Wednesday, October 3, 2012

Sorry, you are over 80

India has between 11,000 and 20,000 centenarians, says a UN report. The number will go up, and before long, there will be more older people than children below 15. Not surprising, considering healthier lifestyle habits, easier access to good hospitals and availability of effective medicines.

That is the only good part -- people are living longer. But how well they are living, is the worrying point. The agony and struggle of one of my relatives, who recently turned 80, is depressing. Here's his story.

One June evening, this gentleman -- whom I will call uncle, a sprightly go-getter whose enthusiasm belies his age -- was standing on a pavement along with his two friends in Adoor, central Kerala. They were waiting for the traffic to clear, so they could cross the road.

One moment they saw a speeding car hit a motorcycle, and before they could realize what happened, the car had got onto the pavement and knocked them down. The motorbike driver was killed on the spot, and the three senior citizens suffered injuries. Uncle was admitted to a hospital in nearby town of Tiruvalla with injuries in his head and ribs.

He was in coma for over a month. Good doctors and medical facilities, aided by the uncle's zest for life, ensured he made slow but steady progress. He is bedridden and needs constant assistance.

The family was given to understand that uncle's condition was not an irreversible one; with advanced medical aid, there could be significant improvement. So, they contemplated shifting him to a speciality hospital in Kochi, where he would get better medical help. But the response from the hospital was shocking. They flatly refused to admit him, saying he was above 80.

Since uncle's children and immediate relatives are in Chennai and Bangalore, they planned to move him to Chennai. And their inquiries with hospitals continued. But the responses were no different. Hospitals were reluctant to admit a patient who is above 80. Some were blunt about it -- doctors said they would rather attend to youngsters who have more life ahead of them than attend to an old man. Others were evasive or diplomatic.

Responses went like these: "O, this is a complicated case". "It's an accident case, what has happened to the case?" "There are no beds, why don't you check other hospitals?" One hospital said they would admit if one lakh rupees was paid.

Probably this has something to do with the fact that people above 80 are not covered under health insurance.

Not that there are no in-patients above 80 in any hospital. But this experience indicated a general reluctance on the part of hospitals. Finally, uncle was moved to Chennai from Kerala in an ambulance and admitted to a hospital with great difficulty.

The immediate thought the hospital responses triggered was: Isn't life worth living after 80? True, a youngster's life is more valuable than an elder's, but is that an excuse to deny medical attention to an elderly person? What is the implicit suggestion here -- that there's no point living after turning 80?

It's tragic to see elders languish and left to fend for themselves for absolutely no fault of theirs. Making matters worse are insensitive mindsets and archaic rules.

People are living longer. Good, but as long as they are healthy. Considering that the number of elders is rising, there has to be radical changes -- in institutional rules as well as social and personal attitudes -- in the way we care for our elders.

One, the 80-year cap on insurance cover has to be lifted. Even if there is no full reimbursement, there has to be some significant institutional help for people above 80.

Two, hospitals need to have good geriatric wards; and those that have, need to scale up their functionality significantly.

Three, there has to be better synergy between old-age homes and hospitals.

Only then, we can truly rejoice at the prospect of living longer.

( Crossposted from Kaleidoscope )


  1. I did not know that there is a 80 yr cap on health insurance! People of that age are the ones most likely to need health insurance. Perhaps it can be made available at a higher premium?

    1. Yes, we had news that govt is finally waking up and planning to remove these lacunae.

  2. If your uncle had been a politician, then he would have got royal treatment , for don't we have all old people running our country and getting all medical treatment in India as well as abroad at our expense.
    Having said that, I do feel that people are living very long, and some maybe very healthy too because of their positive attitude to life, and many may want to leave this world before they become a burden to society, but there is no law allowing them to have the free will to do so, which is very sad.
    And sometimes we have very old and highly irritable people whose very existence is a burden for the family and the world in general.
    I am sure none of the younger generation want to live till 80 and above, and maybe, by then the laws too would change.
    This is my first time visit to your blog. Interesting!

    1. Good points.
      Regarding euthanasia, it'sn't there mainly because it's very difficult to ascertain the intentions of the person, and two, the fear that the law may be misused.
      The point you make about positive attitude is right.

  3. So many bars to benefits reaching those who need it most. Good post drawing attention to such issues.