INTRODUCTION

Family is an important institution. India's people would live in joint family who had
parents, husband or wife, grandparents, children, grandchildren, uncles, aunts and cousin. It has
been a custom to find that the parents and grandparents would take care of the house's infants and
kids. Also, when they grow up, they become a support system for their parents and grandparents
too. When they fall ill, they take care, give them proper medical facilities, and spend quality time
with them.

Old age home are a place for the homeless and those who have been evicted from their
homes in old age. The inmates have all the comforts of home, including food and clothing. But
it is sad that they do not get the love and care of their most needed loved ones here. In
our country, they importance of family and respect for parents is great. A lot is changing
today in such matter. In many place, the role of again parents is exposed in changing
lifestyles. Therefore, the number of old age homes in the country is increasing
exponentially.

There are many reasons for the increase in such old age homes. Many forget his moral
value when he gets busy getting better education and job. Elderly parents are left out when
joint families are transformed into nuclear families. But many are unaware that only parents
can love their children unconditionally. This kind of old age home become a blessing for
those who have on one and no one to take care of them. The situation of each family is
different. There are people in our country today who do not hesitante to send their parents
to old age homes for their own comfort while some seek the help of people like home
nurses for the comfort of their parents. Today, old age home are becoming the last resort for
many senior. Those who are abandoned by their children and end up in place like this live
alone in large numbers .Most of time he thinks about his family.

It is estimated that there are an average of 35old age homes in each district of
Kerala. But their number is increasing day by day. Statistics show that Kerala has the largest
number of old age homes in India. Until a few years ago, this culture existed only in the
united states, England and Germany, but now it has taken hold of Kerala like an octopus. This
shows that the number of old age homes is increasing in Kerala as neglect of the elderly is

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on the rise. The reform illusion of modern Kerala is to leave the parents in old age home
at the last minute after living for their children for a whole lifetime. In Kerala, old age
homes are proliferating like schools today. Modern man forgets many values and forgets
the love, care and affection given to him by his parents. Such context point to the level
of cultural decline of the so-called modern and fully literate Malayalee’s. Those who fall
into the cycle of neglect and ridicule are unable to break through and became exhausted
and swell up in a world of isolation. Those who deny that such heart breaking pain will
come to them tomorrow will never thinks. But parents who are most indebted in life are easily
thrown away. The truth is that today's generation has grown up only to isolate those parents
who taught them to look at the world move forward with bold steps.

The home which cares for the old age people or senior citizens is termed as Old age Home.
These homes are meant to protect, guard, nurture, feed, and groom geriatricians. Old age Homes
are basically found in Metropolitan Cities to provide a pleasant part of retirement life. It can be
also termed as a Retirement home

In the current moving world and the commitment, every family has to fulfil their needs,
both husband and wife are forced to work. That too in this digital era, most people prefer working
abroad as an aspiration or career upgradation. So, it becomes hard for them to take care of their
parents. An old age home, also called a retirement home, is a residential facility with nursing and
assisted living facilities designed for older adults. They receive the necessary assistance and care,
from meals, housekeeping, medical care, and recreational activities to maintain their quality of
life. The purpose of old age home is to provide safe and secure haven for those with nowhere else
to go and no one to support them.

While some older adults move into an old age home voluntarily, others may have no other
options due to financial, social, or health-related circumstances. Old age homes can be either
privately owned or operated by the government or non-profit organizations.

Challenges of aging make it difficult for people to live independently. Some older
adults experience physical and cognitive decline with limited support from families or the
community. Others may face health and financial constraints to maintain a quality life. Old-age
homes thus emerge as an option for older adults who require additional support and care.

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 Old age homes have become an increasingly relevant aspect of the evolving Indian society
due to various factors.

Urbanization : The onset of modernization, urbanization, and advancements in medical

science have led to an increase in life expectancy. Moreover, the younger generations are migrating
more frequently, leading to a shift in family dynamics. As a result, the importance of old age homes
are becoming more prominent as they offer a comfortable and secure living space for seniors while
providing companionship, care and independence.

Supporting the underprivileged : India’s elderly population is projected to reach 340

million by 2050 from 138 million in 2021. Many of these elderly have limited family support and
face financial insecurity, social isolation, and health problems. In some of the worst case scenarios,
they are subject to physical abuse and abandon, not to mention the psychological upheaval. The
importance of old age homes in India cannot be overstated as they provide the basic amenities and
support to a vulnerable population.

Cost factor : The rise in chronic diseases and expensive medical treatments has further
strengthened the need for old age homes in India. The cost of treatment for chronic illnesses can
be prohibitively expensive for many families, making the option of an old age home a more
feasible alternative.

According to the Ministry of Social Justice and Empowerment 2019 report, there were
around 728 old age homes in India. This number is only expected to grow significantly in the
coming years.

Old age homes do provide shelter and healthcare support to the elderly, but it’s the activities
that help them cope with the vagaries of old age. Various activities that improve the functioning of
their brains and emotional health are as follows:

Recreational activities : Activities like indoor games, gardening, singing, dancing, movies,
etc. keep the residents engaged and entertained. Such activities help break the monotony of life
and build camaraderie among fellow residents.

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 Skill-building and community development activities : Many old age homes organize
workshops and classes where seniors can learn new skills such as knitting, painting, and cooking.
This not only helps them stay engaged but also fosters a sense of community and belonging.
Community development activities such as tree-planting drives and cleanliness campaigns help
seniors stay active and connected to their surroundings.

Exercise and fitness programs : Regular exercise and fitness programs are organized to
keep the residents physically active and healthy. This includes yoga, meditation, and other forms
of exercise to enable them to lead a quality lifestyle.

Socialization opportunities : Old age homes encourage socialization among the residents
to prevent loneliness and isolation. This includes group activities, celebrations, outings, and
specific religious or spiritual sessions enabling them to lead a quality lifestyle.

Overall, the importance of old age homes lies in providing not just basic amenities to the
elderly but also helping them lead gleeful life.

Old age homes have often been seen as a last resort for the elderly who do not have anyone
to care for them. However, the importance of old age homes in providing a supportive and caring
environment cannot be debated. Following are the several advantages:

Safety and Security : Older people are often vulnerable to crimes and abuse. With a secured
roof over their heads, old age homes protect seniors from physical harm and crime.

Access to healthcare : As people age, their healthcare needs become more complex. Old
age homes ensure that the residents receive the medical attention they need. This includes personal
care, specialized attention for chronic ailments, emergency care, ambulances, periodic medical
check-up camps, etc.

Companionship : Old age homes often organize events and celebrations that make residents
feel like being part of a wider community. This can help seniors feel a sense of belonging and
purpose. This can be especially important for those who may feel like they are no longer
contributing to society in meaningful ways.

Mental and Physical Health : Socialization is crucial to the emotional and mental well-
being of older people. Old age homes provide many opportunities for socialization, such as group

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activities, exercise programs, outings, and celebrations. Mental and physical well-being reduce the
risk of depression, anxiety, and other health problems.

Ease of financial burdens : Old age homes provide affordable housing and access to
medical care, easing financial burdens. Some old age homes offer opportunities for residents to
participate in activities that can generate income, such as handicrafts, gardening, and cooking.
These activities not only provide a source of income but also help the elderly feel productive and
useful.

Despite the growing importance of old age homes in India, they are not without their
challenges. Many of these homes are in a dilapidated condition --- not equipped to provide
adequate care and support to the elderly. Moreover, the stigma associated with living in an old age
home is a significant barrier for many elderly who may be reluctant to leave their homes and
families.

Furthermore, chronic diseases are on the rise. Many old age homes lack infrastructure and
expertise in providing adequate medical care to elderly residents. The ones with better services can
be out of reach for many. Also, living in an old age home is not equivalent to living in one’s own
home, leading to psychological distress.

The Indian government has taken several measures to promote the welfare of the elderly,
including the National Policy on Older Persons 1999 and the Maintenance and Welfare of Parents
and Senior Citizens Act 2007. However, without stringent regulation and oversight, the proper
functioning of old age homes becomes a challenge. Reports of abuse, neglect, and poor living
conditions in some old age homes have highlighted the need for greater scrutiny and regulation by
the authorities.

The basic needs of the elderly are similar to those of younger individuals, but with some
variations that reflect the aging process. As people age, their physical, emotional, and social needs
change. Addressing their basic needs requires a multifaceted approach that includes physical,
emotional, and social support and opportunities to participate in the wider community.

The basic needs of older people include:

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 Quality and affordable healthcare : Access to quality healthcare comprises regular check-
ups, access to medication, and medical procedures when necessary. It is a concern as the cost of
medical treatment can be exorbitant for many.

Adequate nutrition : As people age, their nutritional requirements change. They may need
varying amounts of certain nutrients like calcium, vitamin, and protein to maintain their health and
well-being.

Personal Security and Safety : Older people are often more vulnerable to physical harm,
abuse, neglect, and crimes. Providing them with a safe and secure environment is crucial for their
well-being.

Emotional and social support : Emotional support from family members, friends, and
caregivers is important to help them cope with the challenges of isolation and depression.

Mobility and transportation : Many elderly have mobility issues or live in remote areas that
can limit their ability to move around and access services. Provision of transportation options or
assistance can help them remain active and engaged.

Financial Security : Financial security is of utmost importance as it impacts all other

aspects of their lives. It provides them with a sense of stability and self-reliance. Without adequate
financial resources, older people may struggle to meet their basic needs. Ensuring their financial
security through senior-friendly tax structures, health insurance plans, etc. should be a top priority
for policymakers.

Although the constitution of India defined as welfare state and Indian family as a social
institution is well known for the emotional and physical support that it provides to its extended
members, many a time it fails to respond to the needs of older people in the age group of 60 years
and above in difficult circumstance specially in the metropolitan cities. Immediate support and
care of the family are not available due to many reasons ranging from economic instability of the
family to provide such support to the breakdown of joint family system to the social bias against
the vulnerable older people as also the attitude and value attached to such section group. I hey
were not only abused by their natural children, in-laws within the own parent; rater they tortured
them both physically and mentally, worse thing is that many of the young generation wish for their
early death as they considered their living under the same shelter gives an economy burden.

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Sometimes society itself drives such aged person out of the system to lead lives of sub human
existence. More often vulnerable aged people in distress ends up as servant, slave in the family in
a different form for their own survival.

It is understandable that aging is a natural process but is quite difficult to accept it. Facing
up to the realities of fading away of mental and physical energies is seldom easy. The phases of
creativity, achievements and triumphs get over by and by. At this age, there is not left much to look
forward. Adding to these woes, sickness and disabilities, which usually come along with age. I he
family at times abandons this person and no one bothers about him anymore. A person who once
used to enjoy his rightful place at the centre of the family scene is today driven to the periphery.
Once an active participant, today he is left with the role of mere an observer. He just stands and
watches as life passes them by. At this fag-end life, what is needed most is to care and support both
physically and emotionally. To help and provide this care, a residential program for the aged is
being proposed through this project. So far, the intervention to this vulnerable section group cover
only a fringe of the problems and very limited intervention in this regards has been made by few
organization, hence We as a part of the responsible citizen of the country wish to intervene
immediately through more flexible and innovative approach for the aged people in distress in
diverse situations under different conditions. The programme will be focus to those living in
difficult circumstances through a Home-based holistic and integrated approach.

Ageing is a natural, biological and universal phenomenon which occurs in a unique manner
in every individual’s life. The process influence by variety of factors including genetic and
environmental factors. Emerging changes in social and cultural values, elderly are prone to various
chronic physical, emotional and mental health disorders. However, the needs and problems of
elderly vary significantly based on their age, socioeconomic condition, health and living status.
Along with medical treatment, there is a need for the preventive and promotive health care
strategies for successful aging and to improve well-being and quality of life. The elderly essentially
require understanding, compassionate care, unconditional support and love with human touch.

According to the Ministry of Statistics and Programme Implementation, Government of

India, the Population Census 2011 reported that there are nearly 104 million elderly persons in
India, wherein 53 million were females and 51 million were males. Old age is a period of transition
when one has to deal not only with the physical aging, but also with the challenges affecting mental

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and social wellbeing. The elderly are vulnerable to suffer multiple physical, emotional, mental and
social problems. The commonest old age problems are- physical dependence, loneliness,
hopelessness, insecurity, diminished self concept, depression and other diseases like arthritis,
diminished vision and cancer etc.

The World Health Organization defines Quality of Life as ‘an individual’s perception of
life in context to culture and value system in which he or she lives and in relation to his or her
goals, expectations, standards, and concerns. It is a broader concept covering the individual’s
physical health, mental status, level of independence, social relationships, spiritual beliefs, and the
environment. The quality of life can be evaluated by assessing a person’s subjective feelings of
happiness or unhappiness about the various life concerns.

As people advances in age, the QoL is largely determined by their ability to maintain
autonomy and independence. Assessment of QoL plays an important role in the management of
old age homes and it tends to maintain a state of optimal level based on the appraised status in the
major domains of health, work and family or society. If its status in any of these domains is lowered
for a longer duration, attempts are made to reinstate the optimal level as much as possible by
establishing the new QoL level on improvements and increasing a variety of other domains, such
as entertainment, dwelling conditions and meaningfulness of occupation.

The World Health Organization (WHO) has developed a QoL instrument i.e. WHOQoL–
100 (it’s a 100 question assessment on 06 domain) and WHOQoL– BRIEF, which captures many
subjective aspects of quality of life. The WHOQoL-BRIEF is one of the best known instruments
that has been developed for cross cultural comparison of quality of life and is available in more
than 40 languages. It has been adopted in a number of countries, including India. An abbreviated
version of the WHOQoL-BRIEF which contains 26 items (covers four domains of QoL) is
applicable in clinical trials in which brief measures are needed, and also in epidemiological studies
in which quality of life might be one of several outcome variables.

The family is the basic unit of society and our elderly people are the roots of it. The quality
of life of our geriatric population plays a major role in conserving our traditional values and rich
cultural heritage. Quality of life (QoL) is defined as the feeling of combination of an individual’s
functional health, feelings of competence, independence in activities of daily living, and
satisfaction of social circumstances.
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 To develop certain strategies for incorporating family based care which is best suited to the
sociocultural milieu of our Indian society this study was carried out. The problems of the aged
vary from society to society and have many dimensions in our country. However, the disintegration
of the joint family system and the impact of economic change have brought into sharp focus the
peculiar problems; which the aged people are now facing in our country. In the traditional sense,
the duty and obligation of the younger generation towards the older generation is being eroded.
The older generation is caught between the decline in traditional values on one hand and the
absence of an adequate social security system on the other hand, finding it difficult to adjust in the
family.

We have a culture that has placed a lot of sacredness and value on intimate relationships.
But when modernity, the rejection of other cultures, the emergence of nuclear families, and when
every mind and home became limited to himself and his family, old age became a burden in the
society. Aging is not a disease. It is a stage of life. In the journey that becomes life, old age is the
stage from birth as a baby in the mother’s womb, through childhood, adolescence, youth and
middle age.

Young people and children have a kind of contempt for the elderly. When you wonder if
old age is a curse. There is no room for the elderly in the sprawling expanse of nuclear families.
Elderly homes are a place of refuge for the elderly who become orphans when their sons and
daughters-in-law are busy with work and live in faraway lands and Kochu Makkal hostels. But
nursing homes are commonplace today. Malayalee’s are starting to struggle with old age homes.
Moreover, in this new era, Malayalee’s have become those who do not even feel a twinge of
conscience in pushing their own parents in such centers.

The number of Inmates in old age homes in the state is increasing every year. There was a
time when Malayalee’s used to hear old age homes only with wonder. Knowing that such
arrangements are being made in Western countries, the Malayalee’s used to judge that Westerners
do not value relationships. Despite the constant awareness that parents should take care of their
children in their old age, the number of elderly people reaching shelters is not less. The number of
people arriving at nursing homes with their elderly parents is increasing even though they are fully
convinced that such a time will come.

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 Elderly people were the links that connected family relationships to each other. They have
long experience. The elderly were the focal point in the tight-knit joint family system. They used
to provide comfort as a shade tree. But joint families are now an old story. Everyone is becoming
a nuclear family. Everyone is busy there. Whatever the reasons, abandoning parents to be protected
in shelters is cruelty to elderly parents, a great crime. It can only be seen as the epitome of a world
where mercy is drying up.

In the situation where self-sufficiency has been achieved, men and women go to work and
the new generation migrates abroad, leaving the old people isolated at home. This is the reason for
the increase in nursing homes. But there are those who think that nursing homes are the best way
to protect the elderly from being orphaned by the rush of the new generation looking for a way of
life. Old age homes are a boon to those abandoned on the streets and in places of worship. Realize
that aging is not a curse. It will overtake everyone born on earth. Everyone should remember that
today’s child is tomorrow’s old man. Realizing that the proud youth of today will not last long will
help their parents to be kinder.

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