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Category: Business

Autor: anton 11 March 2011

Words: 10086 | Pages: 41

Old Age Homes

–Why it can be a Lucrative Business Opportunity



In the Vedic times, human life of a hundred years was divided into four segments or ashrams. A seven year old was supposed to live in Brahmacharya - ashram / gurukul or a present day distant equivalent of a boarding school till his twenties. The second quarter of his life was to be spent as a householder or a Grhasthya. In the third quarter, he was to retire from routine household activities and set out into the forests, which was called Vanaprastha - ashram. This was the stage where contemporaries lived together, in probably what could be called a rough equivalent of a “retirement retreat”. The last quarter of his life was to be spent in his search for God and to be lived in “Sannyas” in complete renunciation.

We don’t live a hundred years today, but the rationale of retiring from hectic, routine life and moving into an area where one could finally, lead a healthy, peaceful life, and leisurely enjoy all that one has worked and earned for in his youth, is not a modern-day idea, but one borrowed from our roots in the Vedas.

An Aggressive Stance

Half a century ago, old age homes were looked at with antagonism and resentment. They were perceived to be a refuge for those helpless elderly victims who were “cast away” by brutally, ungrateful children.

Current Understanding

This idea is however changing rapidly. Today, a fair number of people opt to move into a retirement retreat, where parents of affluent children well settled abroad, live in a home which provides vigilant security, prompt state-of-art medical facilities, clubhouses for entertainment, and most of all an environment where people understand each other, connect and relate with their contemporaries and are well taken care of.

Future Trends

Demographic study shows that in the next 20 years, the number of senior citizens will grow vastly, with the average human life expectancy increasing, to further contribute to this sea of senior persons.

Financially, the trend is, the middle class moving towards the upper middle class, and upper middle class moving towards affluence.

The number of young people traveling globally for employment is also increasing multifold, due to globalization.

All of these, point in one direction – Well-heeled senior citizens whose children are physically away from parents. They have the financial resources to lead a good life, but not enough of a family to provide constant support. In this fast paced world, in order to survive, the youth needs to be constantly on its toes, and has an abundance of everything except time.

Besides, for issue-less couples, old age is a nightmare, and they are fraught with fear and constant insecurity.

In India, many elders find it outrageous seeking assistance from girl children, especially post marriage. Many cannot imagine living in their daughters’ homes. For those elderly couples with only girl children, life becomes very lonely and insecure.

An Attractive Option

This is where the best alternative is found in a retirement home, or retirement retreat. Extremely vigilant and complete physical security is provided, medical attention is provided almost immediately and round the clock, enough facilities are provided for entertainment, personal care is taken for individual diet and nutrition. All facilities are designed especially to suit the precise needs of persons in this age bracket. Most importantly people do not have to bear with complaints of being outdated, of not fitting into fast paced society, of not understanding and being unable to bridge the generation gap. They live in an environment harmoniously, where they can connect with people around them faced with similar problems.

The most important fact to be considered here, is that if all these facilities were to be provided privately, by a family it would consume immense amount of time, personal attention, would be monetarily extremely expensive, and very problematic for commutation to the different places, as these facilities would be available in disparate, scattered places. For eg, travel a distance to meet your friends, travel to the doctor - if the person is not suffering from a serious ailment, travel to the club, and so on.

It is a fast growing idea with a huge market. Although poor old destitutes do need shelter and should have separate, and very differently managed, old age homes for them at no or low cost, an old age home should no more be looked at as just a “charitable institution” or asylum.

It should be taken seriously as a lucrative venture. It should involve management as a career option just like in hotels and resorts.

This project will show how concepts from our age-old Vedic roots can be combined with modern thought to provide the perfect physical, material, emotional, psychological and spiritual solution to problems faced by senior persons today. This project looks into real-life issues that people have in moving into an old age home, and attempts to provide solutions to them through proper planning and application of effective management techniques. This leads us to a very lucrative option for organizational management.

Historic Genesis

Our Indian tradition regards the Vedas to be the fundamental scriptures of knowledge within which is encapsulated the art of living life, the right way.

In Vedic India, the ordinary family life was called a life of the hermitage (ashram or discipline). The family man knew that there were four ashrams or shelters through which he must pass – brahmacharya (celibate student life), grhasthya (married householder life), vanaprastha (retirement and contemplation) and sannyas (monastic life).

In the ancient times, every child, at the age of seven, entered a brahmacharya ashram or hermitage of discipline that was in charge of a wise guru or teacher; the child was thus freed from the more limiting environment of parents, family and social traditions. The children were not allowed to mix with materially minded people.

Up to the tenth year, the brahmachari was taught the scriptures and meditational practices. In his eleventh year he learnt the duties of a soldier for the protection of others. The following year he was taught business methods and the art of proper dealings in worldly affairs. The young man remained in his guru’s hermitage until in his twenties.

The second stage of his life then started. He returned to his family, took up a householder’s duties and begot children.

At the age of fifty, the man went back to the forest hermitage seeking fuller communion with God. This constituted the third or the “forest hermitage” state of life.

In this way, the individual first pursued spiritual and secular knowledge and practiced self-discipline, and with character formed, he entered family. He was mentally prepared to carry out daily, routine activities without getting overtly attached to them. It was

therefore simpler for him to handover the rights and duties of a householder to the next generation and to retire to the forest, when his children entered the householder’s stage. He gracefully and gladly exited worldly life, leaving responsibilities in the hands of the young, well assured that the world was in the safe hands of the well-trained brahmacharis-turned-grhasthis. Thus, giving half of his worldly possessions to his children and the other half to the guru’s hermitage, the man (often with his wife) retired to the guru’s ashram in the forest.

The fourth or final ashram consisted in complete renunciation of all worldly ties, and the man and his wife wandered and set out on pilgrimage all over India, receiving the veneration and hospitality of all householders and bestowing on all receptive minds, the pearls of wisdom gained from experience.

Translated into modern day life, the system suggests relocating home to an old age home or better still, retirement retreat, to be a practice best suited to comfortable living for those living the second half of their lives.

Aggressive Stance

Since a century, old age homes have sprung up primarily to serve one need – to provide shelter to old people who have no source of aid and find it difficult to live life alone.

Post retirement, old persons usually suffered from a financial crunch. Living expenses were high, the number of members in the family was large, and there were very few opportunities to save for the future. Government options and other initiatives to ensure a secure financial future were virtually non-existent. The elders of the family, therefore, were completely dependent on their children to provide physical, emotional and financial support and security.

As family life began changing, life grew to be fast paced and the concept of nuclear families emerged, the elders began to get isolated. Family values began to change and so did priorities. Incidence of senior members of the family, left uncared for, increased. There was now a need to shelter them and care for them in their last days. Thus, old age homes emerged as their saviour. Old age homes offered care, security, basic amenities, medicines and other essentials at low or no cost.

Old age homes were therefore, mainly for elderly destitutes who had no means to support themselves. It came to be perceived as a charitable organization. The inhabitants were therefore deemed to be in a pitiable condition.

Old age homes came to be looked upon as a home for those cast away. Old people dreaded them, because old age homes meant not only estrangement from loved ones but also symbolized rejection and ungratefulness of children.

All conscientious people, who cared for the elderly despised old age homes, and wanted to remove the need for them. They hoped that the elderly received enough love and support at home, so that the need for such institutions could be eliminated.

Current Understanding

There is now better understanding of the circumstances, which lead elderly persons to a helpless and vulnerable state of living.

Governmental efforts and private initiatives by major corporate houses are providing retirement plans to the elderly, to help secure a healthy financial future.

The Government efforts in this direction have taken shape in the form of Project OASIS

First Report of Project OASIS (Old Age Social & Income Security)

1. Introduction

The least noticed of the destitute in India are the elderly. Millions of elderly in India are trapped in misery through a combination of low income and poor health.

The traditional support structure of the family is increasingly unable to cope with the problem. In a world where the joint family is breaking down, and children are unable to take care of their parents, millions of elderly face destitution. The emerging demographic profile and socio-economic scenario of the country indicate that matters will worsen dramatically in the years to come.

While there is a need to initiate poverty alleviation programs designed to support the elderly, the gigantic dimensions of the problem defy an easy solution. The steady elongation of life expectancy and declining birth rates are inexorably taking us towards an India where there will be such a large number of aged persons, that a poverty alleviation programme, which aims to pay even a modest subsidy would require a staggering expenditure much beyond the capacity of the government.

In this situation, the Government realises that poverty alleviation programmes directed at the aged alone cannot provide a complete solution to the problem. Faced with such large numbers, it is apparent that the problem will have to be addressed through thrift and self-help, where people prepare for old age by savings accumulating through their decades in the labour force. The role that the Government can play in this enterprise is to create an institutional infrastructure to enable and encourage each citizen to undertake this task.

Project OASIS, the first comprehensive examination of policy questions connected with old age income security, took birth in this background. The basic mandate of the Project is to make concrete recommendations for actions, which the Government of India can take today, so that every young person can genuinely build up a stock of wealth through his or her working life, which would serve as a shield against poverty in old age.

It is interesting to note that India already has a high contribution rate to the provident fund system from amongst salaried employees in large establishments. The challenge therefore is not so much to ask workers to save more but to convert high saving rates into old age security. To this end, the Report of Phase-I of the Project recommends: (a) limit early withdrawals, (b) deploy superior financial portfolio management and information system, so as to obtain higher rate of returns, (c) expand the coverage of existing provident fund systems so as to reach more workers, and, (d) improve the customer service of the existing provident fund systems.

The topicality of the Project OASIS is enhanced by the fact that 1999 is being observed as the International Year of Older Persons. The Chairperson of the Committee, Dr. Surendra A. Dave, former Chairman of Unit Trust of India, and the members of the Committee have done well to have produced the Report of the first phase of Project OASIS in a short time-frame. The Project is being ably coordinated by the Invest India Economic Foundation.

Project OASIS is a project of national importance and we should all put our minds and energies to the task of rapidly converting the Committee's recommendations into reality.

2. Problems and Diagnosis

1.Economic security during old age should necessarily result from sustained preparation through lifelong contributions. The government should encourage fully funded old age income security systems that emphasize the values of thrift and self-help. The government should step in only in case of those who do not have sufficient income to save for old age.

2.The existing provident fund or pension programs accessible to Indian workers do not adequately solve the problem of income security in old age. For an individual retiring at age 60 with the prevailing balances (average Rs. 25,000), the provident fund system can only be a minor aspect of income security in old age.

3.The contribution rates of India's workers are already amongst the highest in the world. There is hardly any scope to transform income in old age by raising the contribution rate.

4.The central factor, which should be at work in saving for old age, is the steady compounding, at the highest possible rates of return, of contributions through a person's working life. This steady accumulation, without any withdrawal, can generate a stock of wealth at retirement, which may be entirely out of line with common intuition. For example, saving Rs.5 per working day from age 25 onwards leaves the worker with Rs.6,78,307 (measured in 1999 rupees) at age 60 at a nominal return of 12%. These numbers remind us that low contribution rates are not the essence of the problem. Today, in India, a contribution rate of Rs.5 per working day is possible for everyone above the poverty line and a person at age 60 with a

stock of wealth of Rs.6,78,307 would not be destitute.

5.The terminal wealth at age 60 is highly sensitive to the rate of return. An improvement of one percentage point in the rate of return - i.e. from 12% to 13% - yields a corpus at age 60 of Rs.8,74,065. This is an increase of 29% as compared with what is obtained at 12%. If the interest rate goes up from 12% to just 14.75%, it yields a doubling in the corpus at age 60.

Improving rate of return by such percentage points, without sacrificing long-term safety of funds, is possible by appropriate modifications in investment guidelines, and by entrusting funds to professional managers.

6.Such accumulation requires two ingredients: (a) high rates of return and (b) steady accumulation, without either withdrawals or interruptions to savings. The challenge lies in finding institutional mechanisms where individuals actually do save steadily through their working careers, and earn the highest possible rates of return for their wealth, so that the corpus created at age 60 is able to offer income security during old age.

7.The weaknesses of existing schemes lie in these two directions: low rates of return and poor accumulation. The rules governing withdrawal are excessively permissive, thus generating poor accumulation of wealth and a failure to harness the benefit of compounding over decades and provide enough for old age. When workers view their contribution as an escape from tax rather than savings that they benefit from, they would have strong incentives to withdraw early.

8.A similar problem is faced after age 60. We are increasingly in an environment where a worker at age 60 can expect to live beyond age 75. If wealth is rapidly spent away, then individuals may be destitute late in their lives. This process could be checked by access to a competitive market for annuities.

9.Systemic distortions and preferential treatment to certain provisions is undesirable and we need to strive towards creating an equitable environment and simplified provisions to encourage universal coverage both for employed persons as well as self-employed persons. Presently, contributions as well as interest earned of them are not taxed both in case of pensions and provident funds. But pensions, in the hands of, receivers are taxed whereas provident funds (including PPF) are not. This is a disincentive for contributory pensions and needs to be rectified. There is also a strong justification to tax receipts of accumulated provident funds.

10.Once the core problems of the system, which lead to poor accumulation of wealth at age 60, are adequately addressed, the incremental expansion of the coverage of the system would help raise the number of workers who save for old age in this


3. Empowering Provident Funds and Members

3. 1 Encourage Accumulations

1.Contribution rates to provident fund, pension and other social security systems (Employees Social Insurance Scheme and Employees Deposit Linked Insurance Scheme) are already quite high. The Committee is of the opinion that there is no need to step them up further.

2.Premature withdrawals should only be permitted in the event of permanent disability, death, or for specific purposes relevant for old age income security (e.g. housing). Individuals who opt for self-employment or take up employment at an establishment where provident fund provisions are absent, should be discouraged from withdrawing their accumulations

before age 60. They may transfer their accumulations to an Individual Retirement Account.

3.Premature withdrawals (before age 60) should attract a flat, 10% withdrawal tax deductible at source. This disincentive will also encourage members to consider alternative fund sources (banks, housing finance companies and medical insurance) to supplement their savings for other needs. Provident fund withdrawals should also be taxed at the rate of 10% after retirement over and above an initial exemption of Rs.1,00,000.

4.The portion of accumulations at maturity that are used for purchasing an annuity (from annuity providers registered with the IRA) or for other investments specified in Section 54E, should however be exempted from the 10% withdrawal tax. The annual income from annuities should however be taxed at prevailing rates.

5.Delayed receipt of provident funds should be permitted. While a member may stop contributing to the provident fund from age 60, he should be allowed to accumulate till the age of 65 - thereby enabling the member's accumulations at age 60 to further benefit from compounded returns - resulting in a larger annuity at age 65, should he decide to opt for it.

3. 2 Improvement in Rate of Return

1.The present concept of limited, assured returns should be abolished. Instead, returns should be determined from year to year depending upon annual earnings. This will remove the upper limit for returns over a multiple decade investment horizon to members and also eliminate the need for any potential government subsidy.

2.To encourage maximisation of returns on investments during accumulation, the present tax on earnings over 12% should be abolished.

3.Fresh provident fund accretions, as well as earnings from investment of existing funds should be managed by professional, competing fund managers registered with the Securities and Exchange Board of India (SEBI).

4.All exempted establishments should be mandated to engage a professional fund manager registered with SEBI, to manage their existing and incremental provident fund accumulations for superior returns and better risk management, and more effective governance.

5.Investment guidelines for exempted and non-exempt provident funds should be prudently liberalised and investment portfolios further diversified in order to obtain superior returns and better risk management. Trading of securities in the secondary market should be permissible. Initially, investment guidelines for fresh accretions as well as earnings from investment of the existing fund should be modified to allow investment of up to 20% of the funds into investment grade corporate debt and up to 10% in domestic equity. Domestic equity investments should initially be permitted only through index funds on either the NSE-50 or the BSE National indices.

6.The Boards of Trustees of exempt and non-exempt provident funds should be made more compact and effective. The Boards should generally not be larger than 15 persons, of whom at least one-third should have an advanced degree and/or experience in finance or economics.

3. 3 Increase in Coverage

1.The existing restriction limiting provident fund contributions to 177 industries/ classes of establishments should be abolished. All establishments should be covered by provident funds.

2.The minimum number of employees in an establishment should be lowered from 20 to 10, and eventually to 5.

3.The wage ceiling of Rs.5,000 should be abolished; all employees in eligible establishments should be covered.

4.Intensive efforts should be undertaken to educate people about the need for, and benefits from, security schemes, and not to

resort to early withdrawals.

5.These steps will collectively increase the number of establishments covered by provident funds by 0.26 million - thereby

benefiting an additional 6.25 million individuals who will become eligible for provident fund and the employee pension


3. 4 Others

1.Each provident fund member should be allotted a unique identification / account number spanning across all Provident Funds - for comprehensive portability of account during job changes and temporary unemployment.

2.Lump-sum contribution both by the employer and the employee for the last 3 month's installment (before retirement of employee) should be made mandatory to facilitate timely completion of administrative procedures and prompt disbursal of accumulations on retirement.

3.The "Provident Fund Account" should be renamed "Employee Retirement Account (ERA)'' to clarify its true objective.

4. Empowering the Employee Pension Scheme

1.The system of using competing professional fund managers, prudently liberalised investment guidelines, and improved governance covered in the previous chapter, should also be applied for pension funds. This will introduce specialised agencies for fund management (professional fund managers registered with SEBI) and for annuity provision (annuity providers registered with the Insurance Regulatory Authority).

2.The presently limited, assured returns should be replaced by market-determined rates of return.

3.The Government's contribution of 1.16% towards pension accruals should be gradually withdrawn over a period of maximum three years. In the interim, this contribution should be credited to the National Senior Citizen's Fund.

4.The vesting period for pensions should be 10 years. Breaks in contribution should be permissible - provided they are made up later with the correct interest penalty. Lump-sum topping-up by individuals, in case of a shortfall in the minimum contribution period, should be permitted.

5. Empowering the Public Provident Fund

1.The "Public Provident Fund" should be renamed "Individual Retirement Account (IRA)" to focus on its objective.

2.The provident fund system of using competing professional fund managers, prudent liberalisation of investment guidelines, and improved governance should also be applied to the Public Provident Fund. A professional Board of Trustees should be appointed to oversee the investment and administration of the fund.

3.The 10% tax on early and final withdrawals on provident funds should be applied to all permissible withdrawals from the PPF as well. As in the provident funds, this tax should not be levied on the portion of accumulations retained in the IRA for purchasing an annuity at age 60, or invested in approved instruments under Section 54E.

4.The rate of return should be market determined and there should be no tax on it.

5.The limit on the tax-free annual contribution should be raised to Rs.1,20,000, less contribution from an employer, if any. This would make the PPF equitable with PF (which allows Rs.60,000 tax-free contribution from the employee and a matching tax-free contribution from the employer. In fact, tax-free contribution from the employer could even be higher). This would remove discrimination in tax-treatment of self-employed persons vis-а-vis employed persons.

6.Branches of all commercial banks should be allowed to serve as PPF collection centres. A comprehensive publicity programme should be initiated to enhance awareness regarding the details and benefits of the revised scheme.

7.PPF should provide for an optional contribution for insurance against death and permanent disability.

8.A Public Pension Scheme (PPS) should be initiated under the Public Provident Fund. 10% of contributions to the PPF should be mandatorily earmarked for this new Public Pension Scheme with a minimum contribution of Rs.500 a year. The first Rs.500 contribution to PPF every year will go towards the mandatory Public Pension Scheme. Those desirous of contributing higher percentages can contribute more. As in the case of the Employee Pension Scheme (EPS), the vesting period should be 10 years. As recommended in Chapter 3, breaks in contribution should be permissible and lump-sum contributions in case of short-fall in the minimum contribution period, should be permitted. Those who are members of any other pension scheme, on submission of documentary evidence, may be exempted. The quantum of pension would be determined by the accumulation to the credit of the subscriber at the time of retirement, death or permanent disability.

6. Annuities

1.Presently, the function of accumulating wealth and selling annuities are both bundled into existing provident fund institutions.

2.Annuity provision will be more efficiently achieved by a market with competing annuity providers registered with the Insurance Regulatory Authority. The Government should work towards obtaining a thriving, competitive annuity market where private, public and foreign firms compete in selling the cheapest annuities to India's citizens.

3.At age 60, the worker would accumulate a stock of wealth. On the principle of avoiding double taxation, the part which is put into an annuity should be tax exempt. The remainder, subject to the exemption limit, should be taxed at a 10% rate. The annual income obtained from the annuity should be a part of taxable income.

7. National Senior Citizen's Fund

1.There is growing awareness and concern about the case of elderly persons in society. If at all, the problem appears to worsen in future if timely measures are not taken in present. The problem, geographically, is all pervasive and of large magnitude. This should be a concern of all individuals, corporates, the private sector, as well as the government. The government should take a lead in galvanising all these efforts. Towards this end, it is proposed to set up a National Senior Citizen's Fund with a view to encouraging, catalysing, and complimenting all private sector efforts for the betterment of life of senior citizens in the country. The Fund can also be utilised for educating individuals about various security schemes, conducting research into areas concerning senior citizens and building infrastructure relevant to the social security industry.

2.The present contribution of 1.16% by the Government of India to the Employees Pension Scheme should be channelled into this fund as initial corpus till this contribution is gradually withdrawn. A part of the withdrawal tax on provident funds may also be transferred to this fund annually.

3.The fund should be monitored and administered by a Board of Trustees appointed by the Ministry of Social Justice and Empowerment.

Corporates such as ICICI Bank, LIC have exclusive retirement savings schemes and pension options.

Companies provide employees with gratuity, pensions, annuity plans, severance pay in the Voluntary Retirement Scheme and other such packages, which help ensure a reasonably fair sum of money in the hands of the retired employee.

Another major change occurring is the understanding that Old Age Homes are unavoidable. It is no use fighting their existence. Efforts have to be taken to make them more habitable and friendly and provide the comforts that are denied to the elders, back home.

This understanding has led to Old Age Homes being considered very seriously. Efforts are now taken to plan their establishment, and comprehend and fulfill the needs they are meant to serve.

Important Considerations of Old Age Homes

Why choose to live in an Old Age Home?

Many factors have contributed to the alienation of the elders.

• Migration of young couples from the rural areas to cities in search of better employment opportunities to fend for themselves.

• Elders who have been in control of the household for a long time are unwilling to give up the responsibility to their children.

• Youngsters on their part are sometimes resentful of the attitude of their parents.

• The joint family system has broken down leading the youngsters to stay away from their parents most often leaving the elders fend for themselves.

• Many youngsters have moved to places far away from their native homes and in the recent past to many countries abroad. So even if they want to they cannot accommodate their parents in their own homes.

• Elders are sometimes too incapacitated or unwell to look after themselves or get medical care especially in an emergency.

All these have made the old age homes seem more relevant in the Indian context than ever before.

What are the types of Old Age Homes in India?

There are two types of Old Age Homes in India. One is the "Free" type which cares for the destitute old people who have no one else to care for them. They are given shelter, food, clothing and medical care.

The second type is the "Paid" home where care is provided for a fee. Nowadays, such "Retirement" homes have become very popular in India and they are well worth considering.

Basic characteristics an Old Age Home should possess.

Where should an Old Age Home be located?

An Old Age Home should have a calm, pollution free environment and all other basic necessities just as any comfortable housing project.

It could be located in a rural or urban setting depending on the type of people expected to live in it. While some people may like quiet idyllic surroundings, others may prefer an urban area where they have quick access to facilities in the city.

How should an Old Age Home be designed?

Old Age Homes could be the dormitory type, independent rooms or cottages depending on the social and economic status of those who are going to live in the homes. The rooms should be well ventilated.

What could be the participation of the residents in the running of the home?

The residents should be encouraged to participate in the day-to-day activities of the home, which may be anything from cooking to maintaining the cleanliness of the home. They could also periodically organize celebrations of various festivals and social events.

Facilities for taking up jobs

Many of the retired Indians have invariably borrowed heavily on their retirement funds to conduct their daughter's marriage or for some such expense. Invariably they are not able to pay this back.

For all these reasons it may be necessary for the elderly to find a definite source of income for themselves.

But a career is not for economic reasons alone. It keeps the elderly physically and mentally occupied, and in turn helps them to lead an active life. It also increases their self-confidence and esteem. So even those who are financially comfortable can decide to take up a career and enjoy the benefits of healthy living.

Basic facilities an Old Age Home should provide.

How should an Old Age Home be designed?

As much as possible all facilities in the home should be at the ground floor level. If upper floors have to be built then a sloping ramp has to be provided which would also facilitate easy passage of wheel chair when needed.

The toilets and bathrooms should have rough flooring (anti-skid) so that the elders do not slip. Suitable railings should be provided for support. A room should be set apart where sick people needing short-term treatment could be housed.

Recreation rooms and rooms for medical care should be built.

Who are the people required to work in an Old Age Home?

A home for the aged will need an administrator who will be responsible for the running of the home.

Supporting staff such as clerks, cashier cum accountant, nursing staff, attendants, maids and a cook are the basic required staff for the efficient running of an old age home.

A medical officer will be needed to attend to the health needs of the inmates. If the home is very close to a hospital where emergencies can be treated then, it may be enough to avail the services of a Doctor, who works there part-time.

A nutritionist can play an important role by providing special attention to the nutritional requirements of the residents. At least a part-time nutritionist should be appointed.

A professionally qualified social worker is an essential member of the team of personnel.

Wherever possible nursing staff and health care workers trained in Geriatric care should be appointed.

What are the requirements for medical care in such an institution?

All medicines and medical accessories that may be needed for treatment of the residents should be stored as per the advice of a senior physician. For eg: Oxygen cylinders, suction apparatus and intra-venous sets should be readily available. Drugs should be replaced periodically, considering their expiry date. Transport facilities should be available in case there is a need to rush them to the hospital for intensive care.

What are the other facilities that could be provided in an Old Age Home?

Recreational and reading facilities such as, televisions, video players, newspapers and books should be available. Depending on the extent of the physical activity of the residents other facilities for active sports such as tennis, table tennis, squash can be provided. Depending on the need billiards and card tables and other entertainment facilities can be provided.

In today's context computers with internet connections are more a necessity than an option especially to receive and send e-mail to the near & dear. The ability to browse the world wide web will allow the residents to be informed and mentally active.

Keeping in mind all of the above, today several institutions are helping the aged.

Some institutions that have been carrying out exemplary service are:

St. Anthony’s Home for the Aged.

Helpage India

Dignity Foundation

Of these, Old Age Homes for the Poor, where the admission is given free of cost or at a very low cost, are

St. Anthony’s Home for the Aged.

Helpage India

St. Anthony’s Home for the Aged. Bandra

Clarist Franciscan Sisters of the Most Blessed Sacrament

An interview with Sister Angela, the person in charge of the Home, herself in her late 60s, revealed its functioning, right from its early beginnings in 1972.

The interview: (My questions in Italics followed by Sister Angela’s answer to it)

When and how was the Home started?

The home was started in 1972, by the Archbishop of Mumbai. Clarist Franciscan Sisters had begun with other Homes in Calcutta for the destitutes and orphanages. The need for an Old Age Home was felt in Mumbai, and the Archbishop started one in Bandra.

Are Old couples admitted in the Home?

No, it is a home for only widows and spinsters. Old single women either widowed or spinsters are more helpless and vulnerable and need greater care and security than old men, or old couples. So such women are cared exclusively for, in this Home.

How many women can be housed in the Home?

There are about 10 rooms and 4 residents per room. At present 38 women live in the Home. One room is reserved for mentally unstable women, or those who need special care or isolation. There are only 2 residents in this room.

What is the admission fee to be paid by the residents?

Each resident is expected to pay about Rs. 2,000 per month, which is worked out to be the expenses incurred in food and electricity. When the residents are unable to pay the amount, the expenses are covered by the grants received from the Trust and from donations. However, the residents are expected to pay as much as they can. They are not allowed to hoard their little money to give away to their children, at the cost of payment for services received at the Home.

What are the services available here?

Local doctors undertake regular medical check-ups, every once in 3 days. In case of emergency they are available on call, 24 hours.

There is an inhouse library.

Food, clothing and shelter are available.

Frequently, clothes and other necessities are donated by locals.

Regular counseling and Bible and Gospel reading are undertaken, especially during critical times. Admission into a Home, news of death in the family or death in the Home and other depressing acts by family, such as an inattention, uncaring attitude, are moments of depression and pain. During these times, there is a need for the attention of the psychiatrists and counselors and the priest gives sermons on the Bible and Gospel, to build hope, courage and faith in God. It provides them a crutch and emotional anchor.

What is the daily schedule of the residents?

They ladies wake up in the morning at 7. After their morning ablutions, they assemble at the hall for prayers at 8:30. After the prayers, they wash up and assemble in the mess for breakfast at 9:30. Post breakfast, they retire to their rooms for some rest. They may read, knit, walk around in the garden, etc. Lunch is at 12.30, after which they retire to their rooms for an afternoon nap. Visiting hours for family is from 4 to 6. After snacks and tea at 4, neighbourhood volunteers come to the Home to spend time with them. They have yoga and light stretching exercises. Some people come and sing at the hall, and entertain the elders. Evening prayers are conducted at 6 after which light dinner is served at 7:30. They watch television or chat till about 9 and retire to bed.

They are constantly kept busy, because it is the best way to keep boredom at bay and to reduce self-pity and brooding.

What is the external aid received by the Home?

Rotary clubs donate generously. Several people from the neighbourhood donate grain, supplies, etc. Salman Khan, the movie actor, had auctioned an award and donated the proceeds to the Home. After this incident, several other people also came forward to donate to the institution. All donations receive tax rebates.

Sister Angela concluded with saying, she would be happier if the children of elders cared for their parents and the need for an Old Age Home did not arise.

Helpage India

HelpAge India is a registered national level voluntary organisation. It was formed in 1978 with active help from Cecil Jackson Cole, a founder member of Help the Aged in United Kingdom. HelpAge India is one of the founding member groups of HelpAge International, a high profile body of 51 member countries representing the cause of the elderly at the United Nations.

HelpAge India aims at fostering welfare of the aged in India and raising funds for projects that assist the elderly. It also aims at creating awareness among the younger generation about the problems of the elderly. HelpAge India supports nearly half the old age homes in the country. Every October 1st, Elders Day is celebrated with get-togethers and fun filled programmes in Chennai. A beauty pageant is conducted for grandmas and grandpas from all old age homes in Chennai on that day.

Other important activities conducted are:

Ophthalmic Care Free cataract operations

Mobile Medicare Taking medical care to the doorsteps of the elderly

Adopt-A-Gran Scheme Linking elders with sponsoring families/organisations

Day Care Centres Day care and support to the elderly

Income Generation Programmes Micro-credit to promote elders’ independence

All donations are exempted under sections 35AC and 80 GGA of Income Tax Act 1961.

Paid Old Age Homes, which are usually private institutions, provide a lot of additional facilities and comfort to the elders.

One such Institution is Dignity Foundation.

It carries out several activities to provide a comfortable living to elders, who are financially well-off, or are being sponsored by financially-sound children.

This occurs mainly when children are working abroad, and the NRIs want their parents to be safe and well taken care of. Many times, elders do not wish to leave their home country and decline their children’s invitation to live with them abroad.

At such times, private institutions provide the solution to care and security and companionship of contemporaries.

Dignity Foundation

In April 1995 an organisation was set up to cater to the needs of the elderly, starting with the publication of the magazine Dignity Dialogue. In a year's time this organisation eventually grew to add services along with the magazine and came to be called Dignity Foundation. The Foundation is premised upon scientific developments in the fields of Geriatry and Gerontology. It offers structural opportunities to exercise the choice of how to live young in chronologically advancing years

Dignity Foundation was formed to help senior citizens lead productive lives in their post-retirement old age. The foundation manages a number of programmes that encourage people to face the ageing process with confidence and dignity, emphasizing that old age does not imply an unproductive life, helplessness, hopelessness or haplessness. Some of the foundation's successful projects include Dignity Dialogue magazine, Helpline, Companionship, Second Careers, Computer Training, Cleaning Mumbai, Homes and Green Guards.

The Dignity Foundation is a registered public trust recognised by the Charity Commissioner and is entitled to benefits of Section 80(g) of the Income Tax Act. The growing activities of the foundation today need external funding, partnerships and people. Dignity Foundation has a team of experienced people to manage its operations and provide vision for its growth.

1. Mission Statement of Dignity Foundation

 We will provide opportunities that inspire and motivate Seniors to lead active and meaningful lives post-retirement

 We will facilitate seniors to derive self-esteem i.e., dignity, through involving themselves in activities that promote "successful" ageing.

 We will provide best-in-class social support systems (Elder Care, Housing, Companionship etc) that deliver care facilities for families where none exist

 Provide a wide range of innovative services designed to enrich every aspect of the lives of Seniors.

2. Objectives

 Provide information to seniors through publishing, holding seminars and discussions

 Undertake various services for their support and welfare and enable them to live productive, meaningful and interesting lives, drawing upon their knowledge, skills and experience.

 Construct a database to determine needs of senior citizens in India and devise ways to meet them

 Build awareness by dissemination of such data.

 Institute services that cater to needs.

 Mobilise senior citizens into an identity group.

 Undertake advocacy with government and public welfare bodies.

3. Milestones

In Research Database:

 Documentation of views of seniors on productive ageing

 Case studies of elder abuse

 Case histories of loneliness and depression

 Attitudes on marriage and remarriage, housing, investments, second careers

In Dissemination:

 63 Practical Life Changing Tips @ Rs. 10/-

 12 issues of Dignity Dialogue per year @ Rs. 30/- per issue

 Grandma's Remedies @ Rs. 10/-

 Yogasanas for Dignitarians @ Rs. 10/-

In Services:

The goals of the Foundation are two fold. One is to rid the minds of the senior citizens of the fear that age means decline and retirement means loneliness, isolation, loss of prestige and so on. The Foundation works assiduously to re-instill in the elderly minds the confidence that age and productivity are not mutually exclusive. It does this by utilising their experience and maturity in activities that serve the needs of the community. The other goal is achieved by attending to the needs of the elderly whose social support systems have weakened or are non-existent.

The philosophy of productive ageing propagated by Dignity Foundation has found practical acceptance in a very large measure in Mumbai city and other cities that have a clientele of magazine subscribers. In Mumbai alone over a thousand senior citizen volunteers participate actively in the services provided by the Foundation. The volunteers range in age from 50 to 85 years.

4. Management

Dr Sheilu Srinivasan, Founder-President : An MA & PhD in Social Sciences/Social Work, Dr Srinivasan has been Corporate Manager, Macmillan India and Head of Publishing Division, Tata Institute of Social Sciences before starting Dignity Dialogue magazine which expanded to become the present Dignity Foundation.

TC Narayan, Chief Executive : He has been Director, Inchcape Group Company, Director of Shaw Wallace & Company, Managing Director of a $200 million Fertilizer project, Group Vice-President of an international financial institution based in Singapore and Chairman of P&O Company, before dedicating his time and experience to the cause of senior citizens.

The Foundation is managed by professionals in the field of Management, HRD, Social Work, Psychology, Sociology, Marketing, Editing and Printing and Finance.

5. Finance

Dignity Foundation is funded by subscriptions to the magazine - Dignity Dialogue, fees for membership of the Foundation, donations from philanthropic organisations and individuals and sponsorships from banks and companies for specific projects.

The mobilisation of a financial corpus for the Foundation is the crucial need of the day. The nucleus of a corpus has been set up with the help of donations. The Central Government has given permission to the Foundation to receive donations from abroad under the Foreign Contributions (Regulation) Act. Many individuals have registered their support for the cause.

Donations to the Foundation enjoy the benefit of Section 80-G of the Indian Income Tax Act.

i. Dignity Network

Acceding to persistent demands from outside Mumbai the Foundation has opened Chapters in Calcutta, Chennai, Jamshedpur and Delhi.

There are 8 centres in Mumbai and 11 in Maharashtra.

The current programme of Dignity Foundation includes:

ii. Dignity Dialogue

A monthly magazine, Dignity Dialogue focuses

on issues of relevance to senior citizens including information on health, alternative medicine, hobbies, second careers, financial management, yoga, philosophy, among many others. It also details the activities and programmes of the foundation, profiles eminent senior citizens and provides a forum for discussion on productive ageing.

iii. Dignity Second Careers

Dignity Second Careers was started as a separate division of the Foundation with the objective of enabling people over 50 years of age to seek a productive occupation of their choice that would enrich their lives before and after retirement. During the first career it is possible that the job satisfaction gets overshadowed by other pressures and compulsions. A second career allows the precedence of job satisfaction over other needs.

Retirement is yet another situation that is daunting for the person who has been working for long years. The transition from a busy working life to retirement can be traumatic. For women after all the productive years of home making there is an opportunity out there to actualise their desires to contribute to the economic mainstream. Nothing comes easy but seeking a career outside the home even after 50 is made possible through Dignity Second Careers. Productivity that will keep the mind and body agile is what Dignity Second Careers is all about. It means finding employment to suit one's particular needs in terms of time, interest and compensation.

Through Dignity Second Careers, we provide:

 Opportunities to explore career options.

 Job placements.

 Core consultancy enrichments.

 One man business opportunities.

 Pursuit of a passion/hobby.

Dignity Second Careers maintains a database of such senior citizens and organisations that would be willing to employ them and sets up interviews and assists in placement.

iv. Dignity Computer Training

Dignity Foundation, encouraged by the interest in senior citizens to learn computers, has tied up with a number of computer education institutes to conduct training programmes especially for senior citizens.

v. Dignity Civic Service

The BMC-Dignity Foundation "Joint Venture" Agreement

In line with Dignity Foundation's practice of providing structural opportunities to senior citizens for productive ageing, an Action Plan was worked out with the Brihanmumbai Municipal Corporation (BMC) towards the objective of 'Keeping Mumbai Clean'. If a small city like Surat can achieve unprecedented success in cleaning up the city, so can Mumbai through senior citizens who can give the lead - that was the reasoning behind the programme.

1. Dignity Foundation (DF) has appointed from its subscriber database a total of 663 Dignitarians corresponding to 221 Zones of BMC spread over 23 Wards (now 24). It has appointed 23 Chief Dignitarians who lead and monitor the activities in each of the 23 Ward areas (as of 2002 only 20 out of 23 ward groups are active.)

2. The Chief Dignitarian in each Ward is responsible for mobilising, coordinating and reporting action initiated. He also initiates discussion for new ideas, improvement programmes, grievances, and solution by consensus.

3. The Chief Dignitarian also liaises with the local Ward Officers and undertakes supervisory roles wherever required - staff attendance, spot guidance to staff.

4. DF coordinates Reports from all 23 Wards, and submits to BMC:

a. Remedial and rectification action plan and implementation - results of group discussions that the Chief Dignitarian has in his/her Ward. Handling of garbage in assorted bags (degradable and non-degradable) and instructing residents to act accordingly, ensuring everyday clearance of accumulated garbage, responsible disposal of debris from building /road construction, measures for controlling the choking of drainage holes, and other cleansing work will be the first priority.

b. Suggestions for new/beautification ideas, and funding proposals using local initiative - planting of trees, introduction of potted plants, creation of localised manure through conversion of available garbage and other related activities.

c. Problem areas that require official intervention, and those that cannot be handled by residents alone.

5. DF has appointed one One Project Director and 2 Deputy Project Directors to help ward Dignitarians to organise and extend timely volunteer help to the Corporation.

6. Magazine Dignity Dialogue regularly originates articles promoting civic sense, report the progress of the Dignity Civic Service, recognise important contributions of local Dignitarians and instill in them a sense of pride in keeping their Ward clean. Regular reporting of Awards Winners and the actual stories that go along with the cleaning campaign will get published.

vi. Security with Dignity

One of the most distressing problems facing the senior citizens in the city of Mumbai is violence and murders at the hands of workers who frequent their homes. Most senior citizens who live alone in the city or who are on their own for the greater part of the day, become vulnerable to such attacks.

Through constant lobbying Dignity Foundation was able to succeed in getting the Govt. of Maharashtra to release an elaborate action programme called, "The Government Protection Programme" .This programme is operated by Dignity Foundation in co – ordination with the Mumbai Police Department.

The programme was launched on World elders Day – 2nd October 2003 in the presence of our Deputy Chief Minister, Hon. Chhagan Bhujbal and the Sheriff of Mumbai, Mr. Kiran Shantaram at the BSE auditorium.

Dignity Foundation has raised a group of Volunteers called "Security Wardens". As in the other services, the wardens are drawn from Senior Citizen population. They are all members of the foundation. Extreme emphasis is laid on Screening in the right volunteers. Therefore volunteers are only selected on the basis of how they have been assessed on an assessment test and after rigorous background checks and police verifications.

The whole operation is based on the Mumbai Police Model. Just as the Mumbai Police is divided into Regions, Zones, Divisions and Area Police Stations, the Security Wardens are operating in the same hierarchical model. Each police station has 10 security wardens attached to it, who coordinate with the police officials of that station. A group of police Stations in an area form a division, which is headed by the divisional warden. A zonal warden manages all the divisions that fall under a zone. A regional warden is in - charge of all the zones that fall under his / her region.

All wardens manage the ground - work i.e. the data collection that is required of them. They are required to gather information about how many senior citizens reside alone in the area or are alone for the greater part of the day. Gather detailed information about their daily routine, who are the people that visit their homes on regular basis, a list of the service providers that frequent their homes (dhobis, milkman, plumber maidservants hired help etc) and if possible get them registered at the police station.

Complete confidentiality of all information is maintained at all times. The information is passed on to the corporate volunteers attached to each police station, who prepare the database, which is maintained at Dignity Foundation. The information is made available to the police only when the circumstances demand of it. Apart from this, the wardens are instrumental in organizing monthly meeting for the senior Citizens with the police Officials of their area.

vii. Dignity Green Guards

Aimed at greening Mumbai city, this programme will be managed by volunteers who will provide free saplings and help maintain public gardens, parks and other open spaces.

viii. Dignity Companionship

A unique project, Dignity Companionship has enrolled a number of young and old people as volunteers. The volunteers visit lonely senior citizens, spend time with them, help out a little and provide companionship.

ix. Dignity Helpline

The helpline is an 18-hour service to address distress calls from senior citizens facing problems. Calls are attended to by trained volunteers who give the callers a patient hearing, counsel where possible and try to help out even if it means paying the person a visit. A trained psychologist is also available should there be a need for advanced counselling.

Dignity Helpline started as a telephonic extension to the Dignity Companionship service. The nature of emergency help for elders in difficult circumstances has changed the functioning of the Helpline. It is today dedicated exclusively for the help and rescue of older persons. Distress calls from elders seeking assistance are handled by a qualified social worker. Everyday Helpline receives 8-10 calls of elders who are being:

- Abused

- Harassed

- Neglected

- Denied their rights

The trouble may be with their children, relatives, neighbours, institutions etc

The nature of help rendered:

x. Volunteers

Dignity volunteers are themselves senior in age. There are about 500 of them in three cities. They receive training in simple skills of counseling and help rendering.

The volunteer is there to

- Assist

- Guide

- Be a support

- Involve the client in meaningful activities

- Enrich their lives

- Help promote interests

- Encourage meeting with other people

The volunteers through their regular interaction with the client and their families help to first identify the areas where changes can be made to eliminate their loneliness.

Dignity volunteers found that in many cases their counseling by itself was not enough. Other types of additional assistance are often required for an effective and speedy redressal of grievances. The following referral network has been put in place to deal with the above problems:

 Legal aid

Lawyer's help to advice Dignity Foundation as well as the victim on matters relating to property, will, nomination, transfer, name change etc.

- A group of lawyers are available at regular intervals for consultation to the distressed parent/s.

- Assistance has also been provided in successfully bringing to the notice of the High Court, the agony suffered by the aggrieved parent/s who have filed cases of harassment, trespass, etc. but had not had a hearing for as long as twenty years.

- Legal assistance is also provided in the form of informative articles, which find a regular place in the magazine Dignity Dialogue published every month.

 Reconciliation forum

It has been set up with a view to expediting the solution to legal problems and helping the parties avoid expensive and time-consuming litigation. The forum consists of retired members of the higher judiciary, civil and police service and a psychiatrist / psychologist / counsellor and social worker. The forum meets to study selected cases presented by Dignity Foundation after all possible channels of negotiation have been exhausted by the Foundation volunteers & staff. These are usually cases that could have a conclusion and benefit from advice and pressure from an eminent group of persons.

 Police assistance

The Police Commissioner's Office in Mumbai and Chennai have directed all the police stations in Mumbai and Chennai that elder abuse cases brought in by the Dignity Foundation volunteers need to be attended to on top priority. This has already proved very successful. Children / relatives have, in most cases, been effectively prevented from inflicting mental and physical torture on their parents

- Police help to warn the errant "child" to treat the parent better. Police authority is also used to provide emergency assistance and rescue from imminent abuse.

- The second move by the police in Mumbai has been to request the Foundation to institute Chapter Case proceedings with the help of the Asst. Police Commissioners who have special magisterial powers to bind the errant son/daughter/caretaker to good conduct.

 Psychological Assistance

A Psychiatrist's / Psychotherapist's/ Counsellor's help is sought for dealing with the psychological problems that are common among the abused parents or in helping the parent cope better with the circumstances. Clinical assessments are made on the basis of which recommendations are given.

xi. Govt ID Card for senior citizens

In the developed countries of the West and East senior citizens are treated with much care and concern, giving cognizance to their special life circumstances. Almost all western countries issue Identity Card and the card entitles senior citizens to special concessions and benefits.

For the first time in India an all-purpose ID card was issued by the Chief Minister of Maharashtra in a function organised by Dignity Foundation and Rotary Club of Bombay Pier in 2001.

In a meeting with the Chief Minister Dignity Foundation functionaries had impressed on him on the need to introduce the ID card with a view to establish the senior citizens' identity required in many places. The card will also serve as a medical aid card, a necessity in these days of violence and attacks. The Chief Secretary had directions from the CM to examine and follow up the idea. Under his instructions, the Ministry of Social Welfare arranged for the issue of ID card against payment of Rs. 30.

Administrative charge has been vested in Dignity Foundation and FESCOM - two NGOs who took the initiative to work for the issue of cards.

Celebrating this "victory" the senior citizens came together for a 2000-strong Rally starting with the NOVARTIS WALK on Marine Drive for the Elders Day.

Since much of their physical security rests with the Police, the senior citizens seized the occasion to tie a "Suraksha Bandhan" to Police Officers invited from all the 79 Police Stations in Mumbai.

xii. Senior Citizens Counselling Centre

A Single Window Source of Counsel in all matters relating to Senior Citizens

In a major step to cater to the needs of the elderly Rotary Club of Bombay Pier and Dignity Foundation together set up the Senior Citizens Counselling Centre in the Dignity Foundation premises.

The subjects on which the elderly can seek free guidance include:

 Finance (Taxation, investment, investor complaints, Credit cards etc)

 Legal (Property, will, divorce, harassment, fraud etc.)

 Insurance (Life, General and Medical)

 Medical (General health, arthritis, blood pressure, eye, diabetes etc.)

 Psychological counselling

 Property purchase

 Homes - Old Age homes

 Travel assistance and bookings -- Air and train

 Security Alarm provision

Dignity Foundation gives seniors the freedom to walk in and walk out of the organization at any time.

Future Trends

Old Age homes are changing into Retirement Retreats. Instead of being forced by circumstances and family to move into an Old Age Home, which just about takes care of basic essentials of elders, future trends suggest elders choosing to move into a Retirement Retreat which provides a one stop solution to all facilities and services exclusively tailored to suit the special needs of senior citizens.

One such institution, which intends to provide these services, is Dignity Foundation.

Rationale behind Dignity Foundation

People work hard all their life, hoping that someday they can put their feet up on a sunny porch and do nothing more than read a book. But when that day does arrive, they start missing the frenetic pace - feeling left out and without purpose. Suddenly, they don’t want to slow down. They wish they could turn back the clock, and start rushing again.

However prepared they think they are for retirement, the reality is very different, and the emptiness looms large. That period of their life that they yearned for all their working years, does not seem to hold the same appeal anymore. They begin to feel this is beginning of old age, and it’s downhill from here.

Dignity Lifestyle looks at retirement from a whole new perspective. Not as the onset of old age where one settles comfortably into a rocking chair, but rather, the beginning of an ‘active’ new lifestyle where one can deploy one’s skills to serve society, and feel gainfully employed once again. One could, for instance, manage one of Dignity’s village development projects, or assist in running the township.

Loved ones may look after seniors and tend to their physical needs, but they are

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