Chandana Sarmah
Associate Professor
Department of Anthropology
University of Guwahati, ASSAM
Email: chandanasarmah@gauhati.ac.in
Living long has been and still is one of the secret desires of all individuals. The myth of searching for the fountain of youth to the current industry relating to retaining one’s looks and vigour bears testimony to this. Interestingly, the present trend of scientific research on the subject, which began about 100 years ago, the objective is to delay or prevent the ageing process. However, the process of ageing and what triggers the ageing process have largely remained an enigma to date. Current research on ageing does not suggest that the process of ageing can be prevented or reversed soon, but it does predict higher probabilities of increased longevity and more years of active life.
Gerontology or the study of ageing and the elderly is a relatively young science. Ageing is a multifactorial process, and this branch of study requires a multidisciplinary approach. Ageing can be examined from a biological perspective which incorporates aspects from the cellular level through molecular aspects to biochemical changes as also from a socio-psychological perspective. The Sage Handbook of Social Gerontology (2010) identifies eight fundamental and disciplinary perspectives on the social aspect of ageing. These include the psychological, historical, economic, anthropological, demographic, epidemiological, disability and the social construct of causality. Another significant perspective is the environmental perspective. Moreover, there are other aspects like social structure, culture, social change, development along with the state policies that influence the ageing process of individuals. It has emerged as one of the most enduring and complex issues in human societies today. The complexity arises more significantly from its multifactorial determinants.
Anthropological Gerontology is one of the subdisciplines within gerontology and it deals with understanding ageing or growing old in a bio-cultural context. In recent years the demographic transition towards population ageing and the associated consequences has led to its emergence as an important area of research. The aim of bio-cultural gerontology is to establish genetic, environmental and lifestyle factors which allow some individuals to maintain function while others experience a sharp decline. The lifespan perspective of understanding ageing by psychology is applicable to all disciplinary approaches. The biological and socio-economic aspects of the life of the elderly are determined by the quality of interaction individuals have with their environment. Therefore, what we are in our old age is the outcome of the life we have lived in our younger years.
P. B. Baltes (1987) in his theoretical proposition of lifespan developmental psychology identifies three sets of influences that interact to produce developmental changes in one’s lifespan. These are normative age-graded influences, normative history graded influences and non-normative influences. These influences bring about tremendous heterogeneity in older persons, the experience of the ageing process and influences on longevity. Any bio-social occurrences, factors and experiences an individual has during his/her life course are largely determined by ethnicity, the cultural and behavioural aspects, as also the environment to which he/she belongs. A person grows old in a social and cultural context. Values, beliefs, norms, and customs define the status and role of the elderly in any society. Thus, the holistic anthropological approach based on empirical studies can provide the intricate details of these differences in the ageing process at the level of the individual as well as the population.
Drawing inferences from ethnographic evidence, Fry (2010) observes that from the perspective of Anthropology, old age has not generally been viewed as a problem for the majority of the world cultures. Every individual who grows old must experience issues of declining health and reduced adaptation to existing environmental conditions, etc. Being an older person all through history have had its difficulties but most of these issues were managed within the families. Ageing emerged as a social problem only in industrialised or urban contexts. Most traditional societies have vital social support systems and care for elderly or disabled individuals. Elderly individuals are invariably well integrated into the social fabric. This may happen because they have attained wealth or position and continue to exercise authority. Many societies depend on age grades for governance and the elderly often occupy high positions or ranks in these systems. Rules of inheritance and customary rules of residence also give the elderly advantage. Cultural norms play a critical role in the transference of values, sending persistent messages and a call to duty towards the elderly.
Anthropological literature has a legacy of research into ageing and understanding integration and function of age structuring and social significance of age in different communities. These homogenous age groups serve different purposes like socialisation, social control, orienting youth to political order, etc. Such ideas are found in writings on social organisation among various cultures by different scholars in the 20th century. However, there is also evidence in the literature about elderly and disabled individuals being abandoned. One of the frequently cited examples is the practice of Senicide among the Innuits of the Arctic region of Greenland, Canada, and Alaska. There are several other societies including some in India that continue to practise this inhuman practice. In Tamil Nadu in a practice called Thalaikoothal translated from the Tamil language as ‘leisurely oil bath’, the elderly are given a hot oil bath before dawn and then fed several glasses of tender coconut water. Consequently, the frail old individual develops a high fever and are then left unattended. Most of them would die ‘so-called natural death’ in a day or two. Such customary practises are no longer recorded, and their justifications remain unknown. Aged is often viewed as a burden not only in contemporary urbanising societies but historically and culturally many societies have shown deliberate neglect to them.
Primarily, shift in traditional occupation and consequent development and changing family patterns have resulted in issues relating to an ageing population as a problem. Urbanisation, modernisation, globalisation, etc. no matter what nomenclature we may use, have resulted in altering family and social structures to a large extent. Social transformations are inherent to every society. Challenge is to find adaptations that keep the basic social fabric of the society intact. This is where several communities per se have not been able to keep traditional family values and social responsibilities intact. In recent years, there are several instances in which legal institutions of the states like the Supreme Court had to intervene to restore the rights of the senior citizens. Lack of social support, care, and isolation of the elderly and institutional neglect by the state are common concerns. Cowgill and Holmes (1972) have contextualized some of these concerns in the texts of modernization. The theoretical premise of these arguments essentially refers to changes in the status and functions being performed by the elderly under existing occupational structures.
Welfare states all over the World are designing measures for the welfare and well-being of the elderly. But the measures are not enough to provide a sense of security that the elderly are accustomed to while living within families. Disintegrating families leave the elderly in disarray. Welfare and rehabilitation policies for the elderly concentrate on health and functionality but little attention is paid to the importance of ensuring secured family homes for the senior citizens.
Current studies on ageing across the globe including World Health Organisation (2015) concentrate on aspects of health, functionality, welfare, and sociability. Healthy ageing is defined by WHO, as a process of developing and maintaining the functional ability that enables well-being in older ages. Functional ability is about having capabilities that enable all people to be active and to do what they have reason to value. Social integration and functionality, thus play a very significant role in healthy ageing associated with adaptation to the existing environment. Health, as a result, remains vital to the ageing process.
India is celebrated for being a young nation, but the rising problems of senior citizens are not far behind. The average life expectancy of the Indian population has increased by about twenty years, from the time of the country’s independence. Medicine and impetus on public health have made a significant contribution to it. The decline in fertility and mortality rates and enhanced life expectancy has contributed towards the growth of the significant portion of population ageing. The demographic theory argues a country’s population is said to be ageing when there is an increase in the proportion of the elderly population to the total population of the country. Indian population can be said to be an ageing population as per the UN definition. At the time of the census of 1961, the proportion of elderly in India was 5.6%. It took three decades to have a 1% rise. In the 1991 census, the proportion of elderly was 6.6%. After 1991 the rate of growth has been 1% per decade reaching 8.3% in the year 2011. The proportion of elderly people in India is now growing at an exponential rate and is expected to grow further in the coming decades. This demographic shift towards the ageing population in India brings with it the need for public health care and services, social support, and productive engagement of elderly people in society.
The Indian Ageing Report (UNFPA 2017) identifies three major characteristic features of India’s elderly. These are:
rapid growth rate, particularly in the oldest old age category,
the concentration of India’s elderly in rural areas and
the feminisation of ageing.
These features have been identified from the census figures. The regional and cultural diversity that our country presents also represents variation in the ageing experience. Acknowledging the existing and impending needs of the elderly, The Government of India has proposed several measures. For the first time in the year 1999, a National Policy for the Older Persons is framed. In 2007, a policy for the Maintenance and Welfare of Parents and Senior Citizens) and in 2010 came National Programme for Health Care of Elderly (2010).
In 2016 the Ministry of Health and Family Welfare, Government of India has launched an ambitious project for the first Longitudinal Ageing Study in India. The Indian Institute of Population Studies, Mumbai serves as the nodal institute for the study which aims to include all individuals above 45 years of age across all the states and union territories of the country. This study will follow a selected study sample for a period of 25 years. The results of the first phase of the study (2017-2019) reveal that the highest proportion of elderly (60 years and above) live in the state of Kerala (20%). It is important to mention that Kerala has a robust health care system and the welfare state takes care of several parameters of the senior citizens, the state of Himachal Pradesh (17%) comes next. The hill state is known for its close-knit family system as younger adults move to cities and senior citizens stay back home taking care of the family. Closely following Himachal Pradesh is the state of Tamil Nadu accounting for 16% elderly. Critical to the state is again a good health structure. Results of the study reveal that the state of Arunachal Pradesh has one of the lowest proportions (6%) elderly population in the country.
There are some significant issues that emerge from the study. One of them is that only 6% of the officially retired elderly persons currently receive an old-age pension. Economic dependence thus emerges as a major issue. Existing policies are not enough to support the elderly in the dusk of their lives. Contrary to popular perception and emphasis on declining physical abilities of the elderly, these are belied by the fact that 54% of the elderly continue to remain physically active. Social intervention policies that borrow from the experiments being carried out in the west must give due diligence to the fact that only 5.7% population of the elderly in the study sample lived alone. One of the notable tragedies of the Covid-19 were reports of disproportionately high fatality of senior citizens living in the old-age homes in the west. This brings back into focus urgent reorientation for strengthening familial support for elderly persons and ensuring social support and security within the household. The feminisation of ageing is another stark reality. The study reasserted the global phenomenon that more elderly women survive into older ages than elderly men.
ELDERLY IN THE STATE OF ASSAM
According to the census reports, 6.5% of the population in Assam belong to the elderly category. The elderly people of the state predominantly live-in rural areas as urbanisation are a relatively new feature in the state. Even in the urban areas, there is a large section of elderly people who have rural origins and have migrated to urban areas at some point in their life. The elderly people in the Assamese society still occupy a respectable position and primarily remain integrated within the family. However, with the migration of the younger generation for education and employment to places outside the state, issues of physical separation, living alone and changing family structures are becoming crucial concerns in recent decades. These issues aggravate the aspects of security, care, and support of elderly people.
One must assert here that undeniably support and security within the family system is the key for healthy ageing, but due to fission in families, primarily because of high mobility of the young for employment to urban areas, social structure and state support systems also needs strengthening. At the beginning of the first decade of the 21st century, during data collection for my PhD thesis, I recorded that the need for institutional support for the elderly in the state was low. There was only one state-funded old age home in Guwahati. Now the number of old age homes have gone up significantly primarily because of changing socio-economic conditions and fission in family structures. Few old-age homes have come up in the rural areas and the presence of several senior citizens also reflect changing rural social support systems.
However, in the context of tribal communities in the state of Assam, trends of ageing are relatively far more encouraging. Empirical studies conducted among the Tiwas and Karbis in three major districts (Kamrup, Marigaon, Karbi Anglong) of Assam show that the elderly in these communities experience healthy ageing and continue to be respected and cared for till the end. They live a life of dignity, as rules of inheritance of property and residence provide culturally inscribed social security. Among the Tiwas, in the absence of a son, Tiwas living in the plains, have a customary practice of having a resident son-in-law. This practice among the patriarchal Tiwas living in the plains may have been derived from their matriarchal origin from the hill areas. The ubiquitous motive of this pattern of residence is to take care of the inheritance of their cultivable land but it also ensures social support for elderly parents.
Among the Karbis, childless elderly couples are provided social support by the clan. Because of these normative cultural practices, less than 1% of the elderly among these communities are found to be living alone. Adult children set up independent homes after marriage, but one adult child continues to live with the ageing parents out of filial piety. Another very positive aspect of ageing in a tribal context are the opportunities for healthy ageing. Elderly people remain functionally active and continue to play a significant role in the family and social life of society. They are hardly ever removed from the family division of labour, keeping the value of productive labour associated with the senior citizens intact. This helps them remain closely integrated into the social organisation of the community. Similar findings also emerge from studies by other scholars among the Sonowal Kacharis and Kaibarta communities. But it remains to be seen how long these positive features continue to be part of their social life under changing socio-economic conditions.
The elderly in the tribal context of Assam though remain functionally active, preventive health measures fail to meet the expected level. Primary prevention of avoidance, especially about habitual drinking of alcoholic beverages and smoking is absent. Secondary prevention or consultation with medical practitioners is also limited. Even when consultation is done, follow up of the management procedures remain incomplete. The reasons for this may be lack of awareness, easy access to health measures and affordability. This results in greater reliance on the local medicine man and ethnomedical practices. In some studies, these limitations are inferred as deliberate avoidance of the allopathic system of cure.
There is also the prevalence of the double burden of malnutrition among the tribal elderly. In the higher age groups (80+ years), undernourishment is prominent, while among the young (60-69 years of age) and the middle old (70-79 years of age) malnourishment is of common occurrence. Among the elderly Karbis of Karbi Anglong, the fat mass index which is an indicator of fat proportions in the body is found to be high. This indicates that there may be a prevalence of non-communicable metabolic diseases among the elderly. This aspect remains to be examined among them.
The regional and cultural diversity that our country presents provides immense scope for mapping the ageing process from a bio-cultural perspective. Cross-cultural perspectives shall help in better policy formulation. These will provide multiple inputs for developing diverse institutional social support systems in conformance with the cultural practices instead of blind borrowing from the western world models for the care of the elderly. This is critical for meeting the developmental needs of the elderly as well also methods for utilising India’s demographic dividend. In urban context existing social support networks are generally not so effective. The rural systems can be used as a model to provide support and care for elderly persons within the neighbourhood and housing societies. There is some evidence in the public domain from metropolitan centres for having experimented with alternative models augmenting infrastructure for the elderly in the neighbourhood or within the gated communities.
Models of Ageing from rural or a tribal context provide a healthy framework for active ageing which is not always the case in an urban context. Elderly people can serve as a human resource for the development and management of local needs and resources. This can serve as an avenue for engaging elderly people. Health as we generally understand declines with age and is a major concern for elderly persons. Access and availability of public health facilities and uniform development of health infrastructure across the country are essential. The rural and tribal communities tend to remain marginalised in these sectors. Though efforts are being made by the Government and other non-governmental organisations, yet a lot remains to be done.
Ageing in the Indian context is examined primarily from a demographic perspective, while the micro-level aspects remain neglected. From the perspective of anthropology, the scope and potential for ageing studies remain underutilised. Traditional anthropological approaches of holism, comparative and cross-cultural studies can provide significant insights into the ageing process. The first longitudinal study in India is expected to take care of some of these issues as it takes into consideration the demographic, social, economic along with significant biomarkers of ageing. Anthropology, in my opinion, is well equipped to study multiple issues relating to ageing. Its ability to provide cultural perspectives in localized contexts is its greatest strength. Major challenges to appropriate rehabilitation of the elderly are posed by rapidly changing social and cultural contexts. This also results in declining adaptation due to socio-psychological causes. Social isolation in societies where senior citizens were well integrated, is becoming a major concern in ageing societies. Cultural mechanisms to cope with the senescent changes, social integration mechanisms, care provision and social support are areas of research to which anthropologists must devote greater attention.
ACKNOWLEDGEMENT
I express my gratitude to Prof. K.K.Misra for his editorial comments.
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