“Lifecare enabled Communities” –
An emerging concept in Senior Living
Senior living solutions is a topic being discussed by many and is
relevant in today’s society. “Lifecare Enabled Retirement Community”
is a new variant and is considered to be a sustainable solution for the issue. Mrs. Annamma John, a 74 year old retired
government officer moved out of her own house 12 years back
when both her sons were securely settled in the US and
middle east when she was widowed at the age of 62.
It was a very difficult decision for the family to take as there is
a definite stigma attached to old age homes. She was not going to
a usual old age home where older persons were lined up in a
dormitory and who have to follow strict time table laid by the
management or the charitable NGO. It was also not a
place where older persons where found abandoned by their
family and the society and where older persons had to live
the rest of their life at the mercy of others. Even though she was
going to a ‘Five star’ senior citizens Home where she has to
pay a lump sum amount in Lakhs as deposit and monthly
subscription, many of her relatives could blame her and her sons.
Today, Mrs. John is very happy and says it was a wise
decision she had taken taking into account the rising incidence
of crime and violence against older persons. Almost all of the
residents of such homes have a similar story to say.
The concept of an old age home was brought into our Indian
culture just a few decades back as the conventional family structure
of a Joint family system fragmented giving rise to nuclear families. Migration of younger generation in search for better
job opportunities and financial security left the older generation alone
and in agony when the expectation that
“children will look after their parents” could no longer be realized.
Those who had migrated early and have come back home after
retirement added up to the number of older persons who require
care and support. According to data available with State crime records bureau of Kerala, suicides among elderly is very high that points to the psychosocial distress faced by today’s elderly. As per statistics, elderly comprise of more than 9% of the total Indian population and around
12% of Kerala population is elderly. The population of elderly are
increasing rapidly as more are entering the 60s group while
older persons are living longer. It is projected that the population of
elderly is going to rise substantially in the coming decade.
One of the major concerns of older persons is the uncertainty
remaining in the place of stay in their later life. As there is lack of care givers, safety and security of staying alone in a house is questionable. There are only limited options for these elderly regarding place of stay.
Very often they will have to shift from their original house to a
new place with their children. There are occasions where children
decide to separate their parents for convenience. Here this old man is forced to stay with one of his sons separate from his wife breaking decade’s long companionship which is often very painful for
older couples. When children are not able to take their parents
along with them, their parents are been entrusted to one of the
relatives with whom the older person may not be even
comfortable with. In all these situations where they have to leave
their own house and stay in a new place, they loose all their
social contacts, friends and familiar surroundings.
Such older persons get dependent, depressed and their
quality of life suffers. Another option for these older persons is to
shift to an old age home. Stigma attached to old age homes is the
major disadvantage for those who care. One major concern with
old age homes is the fact that independency and dignity is often compromised as the inmates have to live the rest of their later life
abiding to rules and regulations prescribed by the management -
even regarding time of prayer. Now there are a lot of paid old age
homes coming up in India which offer better services preserving
dignity and promoting active ageing. Another senior living option
nowadays is to hire a home nurse to care at home. But unfortunately,
older persons find extremely difficult to cope with and adjust with most of the home nurses who are not trained in geriatric care. Moreover, crime reported with home nurses is also increasing and hence popularity of arranging a home nurse on a longer duration as a solution for senior
living is not often sought.
It is at this juncture, new ventures in senior living are coming up such as ‘Retirement communities’ and ‘Continuing care retirement communities’ (CCRC). In this concept, the older persons can purchase residential properties with certain conditions and can live there for the rest
of their life. A continuum of care is assured as the older person’s life
shift between independent living, assisted living and ambulatory care.
Many retirement communities have all the care facilities short of a
hospital in the same premise. In this concept the older person
lives his rest of life in own home with dignity, safety and security in all aspects. The services available in such apartments in a retirement community range from assisted living (that provide some
housekeeping, social activities, supervision and assistance with basic activities like personal hygiene, dressing, eating and walking) through skilled nursing care for seniors requiring medical care
prescribed by a physician. A continuing care community is suitable
for older persons who live in isolation and long to have a social life with persons of their age immersed in a hospitable environment. The only disadvantage of a retirement community is that it is yet another old-man’s place. Those older persons who wish to live integrated in a normal community will not find a retirement community appealing in a traditional Indian setting.
With this background, another model for senior living is
being proposed. This “Lifecare enabled Community” is a
new concept that should
come up in future. What is special with this community is that,
it is a normal community where all age group stays.
If there is an older person
staying in such a community, the particular home is
automatically covered with ‘Lifecare’ and the person receives all
service that he could have got in an old age home or a retirement community. Such ‘lifecare enabled communities’ overcome the
cultural stigma of an old age home and at the same time deliver all
care and service expected from being in an retirement home.
The key features that are available in such a community are
Day care Center, Extensive educational / cultural and
recreational activities, Emergency Nurse call facility,
regular health checks, nursing care, Updated medical / other
data on the Web – password Protected for relatives, meal
delivery on demand, companion for scheduled outings and
The new proposed concept of ‘Lifecare Enabled Communities’
will keep the elderly integrated to the society and will never
alienate them from the main stream. More builders and service
providers need to enter this
arena to build such enabled communities that will solve
chunk of problem faced by the elderly. Just as residential
services and amenities such as children’s play ground,
health club, swimming pool etc, the trend would be to add
as an added service. “Ageing in place” – a philosophy that is
considered as ideal and at the same time the most difficult to
materialise can be realised if such “lifecare Enabled Communities”
Dr. Praveen G Pai
A Specialist in Gerontology