Wednesday, January 13, 2010

Older Persons in India

As a kid growing up in India, I remember spending more time with my grandparents than my parents. We lived in a big house, with five families in it. These were not just husband-wife families, but husband-wife, kids and grandkids type of families. In the house where I grew up with my sisters, we fit a total of 25 people, with about four to five people in one room.

Even as I was growing up, I never realized what a profound effect this setting would have on my life. Now that I am grown up and have lived in different countries, sometimes on my own and sometimes with friends, I realize that my grandparents played a major part in my formation.

In India, the concept of nuclear families has just started setting in during this decade. Joint families are still the prevalent norm, especially in rural India. Looking back, I think my house was like the community centre of the neighborhood. Every afternoon I remember coming home from school, I would see at least ten women sitting in our big front garden, knitting, sewing, talking about the neighborhood, basking in the sun and enjoying endless cups of chai.

My grandmother was what you would call the chieftain of this tribe of women. I would always see her, seated in the best chair, the white cane chair, with all the women surrounding her. The other women appeared in awe of my grandmother as she was dreadfully good looking. Before the partition of India and Pakistan, my grandparents lived in Lahore (now in Pakistan) and my grandmother’s family was one of the wealthiest in Pakistan. When they moved to India, however, they lost all their property and wealth. The only thing my grandmother brought to India was her beauty and her fascinating stories of wealth, grandeur and glory in Pakistan. Every day I would hear her talk to the other women about this diamond that she owned or that emerald that she wore. I knew that my grandmother was the talk of her town in Lahore and she effortlessly maintained this image in India, in my little town of Chandigarh, as well.

Looking back, I realize how much that joint family structure and my grandparents changed my life. Both my parents were working, so my sisters and I would spend the remainder of our days, after school, with our grandparents. My grandmother instilled something in me that makes me feel hugely indebted to her- a belief in a superpower. She was a firm believer in God. To me interested in God and religion she would sit with me and write songs and poems about Indian Gods and Goddesses and then she would ask me to think of a nice melody for them. After that, my grandmother would sit for hours singing the song and I would sit and listen to her and imagine her singing the same song in her big mansion in Lahore. The songs were very simple but powerful in their message. Songs of Gods’ glory, the virtues of doing right, the benefits of prayer and meditation, were all things that I heard and learned from those songs. Although my parents were both working, I never felt their absence and grew with immense love and care and a profound sense of security that no matter what happened, my grand mom’s love and devotion to God would always protect me.

Even today, when I am distressed I think of the powerful message of those songs and it empowers me in a way that nothing else can. This is when I realize the deep impact grandparents have on our lives. Our grandparents are from a different and older generation. They help to remind us of the simple rules of life that we often forget while trying to make a living. Simple things that our grandparents taught us are the most precious means of living a fulfilling life- respecting our elders, being kind to other people, loving our neighbors, being helpful, praying and meditating are just a few things that I learned from my grandparents.

One of the hardest times, however, in my life was when my grandmother was diagnosed with Ovarian Cancer. Even more difficult was the shock that my grandmother felt when she learned that she was sick. The biggest shock, however, for her was finding out that she would stop having a normal lifestyle after that diagnosis. My grandmother had to undergo surgery and after that surgery, she never had the same life. One of the reasons that she had such a hard time in post-surgery was because the doctors failed to provide her with adequate information on what her life would be after the surgery. This is where India’s health system reveals its weaknesses. In India few post-surgery treatment facilities exist for patients. Due to the large population and high number of patients, not every patient gets the treatment that they deserve. Moreover, psychological assistance is not so readily available for patients who go through life changing operations.

My grandmother was a very social woman, she used to go out everyday to meet her friends, go for weekly community gatherings, etc, but after her operation she was attached to a device that did not permit her too much mobility. This immobility paralyzed her more than the disease, more than the surgery and more than the lack of post-surgery treatment. In India, the people in the health system give no information to assist older patients before and after surgery. The information that my parents had was similarly qualified and inadequate. A lot of times, doctors forced procedures and treatments without providing them essential information about the complications associated with such major surgeries.

The direct effect of this immobility gave rise to depression and loneliness for my grandmother. Even with us around her, she longed for her social and active life. After her surgery, she felt trapped and disappointed. She would often cry and wish that she had never had the surgery. Seeing her unhappy made these days some of the most trying periods for my entire family. The sedentary lifestyle and the ensuing depression eventually got the better of her. She developed Alzheimer’s disease. My grandmother started forgetting names and places, she would forget to eat, and she started to slowly wither away.

The surgery began the end of my grandmother’s life; instead of making her better, it took the very life out of her. For a woman who was used to a life of comfort as a child and then of a social and active lifestyle as a young woman, the change was much too big and she was completely unprepared for it. A lack of information from the doctors complemented with a lack of any kind of professional psychological assistance, took away any hope for a decent and respected old age for my grandmother.

In a country that is increasing its power every year and boasts of leading medical and technological advancements, such discrepancies in the care of elders is inexcusable. India has some of the smartest doctors in the world. It also exports some of its smartest doctors to the world. But this progress fails when it comes to dealing with the health issues of older people living in its own borders. My grandmother’s case is just one example. Many challenges and abuses face older Indians but the medical doctors and other health workers completely ignored them. India must work on providing mental and psychological help to older people who undergo life-changing treatments. Besides this issue, other problems demand attention: abandonment of older persons, lack of access to some form of social security as well as deficient medical and health facilities for older people.

In the Indian culture, most people consider elders responsible for holding values and protecting wisdom, earning them great respect. The new generation however, caught up in its frenzy for advancement and fast progress is slowly eroding this bedrock of the Indian family system. In the joint family structure that is still prevalent in many parts in India, grandparents still give very strong support system to families, especially in families where both parents are working. The majority of grandparents spend their entire older lives caring and providing for grandchildren and their parents. In such a scenario, to think of older people going through a frightful and painful older life is ethically wrong. India must change its policy decisions to ensure that more research is done on various issues affecting the older persons in the country. More importantly, India’s citizens must create solutions to these problems as soon as possible. Older people spend their entire lives making lives better for others. It is only fair that they are taken care of in their old age.

By Pia Malhotra, for Global Action on Aging


  1. Pia, thank you for sharing your very personal story with the GAA community which radiates your grandmother's love for you and illustrates the urgency to strive for more efficient healthcare systems in India and across the globe. It also highlights the value of an intergenerational bond which has been increasinly strained by our fast-paced lifestyles. I hope that younger generations today will once again engrain these values into their families.

  2. Grt note,yes we all need to work jointly for our elder's right.