IMPROVING THE WELL-BEING OF ELDERLY RESIDENTS IN OLD AGE HOMES: PROBLEMS, INSTITUTIONAL SUPPORT, AND POLICY RECOMMENDATIONS FROM VARANASI DISTRICT

Abstract

India has one of the fastest increasing populations of persons aged 60 and over projected to nearly double by 2041 from about 150 million in 2021and this demographic trend, combined with migration of working-age children to cities and overseas, is a driving force behind an uninterrupted increase in institutional care for older individuals even within a culture historically inclined towards joint-family caregiving. Among these locations, the Varanasi district where links to pilgrimage influenced charities are prevalent alongside newer paid facilities provide a particularly informative form to study how old age homes deal with this transmutation. This study conducted structured interviews with 310 residents in 19 old age homes (six government-run, nine run by NGOs/trusts and four privately paid) in Varanasi district to identify the major issues faced by them and their institutional-level support. Data were gathered through structured interviews, a validated well-being scale and facility level audits of medical, nutritional, recreational and grievance-redressal infrastructure. The results showed that health-related ailments (73.9%) and psychological distress (66.1%) were the most frequent problems, with female residents reporting a support deficit higher than males in every domain measured; resident family neglect was also higher for females than for males. The type of ownership revealed a striking divide in institutional support, with government-run houses performing worst in terms of psychosocial counselling (3.2/10), and privately paid facilities scoring highest on medicine provision (7.8/10), suggesting the existence of a two-tier system for the quality of eldercare received. Psychological well-being was moderately positively associated with frequency of care visits by family (r = 0.83), supporting the notion that individual residential care cannot meet its therapeutic purpose without regular family contact. The findings led the researchers to recommend tighter staff-to-resident ratios in government facilities, ensure minimum psychosocial counselling provisions across all registered homes; and for each ownership category (government or non-government) to mandate establishment of a grievance and monitoring cell at the district level under the Maintenance and Welfare of Parents and Senior Citizens Act, 2007 so that care can be standardized.