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Today’s elders are the young yuppies of yesterday and the teenage menaces of the day before. As a generation moves on, assuming that the slender thread of life is not snapped off early, we must all enter the domain of the elderly. Aging is a universal fact of life. From birth onwards, we grow up, grow older and eventually some of us grow really old.

The purpose of this article is to present facets of our geriatric Parsi community that should provoke families, health care givers, insurance companies, legal minds, individuals and punchayets into discussions about how to sustain dignified long-term care for the aging Zoroastrian community.

The Parsi community is blessed (or cursed) with extreme longevity, with women outliving men by a ratio of 3:1. At any given time, the elderly population in most countries represents nearly 20 percent of the entire population, and future trends will bring it close to 25 percent. As medicine improves man’s life span and technology helps in combating diseases, the numbers reaching old age can only increase. 

Aging is not just a biological experience but a psychological, social, physical and religious one. It involves changes in familial and social roles, altered responsibility at work and at home, and differing forms of participation in all activities. It involves accepting changes as gracefully as possible. Aging is that time of life when individuals again question the ethical reasons for their existence, particularly when it becomes irksome and a burden to themselves and their loved ones.

All aged people are not necessarily sick, poor, weak or voiceless. Many are able-bodied and healthy in mind and body, with an appetite for life and the desire for a normal sex life. However, a significant proportion of aged people does suffer from abject poverty, social and emotional exclusion, loss of dignity due to health problems. They are often forced to live in varying degrees of monetary difficulties, face housing problems, are often excluded from cultural, educational and recreational activities, and are inadequately represented in social fields. They suffer because they are generally oblivious of or unable to fight for their human rights. 

What makes the ethical and social issues of our elderly more poignant is that this is a particularly vulnerable period of life when violating rights can easily be done with little or no feelings of guilt. It is a time when the aged are often defenseless, mute or incapable of protesting. Man’s inhumanity to man is deeply felt by the elders, more so by the ill and even more so by the defenseless poverty stricken aged. 

The fundamental rights of human beings do not change at any age, even though priorities do, and their needs tilt the balance one way or another. The basic ethical rights of life remain constant for individuals in all situations and at all ages. The right to live their lives in their own way and to make decisions for themselves are often thoughtlessly snatched away under the premise that they are incapacitated, senile or even ‘mad’ and do not know what is good for themselves. The right to retirement with sufficient income to ensure financial security, health and dignity in the evening of life is a very important societal obligation.

Health is one of the basic concerns of the elderly. Attempts to delay aging, and all its inherent physical, mental and psychological problems are an important aspect for research. If prevention is not possible, we must anticipate old age problems and provide care for those who need it. Dedicated youngsters, social workers, volunteers and medical personnel should be trained to go to hospitals, old age homes and clinics, to inculcate in them a sense of responsibility. The best care would undoubtedly be at home by loving and understanding family members. But as the joint family system disintegrates, avenues for alternate help must be thought of. 

Physical ill health and conditions like diabetes, arthritis, obesity, osteoporosis and cancer are as important as deteriorating mental health and loneliness. The development of new technologies which could provide a positive support for the elderly such as gadgets to help them to move about, wheelchairs, home lifts, hearing aids, etc are needed.  Health care for old people is the moral responsibility of government, social organizations and families. Insurance for the elderly must be made available at affordable premiums, and planned for early when the individuals are young, earning members of society. 

In the West enormous amounts of time and money are spent on researching Alzheimer’s disease, dementia or cardiac problems, which are frequently seen in aging Parsis. Other problems stem from circumstances relating to poverty, malnutrition, general debility, fractures and abject loneliness. 

In male dominated societies women suffer at all ages, but particularly so in old age with breaches of rights and instances of violence, abuse and neglect. Elderly ladies suffer from lower socioeconomic recognition, greater disability and infirmities, more solitude, less access to recreation, cultural and human interaction. Their participation in decision-taking processes even in their own families may become non-existent. Men of the same age are relatively more privileged. Moreover, since women live longer than men, their sorrows of widowhood and loneliness compound the situation. And yet, elderly women are still important caregivers to the younger as well as the older generations.

With their vast reservoirs of experience, memories, fortitude and tolerance the elders have the capacity to face hardships with resilience and stoicism. In ancient times the elders were the teachers, story tellers, keepers of tradition and the repositories of wisdom. However, today they are perceived as a burden to society, though they do contribute to society by inculcating values and perpetuating traditions in their families. 

Humor among Par-sis, often of the harmless slapstick variety, helps tide over crises in life.  Facing aging and death, their own and that of their loved ones, with caring hearts and humane empathy are lessons that our elderly teach mankind.

Women in particular take on Herculean tasks, looking after their families, relatives and grandchildren, remaining a source of care and stability even at an advanced age. Thanks to immigration, urbanization and increased numbers of young women in the job market, elderly women are replaying their roles as mothers instead of grandmothers. Broken homes, divorces and familial instability have perforce made the older generation caregivers again.

For married elders, the first one to develop a chronic illness can usually rely on the spouse for most of the direct care needed. Of all those assisting people aged 65 and older, spouses accounted for 24 percent, daughters 20 percent and sons a mere six percent, which shows that immediate family members comprise 50 percent of all caregivers. 

If there are dilemmas for the old, there are often equal or greater ones for the young. Thousands of Parsi families face the difficult task of caring for frail and incapacitated parents, aunts and uncles even as they struggle to bring up their own young children. Medicine offers many palliatives, but it cannot fend off the inevitable. There are no easy or mathematical answers for the ethical, social, legal, economic and medical challenges ahead. 

How we spend our old age needs to be thought through when we are still young and able-bodied. Financial security is one of the most important needs. Planning for pension or placing savings in secure assets will help ward off the feeling of total dependence on family or friends. Recognizing this need early in life would prevent years of dejection and rejection when old age finally arrives. Health insurance policies and monies kept aside for looking after the needs of the elderly are a priority. 

Strengthening bonds of friendship, affection and respect with family members, friends and support system groups needs years of nurturing and foresight. Developing hobbies, new interests and keeping the mind active with some form of work will help create a happier frame of mind. There are many outlets for the able-bodied elders: eg, they can read to the blind, aid in NGO (nongovernmental organization) programs, help in homes, cancer rehabilitation programs, etc. Youngsters must be taught to set aside some quality community time for the frail, the ill and the incapacitated.

The importance of writing a will should be disseminated by the government and via the media. A will made when an individual is in his/her right senses is a legal document which should be respected to the letter. When estates, monies, jewelry and assets are at stake, there is the possibility of a whole chapter of crime opening up. At a time when the aged are feeble and unable to protect their own interests, a will made earlier still stands and there should be a legal process to protect the interests of the individual. Issues of health and the wishes of persons regarding their care, donation of their organs for transplantation or for medical research need to be seriously considered.

We need to think and develop social protection systems, well run old age homes with recreational facilities, hospitals trained for geriatric patients, subsidized health care at concessional rates, realistic insurance policies for the aged and employment opportunities for the ‘active aged’ to give a sense of usefulness to them, and harness the skills they have garnered over the years.

Dr Roshni Farokh Chinoy is a cancer pathologist working at Prince Aly Khan Hospital, Bombay. Zarina Pundole (née Chinoy) is a solicitor now working in the US.