From Family-Based Care to Formal Elder-Care Systems in India: A Comparative Systematic Review of the Social, Cultural, and Economic Drivers of Palliative and Residential Geriatric Care in Kerala and Rajasthan, 2015–2025..
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Abstract
Ageing of the population has turned out to be one of the most pertinent demographic changes of the twenty-first century, which has added more long-term care services to the demand in most societies. The percentage of individuals over 60 years old in the world is expected to increase at an alarming rate, posing novel challenges to health services and care models (United Nations, 2023; World Health Organisation, 2022). Historically, joint family systems and strong culturally-driven expectations of intergenerational support in India have facilitated the presence of traditional family-based elder care as the main model of elder care. Nevertheless, the process of urbanisation, migration of labour, reduction in household size, and increased weight of chronic diseases are slowly changing the nature of caregiving (Irudaya Rajan & Mishra, 2020). This paper will discuss the rise in the number of palliative care centres and geriatric homes in India between 2015 and 2026. The study merges an international systematic literature review with a content analysis based on the themes of Kerala and Rajasthan, using digital content. The results show that demographic ageing, the lack of family caregiving abilities, and the increasing healthcare demands are promoting hybrid institutional elder care in modern India...
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References
Aboderin, I., & Beard, J. R. (2015). Older people’s health in sub-Saharan Africa. The Lancet, 385(9968), e9–e11. https://doi.org/10.1016/S0140-6736(14)61602-0
Agarwal, A., Lubet, A., Mitgang, E., Mohanty, S., & Bloom, D. E. (2019). Population aging in India: Facts, issues, and options. Population and Development Review, 45(3), 575–600.
Amrita Institute of Medical Sciences. (2020). Geriatric medicine services. https://www.amritahospitals.org
Apna Ghar Ashram. (2022). Residential services for abandoned elderly. https://www.apnagharashram.org
Beard, J. R., Officer, A., de Carvalho, I. A., Sadana, R., Pot, A. M., Michel, J. P., Lloyd-Sherlock, P., Epping-Jordan, J., Peeters, G., & Mahanani, W. (2016). The World report on ageing and health: A policy framework for healthy ageing. The Lancet, 387(10033), 2145–2154. https://doi.org/10.1016/S0140-6736(15)00516-4
Beard, J. R., Officer, A., Cassels, A., & others. (2020). Decade of healthy ageing: Baseline report. World Health Organization.
Bhattacharya, S. (2017). Family structure and elderly care in India: Emerging trends. Indian Journal of Gerontology, 31(2), 154–168.
Bloom, D. E., Chatterji, S., Kowal, P., Lloyd-Sherlock, P., McKee, M., Rechel, B., Rosenberg, L., & Smith, J. P. (2015). Macroeconomic implications of population ageing and selected policy responses. The Lancet, 385(9968), 649–657. https://doi.org/10.1016/S0140-6736(14)61464-1
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Chatterji, S., Byles, J., Cutler, D., Seeman, T., & Verdes, E. (2015). Health, functioning, and disability in older adults: Present status and future implications. The Lancet, 385(9967), 563–575.
Chatterji, S., & Kowal, P. (2017). Ageing and health research: Global perspectives. The Lancet, 385(9967), 570–578.
Colombo, F., Llena-Nozal, A., Mercier, J., & Tjadens, F. (2011). Help wanted? Providing and paying for long-term care. OECD Publishing. https://doi.org/10.1787/9789264097759-en
Dignity Foundation. (2023). Senior citizen welfare initiatives. https://dignityfoundation.com
Ghosh, S. (2016). Social isolation and vulnerability among elderly populations in India. Journal of Social Policy and Administration, 50(5), 567–585.
Government of India. (2020). National Programme for Health Care of the Elderly (NPHCE). Ministry of Health and Family Welfare. https://main.mohfw.gov.in
HelpAge India. (2022). Elderly care programmes in India. https://www.helpageindia.org
HelpAge International. (2018). Global age watch insights report. HelpAge International.
Institute of Palliative Medicine. (2023). Palliative care services in Kerala. https://palliativecare.in
Irudaya Rajan, S. (2017). Ageing in India: Long-term care and elder care policies. Economic and Political Weekly, 52(40), 50–57.
Irudaya Rajan, S., & Kumar, S. (2020). Living arrangements and institutional care among older persons in India. Journal of Population Ageing, 13(2), 157–175.
Irudaya Rajan, S., & Mishra, U. S. (2020). Ageing and health in India. Springer.
Kerala Health Department. (2024). Community palliative care programmes. Government of Kerala. https://dhs.kerala.gov.in
Khosla, R. (2019). Elderly care policies in India: An analysis of policy frameworks. Journal of Population Ageing, 12(4), 463–481.
Kozinets, R. V. (2020). Netnography: The essential guide to qualitative social media research. Sage Publications.
Kumar, S. (2013). Kerala’s community-based palliative care model: A public health approach. Indian Journal of Palliative Care, 19(1), 21–25.
Kumar, S., & Numpeli, M. (2018). Neighbourhood networks in palliative care in Kerala. Indian Journal of Palliative Care, 24(3), 289–292.
Lamb, S. (2018). Successful aging as a contemporary obsession: Global perspectives. Rutgers University Press.
Lloyd-Sherlock, P. (2016). Ageing and health policy in developing countries. The Lancet, 385(9968), 678–680.
Lloyd-Sherlock, P. (2017). Long-term care in developing countries: Challenges and policy responses. Social Policy & Administration, 51(7), 1102–1120.
Lloyd-Sherlock, P., & Kalache, A. (2020). Improving policy responses to population ageing in developing countries. Global Health Action, 13(1), 1789377.
Moon, H., Shin, J., & Lee, J. (2019). Long-term care systems in ageing societies: Comparative policy perspectives. Health Policy, 123(5), 437–444.
Narayan Seva Sansthan. (2021). Elder care programmes. https://narayanseva.org
NITI Aayog. (2021). Senior care reforms in India: Reimagining the elderly care ecosystem. Government of India.
OECD. (2017). Preventing ageing unequally. OECD Publishing.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pallium India. (2024). Community palliative care programmes. https://palliumindia.org
Prince, M., Wimo, A., Guerchet, M., Ali, G. C., Wu, Y., & Prina, M. (2015). World Alzheimer report 2015: The global impact of dementia. Alzheimer’s Disease International.
Rajagopal, M. R., & Palat, G. (2002). Kerala, India: Status of cancer pain relief and palliative care. Journal of Pain and Symptom Management, 24(2), 191–193.
Rajasthan Social Justice and Empowerment Department. (2024). Senior citizen welfare schemes. Government of Rajasthan. https://sje.rajasthan.gov.in
Sinha, A., Patel, M., & Singh, A. (2016). Geriatric healthcare services in India: Current status and challenges. Indian Journal of Community Medicine, 41(4), 293–298.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333–339. https://doi.org/10.1016/j.jbusres.2019.07.039
United Nations, Department of Economic and Social Affairs. (2023). World population ageing 2023. United Nations. https://www.un.org/development/desa/pd/content/world-population-ageing-2023
World Health Organization. (2015). World report on ageing and health. World Health Organization.
World Health Organization. (2020). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care
World Health Organization. (2022). Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health