Things we have learnt regarding the elderly in India

Danielle Cohen
By Danielle Cohen Immigration Law Solicitor Linkedin
Danielle Cohen has over 20 years of experience as a lawyer and a reputation for offering professional, honest and expert advice.
25 January 2023

In assisting elderly relatives from India we often seek the expert opinion of academics. In considering the conditions for elderly people we need to look at the social and practical consequences of living without support from children who are usually in the UK.

  1. Local medical facilities are not comparable to those in the UK, especially in remote areas.
  2. Covid 19 exacerbated the healthcare infrastructure across India and as a result obtaining treatment for non-Coronavirus conditions is extremely difficult
  3. The healthcare system in India is divided into two main sectors, the private and the public. The private consists of an amalgamation of hospitals and private clinics, usually in urban areas. According to the World Health Organisation the poor health infrastructure and insufficient Government funding means that the public Indian healthcare system is lacking in broad healthcare delivery and because of that the private sector has rapidly advanced its coverage among the Indian population.
  4. There is very little focus on palliative care in India, especially for the elderly, and according to the World Health Organisation palliative care is defined as “an approach that improves the quality of life of patients and their families facing the problems associated with illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual” (WHO 2018)
  5. In India there are no organisations or institutions who provide care for the elderly who live alone. This is largely due to the social structure and family culture that considers the parents should be cared for by their family members. Elderly people who have no family members are unlikely to receive state support.
  6. The family unit in India has not traditionally been “nuclear”. Rather, the household not only consists of the nuclear family, but also conforms to patrilocal make up, where numerous generations of family reside together.
  7. It is unrealistic for elderly parents to be supported by extended family members. The cultural expectation is that children should maintain the welfare of the elderly in India and that in turn has fostered a lack of state formulated policy addressing the social needs of the elderly in India.
  8. In terms of care homes they provide limited care options and often are just retirement homes and do not provide medical health and live in care for those with medical needs.
  9. The term of “live in carers” is very different to the ones in Europe. In India you will find live in servants but they are not trained in palliative care and are not qualified. Families will employ live in servants but their function is only to be for carrying out household chores and housekeeping duties. Therefore, live in servants are unskilled workers and there are no institutions that offer palliative care training.
  10. Current social attitudes towards mental health are not positive and there is stigmatisation of mental illness. Therefore, it is particularly important to obtain expert reports to provide a clear analysis of the circumstances of the elderly person living alone in India in every particular circumstance in terms of affordability, of private care, their medical needs, the suitability to care homes and the existing or non-existence of extended family members.
  11. It is important to understand the makeup of the Indian family in question and as there are no ready-made solutions to the particular emotional, physical and economic needs of elderly individuals.