Kathmandu’s Geriatric Home In Mess



Kanhaiya Mathema


Population being a dynamic concept gets changed every time adding to the previous number. The population of Nepal has also increased in recent times. It was about 23 million (July 2016) registering an increase of 5 million from the last 1991census with the growth rate of 2.3 per cent. The current population is approximately 30 million indicating an addition of about 3 million people every 5 years.

With the rise in the socio-economic indicators especially in education and health sectors, both the birth rate and death rate have declined. The population growth rate has come down to1.24% (2016).The death rate has been registered at 5.7 per 1,000 population (2016 est.), meaning thereby, Nepal has most probably attained the third phase of demographic transition. The life expectancy at birth is 70.7 for the general population whereas it stands at 70.1 for the males and 70.3 for the females in 2016 meaning thereby, Nepal has most probably attained the third phase of demographic transition. The population of 65 years and above is numbered at 5.02 per cent (male 723,523 and female 732,620) (2016). This percentage has gone up to 5.27 in 2017.

The number of nuclear family was 4.25 million in 2001census. It has gone up to 5.42 million in the 2011 census. One can imagine that the figure might have increased all the more in recent times.

With such a positive change in demographic indicators and in socio-economic sector, a distinct rise in the aged population can be easily visualised.

Family system and values

The other side of the story indicates the change in the family life of the general population.  A drastic change has occurred in the family system in Nepal.  The nuclear system of family is at vogue and is increasing at present. The family value is rapidly changing. The joint family system is suffering a breakdown from the traditional family system.  In a way, it has become the victim of modernisation and global opening of the national borders.  It has dropped the insurance for the older people. They are facing a growing insecurity in their lives. Their aspirations and dreams are found to have gone on the long grass.

Unfortunately, the rapid rate of urbanisation, educational development, imitation of western values and declining fertility in the country go on to add to the disintegration of harmony of the joint family system and family structure in the country.

Moreover, the other important contributing factor along this line can be taken as the migration of the young economically active population in general either for employment or for study abroad. There is hardly a household where one cannot come across at least of one young member not being an absentee whether for education or for job abroad. 

The surge in out-migration for foreign employment has brought profound changes in the socio-economic fabric of the country as has been visualised in Status Report for Nepal: 2014/2015. More than 3.8 million permits to work abroad (excluding India) were issued by the government during the 1993/94–2014/15 fiscal years, which represents almost 14 per cent of the current population. According to the recent Census 2011, nearly 71 per cent of the total absent population (1,921,494), or people are living outside the country. Among the many impacts of foreign employment, the social dynamics have changed, with many people in the working-age population remained absent from home, according to the same source. The data for 2010/11–2014/15 as has been given by the Status Report: 2014/2015 also indicate that the number of students leaving Nepal is increasing, from 33 per day to 84 in recent times.

Such a situation has left the aged members of the family at home at the mercy of their faith. Whether they are geriatrics or not, they have been compelled to perform their errands and other functions on their own. It has created a hard time for them irrespective of their level of income. An unfortunate predicament has arisen whereby the aged has to look for external support for their existence. Here comes the need for the establishment of Geriatric Care Home for these people.  Since they are unable to live independently in their own homes, they are being compelled to choose to move into a Geriatric Home. These Homes are supposed to provide various levels of personal and nursing care to the people being admitted there in addition to the provision for accommodation, meals, laundry and help with personal care with a view to promoting the welfare of the senior citizens.

 Nepal’s Tenth Five Year Plan has envisaged guaranteeing a comfortable, secured and honourable life for senior citizens whereby the Geriatric Homes stand as the conduit to fulfill such vision. Actually, these Homes are providing services and care for the unfortunate old ones, and thus it is praiseworthy.

However, writing in Dhaulagiri Journal of Sociology and Anthropology Vol.2 (PP 211- 212), Pradeep Acharya observes that current senior citizen policies are mainly concerned with encouraging NGOs in establishment and operation of elderly homes, providing special privileges to them that set up such homes. He points out towards our rich culture of paying respect to our elderly. The same has been broken by the changing context of the world, desire for a small family, poverty and urbanisation process.

Eclipse in expectation

Surely, migration of the able-bodied has acted  as the push factor while the operation of the Care Homes for the aged have acted as the pull factor for them to present themselves in these places. In fact, the inmates in these Homes are not economically poor nor are financially weak. They have the ability to pay and are in the hope that they would be properly taken care in those Homes against the payment of the high cost that they would incur there. They expect to experience homely environment and peaceful life during their old age in those Homes since they are devoid of the love and care that they deserve from their loved ones. To their total dismay, the environment is totally precarious and sad. Commercialisation has overwhelmed the management. services to the elderly, which are far below the expectation. Sometimes they are being engulfed by mental disorder.

Many of these lack proper sanitation and care for elderly. They have been forced to go through unhealthy and unfriendly environment. Least consolation is in the air against the sufferings and sorrows caused by the absence of the love and care of their family members. They are rolling with their shattered dreams. Let prudence prevail upon the managers of such Homes and the supervising bodies, if any.



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