Abstract
Institutional care in India is considered as the last resort in a society that glorifies filial piety and familial responsibility of family-based caregiving for older kin. While private senior citizen homes and retirement communities are being established in some parts of the country, they cater mostly to the affluent sections of the society. The common people are mostly left at the mercy of a very inadequate number of old age homes run by the state and non-profit organizations. In this study, I discuss three kinds of charitable old age homes: a state-run home in Delhi and two destitute homes run by non-profit organizations, one in Delhi and another in Kolkata. A combination of ethnography and structured interviews has been used for this study which takes into account the spatial arrangement within the homes, the language of control used by caregivers and the unique ways in which care is organized in the homes. The study finds that the three homes depict different caregiving practices corresponding to a different politics of care and interpretation of the needs of the older residents at each of the sites. While analysing the three models of institutional care, the study discusses the concerns with the existing models and also highlights care practices within institutions that embody feminist ethics of care.
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Notes
- 1.
A growing older population necessitates a better approach and planning in the country for providing social care services to the senior citizens, among other things (Shankardass, 2019).
- 2.
The practices of caregiving at the different sites was sometimes found to be at odds with their projected social goal of care. Manipulation of situation by caregivers, paternalism and bureaucratisation of practices of care was commonly observed across various homes and these aspects were kept in mind during the labelling of the models of care.
- 3.
https://www.youtube.com/watch?v=aE8xhQOKHNg (accessed August 24, 2019).
- 4.
http://www.earthsaviours.in/landofgurukal (accessed December 31, 2017).
- 5.
Mr. RK’s work is well advertised in the media. He told the Asian Age that he wants to run the world’s largest ‘charitable temple of humanity’. https://www.asianage.com/life/more-features/140717/gurukul-for-the-needy.html (accessed August 24, 2019). Recently in 2018, he appeared on popular TV show Kaun Banega Crorepati and won INR 2.5 lakhs but was donated by INR 5 lakhs by show host Amitabh Bachhan who was touched by RK’s care for the destitute initiative.
- 6.
From what I observed, it seemed that the older persons man was a fairly educated person, staying there probably out of economic constraints.
- 7.
Chatterji et al. (1998) illustrate the situation of care at a hospital and a clinic in her work, and not an old age home per se. Her usage of the metaphor of ‘medical junk’ to refer to those visiting the government home reminds me of the treatment meted out by the government home superintendent to the resident (1998: 175). Both conjure up the imagination of older people as outcasts of their families who may also be viewed as a burden upon the state. The superintendent scolded the older man for discussing something considered irrelevant by him and asked him to leave the room. Chatterji et al. (1998) had also made a similar observation at the Srinagar government hospital. There the doctor prescribed generic drugs for regular complaints and if the elderly person demanded greater medical investigation, they would be screamed at. Thus, the metaphor of ‘junk’ was prevalent in both these situations, atleast partially so, when one looks at the shortage of staff and resources and overcrowding by older persons in both the situations.
- 8.
I was not informed about where the stranger had found the elderly man. There was limited information passed on to me. Either Ms. AJ did not know it herself or she had been asked not to reveal by the home’s authority, that could not be confirmed. However, it was intriguing to me, since the area the man claimed where his home was very far from the government home. Abandonment could not be ruled out either.
- 9.
The need to constrain the movements of the residents with mental health problems conjured up the vision of them as liminal beings, as ‘monstrous’ bodies, who must be kept away from the others (Shildrick, 2002). They appear as ‘deeply disturbing; neither good nor evil, inside nor outside, not self or other. On the contrary, they are always liminal, refusing to stay in place, transgressive and transformative. They disrupt both internal and external order, and overturn the distinctions that set out the limits of the human subject’ (Shildrick, 2002:4).
- 10.
Such compartmentalisation of the home into different quarters, keeping persons with mental health problems in a separate chamber, demonstrated the need to keep the ‘risky’ and ‘leaky’ bodies isolated and away from public view (Buse et al., 2017: 1445, 1449). The architecture of a place indicates the ideologies of care promoted by the owners of a place, in this case the state’s view. In many western countries, private care institutions are modelled on hotels and malls, indicating the need to sanitize spaces of care homes from ‘disgusting’ and ‘abnormal’ persons. This was because, the owners felt that such persons would tarnish the impression of the home by creating a sickly environment (Buse et al., 2017).
- 11.
However, without interviewing a large number of residents at the government home, I refrain from extrapolating if there was antagonism between the staff and all residents. Just as some instance of friendly relations with the staff does exist in the government home, antagonisms were evident in Sevashram too, for example, when one old woman took me into confidence to criticize the authorities.
- 12.
With respect to experiences of ageing at old age homes, one finds multiple narratives which may problematize common assumptions of old age homes being places of sorrow and fractured lives. Other factors, for example, lives pre-institutionalization, gender roles and marital biographies also determined experiences of ageing. However, I do not discuss that in this chapter.
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Dey, D. (2021). Three Models of Institutional Care in India and the Interpretation of the Needs of Older Persons. In: Shankardass, M.K. (eds) Ageing Issues in India. International Perspectives on Aging, vol 32. Springer, Singapore. https://doi.org/10.1007/978-981-16-5827-3_10
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