Marking ‘World Elder Abuse Awareness Day’, HelpAge India today released Findings from its 6-city survey “The Silent Tormentor: Covid 19 & the Elderly” delving into the impact & challenges faced by India’s elders during the pandemic.
The report unravelled some of the deep seated fears the country’s elders face. It delves into the lives of elders living in the ‘Household’ settings and those living in ‘Old Age Homes’ and the assess the impact & challenges of the Covid 19 pandemic on their lives. It examines the whole new culture of ‘work from home’ of family caregivers and its implications. It also probes into the concerns of Caregivers in both settings to understand their behavior and circumstances.
“What is heart wrenching about this report is that while elders have always been identified as the most vulnerable and susceptible to Covid19, the focus has been on physical health and few have noticed the dreadful impact the pandemic was having on their mental health and well-being. The report clearly brings out the sense of fear, worry and loneliness our elders are facing, and the increased risk of abuse due to growing dependency. While battling health issues, they are also dealing with the loss of loved ones, and struggling at multiple levels. The report also addresses the urgent need, now more than ever, for building a strong and responsive eldercare system. Covid19 had no precedence for us to be prepared, but now we can be. Elder needs must be given the priority, attention and resources it deserves, and even as family caregivers do their best despite challenges, government, community and private sector must work together, to support caregivers and bring in elder friendly policies and programs”, said Rohit Prasad, CEO, HelpAge India.
The Survey with a sample size of 3526 respondents, was conducted across 6 major Tier 1 cities: Delhi, Mumbai, Bangalore, Hyderabad, Kolkata and Chennai, covering SEC A, B, C & D. The survey was conducted by a professional agency - Ipsos Research Private Limited.
The Informal (Household) Setting, brought out some stark realities.
58.6 % elderly had family members who ‘worked/ studied from home’. Despite living in such close proximity throughout the day, 20.5% elders wanted someone to just be with them, and 35.7% elders wanted some to just call them to talk, while 13.7 % felt trapped and frustrated.
20.8% elders had lost either their family members or friends due to Covid19. Of these, when asked what could have been done better to save their lives, the majority , 50.8% elders, said a better medical / health infrastructure, 44.4% said availability of vaccines and 38.7% said availability of medicines & injections on time.
42.1% elders were most worried of being hospitalized if they were Covid affected, and 34.2% were worried of being isolated. 11.5 % had the ‘fear of dying’.
Another major concern was the increasing financial dependency elders had on others, with 41.1% elders being dependent on their family members, 70.2% of these, belonging to age group of 80 – 89 years. Covid hugely impacted the income stream of the elderly, with 52.2% elders saying that their income has been impacted. Loss of job (34.9%) & pay cut (30.2%) of the family members being the top reasons.
Inhibiting health conditions, made it harder for elders to cope during the pandemic with 52.4% elders having joint pains, the most predominating health condition. 44.9 % had difficulty in walking, while 24.4% had poor eyesight and 13.8 % had problems remembering or suffered from lack of concentration, which restricted their overall well-being. It was heartening to see that 77.5% elders were aware of Covid appropriate behaviour to avoid getting affected.
While 58.2% of elders were aware that a vaccine had been developed, 41.8% were not aware that any vaccine had been developed. Of those aware, 78.7% elders felt that getting vaccinated was really important. It was heartening to see that 66.6% elders had got at least one dose of their vaccination, though gaps remain, as 39.4% elders had not.
What was disturbing was the misinformation about vaccination that most elders had, of those aware of the Covid 19 vaccine, 61.2% of elders felt that they will be completely immune to the disease after taking the vaccination. This not only will urge them to throw caution to the wind, but also put those around them susceptible to the virus if Covid appropriate behaviours are not followed.
43.1% elders said that elder abuse is prevalent in society. While 15.6% said they are victims of abuse. Disrespect (45.6%) and beating /slapping (23.1%) were the main forms of abuse. 62.1% felt that during Covid19 the risk of getting abused has increased.
The main abusers were sons (43.8%) and daughter-in-law (27.8%). Surprisingly, 14.2% said that their abusers were their daughters. On a ranking basis - Emotional abuse (60.1%) was the main form of abuse, followed by financial abuse (61.6%) and physical abuse (58.6%).
“We received more than a 1000 calls to our Elder Helpline relating to elder abuse, violence and disputes in the second wave, an increase of 18% from the first. The helpline received almost 20,000 calls in total in the second wave, a 36% increase since the first, with calls about counselling increasing by 111 % and requests for income support by 54%. This is the reality we are living in today, Covid 19 has taken the primary role of the Abuser, affecting elders in the worst way possible, from all corners,” said Dr. Imtiaz Ahmed, Mission Head – Agecare, HelpAge India.
48.1% Caregivers of those in the household setting, said that they are facing difficulty in managing their expenses, as many had lost their jobs and were coping with decreased salary. 36% found it difficult to give full attention or dedicate time to elderly members in their family.
According to the Caregivers, the major challenges faced by the elderly in their house from other family members during the pandemic, was Need for more attention (37.4%), Behaviour of family members (33.6%), financial insecurity (26%) and Inability of the family members on understanding the needs/emotions of the elderly (18.3%).
What is interesting to note is that 61.4% said that the ‘work from home/study’, affected their day-to-day routine in a negative way. This sharply contrasts with the Caregiver perspective, 71.6% of whom said it did not affect the elders day-to-day routine. It exposed a distinct gap by the younger members in the family, in understanding elder needs.
The Formal (Old Age Home) setting brought out some hard challenges old age homes seemed to be facing due to the pandemic. 50% old age homes said they faced scarcity of funds during the pandemic. 37% said that there is no isolation or quarantine rooms created in the old age home, in case any elderly is infected.
For elders living in old age homes the most worrisome thing about getting infected with Covid19 was isolation & quarantine (60.6%), hospitalization (62.2%) and abandonment by caretakers / family members (22.9%).
Loneliness and isolation of elders living in old age homes, was similar to those elders in the household setting. Amongst the top statements that best described their feelings since the pandemic were - “I find myself waiting for people to call more than ever before” (56.7%), “Some days I spend most of the time resting” (54.7%) and “I want someone to just be with me” (30.3%) and “The days seem to last too long” (26.4%).
Loss of communication with their loved one was a major concern for the elderly, 58.5% of elderly felt that the COVID-19 pandemic has affected their communication with them. 59.3% Caregivers said visitors were not allowed in the home to meet their parents or grandparents.
On being asked what are the various restrictions imposed / protocols instituted by the old age home to protect the elderly - 81.1% said no visitors are allowed, 68.9% said they were not allowed to go out and 70.4% said Mandatory wearing of Mask.
36.1% elders living in old age homes said that elder abuse is prevalent in society. While 26.9% have been victims of elder abuse.
While 80.8% knew about the vaccine for Covid19, the misinformation about the vaccine benefits seemed to prevail here as well, with 73.5% elders of the opinion that vaccine will make them totally immune to Covid19.
It was clear that old age homes are struggling to stay afloat during the pandemic, having access to basic service goods and services seemed to be a challenge with 60.2% of Caregivers saying that access to goods / services / benefits was difficult during the COVID-19 pandemic.
The staff of the home and caregivers are under duress with 56.1% of staff feeling stressed due to the shortage of caregivers/attendants during pandemic. 67.6% staff of the old age homes stating that they do not have a health insurance cover. 34.3 % old age homes facing the problem of staff shortage during the pandemic.
50.9% of Caregivers fear getting Covid19 while taking care of the elder residents.
The future is uncertain, but we must ensure that elder needs are addressed, so they can live their later years with dignity and hope.