The elderly population is usually considered to be the group aged 60 years and above. They are the people who brought prosperity to the family, lived very actively and contributed much to the development of their offspring and society. With the increasing of age, older people become incapable to carry out their normal activities as they did before. Yet, they contribute to society in economic, social, moral and other terms. In Bangladesh, 6.9% of the population was classified as elderly in 1950. In Bangladesh, the elderly population is increasing much faster and, currently, they constitute around 7.5% (1.25 crore). The number is expected to increase sharply and reach around 20% (over 4 crore) by 2050 due to growing population ageing. Also, the old-age dependency ratio would be almost triple between 2000 and 2050.
The concept of population ageing usually refers to an increase in the median age of the population in any society. Median age is increased due to declining fertility and increased life expectancy, which in turn may be affected by various biological and socio-economic factors improved living standards and health care services. Of course, the median age has increased all over the world. Consequently, many countries across the world are experiencing population ageing that has various consequences and implications in economic, social and other terms. Since the dependency ratio is increasing because of population ageing, countries have increased expenditure on the elderly population. But, undeniably, many countries including Bangladesh face varied challenges to providing needed supports to the elderly people due to limited economic resources and some other reasons.
As is well-known, elderly people face various physical, economic, social and psychological problems in different countries including Bangladesh. Some notable problems are lack of income or lack of adequate income, extreme poverty, inadequate food and nutrition, lack of living arrangements, various health problems (both chronic and non-chronic), lack of proper health care, exclusion, isolation or loneliness, negligence or lack of social dignity and psychosocial and cultural complexities. Of course, it is also known that health problems increase with age; but a major cause for concern is that many elderly in Bangladesh cannot take required health care services because of a lack of adequate access, in terms of availability, financial accessibility and other aspects. Consequently, the overall situations of the well-being of many elderly people of the country are not good at all. Of different groups, however, lower-middle and middle-class elderly suffer the most.
Of course, there are various initiatives — legal, policy and others — for improving situations of the elderly population. Some initiatives are directly related to elderly persons such as the National Policy on Older Persons 2013, Maintenance of Parents Act 2013 and the Action Plan to implement the National Policy on Older Persons 2013; but some others have provisions on elderly persons such as the National Population Policy 2011 and the National Health Policy 2008. The government initiated old age allowance programme and social safety net programs (including VGF and VGD). In addition to the government initiatives, non-government organizations work on elderly people to support them. But such measures are insufficient for addressing various problems of population ageing or growing elderly people in Bangladesh. Thus, more needs to be done to address the problems of the elderly.
Adequate implementation of relevant policy and other measures is very important, in this respect. In fact, there is a considerable gap in the implementation. Some inadequately implemented but crucial measures are old age allowance, affordable health care services to elderly, elderly-friendly housing facilities, etc. But the coverage of the elderly programmes is very low. Currently, the old age allowance programme provides an adequate amount of financial supports — 500 BDT in a month — to a few thousand elderly and many elderly do not receive affordable health services. Consequently, a vast number of elderly people remain outside of the allowance programme, a large number of disadvantaged elderly receive an inadequate allowance and many elderly fail to get health services.
To the implementation of the existing policy and other initiatives, there are of course various constraints such as an inadequate institutional mechanism, limited financial and other resources, lack of adequate coordination among different stakeholders working for the elderly and political consideration or nepotism in the identification of the needy elderly people. Consequently, many elderly people who are genuinely needy do not get supports, even if they are considered in the existing programmes. Thus, all such challenges need to be addressed as much as possible. In this respect, civil society organizations including relevant national and international elderly welfare organizations, along with the government, need to be made more engaged with the implementation of various elderly-focused initiatives — health and other welfare services to the elderly population.
In addition to the implementation of existing initiatives, emphasis should be given to some loopholes and missing elements. Indeed, the existing measures are inadequate for providing required supports to the elderly population including the disadvantaged elderly. Some missing elements in the existing efforts are inadequate social safety net programs, lack of adequate emphasis on the financial solvency of the elderly, inadequate or no coverage of day labourers or beggars or vagrants aged over 65 years in the old age allowance, lack of health insurance scheme for older persons, lack of age-friendly affordable living, etc. Consequently, many disadvantaged elderly — both in rural and urban areas — who need supports have not yet been adequately brought under the social safety net programme. Thus, all missing aspects and loopholes in the existing efforts need to be well-addressed for improving the quality of lives and wellbeing of the elderly people including the disadvantaged. In this regard, introducing a non-contributory pension scheme, establishing community ageing deposit schemes, introducing a forced savings account for old age allowance, creating older people welfare funds and providing elderly-friendly housing may be very effective in Bangladesh.
Family responsibility to the elderly should be strengthened much. Of course, many families take care of the elderly but many others are unable to do so; more importantly, many families are able to take care of but do not. In fact, there many reasons for the latter cause of inadequate or no care of the elderly including increased nuclear family norms, a systematic detachment of elderly with a two-bed house especially in urban areas and decaying family values to elderly. Thanks to a provision in the Maintenance of Parents Act of 2013 which states that under no circumstances are children allowed to send their parents to old homes beyond their wishes. But many elderly live in old age homes without any connection with their offspring living due to several reasons including problems with kin or with children and perceived burden. Thus, something more needs to be done to address the above reasons for inadequate family care and increase family roles for the elderly family members.
Not less important is that many elderly are abused and neglected or lack social dignity not only in the family but also in the community and broader society. As expected, social attitudes towards elderly people need to be changed from neglecting to supportive. New generations or the youth should be made more responsive and attentive about their duties and responsibilities towards the elderly people in the family and broader society. In this respect, awareness needs to be raised on good social norms and values regarding attitudes towards the elderly. Of course, mass media can play a very effective role in this.
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