Growing old

The issues of an ageing population or elderly people dependent on others is not recently discussed in Pakistan. We like to believe we still live by tradition, and that the elderly within each family will be taken care of by their children. But around the world, as was pointed out on World Elder Abuse Day, observed this past Saturday, global demographics are changing rapidly and according to estimates by 2050, the number of people above the age of 60 will exceed the number of younger believe. WHO data meanwhile suggests that four to six percent of the elderly suffer from some form of abuse which goes mainly unreported.

We do not have any reliable data on the scale of the problem in Pakistan. The limited studies conducted indicate that as social and family structures change, care of the elderly is becoming harder and more sporadic. The lack of homes for older people, the stigma attached to these and the lack of expertise in geriatric care adds to the burden. Population statistics from Pakistan indicate that 11.3 million people are presently over 60 years of age. By 2030, this number will grow to 23.76 million. It is therefore necessary to discuss the problem more openly, with the death rate currently at 6.3 percent, far lower than the birth rate. In short, because of advances in medical treatment, people are dying at a relatively old age even though the average life expectancy in Pakistan is among the lowest in the world – at 66.5. Even so, the large amount of migration out of the country means that often children are separated from parents by geographical space and even when they are physically present in the same country, may be less able due to economic strains to be in a position to care for ageing parents.

Charities which home destitute persons say that in some cases, well-off families have been known to leave elderly relatives at their doorstep and then abandon them. Institutions for mental health also report the same phenomenon. This suggests a growing desperation within families and a need to offer solutions. While we naturally like to think along traditional lines in terms of familial relationships, the fact is that these do change. It is not always possible to carry on practices adopted in the past. There is good and evil inherent in all change. But we need to realistically assess what an ageing population means in terms of healthcare costs, social costs and dependency so that we can devise policies accordingly.