This post has been self-published on Youth Ki Awaaz by IMPRI Impact and Policy Research Institute. Just like them, anyone can publish on Youth Ki Awaaz.

Looking After Those Who Looked After Us: Gendered Intersections In Geriatric Care

More from IMPRI Impact and Policy Research Institute

Owing to fertility rates reducing and life expectancy increasing, the number of people involved in caring for the elderly has drastically reduced.

Researchers of gerontology have noticed a sharp increase in the demand for paid caregivers for the elderly, which shines a light on questions regarding responsibility and care or neglect of senior citizens and the discrimination they face.

To discuss this important and often overlooked subject, the Gender Impact Studies Center, Impact and Policy Research Institute, organized a web policy talk on: “Who Cares for the Elderly? Gendered Intersectionalities in Geriatric Care”, under the state of gender equality #GenderGaps series.

Photo credit: IMPRI.

Professor Vibhuti Patel, a prominent economist, and feminist, and the chair of this discussion, introduced the subject and the speaker of the panel, Dr Anagha Tendulkar, head and associate professor at the department of Sociology at the Sophia College for Women, Mumbai.

Dr Anagha Tendulkar. Photo credit: IMPRI, YouTube.

Demographic, Social, and Cultural Background

Dr Tendulkar, began by defining ageing as a universal process that implies changes in a person’s mental and physical state as they grow older along with a gradual impact on their life and lifestyle.

In the context of academic discourse, ageing can be approached chronologically, physiologically, psychologically, and sociologically. However, Dr Tendulkar believes that our understanding of the concept of ageing is very limited.

The chronological parameter is the most widely used especially in India, but it is a very limited and empirical one.

Demographic or population ageing, on the other hand, according to the World Health Organisation, is defined as the increasing population of older people within the total population.

Older men are able to access better healthcare compared to older women. Representational Image. Photo credit: Suyash Dwivedi, Wikimedia Commons.

According to demographic trends, the whole population of the world is ageing, with the oldest region being Europe, and the youngest being Africa.

While India is known to be the country with a very large youth population, demographic trends reveal that we are heard towards a “grey revolution”.

The population of citizens over 60 years of age has increased steadily, from 55.6 million (6.7%) in 1991 to 104 million (8.6%) in 2011.

By 2026, the number of senior citizens in India is projected to be 173 Million. This rapid growth is concerning because this puts pressure on the availability of care-giving and healthcare facilities, which are already in a frayed state.

Gender-based Differences

One also finds that the population of aged women is slightly higher than that of men.

The concerns related to this pertain to patriarchal social structures, more enforced in the older generations, owing to which most old women do not know how to manage their assets, bank accounts, and so on.

Another pertinent question in this context is the understanding of the process of ageing across gender groups, including men and women, and also members of the LGBTQ+ community, who are the least represented in these studies.

Sociologists have identified multiple gender differentials in the process of ageing. The pace, nature, and quality of ageing vary across the gender spectrum.

These variations mark the inequalities owing to various factors such as marital status, gender of children, caste, class, religion, and so on that translate into the availability or lack of availability of access to opportunities, spaces, resources, etc.

The study of the process of ageing in men mostly revolves around physical health and the phase of retirement.

Documentation on the process of ageing of LGBTQ+ individuals mostly comes from European and North American studies.

However, these are limited, and the studies mainly revolve around health, housing, and social care.

The grey revolution in India has unfortunately been marked by a large number of missing elderly persons and a large number of invisible groups.

This implies a decline in familial obligations and reliance on care facilities which are often overwhelmed.

In India, the family and community are still the primary caregivers to the elderly. Governmental and non-governmental agencies are secondary. While many old-age homes do exist, decent ones at reasonable costs are still a dream.

“Many women’s old age homes are still called widow’s homes. There are cultural nuances that need to be repaired before understanding ageing within Indian society,” Dr Tendulkar noted.

While senior citizens associations do exist, they are largely dominated by elderly men, which means elderly women’s issues go unnoticed.

For older women, ageing represents not just a physical slowing down, but also a de-empowerment in other aspects of life. Representational image. Photo credit: Indian Wire.

Another cultural nuance that Dr Tendular spoke about was that, while patriarchal values are still strongly instilled in the elderly, there is also a gradual feminization of ageing. However, for elderly women, in particular, ageing means de-empowerment.

She remarked that ageing needs to be considered in several intersectional ways. Much of Indian society is still ruthlessly insensitive towards the layers of marginalization that elderly women face.

“Gerontological care must be emphasized, which will automatically reduce the burdens of geriatric care,” concluded Dr Tendulkar.

A Research And Public Policy Perspective

Professor Vina Vaswani. Photo credit: IMPRI, YouTube.

Professor Vina Vaswani, director of the Centre for Ethics, and professor, department of Forensic Medicine and Toxicology, Yenepoya (deemed to be) University, Mangalore, started by noting the various forms of ageism faced by the elderly population in daily life.

According to the 2011 census, 15 million elderly people in India live alone, and nearly 3/4th of them are elderly women.

Highlighting the intersectionality of understanding ageing, referring to the Crenshaw study, Vaswani noted that various socio-cultural factors such as gender, race, sexual orientation, wealth, caste, religion, etc. can oppress or enable mobility.

These intersect social identities which have a direct role in the way one is treated.

Women are at the forefront of all kinds of care-giving. However, this doesn’t reciprocate to elderly women receiving the same amount of care.

Elderly women receive lesser informal care compared to elderly men owing to patriarchal social structures. Moreover, research that can account for this is also scanty.

Policy needs to take into consideration the various aspects of care-giving in order to improve facilities and caregivers must be listened to better.

The people for whom policies are being made must be involved in the decision process, concluded Vaswani.

Healthcare Of The Elderly

Dr Anand P Ambali, professor, department of Medicine and Geriatric Clinic at Shri BM Patil Medical College Hospital and Research Centre, Vijaypura, reiterated that women are most present in both formal and informal care-giving, but receive the least care.

Dr Anand Ambali. Photo credit: IMPRI, YouTube.

Negligence of the health of the elderly, especially elderly women is prevalent, but especially so for the economically weaker sections who neglect to provide healthcare due to financial constraints.

Elderly women are at higher risk for mental illnesses such as depression, due to loneliness and isolation.

Moreover, negligence of preexisting prevalent conditions such as diabetes leads to its aggravation, and diabetes-induced vision issues, etc.

Dr Ambali suggested that exclusive health screening for elderly women must be implemented in order to avoid health aggravations.

Social And Economic Systems

Urmi Nanda Biswas, professor at the department of Psychology, MS University of Baroda, Vadodara, highlighted the reality of gender equity and intersectionalities in the elderly, supported by her academic work.

Professor Urmi Biswas. Photo credit: IMPRI, YouTube.

While women occupy 70% of the healthcare workforce, only 25% of leadership positions in the healthcare industry are occupied by women.

A majority of caregivers especially for the elderly are still considered informal and are usually underpaid. It is also common for them to be harassed in various ways.

Professor Biswas noted that the social structures must be improved with regards to elderly care and insurance providing for the elderly and their health concerns must be better organized.

A Mental Health Perspective

Sailesh Mishra, founder and president of the Silver Innings and founder, A1 Snehanjali – assisted living elder care home, Mumbai, highlights that as women are relied upon for caregiving, their health and capabilities are taken for granted.

Sailesh Mishra. Photo credit: IMPRI, YouTube.
Mishra concluded that mental health policies specifically catering to women and elderly women is the need of the hour.

Space For Discussion

Professor Patel took to answering questions from the audience. On what we can learn from global policies and practices, he answered that Scandinavian countries have provided a great example by implementing paid care-giving work and care banks.

Self-help groups of senior citizen women must be encouraged in order to protect their interests and voice out their grievances.

The globalization of economic structures has contributed to the reduction of public-sector spending, and currently, only 1.2% of the annual GDP is spent on healthcare infrastructures. Geriatric care is the most neglected out of all of the provided services.

Patel concluded that an increased migration out of India means elderly family members are left to care for themselves. Social welfare and protection are of the utmost importance, and taking cues from Scandinavian social welfare structures would be greatly beneficial.

Dr Kumar thanked all of the speakers for their insightful discussions and concluded the session.

Featured image, taken from Pxfuel, is for representational purposes only.
You must be to comment.

More from IMPRI Impact and Policy Research Institute

Similar Posts

By Soumya T

By Ranjeet Menon

By Vaseem Chaudhary

Wondering what to write about?

Here are some topics to get you started

Share your details to download the report.

We promise not to spam or send irrelevant information.

Share your details to download the report.

We promise not to spam or send irrelevant information.

An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

Share your details to download the report.

We promise not to spam or send irrelevant information.

A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

Sign up for the Youth Ki Awaaz Prime Ministerial Brief below