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Caring for the Aged - Good Practices by International Longevity Centre - India, Pune



The International Longevity Centre-India (ILC-I) is a voluntary organisation working for the cause of population ageing since 2003. It is one of the fourteen members of the Global Alliance of the International Longevity Centres whose other members are the United States of America, the United Kingdom, Israel, Japan, the Dominican Republic, Argentina, France, South Africa, Netherlands, Singapore, the Czech Republic, Brazil and China.

Headquartered in Pune in the state of Maharashtra, ILC-I was founded thanks to the vision of late Dr S. D. Gokhale, a social scientist of international repute. Under his guidance, ILC-I played an important role in mobilizing the aged and implementing innovative ideas for creative and quality ageing.

ILC-I initiated many activities with the aim of promoting healthy, productive and participatory ageing. The three projects by ILC-I, Pune, namely Aajibai Sathi Batwa (Sachet of Medicines for Grandmothers), 'Elder Volunteers' Bureau and Athashri Housing Project for the aged are examples of how quality of life of the elderly, particularly elderly women, can be improved.

Project 1- Aajibai Sathi Batwa (Sachet of Medicines for Grandmothers)

Description
This is a unique field project providing partial medical assistance to needy elderly women through sponsorship. The project is being implemented in the slum areas of the city and is benefitting elderly women from the underprivileged section of society. These women are amongst the most vulnerable in the elderly population and have no money to buy medicines for themselves.
In traditional Indian families, the ‘aajis’ (grannies) would have a ‘Batwa’ (small bag) of homemade herbal medicines which they would dispense to members of the family when they fell ill. Today however, the situation is such that many of these aajis do not have money to buy medicines even for themselves.
This is particularly true in the low income group families where feeding the family and education are the priorities. As a result, the medical needs of the elderly are neglected. It is to cover the medical needs of these poor grandmothers that ILC-I is running this project.

Implementation Strategy
Based on extensive surveys and visits to slums and communities of Pune, the aajis in need of medical support are identified by the Programme Coordinator of ILC-I and their names are entered into a database. The primary criteria for inclusion are: they are living alone or with their spouse; are widowed and have no family support; are physically challenged; and even if they live with their family, their medical needs are neglected.
The database is maintained at the ILC-I office, so that upon getting a sponsor, the aaji is selected and the sponsorship commences. A sponsor provides support of Rs. 6000 per annum for an aaji.
Under the project, a network of doctors and chemists from near these communities has been created known as ‘Jyeshthamitras’ (friends of the old). These Jyeshthamitras have agreed to provide their services at nominal/concessional rates. All the expenses incurred by the aaji up to Rs. 6000 p.a. are reimbursed to the doctors and chemists on a monthly basis after submission of their bills.
Two health cards have been designed by ILC-I, one of which is with the aaji and the other with the chemist. The aaji carries her card with her when she goes to the doctor. The medicines are prescribed on the health card which she then takes to the chemist who enters the details on his copy. Thus the aaji does not have to pay any money. The aajis are also counselled by the ILC-I in-house doctor and Programme Coordinator. Bi-annual progress reports of the aajis are prepared and sent to the sponsor, giving details about the medical report and status and the doctors are also informed about the progress to maintain records and keep the sponsors informed.

Project 2 - Elder Volunteers’ Bureau

Description
Being active is the best way to keep ailments and loneliness at bay in old age. The experiences of the senior citizens are a treasure trove and valuable to the society. The Elder Volunteers’ Bureau is based on the concept that the elders are still capable of work and by using their experience and time they will not only contribute to society but will also get independence and dignity.
ILC-I launched the pilot project in 2003 and ran the project for few years. It has now been handed over to Athashri Foundation, a voluntary organisation by Paranjape Builders who takes care of the resources. The project is still mentored by ILC-I.
Over 300 senior citizens are part of the project run in the city limits of Pune, of whom 160 are women.

Implementation Strategy
Elders can register with the Volunteers’ Bureau, providing details like name, age, address, contact number and the type of voluntary service they are interested in. The first step after registration is to match the skills of the volunteers with the agency where the voluntary work is to be done.
Under this project, the senior citizen volunteers can offer their services for a minimum of two hours a week after registering with the bureau. Care is taken to ensure that the place of work is reasonably close to the volunteer’s residence. An orientation is given to volunteers and NGOs about the nature of work, cooperation, expectations and possible problems.
The services offered to the senior citizens under this program are:
  • Volunteering in hospitals
  • Reading and writing for bedridden patients
  • Spending quality time with patients, residents of old age homes, orphanages
  • Offering their services to residents of the homes for the disabled, doing simple daily chores for seniors who are frail and ill and living alone, or helping out with advice on financial and legal issues etc.
  • Volunteering at the Helpline for the senior citizens at the Pune Police Commissioner’s office
  • Volunteering in other social organisations where their skills can be utilized like telling stories, account keeping, organizing events.

The objective of the elder volunteers’ bureau is to utilize the skills, knowledge, talent and experiences of senior citizens to reduce their isolation and restore their status as useful members of society. The initiative gives them a sense of purpose in life


Replicability
The Elder Volunteers’ Bureau has been engaging the elders productively since 2003 and has now become a movement in the city. Over 300 volunteers are now registered with the bureau which initially started with 15-20 people. Many of these volunteers have also formed senior citizens’ groups in their respective areas, making the activity self-sustainable and also building a network of senior citizens’ groups in different areas of Pune.
The activities of the Volunteers’ Bureau have been recognized by the Ministry of Social Justice & Empowerment, Government of India, as an ‘innovative project’ and the bureau has been featured in the Integrated Programme for Older Persons (IPOP) document. The Ministry has requested ILC-I to conduct orientation workshops for other areas in the western region as well as the southern and northern regions of India so that such projects could be replicated in the rest of the country.

A look into the lives of some active senior citizens

Prabha Nene (78 years) is known to most of the citizens who commute through the Prabhat Road area. as she monitors traffic in the area every morning. A former employee of a multinational company, she voluntarily took up the task of monitoring traffic at three different places 10 years ago. Nene has been trained to control traffic by the city police. She also helps school children and elders cross the road at the spots where she volunteers. Whether it is a hot summer day or a rainy monsoon day, she goes on with her work. She is one of the volunteers associated with the bureau since its inception and is an inspiration for other volunteers.
Sunanda Japtiwale, at the age of 54, lost her 21-year-old daughter in an accident. A year later, to overcome her grief, she decided to serve children in need as a volunteer and took up voluntary work with the hospitals and NGOs working on medical health in the area. One of her many activities includes going to Sahyadri Hospital on Karve Road for two hours every Friday morning and helping patients with the process of admission and various tests that they need to undergo. She says, “Many patients coming to the hospital are unaware of the procedure and do not know whom to address their queries to. The hospital staff at the reception is too busy to answer the queries of every patient. I therefore help the patients with filling up forms and assist them in visiting their doctors.” During the rest of the week Sunanda works with organisations like Apla Ghar (institute for the orphans), Sampark Balgram (working for needy children) and Manvya (serving the adults and children with HIV). She and her husband have also donated towards the construction of the Vanprastha Old Age Home at Talegaon Dabhade in memory of their daughter. This has helped both of them overcome their grief and utilize their time and talent effectively.
Anjali and Prabhakar (both in their late sixties), are volunteers from Kothrud area and have been with the bureau since the early years. They persuaded the elderly from their area to get together to start various initiatives. One of them was to run a ‘medicine bank’ for needy patients. They collect unused medicines from hospitals and homes, sort them with the help of doctors and send them to more than 15 charitable hospitals in the city and in the Konkan area of Maharashtra. “This gives us confidence and a feeling of being useful to the society, especially when our children have grown up and become busy with their lives”, says Anjali.


Project 3 - Athashri Housing Project – Pioneering elderly home project

Description
In the late 1990s, when it was a novel idea to design a home especially for the elderly, Dr. S. D. Gokhale played a major role in conceptualizing the Athashri Housing Project which was one of the first residential complexes in Pune built exclusively for the aged. He proposed the basic design of facilities that should be made available in the complex which would facilitate convenient living for the elderly and would be different from an old age home.
The construction of the Athashri Project was completed by Paranjape Constructions Limited in 2001. It was one of the pioneering residential projects of its kind in Pune and provided a better alternative to the old age homes run by institutes or organisations. It gave an opportunity to hundreds of aged women to live comfortably in the company of others like them.

Elder-friendly facilities at Athashri

  • Railings and bars in corridors and in rooms
  • Wheel chair enabled building
  • Stretcher lift
  • Low position of switch board for wheelchair bound people
  • Emergency bell in bathroom, bedroom and living room
  • Sliding doors to bathroom for easy access
  • Specially designed toilets with grab bars
  • Non-skid flooring
Catering to elderly women
In 2001, when the project was completed, old age complexes were a new concept, particularly for financially independent, single elderly women who preferred to live alone. It is no wonder then, that women outnumber the men in the two phases of the Athashri Project in Pashan.
In Phase I, there were 154 residents – 95 women and 59 men out of which 47 were single women. In Phase II, out of a total of 129 residents (including 35 couples), 67 were single women. Though the homes could be owned by anyone, the occupants need to be senior citizens only.

Innovative design and implementation strategy
The amenities in these homes include: anti-skid flooring, grab bars in the bathrooms and corridors, emergency bells in the bathroom, intercom facilities, security services, domestic maid bureau, maintenance staff, doctor on call, ambulance service, tie-up with hospitals, library, canteen facilities, community celebration of social, cultural and religious festivals and transport facility for residents. A club house, gym, and hydro-therapy pool, open spaces with well landscaped gardens and terraces which are all elder-friendly give an opportunity to the residents to mingle with each other.
The safety and health facilities guarantee peace of mind to the senior residents of Athashri. The staff is trained to handle emergency situations. Aastha, the assisted living facility in the same complex, houses elderly residents who are frail due to age and need assistance in daily living. At Aastha too, single women outnumber single men. The residents of Athashri voluntarily go to help the elderly at Aastha and also spend time reading to or talking with them.

Replicability
The project was widely appreciated and soon the demand for similar homes grew. To cater to this demand, the Athashri Project was replicated by many builders while more Athashris were built by Paranjape Constructions Limited in Pune and other metro cities. After the first two phases at Pashan, Athashri complexes have now come up in Bavdhan, Baner and Hadapsar areas in Pune. Similar projects are also being planned in Bangalore, the United States, Canada and Australia.

Conclusion
The three projects by International Longevity Centre-India, Pune are an example of how quality can be added to the lives of the old with simple initiatives. Aajibai Sathi Batwa and the Volunteers’ Bureau are easily replicable for any social organisation or government. The enthusiasm of the senior volunteers is amazing. They are disciplined and sincere when it comes to volunteering. Initially, the volunteers were engaged in a few activities like spending time with patients or working with social organisations for few hours a day. Now, however, the volunteers themselves have formed groups of senior citizens in their respective areas and have found new ways of engaging themselves and serving society. The medicine bank by Anjali and Prabhakar Jawadekar and traffic monitoring by Prabha Nene are excellent examples of how the Volunteers’ Bureau initiative is evolving. What is more, it has expanded all over the city, thanks to the enthusiastic seniors.
Athashri Housing Scheme for the elders too has served as a model and inspired construction groups to undertake similar projects. Such projects are now coming up in small cities too. Sadly, these are targeted at customers from affluent or higher middle class and remain unaffordable for those in lower income groups. There is a need to make elderly homes affordable for the economically weaker sections too. In addition, this initiative needs to be coupled with efforts for creating awareness about planning for old age.
 
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