Spring in their step

More than 60,000 senior citizens have plugged into the Elder Spring programme, a three-pronged effort to give a voice to India’s ageing

Why fret about tomorrow if today be sweet?” Gowri Jayaram’s outlook serves her well and that’s a boon for this 81-year-old who hails from a family of doctors. Dr Jayaram lives alone in Secunderabad in Telangana and the fact does not faze her. “I’m a practical and positive person and I have learned to take one day at a time. I make every effort to keep my mind, my body and my house clean.”

Ganpat Velladi, a 70-year-old farmer from Chanai village in Maharashtra’s Chandrapur district, is not as financially stable as Dr Jayaram, nor quite as sanguine as her. “Proper food and health are the major requirements at this stage in my life,” he says, “My wife and I cannot afford anything more than what we earn.”

Dr Jayaram and Mr Velladi represent two shades from the spectrum of ageing people who have been reached by the Elder Spring initiative of the Tata Trusts. Launched in 2017, the programme’s overarching objective is to help create an empathetic environment for India’s senior citizens.

Hearing their voices

Elder Spring is a committed attempt to fashion models of care and comfort for the country’s ageing. These models are aimed at providing them with accessible healthcare, opportunities for social interaction and financial self-sufficiency, and the reassurance that their voices will be heard. The endeavour is, most of all, about bringing dignity and a sense of hope to India’s silvers.

The target here is an ever-growing segment of the population that is currently pegged at about 130 million people. Despite multiple well-meaning efforts by governments at the centre and in the states, the concerns and priorities of our ageing — classified as those past 60 — remain largely ignored. The need to address these is immediate and acute.

There are three parts to Elder Spring: a rural component that functions in close coordination with state public health departments in one district each in Maharashtra, Telangana and Karnataka; an urban hub-and-spoke archetype — initiated in Bhubaneswar and now expanded to Hyderabad — that works as engagement centres for the ageing; and an ecosystem-building slice that comprises a toll-free response system (or helpline), a digital platform and advocacy.

The different aspects of the programme seek to tackle the gamut of issues faced by the elderly, including higher rates of depression and noncommunicable diseases, widespread illiteracy, locomotor and visual disabilities, verbal and physical abuse, lack of social engagement and financial dependency. A hidden blight here is the ‘feminisation of ageing’ (single women are the most vulnerable group among the elderly).

Rural silvers

Operational in the districts of Chandrapur in Maharashtra, Medak in Telangana and Yadgir in Karnataka, the rural project is essentially a partnership with the public health departments of the three states to implement the Indian government’s National Programme for the Healthcare of the Elderly. Contained within are dedicated weekly clinics for the ageing at primary health centres, village activity centres, and training for doctors, paramedical staff and community health workers in geriatric assessment and care.

Under the project, more than 3,500 clinics have been organised at 89 health facilities in the three districts. Visiting elders have health cards that make it easier to track and treat their ailments. Over a two-year period, in excess of 53,000 people have availed of the screening and healthcare services on offer at the clinics, which have also catered to about 135,000 outpatients.

The village activity centres — there are 68 of these in all — serve a purpose almost as important as the clinics. About 1,200 elders are registered at these centres, which have a slew of events on their calendar: yoga and exercises, awareness and counselling sessions, recreational pursuits and inter-generational bonding.

The urban module began in Bhubaneswar in 2018 as a collaborative undertaking with the Odisha government. One reason for piloting the project there was the higher proportion of elderly in the state (9.5% of the total population in comparison with the India average of 8.6%). Another was the enthusiasm of the Odisha government, among the few in the country with a senior citizens policy.

The Bhubaneswar engagement centre, as it is called, is tailored to promote happy and active ageing. It has developed the infrastructure and seeded a range of activities to do precisely that: yoga and aerobics, digital literacy, sessions on health and spirituality, music, painting and dance, a library, recreational games, volunteering, and reskilling to find gainful employment.

The 4,000-sq ft centre is the hub and this is designed to cater to elders from the middle class as well as those from lower income groups. The intent is to extend the reach of the hub to subcentres, or spokes, which would ideally come up in every city ward. One such spoke is already up and running and others could join the list as the project progresses. About 115 senior citizens have registered at the centre and some 2,500 others have been covered through various sessions.

First-of-its-kind helpline

The ecosystem-building component is, potentially, the most impactful of the three components in Elder Spring. The centrepiece here is the response system, built on a technology platform that is the first of a kind in India and crafted to cater to the many needs of the ageing, from general information (on caregivers, elder-friendly products, old-age homes, etc) and guidance (on legal issues, pensions and the like) to emotional support.

The bedrock of the system is the partnerships with multiple arms of the Telangana government that have enabled it. The system has, in the year since being set up, helped about 9,000 elders. Initially limited to Hyderabad, it now covers the entire state and may well become the model for a country-wide rollout.

Covid-19 has put a spanner in Elder Spring but the initiative has altered course to deal with the challenges thrown up. Two surveys were conducted to gauge the impact of the pandemic on senior citizens in both rural and urban India, particularly those in old-age homes.

At the Bhubaneswar centres, where regular operations have been temporarily suspended, the programme team has connected with its network of seniors through phone and the internet to ease their anxieties and to conduct sessions on coronavirus awareness and prevention, yoga and meditation, home gardening, etc.

The efficacy of the elders project has prompted the state governments involved to explore ways in which the engagement can be deepened. The Maharashtra government is in the process of replicating the rural model in five other districts of the state with funding from the National Health Mission. In Telangana, meanwhile, the government is spreading the initiative to 20 more districts.

The truest measure of the programme’s success lies in how quickly and comprehensively the blueprints it has delivered are adopted by the government. Sugandhi Baliga, who heads Elder Spring, believes that is happening but perhaps not at the pace that was hoped for initially. “With the rural model, the idea is to have the [central government] scale it up across the country,” she says. “That is definitely possible because we have shown that it works.”

The response system is another piece where, with central government support, the possibilities are tremendous. “Our intent has always been to make this national and we have come a fair way in enabling just that,” adds Ms Baliga. Strangely enough, the Covid-19 outbreak has opened many eyes to the usefulness of a national helpline in emergency situations. “We have put in the effort to create proof of concept. They have to take it over and that is underway.”

The big picture aside, it is through individual voices that Elder Spring’s efforts shine brightest. “The programme is the answer for many of us who need a patient ear to listen to us,” says Indira Narayan, president of a senior citizens forum in Secunderabad.

Yoga and exercises are a part of Elder Spring’s happy and active ageing credo