I’ve often wondered exactly when children turn into care-givers for aging parents. As medical care improves and life expectancy goes up, more of us can expect to have our considerably older parents around longer, which is great. But with traditional roles of family changing rapidly in India, the role of middle-aged children as care-givers — a generation sandwiched between taking care of elderly parents and young children — is also changing.
This is a conversation that transcends all geographical boundaries. What differentiates it from country to country are the cultural issues.
For example, each time my parents have dealt with serious medical issues, they’ve refuse to come to my home, even for post-operative care. In addition to the ignominy most parents feel in being a “burden” on their children, Indian parents who have no son hesitate to live in their “daughter’s” homes. In my case, every argument that my sisters and I used to persuade them to stay in our homes, at least until they recovered, fell upon deaf ears. The cultural barrier against living with a daughter was too strong for them to overcome.
In the West, the elderly expect to grow old alone. Their children move out, usually after they finish high school. This gives parents a chance to get used to the idea while they are still relatively healthy. And depending on the country, there are enough elder care homes and retirement communities — Florida’s raison d’etre is the elderly — to take over the caregiver's role as they age. Some countries like the UK help the elderly age with dignity by providing care in their own homes through government-sponsored social service networks.
In India, however, where more children are living separately than ever before, this is probably the first generation of the elderly who are coming to terms with the fact that they may have to age alone. This realisation is making retirement communities and privately outsourced elder-care management companies gain greater acceptance.
Manjiri Gokhale Joshi began Maya Care in 2009, with Pune and Mumbai as its home base. Its services include helping senior citizens visit a doctor, shop, pay bills and attend social engagements. Another company, India Home Health Care, based out of Bangalore and Chennai, focuses on health care and targets non-resident Indians whose elderly parents live in India. And in north India, Epoch Elder Care, the latest to open shop, provides quality at-home elder care to provide the social support and mental stimulation the elderly need.
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“Our services include home visits, companionship and medication management as well as monthly social events to get the elderly out of their homes and engaged with one another,” says Kabir Chadha, a young ex-McKinsey consultant who started Epoch last year. His “elder care specialists” are professionals who have masters’ degrees in elder care management fields like gerontology, social work and psychology.
True, getting old isn’t for the sissies. But it’s equally tough on the sandwich generation, struggling to care for young children and ageing parents when we’re also dealing with mid-life crises and peaking in their careers. “In some ways, being the youngest of my siblings seems unfair. My older sisters have had the benefit of seeing their parents young, and have taken advantage of their support. Now, they are empty-nesters, and I’m the one who has a young child as well as a 90-year old father. My sisters want to help, but they live overseas, and my dad refuses to relocate. So by default, I’ve become his primary caretaker,” says a friend, a single mother, who prefers to remain unnamed. It’s especially hard for her to care for her father, since he prefers to live in a village in Punjab and her life is centered in Delhi.
And in addition to failing physical health, a vanishing mind and depression, greater emotional fragility makes the elderly over-sensitive, which is why caring for them is such a challenging task.
Jyoti Pande Lavakare is a New Delhi-based writer