Senior Citizens In Jeopardy

The latest census data reveals that the population of Nepal is ageing and the proportion of elder population above 60 years of age comprises around 12 per cent of the total population. An ageing population is more or less a passive and dependent one. It increases the demand for health and many other caring services. Older people suffer from both degenerative and communicable diseases due to the ageing of the body’s immune system. The leading causes of morbidity for ageing population are cardiovascular, diabetic, cancer and hypertension. Moreover, physical degenerations, including difficulty in walking, chewing, hearing, osteoporosis and arthritis, are other common health-related risks afflicting the ageing population.

In principle, Nepal is a welfare state but citizens -- young and adults – cannot enjoy state support, services and benefits of all kinds taking most of material burden away from the family as they are entitled in the welfare state. The care and protection of elderly population has been a matter of family obligations. Our tradition requires that as parents are solely responsible for rearing and ensuring affectionate and healthy upbringing of their children, so should the adult children do in their turn to provide all care, comfort using all resources for their ageing parents. The obligations of the offspring, especially sons towards their parents have been prescribed and enshrined in many religious books and scriptures as patrilineal legatee and successor.

In need of care

However, situations have changed today. The values and norms that governed the family ties and relationships in the past are no longer valued and respected today. The adult children in most cases today do not afford to stay with their parents and take care of them in person. Both in the urban and rural areas of Nepal, parents are either abandoned or made to fend for themselves back home as their children tend to migrate in horde to overseas for want of gainful job opportunities. For parents their old age becomes a kind of physically and emotionally racking experience because their family members are not beside them when they need compassion, care and caressing. 

Moreover, a very ominous trend that challenges our family values has been that the close knit family ties and relationships  that used to characterise the parent-child bonding is going on the wane. In some cases, it is also found that the adult male child tend to neglect and abuse their parents, bear pressure upon them to exact the share of property as coparcener. They are least bothered to take cognizance of their obligations towards their parents. However, these unruly and deviant examples are not many and hence said to be an exception.  

But when parents age, lifelong family baggage can spill open. Siblings might find themselves in dispute over who carries most of the caregiving burden, or disagreeing with their parents and each other about which courses of action are best. Old sibling rivalries and feelings of envy and resentment may come up. These types of dispute can rise between siblings, children and parents, and even spouse to spouse. Unresolved conflicts can blossom anew during a health crisis – complicating any attempts to understand how the older adult wants (or would want) to proceed. Death and dying are as much a part of the life cycle as birth and living.  Identifying how an individual wants to spend their final years and communicating that message to family and friends is an important task. 

In such case support of family mediator would be needed. Siblings with strong and opposing views can benefit from the objective family negotiation and mediation offered by an experienced mediator. A mediator can work on behalf of the whole family. He or she will help the family have constructive conversations about their elderly parent’s needs, create a plan that addresses them, and ensure that it’s put into action. 

A mediator can work as an objective third-party to help resolve some of those conflicts and move the discussion forward. Mediators should have training or experience in both mediation and gerontology to be able to properly assist families dealing with this type of conflict. Mediators are also very effective at facilitating family conversations, before a crisis hits. Once decisions have been made and put into writing – families have a tool to use when a crisis hits. That tool can be adjusted as life situations change, and will mitigate the stress and trauma of the crisis.

Family dynamics

According to the experts on elder care mediation, one of the first steps to setting up a successful family facilitation is to identify all the parties who will be involved.  The discussion should focus on what is important to the adult(s), how they have lived their lives and how they picture living their remaining days. Gentle probing into relationship issues between them and children, and between siblings should be used to help understand family dynamics. Based on these discussions, the mediator needs to connect with each person involved and have similar discussions with them identifying their concerns, conflicts and comfort levels. The main goal is to identify who will be involved, how they will be involved, and if they are able and willing to provide the support needed to fulfill the wishes of the older adult. 

The mediator will help identify which are most pressing, which are easiest to solve, which will take more concerted time and adjust each session to address a few smaller issues and one bigger issue. In Nepal, the constitution has guaranteed the rights of senior citizens while act enacted relating to right of senior citizens are also in the statute book. Mechanism like judicial committee exists to help resolve the family disputes at the local level. However, local capacity is lacking in this respect. It is time to conduct training for mediators at the local level by incorporating subjects like gerontology and elder care mediation which can help families to resolve their conflicts that arise in regard to the care and maintenance of the senior citizens.

(The author is presently associated with Policy Research Institute (PRI) as a senior research fellow.  rijalmukti@gmail.com)