupation

The occupation structure clearly indicates that 47 percent of elderly are unemployed. This was

followed by 32 percent elderly involved in elementary occupations which comprise of labor

work, construction and mining work, etc.

27

Chief earner of household:

Table 5.1: Percentage distribution of chief earner of the house among the elderly

household

Chief earner Percent Number

Self 31.9 151

Spouse (Elderly’s) 11.4 54

Son 41.4 196

Daughter 8.0 38

Grandchildren 2.1 10

Relatives 3.0 14

Others 2.1 10

The elderly were asked about the chief earner of the house who is defined as the major

financial contributor towards the household expenses as perceived by the elderly. Overall,

sons are the chief earners of 41.4 percent households, followed by 31.9 percent elderly

themselves being the chief earner, 11.4 percent spouse of the elderly, 8 percent daughters, 3

percent relatives about 4.2 percent grandchildren and others.

Table 5.2: Percentage distribution of chief earner of the house among the elderly

household age wise and gender wise

Chief earner

of the house

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Self

56.7

(34)

22.9

(24)

35.2

(58)

53.8

(28)

23.9

(17)

39.6

(59)

30.2

(19)

15.6

(15)

21.4

(34)

40.2

(81)

20.5

(56)

31.9

(151)

Spouse

(Elderly’s)

11.7

(7)

24.8

(26)

20.0

(33)

2.6

(2)

12.7

(9)

7.4

(11)

9.5

(6)

4.2

(4)

6.3

(10)

7.4

(15)

14.3

(39)

11.4

(54)

Son

28.3

(17)

41.0

(43)

36.4

(60)

35.9

(28)

42.3

(30)

38.9

(58)

50.8

(32)

47.9

(46)

49.1

(78)

38.3

(77)

43.7

(119)

41.4

(196)

28

Daughter

0.0

(0)

6.7

(7)

4.2

(7)

2.6

(2)

9.9

(7)

6.0

(9)

4.8

(3)

19.8

(19)

13.8

(22)

2.4

(5)

12.1

(33)

8.0

(38)

Grandchildren

1.7

(1)

1.0

(1)

1.2

(2)

0

4.2

(3)

2.0

(3)

1.6

(1)

4.2

(4)

3.1

(5)

0.9

(2)

2.9

(8)

2.1

(10)

29

Figure 5.1: Percentage distribution of chief earner of the house among the elderly household

age and genderwise

Source of Income

The surveyed elderly were also asked if they had planned to meet their old age expenses

before turning 60. Only 23.1 percent out of the total elderly agreed to have made plans to meet

their old age expenses.

Table 5.3: Percentage distribution of elderly who have planned to meet their old age

expenses

Plan to meet old age expenses Percent Number

Yes

No

No response

21.4

78.4

0.2

101

371

1

A overwhelming amount of elderly (78 %) did not make any plan to meet their old age

expenses though 23 percent of them decided on their plan for their expenses.

30

The elderly when asked about their current plan for their old age expenses reported the

following:

The plan included various options like depending on their sons, daughter, grandchildren,

relatives, wages/ salary, pension, fixed deposits, investment, business, rent and

interest/dividend. Out of these categories about 67.8 percent of the elderly depended on their

sons for their expenses, followed by 30.9 percent depending on their wages/ salary and 13.1

percent depending on their daughters. The detailed table below gives more insights on the

same age and gender wise

Table 5.4: Percentage distribution of source of income of the elderly age wise and gender

wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Planned for

future

expenses

15.0

(9)

18.1

(19)

17.0

(28)

16.7

(13)

23.9

(17)

20.1

(30)

33.3

(21)

22.9

(22)

27.0

(43)

21.6

(43)

21.6

(58)

21.6

(101)

Plan to depend

on sons

71.7

(43)

67.7

(71)

69.1

(114)

64.1

(50)

69.0

(49)

66.4

(99)

73.0

(46)

61.5

(59)

66.0

(105)

69.6

(139)

66.0

(179)

67.8

(318)

Plan to depend

on daughters

3.3

(2)

11.4

(12)

8.5

(14)

7.7

(6)

15.5

(11)

11.4

(17)

12.7

(8)

28.1

(27)

22.0

(35)

7.9

(16)

18.3

(50)

13.1

(66)

Plan to depend

on wages/

salary

46.7

(28)

29.5

(31)

35.8

(59)

41

(32)

32.4

(23)

36.9

(55)

23.8

(15)

12.5

(12)

17.0

(27)

37.1

(75)

24.8

(66)

30.9

(141)

Plan to depend

on pension/

superannuation

6.7

(4)

5.7

(6)

6.1

(10)

11.5

(9)

4.2

(3)

8.1

(12)

7.9

(5)

6.2

(6)

6.9

(11)

8.7

(18)

5.3

(15)

7.0

(33)

Plan to depend

on old age

pension

5.0

(3)

6.7

(7)

6.1

(10)

0 2.8

(2)

1.3

(2)

0 4.2

(4)

2.5

(4)

1.6

(3)

4.0

(13)

2.8

(16)

31

In the young old age (YO) group majority (69 %) of the elderly depended on their sons for

their expenses. This was followed by their dependence on their daily wage/ salary in which 47

percent males and 29 percent females depended on their salary. Similar trend was followed by

the OO group or 65-69 years age group. In the oldest old category about 24 percent males and

12 percent females depended on salary. With increase in the age the daily wage/ salary earning

elderly declined. Another noteworthy observation was that with an increase in age the elderly

depended more on their daughters. This was seen very well in the oldest old age group where

22 percent elderly depended on their daughters. Merely 3 percent (n=16) elderly depended on

pension for their expenses.

Current Income Source

Plan to depend and current income sources had similar findings.

Table 5.5: Percentage distribution of income source of the elderly age and gender wise

Income Source 60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Income source

depending on

son

51.7

(31)

50.5

(53)

50.9

(84)

44.9

(35)

52.1

(37)

48.3

(72)

55.6

(35)

46.9

(45)

50.3

(80)

50.7

(101)

49.8

(135)

50.2

(236)

Income source

depending on

daughters

3.3

(2)

8.6

(9)

6.7

(11)

9.0

(7)

15.5

(11)

12.1

(18)

7.9

(5)

25.0

(24)

18.2

(29)

6.7

(14)

16.3

(44)

11.5

(58)

Income source

depending on

relatives

6.7

(4)

5.7

(6)

6.1

(10)

3.8

(3)

8.5

(6)

6.0

(9)

4.8

(3)

7.3

(7)

6.3

(10)

5.1

(10)

7.1

(19)

6.1

(29)

Income source

depending on

wages/ salary

40.0

(24)

40.0

(42)

40.0

(66)

41.0

(32)

32.4

(23)

36.9

(55)

22.2

(14)

12.5

(12)

16.4

(26)

34.4

(70)

28.3

(77)

31.3

(147)

Income source

depending in

superannuation/

pension

6.7

(4)

4.8

(5)

5.5

(9)

10.3

(8)

8.5

(6)

9.4

(14)

9.5

(6)

9.4

(9)

9.4

(15)

8.8

(18)

7.5

(20)

8.1

(38)

32

Income source

depending on

old age pension

5.0

(3)

6.7

(7)

6.1

(10)

0 0 0 4.8

(3)

3.1

(3)

3.8

(6)

3.2

(6)

3.2

(10)

3.2

(16)

Almost half of the elderly were financially dependent on their sons; this was seen in all three

age groups. Superannuation and pension is what the elderly gets after their retirement and old

age pension covers pension provided by government schemes which ranges from 300-600

rupees/ month. It was observed that only 8 percent received pension and 3.2 percent received

benefit from old age pension.

Income situation

The study also focused on the current income situation of the elderly. It was seen that about 64

percent of the elderly did not have enough money to meet with their basic requirements.

About 23 percent had just enough money to meet their requirements and 8 percent were in

debt.

Table 5.6: Percentage distribution of income situation of the elderly age and gender wise

Income

situation

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

In debt 8.3

(5)

8.6

(9)

8.5

(14)

6.4

(5)

5.6

(4)

6.0

(9)

9.5

(6)

11.5

(11)

10.7

(17)

8.0

(11)

8.5

(24)

8.2

(35)

I don’t

have

enough to

provide

for basic

needs

65.0

(39)

59.0

(62)

61.2

(101)

56.4

(44)

70.4

(50)

63.1

(94)

66.7

(42)

68.8

(66)

67.9

(108)

62.7

(125)

66.0

(178)

64.3

(303)

I have

just

enough to

provide

for basic

0 0 0 0 0

0 19.0

(12)

16.7

(16)

17.6

(28)

6.3

(12)

5.5

(16)

5.9

(28)

33

needs

I have

enough to

get with

little

extra

25.0

(15)

27.6

(29)

26.7

(44)

29.5

(23)

22.5

(16)

26.2

(39)

0 0 0 18.1

(38)

16.7

(45)

17.4

(83)

It is noted that a large proportion of the elderly did not have enough money to provide for

their basic needs (64.3 %) which was seen across all the age groups. This was followed by

elderly who had a little extra money (17.4 %) after utilizing the rest for their daily expenses.

Expectation of Elderly to meet their expenses

Data on expectations of elderly in terms of living expenses shows that, more than 50 percent

of the elderly were of the opinion that the government should take initiatives to help the

elderly meet with their expenses and about 40 percent felt that the family members should

take the responsibility of the same. 4.4 percent percent felt that they should themselves plan

and not rely on others for their expenses.

Table 5.7: Percentage distribution of Elderlys expectation to meet their expenses age and

gender wise

Elderly

expectation

to meet

their

expenses

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Self

3.3

(2)

2.9

(3)

3.0

(5)

12.8

(10)

5.6

(4)

9.4

(14)

0 3.1

(3)

1.9

(3)

5.3

(12)

3.6

(10)

4.4

(22)

34

Family 46.7

(28)

42.9

(45)

44.2

(73)

38.5

(30)

33.8

(24)

36.2

(54)

47.6

(30)

34.3

(33)

39.6

(63)

43.7

(88)

37.5

(102)

40.1

(190)

Community 1.7

(1)

1.9

(2)

1.8

(3)

0

1.4

(1)

0.7

(1)

4.8

(3)

2.1

(2)

3.1

(5)

2.1

(4)

1.8

(5)

1.9

(9)

Government 46.7

(28)

50.5

(53)

49.1

(81)

48.7

(38)

59.2

(42)

53.7

(80)

47.6

(30)

60.4

(58)

55.3

(88)

47.6

(96)

56.7

(153)

52.1

(249)

Work participation and reasons to work:

The work participation at older ages is often viewed differently in different contexts. For

example, many western countries argue that there exists significant unused labor force

capacity at older ages. Retirement decisions in European countries are linked with the pension

reforms and the work participation ends with retirement (Kalwij and Vermeulen, 2005; Mete

and Schultz, 2002). In developing countries like India, however, the scenario is different.

Labor force participation of the elderly, and particularly of women, is often driven by poverty

(Bhalotra and Umana-Aponte, 2010; Bhalla and Kaur, 2011). India’s occupational structure is

dominated by informal sector employment where there is neither a retirement age nor a

pension (Unni and Revenndran, 2007). According to the NSSO, nearly 84 percent of workers

are employed in the informal sector and this is true even for the senior citizens (Rajan 2004;

Selvaraj et al., 2011).

Table 5.8 Percentage distribution of reasons to find work opportunities

Work Participation 52.4 (n=248)

Reasons for exploring such job

opportunities No.

Percen

t

Need money for current expenses 220 46.5

Need money for future financial

security 91 19.2

Do not want to be dependent on

others for money 39 8.2

No one to depend on for money 23 4.9

35

Want to lead an active life 21 4.4

Need something to occupy

time/keep me busy 21 4.4

Overall, about 52.4 percent of the elderly were interested in exploring work opportunities. The

reasons for exploring such opportunities included need of money for their current expenses

(46.5 %) and need money for future financial security (19.2 %)

Future living of the elderly

The elderly were asked about where they would reside in the future. Majority (94.3 %) had

plans to continue staying in the same household and 3 percent were not sure about their

whereabouts in the future. Very few were interested in relocating to their native.

Table 5.9: Percentage distribution of future living of the elderly age and gender wise

Plan for

future

living

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Continue

in the

same

household

95.0

(57)

97.1

(102)

96.4

(159)

96.2

(75)

94.4

(67)

95.3

(142)

88.9

(56)

94.8

(91)

92.5

(147)

93.3

(188)

95.4

(225)

94.3

(413)

CHAPTER 6: SOCIAL PROFILE

Like the family support, the social factors concerning the elderly are also important in

determining the quality of later life. The social support system of the elderly enables them to

remain integrated within the community and also encourages them to be active members of

the society. Therefore variables such as the activities elderly normally engage in, participation

in social activities, involvement in decision making, volunteering, issues faced by them,

awareness of day care and hobby centers and old age homes and willingness to join them, and

awareness and utilization of old age social security schemes were included to gather

information about the social interaction of the elderly.

Activities Elderly normally engage in

Table 6.1: Percentage distribution of activities elderly are engaged in

Activities Regularly Sometimes No

36

Looking after my sick spouse 42.0 8.2 49.2

(199) (39) (233)

Looking after my grandchildren 27.6 22.4 49.2

(131) (106) (233)

Assisting my children in daily chores 25.9 33.8 39.5

(123) (160) (187)

Reading 9.5 7 82.1

(45) (33) (389)

Listen to radio 8.2 24.7 66

(39) (117) (313)

Watching TV 35.7 32.3 31.4

(169) (153) (149)

Physical activity 18.4 19.4 61.4

(87) (92) (291)

Religious activities 27.8 42.2 29.1

(132) (200) (138)

Music/drama/hobby 2.7 5.9 90.3

(13) (28) (428)

Shopping 55.9 35.7 55.9

(265) (169) (265)

The above table shows various activities the elderly engage in on a daily basis. The table gives

information on the frequency with which they engage in those activities i.e., regularly,

sometimes or not at all.

Table 6.2: Percentage distribution of activities elderly are engaged in age and gender wise

Activities engaged

in

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Looking after my

sick spouse

68.3

(41)

43.8

(46)

52.7

(87)

65.4

(51)

28.2

(20)

47.7

(71)

44.4

(28)

13.5

(13)

25.8

(41)

59.7

(120)

29.0

(79)

42.0

(199)

Looking after my

grandchildren

31.7

(19)

33.3

(35)

32.7

(54)

29.5

(23)

29.6

(21)

29.5

(44)

22.2

(14)

19.8

(19)

20.8

(33)

27.8

(56)

27.5

(75)

27.6

(131)

37

Assisting my

children in daily

chores

28.3

(17)

30.5

(32)

29.7

(49)

30.8

(24)

26.8

(19)

28.9

(43)

20.6

(13)

18.8

(18)

19.5

(31)

26.8

(54)

25.3

(69)

26.0

(123)

Reading

21.7

(13)

3.8

(4)

10.3

(17)

24.4

(19)

2.8

(2)

14.1

(21)

9.5

(6)

1.0

(1)

4.4

(7)

18.9

(38)

1.4

(7)

9.5

(45)

Listen to radio

10.0

(6)

5.7

(6)

7.3

(12)

16.7

(13)

5.6

(4)

11.4

(17)

7.9

(5)

5.2

(5)

6.3

(10)

11.9

(24)

5.5

(15)

8.2

(39)

Watching TV

38.3

(23)

43.8

(46)

41.8

(69)

35.9

(28)

45.1

(32)

40.3

(60)

17.5

(11)

30.2

(29)

25.2

(40)

30.8

(62)

39.3

(107)

35.7

(169)

Physical activity

23.3

(14)

21.0

(22)

21.8

(36)

26.9

(21)

11.3

(8)

19.5

(29)

20.6

(13)

9.4

(9)

13.8

(22)

23.8

(48)

14.3

(39)

18.3

(87)

Religious activities

33.3

(20)

40.0

(42)

37.6

(62)

35.9

(28)

23.9

(17)

30.2

(45)

12.7

(8)

17.7

(17)

15.7

(25)

27.8

(56)

27.9

(76)

27.9

(132)

Music/drama/hobby

6.7

(4)

2.9

(3)

4.2

(7)

2.6

(2)

1.4

(1)

2.0

(3)

3.2

(2)

1.0

(1)

1.9

(3)

3.9

(8)

2.2

(6)

2.9

(14)

Shopping

5.0

(3)

16.2

(17)

12.1

(20)

7.7

(6)

5.6

(4)

6.7

(10)

3.2

(2)

4.2

(4)

3.8

(6)

5.4

(11)

9.1

(25)

7.6

(36)

From table 6.2 it is observed that the elderly spend maximum time in looking after their sick

spouse (42.0 %) and watching television (35.7 %). The number of elderly engaged in various

activities decrease with age.

Table 6.3: Percentage distribution of activities elderly spend most of the time in age and

gender wise

60-64 years 65-69 years 70+ years Total

Spend most

of the time

M F T M F T M F T M F T

38

Spouse 33.3

(20)

16.2

(17)

22.4

(37)

32.1

(25)

11.3

(8)

22.1

(33)

38.1

(24)

5.2

(5)

18.2

(29)

34.3

(69)

11.0

(30)

20.9

(99)

Children 0

19.0

(20)

12.1

(20)

10.3

(8)

11.3

(8)

10.7

(16)

3.2

(2)

27.1

(26)

17.6

(28)

4.9

(10)

19.8

(54)

13.5

(64)

Grandchildren

16.7

(10)

24.8

(26)

21.8

(36)

11.5

(9)

29.6

(21)

20.1

(30)

23.8

(15)

19.8

(19)

21.4

(34)

16.9

(34)

24.2

(66)

21.1

(100)

Neighbors 25.0

(15)

23.8

(25)

24.2

(40)

17.9

(14)

32.4

(23)

24.8

(37)

4.8

(3)

7.3

(7)

6.3

(10)

15.9

(32)

20.2

(55)

18.3

(87)

Friends 20.0

(12)

7.6

(8)

12.1

(20)

23.1

(18)

4.2

(3)

14.1

(21)

7.9

(5)

1.0

(1)

3.8

(6)

17.4

(35)

4.4

(12)

9.9

(47)

Other 5.0

(3)

6.7

(7)

5.8

(10)

3.9

(3)

11.2

(8)

7.5

(11)

8.0

(5)

10.4

(10)

10.0

(15)

5.4

(11)

9.1

(25)

7.6

(36)

About 21.1 percent of the elderly spent most of their time with children, this was followed by

20.9 percent spending time with their spouse and 18.3 percent with the neighbors.

Social activities elderly engage in

The survey shows that involvement of the elderly in social life, whether in attending family

ceremonies like marriages, public meetings, organisational meetings or religious programmes

is very limited. The survey also found that men are more active in collaborating with other

people compared to women though the frequency varied. The attendance of elderly in

religious programmes or services and weddings and funerals, is highest among all social

activities the respondents were asked about.

Table 6.4: Percentage distribution of social activities elderly are engaged in age and gender

wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

39

Attending

ceremonies

40.0

(24)

14.3

(15)

23.6

(39)

21.8

(17)

15.5

(11)

18.8

(28)

15.9

(10)

11.5

(11)

13.2

(21)

25.3

(51)

13.6

(37)

18.6

(88)

Visiting

religious

places

18.3

(11)

10.5

(11)

13.3

(22)

14.1

(11)

7.0

(5)

10.7

(16)

7.9

(5)

6.2

(6)

6.9

(11)

13.4

(27)

8.0

(22)

9.6

(49)

Visiting parks 6.7

(4)

1.9

(2)

3.6

(6)

9.0

(7)

1.4

(1)

5.4

(8)

3.2

(2)

3.1

(3)

3.1

(5)

6.4

(13)

2.2

(6)

4.0

(19)

Visiting

clubs/

association/

societies

5.0

(3)

1.9

(2)

3.0

(5)

0

0

0

0

0

0

1.4

(3)

0.7

(2)

1.0

(5)

Journey to

hometown

3.3

(2)

1.9

(2)

2.4

(4)

3.8

(3)

1.4

(1)

2.7

(4)

0 1

(1)

0.6

(1)

2.4

(5)

1.4

(4)

1.9

(9)

Table 6.4 highlights that most of the elderly engaged in social activities like attending

ceremonies and going to religious places. In case of attending ceremonies considering all the

age groups it was seen that men participated more (total 25.3 percent, 60-64 years 40.0

percent, 65-69 years 21.8 percent and 70+ years 15.9 %) as compared to that of women (total

13.6 percent, 60-64 years 14.3 percent, 65-69 years 15.5 percent and 70+ years 11.5 %). A

similar trend was seen in case of visiting religious places.

Involvement in Decision making

Table 6.5: Percentage distribution of elderlys involvement in decision making

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

40

Marrying of

children

73.3

(44)

61.0

(64)

65.5

(108)

80.8

(63)

60.6

(43)

71.1

(106)

73.0

(46)

52.1

(50)

60.4

(96)

76.1

(153)

57.7

(157)

65.5

(310)

Buying and

selling

property

56.7

(34)

41.9

(44)

47.3

(78)

56.4

(44)

42.3

(30)

49.7

(74)

41.3

(26)

32.3

(31)

35.8

(57)

51.7

(104)

38.6

(105)

44.1

(209)

Buying

household

items

48.3

(29)

48.6

(51)

48.5

(80)

41.0

(32)

46.5

(33)

43.6

(65)

33.3

(21)

30.2

(29)

31.4

(50)

40.7

(82)

41.5

(113)

41.2

(195)

Gifts to

relatives

36.7

(22)

36.2

(38)

36.4

(60)

32.1

(25)

33.8

(24)

32.9

(49)

27.0

(17)

21.9

(21)

23.9

(38)

31.8

(64)

30.5

(83)

31.0

(147)

Education of

children and

grandchildren

50.0

(30)

34.3

(36)

40.0

(66)

48.7

(38)

31.0

(22)

40.3

(60)

30.2

(19)

21.9

(21)

25.2

(40)

43.2

(87)

29.0

(79)

35.0

(166)

Arrangement

of social/

religious

events

33.3

(20)

21.9

(23)

26.1

(43)

28.2

(22)

22.5

(16)

25.5

(38)

20.6

(13)

16.7

(16)

18.2

(29)

27.3

(55)

20.1

(55)

23.2

(110)

The above table shows the decision-making role of the elderly in different instances: marriage

of children, buying and selling property, buying household items, giving gifts to relatives,

education of children and grandchildren, and arrangement of social and religious events.

Issues of the Elderly

Late life is commonly a period of transitions (eg, retirement, relocation) and adjustment to

losses.With aging, the ability to do daily activities (functional ability) declines to some degree

in every person. Also, older people, on average, tend to have more disorders and disabilities

than do younger people. But the changes that accompany aging are more than just changes in

health. Social issues (such as living arrangements or type of work) influence an older person's

risk and experience of illness. The data captures a few issues that the elderly feel are serious to

be dealt with.

Figure 6.1: Percentage distribution of issues faced by the elderly

41

Table 6.6: Percentage distribution of Issues faced by the elderly age and gender wise

Issues which

are seriously

faced by the

elderly

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Insufficient

money/

finance

48.3

(29)

40

(42)

43

(71)

38.5

(30)

54.9

(39)

46.3

(69)

42.9

(27)

55.2

(53)

50.3

(80)

42.7

(86)

49.2

(134)

46.5

(220)

Poor housing 38.3

(23)

29.5

(31)

32.7

(54)

25.6

(20)

38

(27)

31.5

(47)

50.8

(32)

37.5

(36)

42.8

(68)

37.3

(75)

34.5

(94)

35.7

(169)

Poor health 30 21.9 24.8 16.7 25.4 20.8 36.5 37.5 37.1 26.8 28.3 27.6

42

(18) (23) (41) (13) (18) (31) (23) (36) (59) (54) (77) (131)

Insufficient

medical care

31.7

(19)

23.8

(25)

26.7

(44)

21.8

(17)

28.2

(20)

24.8

(37)

34.9

(22)

37.5

(36)

36.5

(58)

28.8

(58)

29.7

(81)

29.3

(139)

Loss of

faculties

16.7

(10)

15.2

(16)

15.8

(26)

11.5

(9)

12.7

(9)

12.1

(18)

34.9

(22)

31.2

(30)

32.7

(52)

20.3

(41)

20.2

(55)

20.2

(96)

Education of

children

8.3

(5)

4.8

(5)

6.1

(10)

1.3

(1)

1.4

(1)

1.3

(2)

3.2

(2)

3.1

(3)

3.1

(5)

3.9

(8)

3.3

(9)

3.5

(17)

Not enough

job

opportunities

13.3

(8)

6.7

(7)

9.1

(15)

11.5

(9)

4.2

(3)

8.1

(12)

6.3

(4)

9.4

(9)

8.2

(13)

10.4

(21)

6.9

(19)

8.4

(40)

Loneliness 20

(12)

25.7

(27)

23.6

(39)

20.5

(16)

35.2

(25)

27.5

(41)

27

(17)

43.8

(42)

37.1

(59)

22.3

(45)

34.5

(94)

29.3

(139)

Lack of

companionship

11.7

(7)

21

(22)

17.6

(29)

14.1

(11)

14.1

(10)

14.1

(21)

19

(12)

31.2

(30)

26.4

(42)

14.9

(30)

22.7

(62)

19.4

(92)

Departure of

children

11.7

(7)

12.4

(13)

12.1

(20)

7.7

(6)

18.3

(13)

12.8

(19)

15.9

(10)

17.7

(17)

17

(27)

11.4

(23)

15.8

(43)

13.9

(66)

Nothing to

keep busy

15

(9)

11.4

(12)

12.7

(21)

5.1

(4)

8.5

(6)

6.7

(10)

14.3

(9)

18.8

(18)

17

(27)

10.9

(22)

13.2

(36)

12.2

(58)

Being

independent

16.7

(10)

7.6

(8)

10.9

(18)

12.8

(10)

9.9

(7)

11.4

(17)

19

(12)

22.9

(22)

21.4

(34)

15.9

(32)

13.6

(37)

14.5

(69)

Feeling

neglected

10

(6)

6.7

(7)

7.9

(13)

7.7

(6)

14.1

(10)

10.7

(16)

15.9

(10)

8.3

(8)

11.3

(18)

10.9

(22)

9.1

(25)

9.9

(47)

Loss of status 10 3.8 6.1 6.4 5.6 6 14.3 9.4 11.3 9.9 4.7 7.8

43

(6) (4) (10) (5) (4) (9) (9) (9) (18) (20) (13) (37)

Loss of

confidence

11.7

(7)

3.8

(4)

6.7

(11)

6.4

(5)

8.5

(6)

7.4

(11)

12.7

(8)

18.8

(18)

16.4

(26)

9.9

(20)

10.2

(28)

10.1

(48)

Fear of crime

15

(9)

2.9

(3)

7.3

(12)

3.8

(3)

11.3

(8)

7.4

(11)

22.2

(14)

8.3

(8)

13.8

(22)

12.9

(26)

6.9

(19)

9.5

(45)

Financial

exploitation

13.3

(8)

11.4

(12)

12.1

(20)

12.8

(10)

8.5

(6)

10.7

(16)

9.5

(6)

9.4

(9)

9.4

(15)

11.9

(24)

9.9

(27)

10.7

(51)

Physical abuse 5

(3)

2.9

(3)

3.6

(6)

2.6

(2)

1.4

(1)

2

(3)

4.8

(3)

5.2

(5)

5

(8)

3.9

(8)

3.3

(9)

3.5

(17)

Verbal abuse

5

(3)

1.9

(2)

3

(5)

6.4

(5)

2.8

(2)

4.7

(7)

7.9

(5)

5.2

(5)

6.3

(10)

6.4

(13)

3.3

(9)

4.6

(22)

The most common issues that elderly complain of are insufficient money (46.4 %), loneliness

(29.3 %), insufficient medical care (29.3 percent, )poor housing (35.7 %) and poor health

(27.6 %). A noteworthy 19.4 percent of elderly feel alone due to lack of companionship, 9.9

percent of elderly feel that being neglected is a serious problem, where a higher percentage of

women complain of neglect than men. The above table also provides the extent of abuse that

the respondents have faced after they have turned 60 years of age. Overall a staggering 10.8

percent of elderly have reported of being financially exploited, and the percentage of elderly

reported having faced physical and verbal abuse is 8.2 percent. Where abuse is reported, it is

marginally higher for men in comparison to their female counterparts.

Awareness and utilization of day care and hobby centers, old age homes

Day care centers are facilities for the supervised care of older adults, providing activities such

as meals and socialization one or more days a week during specified daytime hours. The

participants, primarily persons with physical and/or mental limitations who need socialization,

physical assistance, and/or psychological assistance, return to their homes each evening. The

program is often used by family members caring for an older person who cannot be left alone

safely in the home.

44

Old age homes are meant for senior citizens who are unable to stay with their families or are

destitute. These old age homes have special medical facilities for senior citizens such as

mobile health care systems, ambulances, nurses and provision of well-balanced meals they

work on a payment basis depending on the type and quality of services offered. Some old age

homes have day care centres. These centres only take care of senior citizens during the day.

Table 6.7: Percentage distribution of awareness and utilization by the elderly age and

gender wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Awareness 18.3

(11)

10.5

(11)

13.3

(22)

12.8

(10)

1.4

(1)

7.4

(11)

6.3

(4)

6.2

(6)

6.3

(10)

12.4

(25)

6.6

(18)

9.0

(43)

Hobby centre 30.0

(18)

33.3

(35)

32.1

(53)

35.9

(28)

22.5

(16)

29.5

(44)

33.3

(21)

27.1

(26)

29.6

(47)

33.3

(67)

28.3

(77)

30.4

(144)

Daycare 26.7

(16)

24.8

(26)

25.5

(42)

23.1

(18)

21.1

(15)

22.1

(33)

19.0

(12)

25.0

(24)

22.6

(36)

22.8

(46)

23.8

(65)

23.4

(111)

Old age

home

6.7

(4)

48

(5)

5.5

(9)

6.4

(5)

12.7

(9)

9.4

(14)

6.3

(4)

13.5

(13)

10.7

(17)

6.4

(13)

9.9

(27)

8.4

(40)

The survey data shows that the level of awareness regarding hobby centers, day care centers

and old age homes is low. Only about 9 percent of elderly are aware of one or more of these

facilities for elderly. When asked about their interest to join these facilities, majority of the

overall elderly are not interested in joining. Among those who expressed interest to join any of

the above facilities, it was seen that the percentage of males is more to that of female elderly,

with varying frequencies

Schemes: Awareness and Registration

The term social security refers to programmes established by state that insure individuals

against interruption or loss of earning power (International Social Security Association, 2003).

The main function of social security is to provide income security, access to health care and

basic social services and thus reducing poverty among the elderly. International Labour

45

Organisation (2006) defines social security as the “set of institutions, measures, right and

obligations whose primary goal is to provide income security and medical care to individual

members of the society”. Unlike developed countries India does not have a universal pension

system. There is no comprehensive social security system in India as a whole. Pension policy

adopted by the country is restricted to the workers in organised sectors leaving 90 percent of

the workers in the unorganized sector.

Some of the existing social assistance programmes for the poor in India are state and national

pension schemes, Integrated Programme for Older Persons (IPOP), National Policy for the

Health Care of the Elderly (NPHCE), Indira Gandhi National Old Age Pension Scheme

(IGNOAPS), Annapurna Scheme and Maintenance and Welfare of Parents and Senior Citizens

Act (MWPSC Act), 2007. It is but important to assess whether these social security schemes

were actually reaching the intended beneficiaries, namely, the targeted elderly.

Very few elderly (9 percent, n=45) had an idea about various social security schemes. Out of

these only 9 elderly had registered in at least one scheme. Majority of the elderly did not have

the documents which were essential and also, many were unaware of the procedure for

applying for the schemes.

Table 6.8: Percentage distribution of awareness and registration of schemes by the elderly

Schemes 60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Elderly who are

aware of the

schemes

18.3

(11)

11.4

(12)

13.9

(23)

9.0

(7)

5.6

(4)

7.4

(11)

4.8

(3)

8.3

(8)

6.9

(11)

10.7

(21)

8.4

(24)

9.5

(45)

Elderly who have

registered for the

schemes

1.7

(1)

0.0

(0)

0.6

(1)

3.8

(3)

1.4

(1)

2.7

(4)

0 4.2

(4)

2.5

(4)

1.8

(4)

1.8

(5)

1.8

(9)

It can be seen that very few elderly were aware of the schemes which were meant for the

elderly out of which more number of males were aware of the schemes than the females. The

number decrease with the rise in the age. The purpose of such schemes is defeated as they are

not reaching the targeted beneficiaries. Therefore, it is necessary to understand the

bottlenecks, ranging from documentary proof and application procedures, problems with BPL

46

listing or database and local politics and favouritism. It has been observed that accessing the

bank is difficult; disbursement is also irregular. Another major concern is that the amount of

pension is not adequate. At times, funds are not released or get delayed because of

administrative procedures. Applications remain pending in offices. A proper strategy is

required to target the beneficiaries. The application procedure needs to be simplified.

47

CHAPTER 7: ACITIVITES OF DAILY LIVING (ADL) AND

INSTRUEMENTAL ACTIVITIES OF DAILY LIVING

The ‘activities of daily living’ or ADLs are the basic tasks of everyday life, such as feeding,

bathing, dressing, toileting, mobility (i.e., getting in and out of bed or chair) and continence

(controlling bladder and bowel movement). When people are unable to perform these

activities, they need assistance either from others or from mechanical devices or both. Apart

from providing objective assessments of the ability of the elderly to execute basic daily

activities and the level of difficulty in executing such tasks, ADLs have been found as an

important predictor of home or institutional care, living arrangements, health expenses and

mortality (Palmer and Harley, 2012). Functional disabilities in terms of ADLs, when assessed

also provide understanding of socio-economic and demographic disparities in such functional

limitations; the extent of familial support to those unable to execute the ADL functions gives

an idea about how such informal arrangements can be expected to address the care needs.

The survey asked the respondents to assess their level of independence to carry out six

different types of ADL activities covering physical domains of functionality viz., feeding,

toileting, maintaining continence, dressing, bathing and mobility, under the categories of

‘without help’ and ‘with help’. Also, there were different categories provided for those who

require help, to gain information on who provides help viz., family members, friends,

neighbors, community care givers or others.

Normal aging changes and health problems frequently show themselves as declines in the

functional status of older adults. One of the best ways to evaluate the health status of older

adults is through functional assessment which provides objective data that may indicate future

decline or improvement in health status, allowing the care-takers to intervene appropriately

The Katz Index of Independence in Activities of Daily Living, commonly referred to as the

Katz ADL, is the most appropriate instrument to assess functional status as a measurement of

the client’s ability to perform activities of daily living independently. Clinicians typically use

the tool to detect problems in performing activities of daily living and to plan care

accordingly. The Index ranks adequacy of performance in the six functions of bathing,

dressing, toileting, transferring, continence, and feeding. Elderly are scored yes/no for

independence in each of the six functions. A score of 6 indicates full function, 4 indicates

moderate impairment, and 2 or less indicates severe functional impairment.

48

Table 7.1: Percentage distribution of ADL of the elderly age and gender wise

ADL 60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Feeding

95.0

(57)

95.2

(100)

95.2

(157)

96.2

(75)

91.5

(65)

94.0

(140)

87.3

(55)

87.5

(84)

87.4

(139)

92.8

(187)

91.4

(249)

92.1

(436)

Toileting 93.3

(56)

95.2

(100)

94.5

(156)

96.2

(75)

88.7

(63)

92.6

(138)

88.9

(56)

81.2

(78)

84.3

(134)

92.8

(187)

88.3

(241)

90.5

(428)

Continence

85.0

(51)

91.4

(96)

89.1

(147)

92.3

(72)

90.1

(64)

91.3

(136)

85.7

(54)

82.3

(79)

83.6

(133)

87.6

(177)

87.9

(239)

87.7

(416)

Dressing 95.0

(57)

96.2

(101)

95.8

(158)

96.2

(75)

90.1

(64)

93.3

(139)

90.5

(57)

83.3

(80)

86.2

(137)

93.9

(189)

89.8

(245)

91.8

(434)

Bathing 88.3

(53)

96.2

(101)

93.3

(154)

96.2

(75)

90.1

(64)

93.3

(139)

93.7

(59)

85.4

(82)

88.7

(141)

92.7

(187)

90.5

(247)

91.6

(434)

Walking

and

transferring

85.0

(51)

84.8

(89)

84.8

(140)

92.3

(72)

78.9

(56)

85.9

(128)

81.0

(51)

66.7

(64)

72.3

(115)

81.6

(174)

76.8

(209)

79.2

(384)

The above table gives an idea of the activities which carried out by the elderly independently

(without help). Majority of the respondents are able to perform ADLs without any help. There

were some of the elderly who were unable to carry out the activities due to functional

impairment.

Table 7.2: Scoring of the ADL scores

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

0-2 (Severe

Functional

6.7 4.8 5.5 3.8 9.9 6.7 11.1 16.7 14.5 6.9 10.2 8.8

49

Impairment) (4) (5) (9) (3) (7) (10) (7) (16) (23) (14) (28) (42)

3-4

(Moderate

Functional

Impairment)

5.0

(3)

2.9

(3)

3.6

(6)

10.3

(8)

11.3

(8)

10.7

(16)

12.7

(8)

19.8

(19)

17.0

(27)

9.4

(19)

11.0

(30)

10.3

(49)

5-6

(Independent)

88.3

(53)

92.4

(97)

90.9

(150)

85.9

(67)

78.9

(56)

82.6

(123)

76.2

(48)

63.5

(61)

68.6

(109)

83.5

(168)

78.6

(214)

80.7

(382)

Figure7.1: Percentage Distrubution of ADL score

Majority of the elderly (80.7 %) were independent and could carry out the ADL by

themselves. About 10.3 percent had moderate functional impairment and 8.8 percent had

severe functional impairment.

50

INSTRUMENTAL ACTIVITIES OF DAILY LIVING

Apart from ADLs, the ‘instrumental activities of daily living’ (IADLs) constitute an

important dimension of functional limitations or disability among the elderly. IADLs are

designed to involve a more complex set of functioning than the ADL-based functional

disability measures; they require more skill, judgment and independence than the ADLs

(Kovar and Lawton, 1994). The eight domains, all of which were covered in the survey,

included the ability to telephone, go shopping, food preparation, housekeeping, doing laundry,

travelling, responsibility for own medication and ability to handle finances. The table presents

the percentage of elderly with difficulties in executing different IADL tasks under the

categories of ‘without help’, ‘with help’ and ‘unable to do’.

Table 7.3: Percentage distribution of IADL of the elderly age and gender wise

IADL 60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Maintaining finances

Without

help

65.0

(39)

53.3

(56)

57.6

(95)

74.4

(58)

54.9

(39)

65.1

(97)

54.0

(34)

42.7

(41)

47.2

(75)

65.1

(131)

50.0

(136)

56.4

(267)

With

help

33.3

(39)

36.2

(38)

35.2

(58)

25.6

(20)

40.8

(29)

32.9

(49)

41.3

(26)

35.4

(34)

37.7

(60)

42.2

(85)

30.1

(82)

35.3

(167)

Unable

to do

1

(1)

9.6

(10)

5.3

(11)

0 4.2

(3)

2.1

(3)

3.2

(2)

19.8

(19)

13.2

(21)

1.4

(3)

11.7

(32)

7.3

(35)

Transportation

Without

help

75.0

(45)

73.3

(77)

73.9

(122)

87.2

(68)

64.8

(46)

76.5

(114)

57.1

(36)

46.9

(45)

50.9

(81)

74.1

(149)

61.7

(168)

67.0

(317)

With

help

23.3

(14)

21.9

(23)

22.4

(37)

12.8

(10)

32.4

(23)

22.1

(33)

36.5

(23)

40.6

(39)

39

(62)

23.3

(47)

31.2

(85)

27.9

(132)

Unable

to do

1.7

(1)

4.9

(5)

3.3

(6)

0 2.8

(2)

1.4

(2)

4.8

(3)

11.4

(11)

8.1

(14)

1.9

(4)

6.6

(18)

4.6

(22)

Shopping

51

Without

help

78.3

(47)

75.2

(79)

76.4

(126)

82.1

(64)

67.6

(48)

75.2

(112)

63.5

(40)

55.2

(53)

58.5

(93)

75.1

(151)

66.1

(180)

69.9

(331)

With

help

15.0

(9)

21.0

(22)

18.8

(31)

17.9

(14)

25.4

(18)

21.5

(32)

31.7

(20)

27.1

(26)

28.9

(46)

21.3

(43)

24.2

(66)

23.0

(109)

Unable

to do

6.7

(4)

3.9

(4)

5.3

(8)

0 7.0

(5)

3.5

(5)

4.8

(3)

16.6

(16)

10.7

(19)

3.4

(7)

9.1

(25)

6.7

(32)

Preparing meals

Without

help

25.0

(15)

79.0

(83)

59.4

(98)

38.5

(30)

71.8

(51)

54.4

(81)

17.5

(11)

54.2

(52)

39.6

(63)

27.8

(56)

68.3

(186)

51.1

(242)

With

help

63.3

(38)

19

(20)

35.2

(58)

57.7

(45)

26.8

(19)

43.0

(64)

69.8

(44)

32.3

(31)

47.2

(75)

63.1

(127)

25.7

(70)

41.6

(197)

Unable

to do

11.6

(7)

1.9

(2)

6.7

(9)

2.6

(2)

1.4

(1)

2.0

(3)

9.5

(6)

12.5

(12)

11.0

(18)

7.4

(15)

5.5

(15)

6.4

(30)

Using telephone

Without

help

38.3

(23)

16.2

(17)

24.2

(40)

30.8

(24)

11.3

(8)

21.5

(32)

11.1

(7)

7.3

(7)

8.8

(14)

26.8

(54)

11.7

(32)

18.1

(86)

With

help

23.3

(14)

34.4

(36)

30.3

(50)

29.5

(23)

29.6

(21)

29.5

(44)

23.8

(15)

13.5

(13)

17.6

(28)

25.8

(52)

25.7

(70)

25.7

(122)

Unable

to do

38.3

(23)

49.6

(52)

45.7

(75)

39.8

(31)

59.2

(42)

44.5

(73)

65.1

(41)

78.1

(75)

71.6

(116)

47.2

(95)

62.1

(169)

55.8

(264)

Managing medications

Without

help

76.7

(46)

77.1

(81)

77.0

(127)

84.6

(66)

71.8

(51)

78.5

(117)

58.7

(37)

52.1

(50)

54.7

(87)

74.1

(149)

66.9

(182)

69.9

(331)

52

With

help

21.7

(13)

20

(21)

20.6

(34)

14.1

(11)

26.8

(19)

20.1

(30)

34.9

(22)

42.7

(41)

39.6

(63)

22.8

(46)

29.8

(81)

26.8

(127)

Unable

to do

1.7

(1)

1.9

(2)

1.8

(3)

1.3

(1)

1.4

(1)

1.3

(1)

4.8

(3)

4.2

(4)

4.5

(7)

2.9

(6)

2.5

(7)

2.7

(13)

Basic home maintenance

Without

help

50.0

(30)

79.0

(83)

68.5

(113)

57.7

(45)

74.6

(53)

65.8

(98)

42.9

(27)

54.2

(52)

49.7

(79)

50.7

(102)

69.1

(188)

61.3

(290)

With

help

46.7

(28)

17.1

(18)

27.9

(46)

41.0

(32)

23.9

(17)

32.9

(49)

50.8

(32)

36.5

(35)

42.1

(67)

45.7

(92)

25.7

(70)

34.2

(162)

Unable

to do

3.4

(2)

3.9

(4)

3.6

(6)

1.3

(1)

1.4

(1)

1.3

(2)

6.4

(4)

9.3

(9)

7.8

(13)

3.4

(7)

5.1

(14)

4.4

(21)

Laundry

Without

help

30.0

(18)

81.0

(85)

62.4

(103)

51.3

(40)

76.1

(54)

63.1

(94)

28.6

(18)

52.1

(50)

42.8

(68)

37.8

(76)

69.4

(189)

56.0

(265)

With

help

58.3

(35)

16.2

(17)

31.5

(52)

48.7

(38)

22.5

(16)

36.2

(54)

60.3

(38)

33.3

(32)

44.0

(70)

55.2

(111)

23.8

(65)

37.2

(176)

Unable

to do

11.7

(7)

2.9

(3)

7.3

(10)

0 1.4

(1)

0.7

(1)

11.1

(7)

14.5

(14)

12.8

(21)

16.9

(14)

6.6

(18)

6.7

(32)

The table presents the percentage of elderly with difficulties in executing different IADL

tasks. About 53.4 percent elderly are unable to use a telephone, 35.3 percent of elderly need

help in maintaining finances, 34.2 percent in basic housekeeping activities, 41.6 percent in

preparing meals and 37.4 percent in preparing meals. Males from all the three age groups were

unable to prepare meals as compared to that of females (63.3%, 57.7%, 69.8 %) and 26.8

percent were unable in managing medications. Unlike ADLs, the IADL domains reveal that

difficulty in carrying out IADL tasks which shows trends with respect to gender. This means

that the prevailing gender norms in the society are significantly influencing who does or is

primarily responsible for what type of tasks.

53

CHAPTER 8: PRIMARY CAREGIVER

Primary caregiver

Caregiving, simply, is the regular provision of care to someone. The nature of care depends on

the specific needs of the recipient. An older person, for example, may need help with

household tasks such as cleaning, preparing meals, and arranging medical services or

transportation. Those who are more disabled may need assistance with daily living activities

such as dressing, bathing or toileting. Older people may require help with thought-related

tasks: making decisions, managing money, and getting from place to place. An elderly may

also need care due to loss of health, loss of memory, the onset of illness, an incident (or risk)

of falling, anxiety or depression, grief, or a disabling condition.

Relationship with the Primary caregiver

The care giver may be a family member, a trained professional or another individual.

Depending on culture there may be various members of the family engaged in care. Family

caregivers are a varied group. Many are spouses of the older person and are, themselves, often

limited in the activities they can perform. Another large group of caregivers are the children of

older people, particularly daughters and daughters-in-law, and, on occasion, sons. Caregivers

also include other relatives — sisters and brothers, nieces, nephews, cousins and

grandchildren — as well as friends and acquaintances.

Table 8.1: Percentage distribution of time spent by the caregiver age and gender wise

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Caregiver

Spouse

68.3

(41)

24.8

(26)

40.6

(67)

51.3

(40)

16.9

(12)

34.9

(52)

47.6

(30)

7.3

(7)

23.3

(37)

55.2

(111)

16.4

(45)

32.9

(156)

Children

16.7

(10)

55.2

(58)

41.2

(68)

32.1

(25)

49.3

(35)

40.3

(60)

39.7

(25)

67.7

(65)

56.6

(90)

29.8

(60)

57.8

(158)

46.0

(218)

Others 15.0

(9)

18.1

(19)

16.5

(28)

16.6

(13)

33.2

(24)

24.9

(37)

12.7

(8)

24.9

(24)

18.8

(32)

14.9

(30)

24.5

(67)

20.5

(97)

54

Availability of the caregiver

Full time 55.0

(33)

40.0

(42)

45.5

(75)

56.4

(44)

32.4

(23)

45.0

(67)

57.1

(36)

37.5

(36)

45.3

(72)

56.2

(113)

36.9

(101)

45.2

(214)

Only

during

the night

35.0

(21)

42.9

(45)

40.0

(66)

25.6

(20)

45.1

(32)

34.9

(52)

31.7

(20)

43.8

(42)

39.0

(62)

30.3

(61)

43.5

(119)

38.0

(180)

Only

when

called

1.7

(1)

9.5

(10)

6.7

(11)

7.7

(6)

12.7

(9)

10.1

(15)

7.9

(5)

13.5

(13)

11.3

(18)

5.9

(12)

11.7

(32)

9.3

(44)

Unavailability of the caregiver

Able to

manage

by

myself

73.3

(44)

68.6

(72)

70.3

(116)

61.5

(48)

62.0

(44)

61.7

(92)

57.1

(36)

59.4

(57)

58.5

(93)

63.6

(128)

63.3

(173)

63.6

(301)

Someone

else

comes in

20.0

(12)

24.8

(26)

23.0

(38)

24.4

(19)

23.9

(17)

24.2

(36)

30.2

(19)

31.2

(30)

30.8

(49)

24.8

(50)

26.7

(73)

26.0

(123)

Time provided by caregiver- sufficient

Yes

90

(54)

86.7

(91)

87.9

(145)

83.3

(65)

80.3

(65)

81.9

(122)

85.7

(54)

78.1

(75)

81.1

(129)

86.0

(173)

81.6

(223)

83.7

(396)

The study shows that, majority of the male elderly have their spouse as their primary

caregivers, however this doesn’t hold true in case of females as with increase in the age their

caregiver has changed. As there more number of widowed females their caregivers have been

either their children or relatives. The others in the caregiving category included relatives,

neighbors. There was no institutional caregiver for any of the elderly in the sample.

About 55 percent males and 40 percent females in the 60-64 years group had caregiver present

for the entire day. 35 percent of the male elderly and 42.9 percent female elderly had

caregivers available only at night. Similar trend for the other age groups was observed.

55

In cases where there was no caregiver the elderly managed by themselves. Though with the

increases in age the number of elderly who managed by themselves decreased. In cases of

unavailability of the caregiver they called upon either any family member, relative or

neighbours for assistance. Majority of the elderly reported that the time provided by the

caregiver was sufficient.

56

CHAPTER 9:HEALTH AND NUTRITION

It is usually believed that chronological age largely determines individuals’ social

participation. But the major life events such as loss of spouse, retirement, affliction with

chronic condition(s) significantly influence life quality of older persons. These life transitions

are largely intertwined with socio-economic statuses and gender of older people. Given the

deterioration that comes with ageing, health problems among the elderly have not yet received

widespread attention; and, health care resources are insufficient for meeting their health care

requirements. Problems related to health are more serious among the many problems faced by

the elderly, in view of the fact that their entire functioning is closely linked with their health

condition. Due to deteriorating physiological conditions with age, the body becomes more

prone to illnesses which are multiple and chronic in nature. The association of old age with

ailments and infirmities is deep-rooted and many of the sufferings, even when curable, are

accepted as natural and inevitable by the elderly and society.

Disability

Table 9.1: Percentage distribution of type of disability of the elderly

Type of disability Percent Number

Visual

Multiple

Hearing

Loco-motor

Speech

8.2

0.6

1.6

1.8

0.2

36

3

8

9

1

The above table depicts the number of elderly which suffer from disability. Elderly with

visual disability was high (8.2 %).

57

Figure 9.1: Type of disability

Self-rated health

The self-rated health is considered as a strong predictor to understand the health status of

people in general and the elderly in particular. The self-rated health was assessed in the survey

using a 5-point scale (1) excellent, (2) good (3) average (4) poor (5) worse.

The survey found that 6 percent of the elderly reported to have excellent health condition

whereas 41 percent of the elderly reported to have an average state of health, followed by 37

percent who reported to have a good health, 13 percent reported to have a poor condition of

health. Only 2 percent of elderly perceived their health to be worse.

Table 9.2: Percentage distribution of self-rate health of the elderly age and gender wise

Rate Health

(Self

Reported)

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Excellent 6.7

(4)

5.7

(6)

6.1

(10)

12.8

(10)

4.2

(3)

8.7

(13)

3.2

(2)

4.2

(4)

3.8

(6)

7.9

(16)

4.7

(13)

6.3

(29)

Good

46.7

(28)

40

(42)

42.4

(70)

51.3

(40)

29.6

(21)

40.9

(61)

34.9

(22)

21.9

(21)

27.0

(43)

44.7

(90)

30.8

(84)

36.7

(174)

Average 36.7 42.9 40.6 33.3 50.7 41.6 36.5 42.7 40.3 35.3 44.8 40.8

58

(22) (45) (67) (26) (36) (62) (23) (41) (64) (71) (122) (193)

Poor

8.3

(5)

7.6

(8)

7.9

(13)

2.6

(2)

12.7

(9)

7.4

(11)

23.8

(15)

24

(23)

23.9

(38)

10.9

(22)

16.1

(44)

13.9

(66)

Figure 9.2: Percentage distribution of self-rate health of the elderly age and gender wise

The study observed that about 41 percent of the sample reported to rate their health as

average. In the first age group a total about 42 percent, wherein males (47 %) and females 40

percent rated their health as good, in second age group 41 percent, with 51 percent males and

30 percent females and in third 27 percent with 35 percent males and 22 percent females.

14 percent elderly rated their health as poor and this trend increased with increase in age. The

YO had 8 percent elderly, with 8 percent males and females each the category, in MO there

were 7 percent elderly with 3 percent males and 13 percent females and the Oldest Old Age

group had 24 percent elderly rating the same.

Acute Morbidities

59

Morbidity is a state of ill health caused by any disease. Acute morbidity is defined as any

elderly person reporting any event of sickness or ill health during the 15 days prior to the

survey. The reporting is based on the responses of the elderly persons and has therefore been

termed as self-reported morbidity. Depending upon the duration of any illness during this

reference period, there could be four possibilities: (i) morbidity or illness episodes that started

more than fifteen days ago and are continuing during the reference period, (ii) illness or

morbidity episodes that started more than fifteen days ago and ended during the reference

period, (iii) illness or morbidity episodes that occurred during the reference period and were

continuing on the date of survey, and (iv) illness or morbidity episodes that both started and

ended during the reference period.

Table 9.3: Percentage distribution of acute morbidities faced by the elderly age and gender

wise

Diseases 60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Fever 48.3

(29)

46.7

(49)

47.3

(78)

37.2

(29)

54.9

(39)

45.6

(68)

44.4

(28)

47.9

(46)

46.5

(74)

57.2

(115)

49.2

(134)

52.6

(249)

High BP 25

(15)

29.5

(31)

27.9

(46)

17.9

(14)

31

(22)

24.2

(36)

19

(12)

34.4

(33)

28.3

(45)

20.3

(41)

31.6

(86)

26.8

(127)

Cough and

cold

33.3

(20)

33.3

(35)

33.3

(55)

32.1

(25)

33.8

(24)

32.9

(49)

36.5

(23)

37.5

(36)

37.1

(59)

33.8

(68)

34.9

(95)

34.4

(163)

Diarrhea 1.7

(1)

2.9

(3)

2.4

(4)

1.3

(1)

1.4

(1)

1.3

(2)

1.6

(1)

5.2

(5)

3.8

(6)

1.1

(3)

3.6

(10)

2.7

(13)

Asthma 3.3

(2)

1.9

(2)

2.4

(4)

5.1

(4)

5.6

(4)

5.4

(8)

12.7

(8)

5.2

(5)

8.2

(13)

6.9

(14)

4.0

(11)

5.2

(25)

Gastric 6.7

(4)

14.3

(15)

11.5

(19)

6.4

(5)

4.2

(3)

5.4

(8)

15.9

(10)

12.5

(12)

13.8

(22)

9.4

(19)

14.7

(40)

12.4

(59)

Headache 11.7

(7)

18.1

(19)

15.8

(26)

12.8

(10)

23.9

(17)

18.1

(27)

22.2

(14)

13.5

(13)

17

(27)

15.4

(31)

17.9

(49)

16.9

(80)

60

Leg ache 43.3

(26)

41

(43)

41.8

(69)

38.5

(30)

33.8

(24)

36.3

(54)

36.5

(23)

38.5

(37)

37.7

(60)

39.2

(79)

38.2

(104)

38.6

(183)

Body pain 43.3

(26)

50.5

(53)

47.9

(79)

51.3

(40)

45.1

(32)

48.3

(72)

55.6

(35)

61.5

(59)

59.1

(94)

50.2

(101)

52.9

(144)

51.7

(245)

Cataract 5

(3)

7.6

(8)

6.7

(11)

6.4

(5)

8.5

(6)

7.4

(11)

12.7

(8)

12.5

(12)

12.6

(20)

7.9

(16)

9.5

(26)

8.8

(42)

Data on acute morbidities shows that, the most common of them are fever (53 %), body pain

(52 %), cough and cold (34 %), leg ache (39 %) and high blood pressure (27 %).

Chronic Morbidities:

Non-communicable diseases (NCDs), including mental health, are being acknowledged as

major contributors to the disease burden in India. The burden of chronic diseases has been

rising, keeping pace with the demographic transition and the increasing numbers of senior

citizens. Accordingly, it is important to examine the prevalence of chronic ailments.

Table 9.4: Percentage distribution of chronic morbidities faced by the elderly age and

gender wise

Diseases 60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Arthritis 8.3

(5)

17.1

(18)

13.9

(23)

11.5

(9)

14.1

(10)

12.8

(19)

9.5

(6)

14.6

(14)

12.6

(20)

9.4

(20)

15.4

(42)

13.1

(62)

Hypertension

23.3

(14)

23.8

(25)

23.6

(39)

19.2

(15)

26.8

(19)

22.8

(34)

14.3

(9)

20.8

(20)

18.2

(29)

13.9

(28)

23.4

(64)

19.4

(92)

Cataract

11.7

(7)

11.4

(12)

11.5

(19)

7.7

(6)

22.5

(16)

14.8

(22)

22.2

(14)

12.5

(12)

16.4

(26)

13.4

(27)

14.7

(40)

14.1

(67)

Diabetes 11.7

(7)

20.0

(21)

17.0

(28)

14.1

(11)

19.7

(14)

16.8

(25)

4.8

(3)

17.7

(17)

12.6

(20)

10.4

(21)

19.1

(52)

15.4

(73)

Asthma 8.3 6.7 7.3 7.7 4.2 6 14.3 8.3 10.7 9.9 6.6 8.0

61

(5) (7) (12) (6) (3) (9) (9) (8) (17) (20) (18) (38)

Heart

diseases

6.7

(4)

3.8

(4)

4.8

(8)

10.3

(8)

2.8

(2)

6.7

(10)

3.2

(2)

4.2

(4)

3.8

(6)

6.9

(14)

3.6

(10)

5.0

(24)

Osteoporosis 6.7

(4)

5.7

(6)

6.1

(10)

7.7

(6)

8.5

(6)

8.1

(12)

7.9

(5)

13.5

(13)

11.3

(18)

7.4

(15)

9.1

(25)

8.4

(40)

Skin diseases 8.3

(5)

3.8

(4)

5.5

(9)

5.1

(4)

2.8

(2)

4

(6)

4.8

(3)

3.1

(3)

3.8

(6)

5.9

(12)

3.2

(9)

4.4

(21)

Renal

diseases

8.3

(5)

3.8

(4)

5.5

(9)

6.4

(5)

0 3.4

(5)

7.9

(5)

0 3.1

(5)

7.4

(15)

1.4

(4)

4.0

(19)

Paralysis 1.7

(1)

0 0.6

(1)

2.6

(2)

4.2

(3)

3.4

(5)

1.6

(1)

6.2

(6)

4.4

(7)

1.9

(4)

3.3

(9)

2.7

(13)

Liver

diseases

16.7

(10)

3.8

(4)

8.5

(14)

12.8

(10)

2.8

(2)

8.1

(12)

15.9

(10)

6.2

(6)

10.1

(16)

14.9

(30)

4.4

(12)

8.8

(42)

Chronic lung

diseases

6.7

(4)

5.7

(6)

6.1

(10)

7.7

(6)

12.7

(9)

10.1

(15)

6.3

(4)

4.2

(9)

5.0

(13)

6.9

(14)

8.8

(24)

8.0

(38)

Depression 8.3

(5)

9.5

(10)

9.1

(15)

5.1

(4)

9.9

(7)

7.4

(11)

7.9

(5)

14.6

(14)

11.9

(19)

6.9

(14)

11.3

(31)

9.5

(45)

Cerebral

stroke

5

(3)

2.9

(3)

3.6

(6)

0 0 0 1.6

(1)

2.1

(2)

1.9

(3)

2.9

(6)

1.8

(5)

2.3

(11)

Fall 21.7

(13)

20

(21)

20.6

(34)

20.5

(16)

12.7

(9)

16.8

(25)

22.2

(14)

22.9

(22)

22.6

(36)

21.3

(43)

19.1

(52)

20.0

(95)

Vertigo 41.7

(25)

40

(42)

40.6

(67)

25.6

(20)

42.3

(30)

33.6

(50)

36.5

(23)

39.6

(38)

38.4

(61)

33.8

(68)

40.4

(110)

37.6

(178)

62

The most common chronic morbidities reported by the elderly were arthritis (51 %), vertigo

(37 %), fall (20 %), hypertension (19 %) and diabetes (15 %).

Nutrition Screening Checklist

Older people are vulnerable to malnutrition for many reasons including physiological and

functional changes that occur with age, lack of financial support and inadequate access to

food. The functional status of the elderly is their ability to carry out their day to day activities

including preparation of food and intake, thereby affecting nutritional status. In India, the

problem of the health of the elderly is compounded by poor nutrition together with medical

issues, including both communicable and noncommunicable diseases. Malnutrition and

morbidity create a vicious cycle.

The nutrition and health of the elderly is often neglected. Most nutritional intervention

programs are directed toward infants, young children, adolescents, and pregnant and lactating

mothers. However, nutritional interventions could play a part in the prevention of degenerative

conditions of the elderly and an improvement of their quality of life. A timely intervention can

stop weight loss in those at risk of malnutrition. Unfortunately, not much explanation has been

given for the precise estimate of under-nutrition in this age group in the field of research.

Given adequacy in the research in the nutritional aspect of elderly an evaluation of nutritional

status is important for the creation of a database to assist with the initiation of important

programs and formulation of policies.

In the present study a remarkable proportion(58%) of elderly consumed tobacco, smoke or

alcohol. Almost half of the elderly (47 %) did not have money to purchase food for their daily

requirement. A more elaborate description of the above information is given in the Table 9.5

Table 9.5: Percentage distribution of nutrition screening checklist among the elderly

60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Illness or

condition

due to

33.3

(20)

21.0

(22)

25.5

(42)

12.8

(10)

25.4

(18)

18.8

(28)

28.6

(18)

35.4

(34)

32.7

(52)

23.8

(48)

27.2

(74)

25.7

(122)

63

which there

is a change

the kind

and/ or

amount of

food I eat

Consume

fewer than

two meals

per day

35.0

(21)

21.9

(23)

26.7

(44)

30.8

(24)

35.2

(25)

32.9

(49)

47.6

(30)

35.4

(34)

32.7

(52)

37.3

(75)

25.7

(70)

30.6

(145)

Consume

few fruits,

vegetables

or milk

products

53.3

(32)

39.0

(41)

44.2

(73)

34.6

(27)

35.2

(25)

34.9

(52)

44.4

(28)

41.7

(40)

42.8

(68)

43.2

(87)

38.9

(106)

40.8

(193)

Consume

tobacco,

smoke or

drink

alcoholic

beverages

almost

every day

73.3

(44)

51.4

(54)

59.4

(98)

67.9

(53)

45.1

(32)

57.0

(85)

66.7

(42)

53.1

(51)

58.5

(93)

69.1

(139)

50.3

(137)

58.3

(276)

Tooth or

mouth

problems

25.0

(15)

24.8

(26)

24.8

(41)

35.9

(28)

39.4

(28)

37.6

(56)

52.4

(33)

45.8

(44)

48.4

(77)

37.8

(76)

36.0

(98)

36.7

(174)

No enough

money to

buy food

40.0

(24)

44.8

(47)

43.0

(71)

34.6

(27)

57.7

(41)

45.6

(68)

52.4

(33)

53.1

(51)

52.8

(84)

41.7

(84)

51.1

(139)

47.1

(223)

Eat alone 13.3

(8)

21.0

(22)

18.2

(30)

16.7

(13)

18.3

(13)

17.4

(26)

19.0

(12)

30.2

(29)

25.8

(41)

16.4

(33)

23.5

(64)

20.5

(97)

Take more

than 3

medicines

per day

33.3

(20)

33.3

(31)

33.3

(55)

21.8

(17)

42.3

(30)

31.5

(47)

27.0

(17)

41.7

(40)

35.8

(57)

26.8

(54)

38.6

(105)

33.6

(159)

Lost/

gained 5

25.0 29.5 27.9 34.6 36.6 35.6 42.9 44.8 44.0 34.3 36.7 35.7

64

kgs in the

last month

(15) (31) (46) (27) (26) (53) (27) (43) (70) (69) (100) (169

Unable to

shop, cook

or feed self

50.0

(30)

41.9

(44)

44.8

(74)

44.9

(35)

49.3

(35)

47.0

(70)

49.2

(31)

62.5

(60)

57.2

(91)

47.7

(96)

51.1

(139)

49.6

(235)

About 31 percent of the sample consumed less than 2 meals in a day. This was seen more

common in women as compared to men.

As mentioned before a large proportion of the elderly consumed tobacco, smoke or alcohol on

a regular basis. In case of women they consumed tobacco and miseri. Addiction of these

substances decreases appetite leading to reduce the dietary intake. Dental issues like loss of

teeth, caries and cavities were prevalent in 37 percent of the elderly. About 47 percent of the

elderly did not have enough economic sources to buy food. 21 percent of the elderly had their

food alone.34 percent had more than 3 medications in a day. It is said that due to consumption

of various drugs the drug nutrient reaction hampers the absorption of various nutrients

affecting the nutrition status. 36 percent elderly had fluctuations in the weight.

About half of the surveyed elderly were unable to shop, cook or feed themselves.

Age-wise and gender wise analysis of the nutrition screening checklist score of the

elderly

Table 9.7: Percentage distribution of total score of nutrition screening checklist among the

elderly age and gender wise

Scores

range

60-64 years 65-69 years 70 years and

above

Total

M F T M F T M F T M F T

0-2

(Good)

13.8

(8)

15.2

(16)

14.5

(24)

19.2

(15)

18.3

(13)

18.8

(28)

4.8

(3)

7.3

(7)

6.3

(10)

12.9

(26)

13.2

(36)

13.1

(62)

3-5

(Moderate

Nutritional

Risk)

23.3

(14)

26.7

(28)

25.5

(42)

18.3

(13)

23.1

(18)

20.8

(31)

12.7

(8)

13.5

(13)

13.2

(21)

17.4

(35)

21.6

(59)

19.8

(94)

65

6 and

above

(High

Nutritional

Risk)

63.3

(38)

58.1

(61)

60.0

(99)

57.7

(45)

63.4

(45)

60.4

(90)

82.5

(52)

79.2

(76)

80.5

(128)

67.1

(135)

66.9

(182)

67.0

(317)

The Nutritional Checklist was used to assess the risk of elderly to malnutrition. The checklist

has a scoring system wherein pre-determined points are allotted to each question. The

respondent is supposed to select the statement that applies to them. The nutritional scores

finally obtained are categorized into three sections; Score0-2: Good, Score 3-5: Moderate

Nutritional Risk, Score 6 or more; High nutritional risk. Each case can be individually

analyzed to assess their nutritional scores.

Only 13 percent elderly were observed to have a good nutritional score, wherein there was

marginal difference on gender basis. About 19.8 percent elderly were at moderate nutritional

risk which was seen more in women (21.6 %) as compared to that of men (17.4 %). This trend

was followed in all the three age groups.

About 67 percent of the elderly were at high nutritional risk. The score increases with respect

to the increase in age

Anthropometry

Body Mass Index (BMI) is an important indicator of nutrition status. It is usually measured

using anthropometric measurements which include height and weight.

Table 9.8: Percentage distribution of BMI of elderly age and gender wise

BMI Range 60-64 years 65-69 years 70+ years Total

M F T M F T M F T M F T

Underweight

10.0

(6)

3.8

(4)

6.1

(10)

19.2

(15)

9.9

(7)

14.8

(22)

30.2

(19)

26.0

(25)

27.7

(44)

19.9

(40)

9.5

(26)

16.0

(76)

Normal

58.3

(35)

52.4

(55)

54.5

(90)

57.7

(45)

57.7

(41)

57.7

(86)

50.8

(32)

53.1

(51)

52.2

(83)

55.7

(112)

54.0

(147)

54.7

(259)

Overweight 25 31.4 29.1 12.8 23.9 18.1 14.3 13.5 13.8 16.9 23.1 20.5

66

(15) (33) (48) (10) (17) (27) (9) (13) (22) (34) (63) (97)

Obese

5

(3)

9.5

(10)

7.9

(13)

9

(7)

8.5

(6)

8.7

(13)

4.8

(3)

7.3

(7)

6.3

(10)

6.4

(13)

8.4

(23)

7.6

(36)

Data on BMI revealed that almost 55 percent of the elderly belonged to the normal range.

There were 21 percent elderly who were overweight, 16 percent underweight and 8 percent

obese. Malnutrition includes both underweight, overweight and obese, thus it can be

summarized that about the remaining 45 percent belonged to this category.

In the underweight sample it was seen that a higher proportion of males (20 %) were

underweight as compared to that of females (10 %). This trend was seen across all the age

groups; males 10 percent (60-64yrs), 19 percent (65-69 yr) and 30 percent (70+yr) compared

to females 4 percent (60-64yrs), 10 percent (65-69 yr) and 26 percent (70+yr). In the obese

and overweight category females were more in number then males.

67

Conclusions

This study gives an idea about status of elderly living in Ramtekdi area with respect to various

aspects like economic, social and health. This survey helps us to draw conclusions and

suggestions for making actionable measures for further intervention. An adequate dietary

intake is an essential component of successful ageing, maintaining health and well being of

the elderly. Nutrition depends on a viscous cycle of multi dimension variables and factors like

physical health, social environment, and economic factors like affordability to receive the

requirement of every individual.

With increasing age there is physical deterioration and changes in terms of physiology which

makes the elderly susceptible to a number of communicable and non-communicable diseases.

Certainly the prevalence of NCDs is way more and requires serious attention. One such non

communicable disease or a condition is malnutiriton. Malnutrition was initially considered

with regard to not meeting the protein energy requirement of the body; but now it is more than

protein energy but now concentrates on undernutrition and overnutrition.

Changes in nutrition or Nutrition transition was persistent accompanied by change in the

preference of dietary habits. A trend to prefer high calorific diet which is also available at

cheaper costs has led to obesity. In case of elderly there is an increase in incidence of obesity.

Sedentary lifestyle with less physical activity is another contributing factor to various

mortalities among the elderly.

The key determinants which determine the nutritional status among the elderly include social

factors with change in trends of caregiving and weaker social support. Another factor which

hampers their health and nutrition status is social isolation, staying away from the family,

infrequent visits by family members, singlehood, destitution all has a negative effect on their

health. Stress and worries along with loneliness sometimes cause the elderly to face

psychological complications which affects their daily chores. They do not take any interest in

their life and neglect taking care of themselves. Change in food habits also make them less

likely to adapt to the food thus affecting the dietary intake drastically. With this social

environment they develop friendship and bond with neighbors.

Economic factors like poverty, destitution causes inability to access optimum dietary intake.

Affordability and accessibility determines the choice and preference of the intake dietary food.

In case of better socio economic status there are two possibilities which are consumption of

excess and high calories food and other wherein there is knowledge and acceptance of healthy

eating habits and enhancing the dietary intake to enhance the nutritional content of the food.

Psychological factors like loneliness, develop into psychological complications along with

other co-morbidities contributes to poor health condition. With ageing there is visual deficit,

68

decreased taste and smell due to less activity of receptors, dental problems reducing the

dietary consumption.

Thus it can be summed up that living arrangement, economic status, gender issues, food

security, urbanization, poverty, physical activity, drug nutrient interaction, food preference and

choice and caregiver are factors which affect the nutrition status in the elderly

The major findings of the study include higher number of females as compared to males

which could be due feminisation of ageing, women have higher life expectancy, higher

number of widows, comparatively fewer addictions improving their health status. Majority of

the elderly did not receive any pension. Social factors which affected their dietary intake

included weak familial support system, social isolation and disruption, loss of primary

caregiver which in turn affected them by leading to psychological complications along with

other health complication further hampering the dietary intake.

Action points for intervention:

Majority of the elderly are not beneficiaries of any social security scheme. There is a

need for enrolling these elderly and increase penetration of scheme awareness within

the community.

Elderly economic situation is observed to be unsatisfactory. Income generation

programmes should be designed and executed effectively.

Considering the health status, elderly with disabilities need to be provided special

provisions to cater to their functional needs.

Screening of elderly suffering from diabetes or any other major chronic morbidity

should be conducted and their health status should be monitored at regular intervals.

Elderly who fall in BMI category other than normal should be assessed clinically for

symptoms and lifestyle behavior that cause risk to malnutrition.

A high number of elderly have been noted to be addicted to smoking/drinking/chewing

tobacco. These elderly should be identified and interventions need to be designed to

avoid further deterioration of health.

69

Social Mapping of Utility Agencies in Study Areas

Background

Social Mapping of utility agencies in an area is important as it helps not only the elderly who

are in need of various services from such agencies, but also for the agencies to interact with

other agencies around them. The present effort in social mapping will also be useful for Non-

Governmental organizations, researchers and academicians who are involved in the field of

ageing. An innovativeness of the present effort is that agencies present in each of the study

areas are plotted in specially prepared maps with help of geographical information system

(GIS). Such a effort will greatly help in understanding the spread of agencies and their

accessibility in the particular study area.

All the agencies which are required by the elderly for their day to day activities are considered

for social mapping. A list of organizations covered under social mapping is attached herewith.

Methodology

The methodology adopted was to identify various utility organizations in the study areas and

physically verify these organizations on a census basis. Given the physical verification of the

agencies by the trained field workers, we may assume that the social mapping covered all the

listed agencies in the study areas. The agencies are plotted on a road network map and

detailed list is given subsequently. The location of an agency in each study area can be

observed by an identification number given to that particular agency in the map.

Social mapping technique which is adopted while creating the maps is very informative. It

acts as a important tool to assess location aspects and focus on relevant needs. As mobility is a

major issue for the elderly; utilization of services, provided by the agencies, depends on ease

of accessibility. Prior to the physical identification of agencies, a list of probable agencies for

their inclusion in the social mapping was shared with the nodal agencies in both the study

areas.

A total of 507 agencies were identified across study areas (Ramtekdi, Pune:104; Dharavi

&Matunga Labour Camp:144; Lower Parel:259). This was a time consuming exercise as

many of the organizations were located on internal roads or between housing structures. Field

checking helped in reducing the error in plotting, yet there is a possibility of margin of error of

5-10 meters in plotting of agencies. Due to limited geographical extent of the study area, use

of global positioning satellite(GPS) to pinpoint exact location of an agency proved unsuitable.

The social mapping in Ramtekdi area near Hadapsar, Pune helped in identifing 104 utility

agencies. Majority of these are provision stores (26), followed by common toilets (15) and

community centre/mandal (12). Other than these there are three public distribution system

70

shops in the area. In case of health related agencies, it was observed that seven

hospitals/clinics along with 3 medical shops are present in the study area. The concentration

on the agencies is higher in the eastern part of the study area due to high density of houses in

the area.

Number

Autorickshaw Stand 1

Common Toilets 15

Community Centre/Mandal 12

Grocery Shop 5

Health centre 1

Hospitals 2

Hospitals & Clinics 5

Library 3

Medical Shop 3

MLA Office 1

Mobile Recharge / Repair Shop 6

Mobile Shop 2

NGO Centre 3

Others 7

Parks & Grounds 1

Political Party Office 4

Provision Store 26

Public Distribution System 3

Religious Places 3

Telephone Booth 2

Total 105

Establishing Linkages between Nodal Agency &Utility Agencies

The study clearly revealed that there is ample scope to establish linkages between nodal

agency and utility agencies through various programmes over a period of time, which will

have a positive impact on the elderly community in the study area. Besides stressing about the

importance of linking programmes with other stakeholders, the following points are listed for

the consideration of the agency.

- The agency can involve other NGOs and Senior Citizen Associations to increase

awareness about social security schemes for the elderly.

71

- It can organize counseling sessions by doctors from hospitals/clinics in the vicinity to

create awareness about ill-effects of tobacco chewing/smoking/drinking.

- Religious places in the area can be used as the venue in case of limited options and to

attract elderly to attend such sessions.

- Similarly it can also tie up with the doctors for routine health check-ups, health camps,

as many of the elderly have health issues like diabetes, arthritis and hypertension.

- Tie-ups can also be made with few medical shops in the study areas, from where the

agency volunteers can get discounted medicines for the elderly and distribute it at the

agency/ arrange for home delivery.

- There are several community centre/mandals in the study area which can engage

elderly in their social activities. The agency can act as a bridge between the elderly and

the community centre/mandals in this regard.

- Agency can tie up with specific mobile shop / service provider to enable elderly to get

special tariff plans and cost-effective simple handsets.

- Food security of the elderly is a major concern in study areas. Grocery shops/provision

stores can be made partner to purchase items of day to day diet at wholesale rates and

make it available to elderly at a retail rate.

- It was observed that the study areas are close to business districts which can facilitate

the agency to explore opportunities of involving corporate partnership/funding in its

programmes as part of their CSR initiatives.

72

73

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78

ANNEXURE

INTERVIEW SCHEDULE

SITUATIONAL ASSESSMENT OF THE ELDERLY

I. IDENTIFICATION

Name Tenement

Number

Name and number of

building

Locality Contact No.

(optional)

II. DEMOGRAPHIC INFORMATION

Sr

No

Question Response Code

1. Gender Male

Female

Male = 01

Female =0 2

2. Age (completed years)/

Date of birth

3. Marital Status (present) Married =01

Widowed=02

Separated =03

Deserted =04

Divorced=05

Never married=06

4. How old were you when you got

married (age in completed years)

Age: Age

NA= 00

79

5. Duration of widowhood/ divorce/

separation OR

Age when widowed/ divorced/

separated

Age

NA= 00

6. Chief owner of the house Self = 01

Spouse =0 2

Son = 03

Daughter =04

Grandchildren = 05

Relatives= 06

Others = 07

(Specify)___________

III. HOUSING CONDITION

Sr

no

Question Response Code

1. Type of dwelling Flat in the building= 01

Tenement with a common toilet=

02

Others= 03

(Specify)___________

2. Ownership of house Rented= 01

Owned= 02

80

If, owned by whom Parents= 01

Self= 02

Son= 03

Daughter =04

Grandchildren= 05

Relatives= 06

Others= 07

(Specify)___________

3. Living arrangements Alone =01

With spouse only =02

With spouse and children =03

With married daughter= 04

With relatives= 05

Others =06

(Specify)___________

4. Any room exclusively for your (and

your spouse’s) use

Yes =01

No=02

5. Are you comfortable using the

existing housing condition?

Yes=01

No=02

81

6. Comfort and utilization of Toilet and

Bathroom Facility

- Do you have easy access to

toilet?

- Type of toilet

- Are you comfortable using the

present type of toilet facility

- Are you scared of falling while

using the toilet?

- Do you have easy access to

bathroom?

- Do you need assistance in

bathing?

- Are you scared of falling while

using the bathroom?

Yes=01

No=02

Indian=01

Western =02

Yes=01

No=02

Yes=01

No=02

Yes=01

No=02

Yes=01

No=02

Yes=01

No=02

82

IV. ECONOMIC CONDITIONS

Sr

no

Question Response

Code

1.

Occupation

Most

recent

Current

Managers= 01

Professionals = 02

Technicians and associate professionals

=03

Clerical support workers =04

Services and sales workers =05

Skilled agricultural, forestry and fishery

workers =06

Craft and related trade workers =07

Plant and machine operators and

assemblers= 08

Elementary occupations= 09

Defense and armed forces= 10

Unemployed=11

Retired=12

2. Individual monthly income

(from all sources)

NA= 00

3. Family monthly income (from

all sources)

NA=00

4. Did you plan to meet your old

age expenses

Yes= 01

No= 02

83

5. What plans did you make

previously to meet your old age

expenses and at present what is

your (and your spouse’s) source

of income?

(Multiple answers possible)

Previous

Present

Depending on sons=01

Depending on daughters =02

Depending on grandchildren= 03

Depending on relatives=04

Wages/ salary= 05

Superannuation/ pension=06

Old age pension= 07

Fixed deposits=08

Investment= 09

Business= 10

Rent= 11

Interest or dividend= 12

Agriculture= 13

Relief payment= 14

Others= 15

(Specify)___________

84

6. Present income situation In debt= 01

I don’t have enough to provide for basic

needs= 02

I have just enough to provide for basic

needs=03

I have enough to get on with a little

extra= 04

I always have money left over= 05

Don’t know/ uncertain= 06

No response=07

7. Are you aware of any schemes

for the elderly?

Yes=01

No=02

8. Have you registered for any

schemes for senior citizens?

Yes=01

No=02

8. Which are the schemes that

you’re benefiting from? (refer

annexure)

9. Some elderly do not have the

resources to meet all their

expenses. Who according to you

should take this responsibility

Self=01

Family=02

Community=03

Government= 04

Non-governmental organizations =05

Others= 06

(Specify)___________

85

V. HOUSEHOLD CHARACTERISTICS

1. Household Composition:

No. Name Relationship

with head of

household

(HH)

Sex

(M/F)

Age Marital

Status

Educational

Status

Occupation Disability

1 SELF

(Relationship with HH: 01= self,02= spouse, 03=son, 04= daughter, 05= father, 06= mother,

07= grandchild, 08= son-in-law, 09= daughter- in-law, 10= others)

(Sex: 01=male, 02= female)

(Marital status: 01= married, 02= widowed, 03= separated, 04= deserted, 05= divorced, 06=

never married)

(Educational status: 01= illiterate, 02= primary, 03= secondary, 04= higher secondary, 05=

graduate/ diploma, 06= post graduate, 07= M.Phil/PhD)

(Occupation: 01= managers, 02= professionals,03= technicians and associate professionals,

04= clerical support workers, 05= services and sales workers, 06= skilled agricultural and

fishery workers, 07= craft and related trade workers, 08= plant and machine operators and

assemblers, 09= elementary occupation, 10= armed forces/defense, 11=Unemployed,

12=retired)

86

(Disability: 01= visual, 02= hearing, 03= speech, 04= loco-motor, 05= mental, 06=multiple

disability)

2. Information on adult children.

Total

No.

No. of

children

alive

No. of

children

living in the

household

No. living in

Mumbai/Pune

No. living outside

Mumbai/Pune

Son

Daughter

Sr. no Question Response Codes

3. What are your plans for the future? Continue in the same HH=01

Plan to shift to another HH=02

Plan to go back to place of origin

(village/native place)=03

Not yet decided/uncertain=04

VI. ACTIVITIES OF DAILY LIVING

Sr.

no

Question Response Codes

87

1. Which are the following day to day

activities that you carry out on your own

or with others help?

ADL:

- Feeding

- Toileting

- Maintaining continence

- Dressing

- Bathing

- Walking and transferring

IADL

- Maintaining finances

- Transportation

- Shopping

- Preparing meals

- Using telephone

IADL:

- Maintaining finances

Without help=01

With help=02

Without help=01

With help=02

Unable to do=03

Without help=01

With help=02

Who provides help

(familial=03,

neighbors=04

friends=05

88

2.

- Managing medications

- Basic home

maintenance/housekeeping

- Laundry

Activities you normally engage in

- Looking after my sick spouse

- Looking after my grandchildren

- Assisting my children in daily

chores

- Reading

- Listening to radio

- Watching T.V

- Physical activity

- Religious activities

- Music/drama/hobby

- Shopping

Regularly=01

Sometimes=02

No=03

VII. FAMILY AND PRIMARY CARE GIVER

Sr

no

Question Response Code

89

1. Who is your primary care-giver

Spouse=01

Children=02

Grandchildren=03

Relatives=04

Others=05

(Specify)___________

NA=00

2. Availability of the primary caregiver Full time(day and

night)= 01

Only during the

day=02

Only during the

night=03

Only when called=04

3. If primary caregiver is away for

sometime (4-8 hrs a day) how do you

manage

Able to manage by

myself=01

Someone else comes

in=02

No special

arrangements

made=03

Helper seldom goes

out=04

4. Is the caregiver time provided

sufficient to meet your daily needs

Yes=01

No= 02

Uncertain=03

90

5. With whom do you spend most of

your time

Spouse=01

Children=02

Grandchildren=03

Relatives=04

Neighbors=05

Friends=06

others= 07

(Specify)___________

6. Involvement in decision making

- Marriage of children

- Buying and selling of property

- Buying household items

- Gifts to relatives

- Education of children and

grandchildren

- Arrangement of social/

religious events

Yes=01

No=02

To a certain extent=03

VIII.SOCIAL ACTIVITES

Sr

No

Question Response Code

91

1. How frequently you engage in

following activities

- Attending family ceremonies/

wedding/ festivals

- Visiting religious places/

spiritual gatherings

- Visiting gardens/ parks/

playgrounds

- Visiting the theatre/ movies/

concerts/ exhibition

- Visiting clubs/ associations/

societies

- Using the library

- Journey to hometown

Regularly=01

Often=02

Rarely=03

Never=04

2. Volunteer for social work activities Yes, at present=01

Yes previously, but

not at present=02

Ready to volunteer,

but not aware=03

No=04

3. If no, would you like to voluntarily

participate in such activities

Yes=01

No=02

92

4. What kind of volunteer work would

you like to do or are already involved

in or have done previously?

(Multiple choice possible)

With children (5-15 years)

With adolescent (15-20 years)

With adults (21-59 years)

With older persons (60+ )

In the area of health

In the area of education

Work with marginalized groups

(destitute women, disabled, poor, etc.)

Work related to your own occupation

Organizing events/programmes

Any other

(Specify_________)

Yes=01

No=02

Can’t say=03

If yes, describe the

kind of activity=04

5. Awareness of day care centers, hobby

centers and old age homes for elderly

Yes=01

No=02

6. Interest in joining such centres/ facility

- Hobby center

- Day care center

- Old age homes

Yes=01

No=02

Uncertain=03

(applies to all three

facilities)

93

7. If yes, specify the type of facility you

expect in it. (To be asked to only those

respondents who have said ‘yes’ for

old age homes in the previous

question)

- Independent room with

medical support

- Dormitory with medical

support

- Others, specify

Yes=01

No=02

(applicable to all

three options)

IX. ISSUES FACED BY THE ELDERLY

1. Issues faced by elderly

Sr

No

Question Response Code

1. Insufficient money/ finance Serious=01

Hardly a problem= 02

No response= 04

2. Poor housing

3. Poor health

4. Insufficient medical care

5. Loss of faculties

6. Education of the children

7. Not enough job opportunities

8. Loneliness

9. Lack of companionship

10. Departure of children

94

11. Nothing to keep me busy

12. Being dependent

13. Feeling neglected

14. Loss of status/ respect

15. Loss of confidence

16. Fear of crime/ violence

17. Financial exploitation

18. Physical abuse

19. Verbal abuse

20. Others

Sr.

no

Question Response Code

2. (For those who feel they do not have

enough job opportunities) Are you

aware of income generation

programmes for elderly?

Yes=01

No=02

3. If given an opportunity, would you

like to work?

Yes=01

No=02

Uncertain=03

95

4. If yes, what are the reasons for

exploring such job opportunities?

Need money for current

expenses=01

Need money for future

financial security=02

Do not want to be dependent

on others for money=03

No one to depend on for

money=04

Want to lead an active life=05

Need something to occupy

time/keep me busy=06

Own/family business=07

Others=08

Specify ________________

96

5. What were your experiences during

job search?

Employer empathy=01

Availability of part-time

jobs/assignments=02

Work from home

opportunities=03

Satisfactory monetary

support=04

Age was a barrier=05

Poor health condition=06

Under-qualified/don’t have

skills required=07

Salary is too low=08

Jobs available are too

physically demanding=09

Undesirable/unsuitable

working hours=10

Jobs available are too far away

from home=11

Others (specify________)=12

6. Would you like to enroll in skill

enhancement activities if required for

a job?

Yes=01

No=02

X. HEALTH AND NUTRITION ASSESSMENT

97

Sr

No

Question Response Code

1. Rate your present health Excellent= 01

Good= 02

Average=03

Poor=04

Worse=05

2. In past 15 days, did you suffer from any health

issue? If yes, specify (No probing)

- Fever

- High Blood pressure

- Cough and cold

- Diarrhea

- Asthma

- Gastric

- Malaria

- Headache

- Leg problem

- Body pain

- Cataract

- Typhoid

- Ulcer

Yes=01

No=02

Others=03

(Specify)_________

98

3. Chronic ailments (in the last 1 year)

- Arthritis

- Hypertension

- Cataract

- Diabetes

- Asthma

- Heart diseases

- Osteoporosis

- Skin diseases

- Renal diseases

- Paralysis

- Liver diseases

- Chronic lung diseases

- Depression

- Alzhiemers

- Cerebral stroke

- Dementia

- Cancer

- Fall

- Vertigo

- Others (specify) _______

Yes=01

No=02

Hospitalized=03

99

NUTRITION ASSESSMENT

Sr.

no

Nutrition Screening Checklist Yes

i. I have an illness or condition that made me change

the kind and/or amount of food I eat

2

ii. I eat fewer than two meals per day 3

iii. I eat few fruits, vegetables or milk products 2

iv. I chew tobacco, smoke or drink alcoholic beverages

almost every day.

2

v. I have tooth or mouth problems that make it hard

for me to eat.

2

vi. I don't always have enough money to buy the food I

need.

4

vii. I eat alone most of the time. 1

viii. I take three or more different prescribed or over-the-

counter drugs per day.

1

ix. Without wanting to, I have lost or gained 10 lbs. in

the last six months.

2

x. I am not always physically able to shop, cook,

and/or feed myself

2

ANTHROPOMETRY

Sr

No.

Measurements Value Code

100

1.

BMI

OR

Calf circumference (CC)

Height:

____ (m)

Weight:

______

(cm)

CC :

_____

(cm)

BMI Classification

>18.5 (underweight)=1

18.5-24.99 (normal)=2

<25-29 (overweight)=3

<30 (obese)=4

CC less than 31cm=1

CC 31 cm or greater=2

2. Mid arm circumference

(MUAC)

MUAC :

______

(cm)

MUAC less than 23 cm=1

MUAC 23cm or greater=2

Annexure

Schemes

1. Annapurna scheme

2. Indira Gandhi National Old age Pension Scheme (IGNOAPS)

3. Indira Gandhi National Widow Pension Scheme (IGNWPS)

4. Indira Gandhi National Disability Pension Scheme (IGNDPS)

5. National family benefit scheme

6. Sanjay Gandhi Niradhar Anudan Yojana

7. Shravan Bal Seva Rajya Nivrutti Vetan Yoajana

8. Others (Specify)_________

101

Percentage Distribution of elderly according to age

Age -wise Frequency Percent

60 69 14.6

61 25 5.3

62 37 7.8

63 23 4.9

64 11 2.3

65 95 20.1

66 21 4.4

67 10 2.1

68 17 3.6

69 6 1.3

70 55 11.6

71 7 1.5

72 11 2.3

73 10 2.1

74 3 .6

75 23 4.9

76 5 1.1

78 6 1.3

79 2 .4

80 13 2.7

81 1 .2

82 4 .8

85 9 1.9

87 1 .2

89 1 .2

90 6 1.3

98 1 .2

108 1 .2

Total 473 100.0