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Thursday, July 4, 2024

A world I want to see as an older person

I have seen older persons being made to take early retirement, either because they are unable to step up to the changing workplace or there are young and qualified young individuals, who the workplaces feel will add fresh perspectives. As also, there is stereotyping older persons as not suitable on account of perceived notions of age-related physical changes, challenges in keeping pace with rapidly evolving technologies, slower processing speed often misconstrued as signs of diminished capability. When I retired at the age of 58 (yes, 58 was the age in my bank) I felt I had a lot more left in me to contribute and learn, but I didn't get much of a choice, after retirement. So, I chose to do the next best thing and that is writing books, podcasting and content writing. Even so, if suitable opportunities had been available for me, I am sure I would have been able to address any limitations and contribute much more to the workplace and the society. 

A world I want to see as an older person - Hira Mehta 

According to me, older persons like me, have the best experience of working with diverse people and in changing work environments. Given a chance older persons can continue to contribute to society and add value. The society can also benefit from utilizing our skills and experience, if not in the corporate world, that suffers from the "age" syndrome, then maybe in other fields, such as education and training. While it is said age is never an issue, I still see it is a stumbling block in most professions and a barrier. The truth is that most older persons, like me, are still mentally and physically fit and prepared to work, but opportunities are few and sometimes difficult to find. There are many like me, who are continuing to seek gainful opportunities and then there are a number of older people who are happily retired and are enjoying their silver years. Then there is also that expectation from the children, emotionally drains older persons, especially when they are expected to look after grandkids after retirement, which can’t be overlooked. There still exists lack adequate job opportunities for those who want to continue to work, not to mention financial support, retirement benefits, inadequate social security and pensions for older persons. Unfortunately, our society is yet to recognize this as a social problem enough to promote age-friendly opportunities, environments and support.  

In every aspect of life there are pros and cons. I have realised that with the advent of social media, there has been a great deal of connectivity, but there is also lack of face-to-face communication, leading to social isolation and disconnection from society for some of my peers. Children are moving away from the homes to make their own nests, so the lack of social security or retirement benefits, the dependency on others for their care and daily needs or their own physical and mental health issues is becoming an issue for older persons. This is resulting in older persons being vulnerable to scams, abuse and with no one to care for their health and daily needs and it has been seen to lead on to issues like depression and loneliness. The family is still one of the biggest support systems for older people in India with around 82% of older people living with their families and yet prevalence of elder abuse in India ranges between 9.6% to 61.7% over different states. Financial inadequacy and issues such as inheritance or property disputes result in elder abuse cases. Most older people do not have access to legal assistance to safeguard their property rights, or protection for abuse related issues. Emotional support and guidance for such cases is also not easily available, either. Authorities, companies, societies still need to recognize and address health needs and safety needs of older persons to ensure that they can age with respect, inclusion, support and without any fear. Governments need to strengthen social welfare programs such as adequate pensions, legal support, health and financial schemes to ensure economic stability and reduced dependency on children. Studies have shown that regular physical and mental activity such as yoga, art of living, meditation is helping older persons. However, in urban India, there is a lack of open spaces, infrastructure, safe spaces, transport inaccessibility and access to such places. Rural India does have open spaces, but here there are other issues more important such as nutrition, awareness and education to manage first. 

As an older person, I want to see a world where workplaces and society offer good health services, social inclusion with opportunities for older persons to allow them to continue contributing their expertise, without being judged by their age. A world that allows me and all older persons, the independence to live on my own terms and with dignity at home and in society.  I see a range of tailor-made social activities and learning opportunities suited to my interests and abilities and being allowed to engage in enriching the lives of the next-gen with my years of experience and expertise. Retirement savings and pension plans, that adequately support the financial needs that ensure that older persons can afford a comfortable lifestyle without worry or stress is so necessary.  As we grow older, in making a good life for our families, we seem to forgot about living life and planning for old age and keep pushing it for later. I see older persons no longer burdened by responsibilities and demanding careers, with that dread of "what do I do now?". I remember, that I did not get the work I wanted after retirement and feeling lost for long. I see myself owning my lifestyle my way. I see some of my peers, perhaps starting businesses from home, enjoying their silver years volunteering or even running marathons. Let me share that I participated in marathons for many years, but today I can't even walk half a kilometre, let alone run, without looking for a place to sit down a while and I am sure if a dog were to run after me, I would get bitten for sure. I have 60+ girl friends who are enjoying 35 kms runs every morning and rightfully boasting about it on their social media pages and all I do is hit that 'like' button and move on. Even so, I see a world, where I have the right to choose what is best for me, without the comparisons and the comfort of getting to do it and looking forward to more without older persons like me, being stereotyped as not capable or suitable on account of age-related perceived notions. Older persons, like me, should feel safe and secure in their homes and neighbourhoods, with good support systems in place to address any concerns or emergencies promptly and with technologies seamlessly integrated empowering them to stay connected to society, family and friends. 

Let me end with this sharing. My father-in-law, a heart patient with loss of sight in one eye and half vision in the other for over ten years of his 99-year-old life, never stopped him from living life on his terms and following his heart. Despite uneven roads, traffic woes, he would walk to the temple ground close to home, meet his friends and return home with goodies for us. His memory never failed him and the stories he told, the songs he sang, the memories he shared embodied his entire being. Neither did it stop him from cooking meals for the family before I reached home, tired from work. I want to see myself living an independent life, just like he did, on my terms with good health, age-friendly environments, infrastructure, transportation, social inclusion and overall well-being support making it easy for me to live well.



By Hira Mehta | Author | Podcaster | Motivational Speaker | Soft Skills Trainer 
"A world I want to see as an older person with rights in my country and community. My thoughts at the Open-ended Working Group OEWG14, UN headquarters, New York, May'24" 

Thursday, June 27, 2024

Caregiving and support for older persons

Learning and thoughts on Caregiving and Support for Older Persons at the Open-ended Working Group #OEWG14, UN headquarters, New York, 20th to 22nd May'24. 

Hira Mehta, official Spokesperson of Silver Inning Foundation at 14th OEWG, UN HQ, NYC, May'24 

Hira Mehta attended an in-person CSO Consultation on the implementation of Human Rights Council resolution on care and support during #OEWG14 on Ageing Rights for older persons (9 am-12 pm, 23 May 2024) at the UN Secretariat Building, UNHQ, New York as representative of Silver Inning Foundation. The meeting was chaired by Asako Hattori and moderated by Martyna Balciunaite, UN official. The topic of discussions were (1) what human rights are relevant for older persons as caregivers and receivers of care and support and (2) what are the specific challenges and rights issues faced by older persons facing discrimination in the context of providing or receiving care and support (older women, older persons with disability, older persons belonging to minorities, etc).


At this meeting, Hira spoke about Dementia and Alzheimer’s and grandparenting responsibilities, especially for women.


Most agreed with her thought that, grandparenting should be a choice and not an expected support. In urban India, the extended family living under one roof is not a given anymore and today's nuclear structure, means more expectations from older persons. In our culture, the role of the grandparent is perceived as a role to teach traditions, moral values, religious values and overseeing their well-being and more. Some older persons find themselves moving abroad every six months to look after the grand kids. While some easily adapt to a new place and society, others find it difficult to leave the old ways and find it difficult to adjust. The choice is often not given and that could cause a great deal of issues for older persons in the household.


Speaking about caregiving, Hira suggested that dementia be included in the disability package of health and health services as an essential, for providing comprehensive support, ensuring access to necessary medical and social services and alleviating the financial burden on families affected by dementia. Dementia causes significant cognitive impairment, affecting memory, reasoning, communication, and the ability to perform daily tasks. This aligns with the definition of disability as a condition that substantially limits one or more major life activities. She also mentioned that most of the time families treat it as old age issues and are unable to recognize it as dementia. Some are not willing to accept the fact and therefore early diagnose takes a back seat resulting in delay of treatment. Treating it as a disability will not only improve the quality of life for those with dementia, but also support the family and caregivers to deal with it effectively. Cost of care is high and dementia care will be expensive, with regard to medical treatments, long-term care services and out-of-pocket expenses. As dementia progresses, individuals will experience functional decline and require assistance with activities of daily living, such as bathing, dressing, eating, and managing medications. Individuals with dementia require regular attention and medical care to manage symptoms, monitor progression and treat comorbidity conditions. Long-term care is involved and many individuals with dementia will eventually need long-term care services, such as in-home care, adult day programs, assisted living, or nursing home care. Therefore, Hira requested that dementia be part of the disability package of health and health services, so that integrating it into disability packages will ensure that persons with dementia receive the support and care they need.


Irrespective of health and health services, governments and authorities should conduct public awareness campaigns to educate the public about dementia. It would help raise awareness about dementia, reduce stigma, and promote advocacy for better care and support services. Governments and health organizations also should develop policies that explicitly recognize dementia as a disability and outline the entitlements and services available. The society and community also need to support by expanding community-based support groups, adult day care centres and care programs.


UN 14th OEWG May'24 


One of the sharing that hit Hira hard at this meeting, was the sharing of a lady from the Far East. Belonging to the LGBTQ+ community, she talked about the stigma and discrimination, especially if institutionalized in the past or after having overcome mental issues, including anxiety, depression and suicidal ideation. Support groups are limited in number and despite increasing visibility and acceptance world over, social stigma and discrimination continue to impact her well-being. She called for attention towards continued efforts needed to ensure comprehensive legal protections, improve access to competent healthcare and combat social stigma and discrimination.


 Assisted living or Elder homes, is an option and respite for family caregivers, who need assistance during times of illness or travel or their own job constraints. Family members may get peace of mind knowing that their loved ones are receiving professional care and support in a safe and nurturing environment. Sadly, sometimes, older persons are not questioned about their preferences. Besides, older persons, may become vulnerable to exploitation, abuse, or neglect by caregivers and sometimes financially exploited too, if family does not pay attention or visit often enough. The 24/7 care by trained staff, helps ensure that older persons with complex medical needs or mobility issues receive the assistance they require. Dependence on caregivers for activities of daily living, the lack of mental stimulation and engagement in institutional settings, however, can accelerate cognitive decline, particularly for individuals with dementia or cognitive impairments. Older persons are at increased risk of experiencing depression, anxiety and other mental health issues with the loss of personal belongings and comfort, independence, social isolation and changes in assisted living environment with the limited privacy and loss of personal space. Financial burdens, particularly in places where long-term care services are expensive or not covered by insurance, often become the reason for home treatments for some families. High costs of care whether at home or assisted living option, can deplete the savings and assets, impacting financial status of the family. While institutionalization may be necessary for some older persons who require intensive care or support, it can have significant implications on mental health and quality of life.


In conclusion, caregiving is an essential aspect of an older person’s life cycle and therefore, it is necessary to continue raising awareness about the realities of caregiving and its cost. Advocating for policies that provide adequate support and resources, whether it is through community programs, government initiatives, or individual acts of kindness is important. There is a need to create a more compassionate and supportive environment, to ensure that both caregivers and care recipients receive the required assistance and resources.



~  Hira Mehta | Author | Podcaster | Motivational Speaker | Soft Skills Trainer

Monday, June 17, 2024

Silver Inning Foundation Oral Statement for UN 14th OEWG on Ageing

Hira Mehta - Spokesperson of Silver Inning Foundation presenting Oral Statement at UN 14th OEWG

 I am Hira Mehta from Silver Inning Foundation, an NGO working with older persons across India. 

In India, 149 million older persons are in 60 plus age group belonging to diverse cultures. More than 65% live in rural area and 90% have no social security. Most of the older persons depend on the family support system. Today, changing values are weakening inter-generational ties that is hallmark of our traditional family institution. 

At age of 58, I was mentally and physically fit, but I had to retire without choice. This left me feeling socially isolated, lost and disturbed for a long time, because I felt I was capable of more. Today, with meager 14$ pension per month, I struggle to live decent life and find it difficult to access and afford right health care.   

Challenges that are significantly influencing older persons’ right to health are unavailability of healthcare facilities and services, lack of awareness, education, early detection and prevention, as also socio-economic factors, such as disparities between urban and rural lifestyle. 

As Older Person I want to ‘Age with Rights’ to maintain healthy well-being with dignity. Therefore, multi-faceted approach with robust healthcare policies, increased investment in healthcare infrastructure, access, affordability and prioritization of preventive healthcare is required. More importantly, expansion of health insurance coverage for all older persons is also needed.  

India, has sizable population of persons with Alzheimer’s disease. Illiteracy and social taboos surround this disease, I must admit that for a long time, even I did not know the difference between age related and dementia related issues. Hence, there is a strong need for awareness campaigns, training, well-defined policy and national dementia plan.  

We align with the statement made by ‘Global Alliance for the Rights of Older People’, a ‘UN Convention for Older Person Rights’ would guarantee older persons’ access to affordable healthcare to help them maintain optimum level of physical, mental and emotional well-being and prevent or delay the onset of illness, to live life with dignity and self-fulfilment. 

Date 20th May'24 

Photo of Civil Society Group at UN 14th OEWG on Ageing

The 14th session of the UN Open-ended Working Group on Ageing (OEWG) was held between 20-24th May 2024 in New York. It is a critical time for civil society to maintain pressure for the adoption of a United Nations' Convention on the rights of older people. 



Silver Inning Foundation Statement for UN 14th OEWG on Ageing

 The 14th session of the UN Open-ended Working Group on Ageing (OEWG) was held between 20-24th May 2024 in New York. It is a critical time for civil society to maintain pressure for the adoption of a United Nations' Convention on the rights of older people. 



On behalf of Silver Inning Foundation Ms. Hira Mehta - official Spokesperson and Ms. Ramaa Subramaniam Co Founder of Silver Inning Foundation participated in this esteem global meet. 


Silver Inning Foundation submitted this following official statement for The 14th session of the UN Open-ended Working Group on Ageing (OEWG) :  https://social.un.org/ageing-working-group/documents/fourteenth%20session/INPUTS%20NGOS/Silver%20Inning%20Foundation.pdf

Date 9th April’24

The Chair, 

Open-Ended Working Group on Ageing on Ageing

14th General Assembly, May’ 24

United Nations

New York

Statement of Silver Inning Foundation for Fourteenth Session of Open-Ended Working Group on Ageing (OEWG) on Ageing on “Right to health and access to health services”

Indian society is undergoing rapid transformation under the impact of industrialization, urbanization, technical & technological change, Education and globalization.  

Consequently, the traditional values and institutions are in the Process of erosion and adaptation, resulting in the weakening of Intergenerational ties that were the hallmark of the traditional Family, this has great impact on older persons.

Senior citizens in India is a person who is 60plus and they belong to diverse groups. Consequently, the ageing issues are also different and a lot depends on the family support system the older persons enjoy. The heterogeneity among the older persons population must be factored into framing appropriate models of care for them.3

As per the latest report, there were 149 million persons aged 60 years and above in 2022 (as of 1 July) 2 comprising around 10.5% of the country's population. And, by 2050, this population will double to 20.8%, with the absolute number at 347 million.

The right to health is a fundamental right that ensures individuals have access to necessary healthcare services and a state of well-being. In India, the recognition and implementation of the right to health have evolved over time through constitutional provisions, legal frameworks, and judicial interpretations. 1

Challenges in Realizing the Right to Health: 1

Healthcare Infrastructure: Inadequate healthcare infrastructure in rural and remote areas, shortages of healthcare facilities, including hospitals, clinics, and qualified healthcare professionals.

 Affordability: The high cost of healthcare services, including diagnostics, medications, and treatments.

 Regional Disparities: There are significant regional disparities in healthcare access, with rural areas and certain states facing greater challenges in terms of availability and quality of healthcare services.

 Health Awareness and Education: Limited health awareness and inadequate health education among the population hinder preventive healthcare measures and early detection of diseases.

 Social Determinants of Health: Socio-economic factors, such as poverty, education, sanitation, and access to clean water, significantly influence health outcomes.

 Gender Disparities: Gender discrimination and biases often result in unequal access to healthcare services for women, particularly in reproductive health.

Addressing these challenges requires a multi-faceted approach involving robust healthcare policies, increased investment in healthcare infrastructure, prioritization of preventive healthcare, expansion of health insurance coverage, and targeted interventions to address health disparities and social determinants of health.1

Government Initiatives and Public Health Programs 1

The Indian government some notable public health programs to promote the right to health and improve healthcare accessibility across the country:

National Health Mission (NHM): The NHM is one of the flagship programs of the Indian government aimed at improving healthcare services, especially in rural and underserved areas. It encompasses two sub-missions: the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM to strengthen healthcare infrastructure, enhancing human resources for health, promoting maternal and child health, addressing communicable and non-communicable diseases.

Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY): is a health insurance program launched in 2018. It provides financial protection to over 500 million vulnerable individuals and families by offering cashless coverage for secondary and tertiary healthcare services.

Recommendations1

           Strengthening Healthcare Infrastructure: Increase investment in healthcare infrastructure, particularly in rural. 

           Enhancing Primary Healthcare: Strengthening primary healthcare services for comprehensive and preventive care.

           Addressing Health Disparities: To address regional and socio-economic disparities in healthcare access and affordability.  

           National Dementia Strategy: Need for national policy with a very clear and well defined action plan since India has a sizeable population of Alzheimer's disease affected people and certain traits like illiteracy and social taboos make the country unique.

           Universal Health Coverage: Universal health coverage by expanding health insurance schemes to all 60plus

           Focus on Preventive Healthcare: Prioritizing preventive healthcare measures, health education, vaccination campaigns, and early detection of diseases.

 

Conclusion: The right to health is a fundamental right in India, enshrined in the Constitution and supported by legal frameworks, judicial interpretations, and landmark court judgments. While progress has been made in promoting healthcare access and improving public health, challenges remain in fully realizing the right to health especially for the older persons.

We at Silver Inning Foundation strongly advocate and demand ‘UN Convention for Older Person Rights’ so that older persons can have access to healthcare to help them maintain or regain the optimum level of physical, mental and emotional well-being and to prevent or delay the onset of illness and Live life with dignity and self-fulfillment.

 

Reference:

1The Right to Health as a Fundamental Right in India: JETIR June 2023, Volume 10, Issue 6 https://www.jetir.org/papers/JETIR2306301.pdf

 2 UNPFA INDIA AGEING REPORT 2023 https://india.unfpa.org/sites/default/files/pub-pdf/20230926_india_ageing_report_2023_web_version_.pdf

3 https://loksabhadocs.nic.in/Refinput/New_Reference_Notes/English/06072020_122044_1021205239.pdf



Sailesh Mishra, Founder President, Silver Inning Foundation


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