SEMINAR REPORT An Attempt to Develop Gerontological Social Work in...
SEMINAR REPORT
An Attempt to Develop Gerontological Social
Work in India
Introduction
A National Seminar on 'Globalisation and Ageing: Implications for
Gerontological Social Work' was organised by the Tata Institute of
Social Sciences and the Family Welfare Agency, on December 22-24,
1997.
The objectives of the Seminar were to:
• examine the effects of globalisation on the roles, power and
status of the ageing;
• analyse the differential situation of the ageing by urban/ru-
ral/tribal context, organised/unorganised sources of livelihood
and gender;
• discuss the following issues of ageing and review research, laws
and programmes for each: Social security, physical health, men-
tal health, living arrangements, care giving, and neglect and
abuse;
• consolidate recommendations for a national policy and laws for
the ageing; and
• draw implications for gerontological social work practice, re-
search, education and training.
An analysis of the emerging needs of older persons, in the context
of globalisation, is summarised in this report, followed by some
guiding principles of work with them and recommendations for a
national policy, work by voluntary organisations, social work curricu-
lum and training programmes for paraprofessionals, that emerged from
the Seminar papers and proceedings.

An Attempt to Develop Gerontological Social Work in India 675
Emerging Needs of Older Persons in the Context of
Globalisation
Socioeconomic Trends
The older persons in India have carried a high status, the oldest man
generally being considered the head of the family. As their family
responsibilities were concluded, they were expected to move out to
play a role in community activities. The dominant paradigm of devel-
opment, comprising technological advancement with industrialisation,
urbanisation and liberalisation, has been changing the socioeconomic
context of ageing. The fast moving world of technology, increasingly
values young and educated professionals. The experiential wisdom of
the older persons is not being considered productive in this scenario.
Moreover, the concept of retirement from work is leading to lowering
of their status as non-productive dependents. It is the earning man who
is now being considered the head of the family. Women, who were
always subordinate to the men in the family, earlier had authority over
younger women. Due to growing consumerism, leading to self-cen-
tredness, the trend is towards inverting of hierarchies and ambiguity of
roles, rather than a movement towards an egalitarian family structure.
This marginalisation is being justified by assumptions that older
persons have reduced physical and intellectual capabilities and are,
therefore, dependent on the younger population. This is usually not
true at the age of 60, just because it is generally the age of retirement
from formal work. The young-old (61-70) are productive human
resources, as seen in the informal sector, and the old-old (71-80) are
capable of being useful to the society and are not dependent liabilities.
The non-productive very old (81+), the disabled and the terminally ill;
the landless and the migrant; and the single older persons in cities,
where community supports are weak, are more likely to be neglected,
abused and rendered destitute. 'Development' has led to migration and
displacement of individuals and families from their roots, traditional
sources of livelihood and community bonds and supports. The prob-
lems of older persons are aggravated due to loosening social support
systems of family and community.
Demographic Trends
Besides the socioeconomic trends, the following demographic trends
are taking place in India, leading to a growing number of and a new
profile of older persons. The evidence is drawn from the Census data.

676 An Attempt to Develop Gerontological Social Work in India
1. The physical context of ageing is changing. The death rate is
reducing, especially in the 0-4 age group. It came down to 29.1
per 1000 in 1991. The expectancy of life at birth is increasing.
It increased to 59.4 in 1991. The birth rate is reducing. It
reduced to 29.5 per 1000 in 1991. As a result of these demo-
graphic changes, the population in the age group of 60+ is
increasing. It increased to 56.7 millions, comprising 6.8 per
cent of the total population in 1991. It is growing at a rate faster
than the rest of the population. The older population is expected
to grow to over 76 million by year 2001, which would comprise
7.7 per cent of the population then.
2. The 60+ population is, by and large, rural (78.1 per cent in
1991), as the young tend to migrate to urban areas. In the rural
population, 7.1 per cent of the people were 60+ whereas 5.7 per
cent of the urban population was in this age group in 1991. On
the other hand, life expectancy at birth is higher among the
urban population (64.9 in 1991) as compared to that of the rural
population (58 in 1991), due to better health services in urban
areas.
3. Longevity also has gender differentials. The life expectancy at
birth is greater for females (59.7 in 1991) than for males (59 in
1991). As a result, the sex ratio in the 60+ age group is better
(932 females per 1000 males in 1991) and increasingly im-
proves with age, compared to the population as a whole (927
in 1991). However, older women have a higher morbidity rate
than older men.
4. As a result of higher longevity among women as well as a
higher remarriage rate among men, a majority of the female
older persons (54 per cent in 1991) are widowed, while a large
majority of the male older persons are married (80.7 per cent
in 1991).
5. Almost three-fourths of the 60+ population (72.85 per cent)
was illiterate in 1991. The literacy rate among the older females
was worse (12.68 per cent) than that of the older males (40.62
per cent) and that among the rural older persons was worse
(21.12 per cent) than that among the urban older persons (48.72
per cent). However, literacy rate among the older persons will
improve in the coming years, as today's young literate grow old.
The labour force participation among the 60+ population was
6.
39.13 per cent in 1991, mainly in the agricultural and informal

An Attempt to Develop Gerontological Social Work in India 677
sector. While it is higher and increasing among the rural older
persons, it has gone down for the urban older persons, as a result
of more people retiring from the formal sectors in the urban
areas. On the other hand, the urban older persons earn much
more than the rural older persons. Moreover, the average salary
earnings of the older persons are much lower than the rest of
the earning population and that of the male older persons are
much higher than that of the female older persons.
Thus, the situation of the older persons is not homogeneously
changing. It differs by sex, urban-rural context and other such factors.
The 60+ population is more likely to be rural, female and single,
illiterate, and poor, compared to the rest of the population and, there-
fore, vulnerable to marginalisation.
Emerging Needs
The growing marginalisation of older persons in the context of socio-
economic and demographic changes, needs to be countered by gov-
ernment and non-government approaches that accept old age as a
developmental stage and not a problem or a disease, and older persons
as human resources and not as liabilities. Besides, often being the care
givers of their grandchildren, increased longevity also means that the
young-old are also likely to be the care givers of their very old parents.
Coordinated approaches are necessary to ensure that the needs of older
persons with reference to their self-fulfilment, health and nutrition;
work and financial security; property and housing; continuing educa-
tion; recreation and mobility; family and community awareness and
interaction; protection from neglect, violence and destitution; and
death with dignity; are met as rights and not as charity.
Guiding Principles for Work with Older Persons
The United Nations Principles for Older Persons are organised in five
clusters: independence, participation, care, self-fulfilment and dignity.
The government may draw from them and develop the following
guiding principles to guide the National Policy for the Well-Being of
Older Persons, in order to counter their marginalisation and ensure
their well-being.
1. Positive Perception of Older Persons
Old age is a developmental phase and not a disease or a problem. The
needs of the older persons generally vary from the young-old (61 -70),

678 An Attempt to Develop Gerontological Social Work in India
to the old-old (71-80), to the very old (81+). Most of the young-old are
productive in the informal sector and often the care givers of their
grandchildren or their very old parents. Most of the old-old are capable
of being useful to the society. They are human resources and not depend-
ent liabilities. Their capabilities need to be constructively utilised for their
well-being and that of the society. Age related discrimination needs to be
prevented in education and employment. The strategies of reemployment,
flexible work, second career, and so on, need attention.
2. Need for Outreach to Vulnerable Older Persons
The vulnerable among the older persons are the non-productive very
old, the disabled and the terminally ill, who are dependent on others
for care; the landless and migrant; and the single, the destitute and the
institutionalised. Voluntary organisations should have outreach pro-
grammes for the vulnerable older persons, especially the women, who
may not be aware of or cannot access the organisations.
3. Rights of Older Persons
The older persons have a right to meet their basic needs of self-fulfil-
ment, health and nutrition; work and financial security; property and
housing; continuing education; recreation and mobility; family and
community awareness and interaction; protection from neglect, vio-
lence and destitution; and death with dignity.
4. Family and Community as Natural Systems
Family and community are the natural support systems of the older
persons, which need to be strengthened. The non-institutional services
should, therefore, be given priority over the institutional services.
5. Sensitivity to the Background of Older Persons
The programmes for older persons should be planned depending upon
the composition of the group with reference to sex, marital and family
status, urban/rural context, literacy and education, organised/unorgan-
ised source of livelihood, religion and so on.
6. Barrier-Free Environment
The planning of the physical structures such as public transport,
government buildings, market, banks, voluntary organisations and the
fixtures and the furniture within, should be barrier-free to facilitate
mobility of older persons.

An Attempt to Develop Gerontological Social Work in India 679
7. Participatory Approach
The voluntary organisations should follow the principle of participa-
tory approach by involving the young-old and the old-old, according
to their interest, in the planning, monitoring and evaluation of the
policies and programmes for them.
Recommendations for a National Policy for the Well-being of
Older Persons
The guiding principles for work with older persons need to be inte-
grated in the legislation, old age pension schemes and grant-in-aid
schemes of the Ministry of Welfare and policies and programmes
of other ministries. Services, when made available, should also be
accessible to those who need them and people should be made aware
of their availability. The state needs to coordinate and collaborate
with the voluntary organisations, academic institutions and interna-
tional organisations, to promote the principles for the well-being of
older persons.
Legislation
Holistic Family Legislation/or Older Persons
A holistic family legislation for older persons is needed to protect older
persons' right to family housing and property. Women's right to family
housing and property needs to be strengthened with reference to her
rights as a daughter, sister, wife and mother. Family violence against
the older persons should be made a cognisable offence.
Age Related Discrimination
Prevention of age discrimination will help to promote the well-being
of older persons in the liberalised economy, where the young are going
to be given increasingly higher preference. This will help to bring
down the old-young dependency ratio. Age related discrimination
needs to be prevented in education and employment. The discrepancies
in retirement age within and across centre and states need to be
reviewed and revised with reference to increased longevity.
Social Security for the Informal Sector
A social security legislation for people who work in the informal sector
could replace the ad hoc national and state-sponsored old age pension
schemes.

680 An Attempt to Develop Gerontological Social Work in India
Care Giving Support
A legislation is necessary to provide care giving leave and financial
support to the male and female care givers of the immobile older
persons, along the lines of maternity leave. Such a support is also
necessary for older persons who are care givers for their parents, or
children, or grandchildren.
Barrier-Free Structure
Public transports and the building bye laws and development control
regulations should ensure that built environment, especially in public
places, are planned to facilitate mobility of the disabled and the older
persons.
Legal Aid and Petitions
Free legal aid should be made available to the older persons. Priorities
may be given to the speedy disposal of petitions by or on behalf of
older persons, as a human right imperative.
Old Age Pension
Pensions provided to older persons who have worked in the organised
or the unorganised sector, should have provisions of including the
dearness allowance and be exempted from tax.
As a majority of India's older persons live below the poverty line, in
the rural informal sector, strengthening the old age pension schemes
targetting at this group, will help prevent destitution among and need for
institutionalisation of older persons, in the absence of a social security
legislation applicable to this people. Financial allocation being done for
institutional services needs to be diverted to these schemes which help
retain the older persons within their family and community settings.
The criteria of destitution/ widowhood/no family support, need to
be reviewed so that older persons, below the poverty line, get financial
assistance, independent of their dependence on family members.
Speedy delivery of pensions is a human right imperative for older
persons. Funeral expenses of the beneficiaries of this Scheme may be
in-built into the Scheme.
Scheme for the Welfare of the Aged
The Scheme for the Welfare of the Aged should be reworded as the
Scheme for the Weil-Being of Older Persons. It should lay down

An Attempt to Develop Gerontological Social Work in India 681
minimum standards and regulations for services and the grant should
have in-built provisions for in-service training, monitoring and evalu-
ation. The Scheme should aim to develop a service centre for older
persons below the poverty line in every district, and be managed by
the Panchayati Raj institutions. This centre may have a three-pronged
approach, depending upon the needs of that district: multiservice
centres for the mobile, outreach units for the home-bound and old age
homes for the destitute older persons. The Old Age Pension Scheme
may also be routed through this centre.
Multiservice Centres
The day care centres may be reworded as multiservice centres which
may be required to provide various non-institutional support systems
to older persons: Developmental programmes for preparation for old
age, death and bereavement and raising family and community aware-
ness for enriched interactions; health check up camps, information and
awareness for prevention of problems and treatment; continuing edu-
cation; training and opportunities for income generation, employment
exchange and sponsorship; training as volunteers; recreation, cultural
and creative art programmes; occupational therapy, counselling and
legal aid; self/mutual help groups; family assistance; information and
referral services; death with dignity; and so on. Older persons may also
function as volunteers for community activities. Telephone helplines
may be sponsored, to provide information and referral services and for
crises intervention in the lives of older persons. A canteen is needed
for older persons who would like to make use of it. Day care centres
for children may be integrated with those for the older persons so that
day care needs of both the groups can be met in an integrated manner.
Outreach Units
Instead of focussing only on mobile medicare, the outreach units may
also run other home/family-based services for home-bound older
persons such as mobile meals, clinics and libraries; volunteer's visits
for help in homemaking and running external errands; and information
and referral services.
Old Age Homes
Although non-institutional services should be given a priority over
institutional services, the destitute and the houseless, and the older
persons who are unmarried or childless, those whose children have

682 An Attempt to Develop Gerontological Social Work in India
migrated abroad and those who have only daughters, face the problem
of care giving even when they have their own home to stay.
The old age homes for older persons may be required to provide for
self-fulfilment, health, nutrition and care giving, continuing education,
and recreation activities and facilitate death with dignity. The institu-
tional life should correspond to normal conditions in the family and
community as far as possible. The institutions may keep their health,
education and recreation services open to non-resident older persons.
The homes for older persons may be combined with those for children.
The residents should be treated with dignity and respect. The residents'
interaction with their family members and community may be encour-
aged but not forced. Institutions should be made an integral part of the
community. Interactions between the residents of old age homes and
the associations of senior citizens may be promoted.
National Institute for Ageing
The changing situation of the older persons and the emerging issues
require a comprehensive and focussed attention to ageing. A national
institute for ageing may be set up, with regional branches, aiming at
coordination and convergence of activities by the various ministries,
voluntary organisations, academic institutions, and international or-
ganisations, towards the well-being of older persons. The Institute may
undertake tasks such as developing and maintaining a data base on
older persons, carrying out and funding research, commissioning state
level status papers, compiling encyclopaedia, disseminating them,
setting up and funding innovative multiservice centres and outreach
units for older persons, networking among voluntary organisations work-
ing for older persons, conducting training programmes, making policy
recommendations, monitoring and evaluating programmes, and so on.
Recommendations for Voluntary Organisations
The management, staff and volunteers of the voluntary organisations
should be committed to the guiding principles while working with
older persons and raise community and government awareness regard-
ing them. They may plan and implement the following activities,
guided by these principles.
Developmental Programmes
Developmental programmes may be organised for facilitating ageing
and coping with the final stage of one's life span. Broadly speaking,

An Attempt to Develop Gerontological Social Work in India 683
these programmes may aim at preparation for and coping with old age,
preparation for death and bereavement and raising family and commu-
nity awareness about ageing, integrating information, attitudes and
skills in these areas.
Developmental Programmes for Preparation for and Coping with Old
Age
Preparation for old age needs to be started at the age of 50, or even earlier,
in the areas of self-fulfilment, health and nutrition, work and financial
security, property and housing, recreation and mobility, changes in roles
and interactions with family and community. These are not to be seen
merely as needs but also as rights of older persons. The ageing need
information, and skills in all these areas in order to cope with old age. The
stereotypes and myths that they themselves carry need to be expressed,
discussed and replaced with positive attitudes.
Developmental Programmes for Preparation for Death and Bereave-
ment
The two realities of certainty of death and uncertainty of its timing,
have to be conveyed to the ageing in order to help them deal with the
anxieties related to their own and their spouse's death. Spiritual/relig-
ious education for understanding death is useful. They should be
helped to turn their negative emotions of hatred, anger, guilt, pain,
depression, resentment, and so on into positive emotions of accep-
tance, forgiveness, love and meaning in death, so that death can be
faced with peace. The developmental programmes should also help the
older persons plan the financial and other aspects of lives for their
spouse after their death.
Family and Community Awareness Programmes about Ageing and
Death
Family and community awareness programmes are necessary to
change the prejudicial attitudes of children, youth and young adults
towards older persons by making them sensitive and responsive to
them. It can also provide skills for them to interact with and reach out
to older persons in the family and the community and protect them
from deprivation and exploitation. They can learn to use the potentials
of older persons towards making contributions to the well-being of the
family and community. Intergenerational programmes may be planned
for this purpose. Family and community awareness programmes

684 An Attempt to Develop Gerontological Social Work in India
should also convey the two realities of the certainty of death and
uncertainty of its timing to every age group. The ethos should be that
no one should die in the family and community without being cared
for and prayed for.
Other Non-Institutional Services
The nomenclature of day care centres need to be changed to multis-
ervice centres as older persons need a range of services and not
necessarily 'care'. The multiservice centres may provide support sys-
tems to older persons: Developmental programmes for preparation for
and coping with old age, death and bereavement and raising commu-
nity awareness; health check up, information and awareness for pre-
vention of problems and treatment; continuing education; training and
opportunities for income generation; employment exchange; training
as volunteers; recreation and creative art programmes; counselling and
legal aid; self/mutual help groups; family assistance; information and
referral services; death with dignity; and so on. Older persons may also
function as volunteers for community activities. A canteen is needed
for older persons who would like to make use of it. Day care centres
for children may be integrated with those for the older persons so that
day care needs of both the groups can be met in an integrated manner.
The voluntary organisations may also run outreach services for
home-bound older persons such as mobile meals, clinics and libraries,
volunteer's visits for help in homemaking and running external er-
rands, and information and referral services. Telephone helplines need
to be developed all over the country, to provide information and
referral services and for crises intervention.
Institutional Services
Although non-institutional services should be given a priority over
institutional services, the destitute and the houseless, and older persons
who are unmarried, childless, those whose children have migrated
abroad and those who have only daughters, face the problem of care
giving even when they have their own house to stay.
The institutions for older persons should provide for self-fulfilment,
health, nutrition and care giving, continuing education, and recreation
activities and facilitate death with dignity. The institutions may keep
their health, education and recreation services open to non-resident
older persons. The residents' interaction with their family members
and community may be encouraged but not forced. The institutional

An Attempt to Develop Gerontological Social Work in India 685
life should correspond to normal conditions in the family and commu-
nity as far as possible. The residents should be treated with dignity and
respect.
Recommendations for Curriculum Planning for Social Work
with Ageing

Introduction
Course curricula all over the country vary, but according to the
University Grants Commission's Second Review Committee Report,
subjects may be grouped under the following heads: Foundation
Courses, Method Courses, Social Work Administration and Policy
Courses and Social Research Course. The contents of gerontological
social work should be integrated appropriately into these various
courses as well as in their field work, so as to have a multifaceted
emphasis on old age in the context of the life span model. Distribution
of the components between the Bachelor's and the Master's level
courses, may be done by the respective schools, in the context of their
total programme. Wherever the pattern of electives exist, gerontologi-
cal social work could be offered as an elective.
Objectives
The objectives for curriculum on gerontological social work are
grouped into knowledge, attitude and skills areas as below.
Knowledge Objectives
1. Understand the theories, concepts and perspectives in geron-
tology and gerontological social work.
2. Examine the historical norms of roles, power and status of older
persons and emerging trends and issues in the context of
liberalised political economy and changing demography.
3. Study the physical, mental, sexual, emotional, economic, social
and spiritual aspects of ageing and emerging needs.
4. Understand and analyse the policies, laws and programmes
affecting older persons.
Attitude Objectives
1. Understand one's own attitude to ageing, and develop a positive
perception of older persons and intergenerational values.

686 An Attempt to Develop Gerontological Social Work in India
2. Perceive that older persons have a right to meet their basic
needs and to participate in the management of their lives.
3. Accept family and community as the natural support systems
of older persons.
4. Develop sensitivity to the background of older persons, espe-
cially to factors that make them more vulnerable.
Skill Objectives
1. Develop skills in psychodynamic, ecological and advocacy
approaches in gerontological social work.
2. Acquire skills in developmental programmes for the ageing,
their family members and the community in general.
3. Develop skills in health, livelihood and family related interven-
tions with older persons.
4. Obtain skills in programme planning, implementation and
practice based research with older persons.
Course Content
Introduction
1. Theories, concepts and perspectives in gerontology.
2. Changing demography of older persons.
3. Guiding principles of work with older persons.
4. Psychodynamic, ecological and advocacy approaches in geron-
tological social work.
Roles, Power and Status of Older Persons
1. Historical norms in different cultural, urban/rural, tribal, eco-
nomic, age and gender contexts.
2. Emerging trends and issues in the context of the liberalised
political economy.
3. Historical norms of practices related to death and bereavement
and emerging trends.
Health of Older Persons
1. Longevity and physical health.
2. Mental and emotional health.
2. Ill health, disabilities and care giving.
3. Sexuality in old age.
4. Spirituality in old age.

An Attempt to Develop Gerontological Social Work in India 687
5. Review of health policies and policies for the disabled and their
implementation with reference to older persons.
6. Health intervention: periodical check up, information and
awareness about prevention of problems, recreation and crea-
tive art programmes, spiritual discourses, counselling, and
access to geriatric treatment.
Older Persons and Livelihood
1. Work participation of older persons in the organised and unor-
ganised sectors.
2. Economic situation of older persons.
3. Age related policies and laws for education, employment,
retirement, social security and pensions.
5. Intervention needs: retirement planning, promoting savings,
investments and making a will, training and opportunities for
income generation, employment exchange and sponsorship
programmes.
Older Persons and Family
1. Interaction of older persons with parents, spouse, children,
children's in-laws, grandchildren and others.
2. Care giving roles between older persons and the family.
3. Issues of division of property and housing.
4. Issues of neglect, abuse, violence and abandonment.
5. Review of laws for inheritance and protection from abuse.
6. Intervention needs: raising family awareness and family and
bereavement counselling.
Review of Policy, Legislation and Schemes for Older Persons
1. Scheme for the Welfare of the Aged: institutional care, daycare
and mobile medicare units.
2. Laws affecting older persons.
3. Policy and plans for older persons.
Intervention with Older Persons
1. Developmental programmes for ageing; developmental pro-
grammes for preparation for old age; retirement planning;
developmental programmes for preparation for death and be-
reavement; and raising family and community awareness about
ageing and death.

688 An Attempt to Develop Gerontological Social Work in India
2. Non-institutional services/Community services: continuing
education; mutual/ self-help groups; training of older persons
as volunteers; counselling and legal aid to older persons; mul-
tiservice/day care centres; home/family-based services; tele-
phone helplines; information and referral services; and death
with dignity.
3. Institutional services
4. Training of paraprofessionals and volunteers
Methods of Teaching and Learning
• Lectures and discussions.
• Lectures by other professionals — geriatricians, lawyers, nutri-
tionists, insurance agents, yoga experts, practitioners, re-
searchers, or older persons.
• Field visits to institutional and non-institutional services.
• Presentations of case studies.
• Library study, writing assignment and class presentation.
• Observation and visualisation.
• Simulation games and role plays.
• Resource file — newspaper cuttings and research articles.
Methods of Assessment
• Classroom tests and examinations.
• Writing assignments.
• Case analysis.
• Carrying out a developmental programme with older persons/
their families/ community.
• Critical appraisal of researches and other policy documents.
Field Work Objectives
Students may be given opportunities to apply their class room learning
in their field work settings, with the objectives of analysing their
perceptions of older persons and promoting positive perceptions and
practising skills in psychodynamic, ecological and advocacy ap-
proaches with older persons, to promote development as well as to
intervene in problem situations. They may identify micro-level prob-
lems with older persons and develop linkages with macro-level prob-
lems and understand the importance for integrated model of social
work.

An Attempt to Develop Gerontological Social Work in India 689
Field Work Placements
Students can be placed in the following settings for practice in geron-
tological social work.
1. Settings with a focus on older persons: multiservice/day care
centres for older persons and homes for older persons.
2. Family and community settings that include older persons:
family service centres; community centres; hospitals and health
centres; industries; women's organisations; organisations for
the disabled; and police stations and civil courts.
3. Settings for creating intergenerational awareness (besides
those listed above): schools and colleges and children's and
youth organisations.
Field Work Content
The intervention programmes may be planned with the older persons
for whom they are meant, some by students under supervision and
some can be jointly undertaken by the supervisor and the student.
Developmental Programmes
Developmental programmes may be carried out with older persons for
preparation for and coping with old age, preparation for death and
bereavement and raising family and community awareness about ageing.
Developmental programmes for specific areas may cover the following.
1. Health related areas: ageing gracefully; health awareness pro-
grammes for physical exercises, nutrition and yoga; health
check up camps; packages to help older persons to understand
and manage illnesses of old age such as diabetes, high blood
pressure, arthritis, ophthalmic, hearing and dental problems;
and certainty of death and uncertainty of its timing.
2. Livelihood related areas: retirement planning; savings and
investment schemes; education on making wills; legal aware-
ness; and income generating programmes
3. Education and recreational programmes: continuing education
and programmes can be related to art, music, picnics, fun
activities, hobby-related activities.
4. Family and community awareness programmes: propagating
the concept of a caring family and community; celebration of
the World Day for Older Persons; sensitivity programmes for
children, youth and adults including discussion, sports activity

690 An Attempt to Develop Gerontological Social Work in India
and adoption programmes; developing linkages between com-
munity and old age homes; intergenerational programmes;
knowledge of rights of older persons and utilisation of the
existing services in the community; and promoting the concept
and implementation of a barrier-free family and community
environment.
Intervention
Efforts may be made to reach out to vulnerable older persons, such as
the very old, the disabled, the terminally ill, the single elderly living
by themselves, the destitute and the institutionalised. Need-based
intervention for counselling, legal aid, family assistance, and informa-
tion and referral services may be provided.
Group Work
Students can be helped to work with various groups such as:
1. Group of families having older persons as the family member.
2. Groups of older persons which can be self help groups, thera-
peutic groups, advocacy groups.
3. Groups of care givers.
Networking
Need-based programmes or innovative programmes can be developed
as a result of networking, for example, identification of elder abuse
cases and legal intervention in the same.
Recommendations for Training Programmes for
Paraprofessionals for Work with Older Persons

Introduction
An army of trained paraprofessionals is required to care for older
persons in the near future. These paraprofessionals could extend the
work of medical, social work and other professionals, as front-line
workers, and help in reaching a wider section of the society.
Objective
The objective of the training programmes is to build skill, knowledge
and attitudes, as well as facilitate practice of social work with older
persons by a set of paraprofessionals. These trained persons will assist
trained social workers and will be guided by them.

An Attempt to Develop Gerontological Social Work in India 691
Trainees
Any person in reasonably good health, who is above 18 years of age,
who has been educated at least up to ninth standard, and who is
interested in social work or in voluntary work should be eligible for
the training.
The programme should be flexible so that if need be other groups
could also be trained, such as spouse of an older person who needs
long term care, family members who may have to give care to a sick
older person likely to be discharged from hospital, and senior citizens
who are in good health and would like to volunteer in caring for others.
Trainers
Social workers, teachers, PHC workers, interested faculty members
from academic departments, people managing old age homes, day care
centres, and so on.
Training Sites
Primary Health Care centers, community centres, colleges/educational
institutes, old age homes, rehabilitation homes, any place where facili-
ties are available such as rotary/ lions clubs and so on.
Duration of Training Programmes
Three to four months course, spread over weekends or an intensive one
month course, may be extended or shortened depending on target groups
(part-time workers, deputed staff on short leave, family members who
need training and so on). A single module may also be used. For
example, only health and caring aspects may be taught to family
members who need to provide long term care.
Course Content
Basic Information on Work with Older Persons
1. Information about adult development and' ageing — who are
older persons.
2. Guiding principles for work with older persons.
3. Role of paraprofessionals: why need paraprofessionals, ration-
ale for training, roles, responsibilities, when to consult super-
visors, limits of their roles.
4. Ethical responsibilities.

692 An Attempt to Develop Gerontological Social Work in India
Physical Aspects of Ageing
1. Major changes with age, age related diseases, sensory difficul-
ties, stroke, heart disease, psychiatric disorders.
2. Multiple diagnosis and poly drug use in older persons, drug-
drug interaction and effect.
3. Prevention of disability, health promotion steps in community
importance of nutrition and physical activity in ageing.
Psychological Aspects of Ageing
1. Common psychological problems, depression, and coping with
loss of job, spouse, physical abilities.
2. Cognitive loss, memory failure, detecting dementia.
3. Anxiety, death anxiety, preoccupation with death.
4. Death counselling.
5. When and whom to refer a person to mental health profession-
als.
6. Guidelines for happy ageing, plan for old age, role of religion,
recreation, social activity and groups in ageing well.
Economic Aspects of Ageing
1. Economics of ageing, dependence in old age.
2. Retirement and planning for retired life.
3. Reemployment, part-time employment, types of work that a
retired person can do, who will employ, list of agencies.
4. Longevity and hidden costs of medical care, chronic illness and
expenses.
5. Eligibility for pension, welfare measures, types of facilities
available, whom to approach, list of agencies.
6. Where and how to apply for financial aid, sources for civic
concessions, subsidies.
7. Making a will, bestowing property, how to save and invest.
Sociological Aspects of Ageing
1. Loneliness and isolation, role loss, and vacuum.
2. Loss of social support, intergenerational support, negative at-
titudes of ageism.
3. Changes in family, living arrangements, coping with it.
4. Neglect, abuse, exploitation, how to identify such cases .
5. Counselling in cases of relationship problems.

An Attempt to Develop Gerontological Social Work in India 693
6. Institution as an option, pros and cons of old age homes.
7. Community participation in elderly care, mobilising social
support.
8. Social rehabilitation of isolated older persons.
Self Care Practices
1. Basics of nutrition/ diet for older persons, high fibre diet, diet
in case of systemic disorders.
2. Importance of personal hygiene, weight control and exercise,
yoga, aerobics, meditation and so on .
3. Habits: eating, bowel, sleep, avoidance of alcohol, tobacco and
so on.
4. Health check up, why and how often, breast exams and mam-
mography for middle aged women, post-menopausal check up
for cancer.
5. Oral/ dental care, cataract, hearing problems.
6. Common precautions to be taken for well-being of older per-
sons: avoiding falls, accidents, injuries.
7. Barrier-free environment: safe household, environment railing,
non-slippery floors, good lighting, creating a safe neighbour-
hood.
Education and Awareness Building
1. Creating mass awareness, motivating community and opinion
leaders, motivating people to attend health camps, using relig-
ious and cultural groups for spreading messages, celebrating.
2. Older Person's Day.
3. Awareness about rights, privileges, schemes available.
4. Organising for self help to fight discrimination.
5. How to use media to one's advantage, pressure lobbies.
6. Resource mobilisation, enlist community support.
7. Learning effective communication techniques and skills.
8. Use older persons to train others, teach and guide children and
adolescents.
Issues in Care Giving
1. Different types of care.
2. Long term care: who provides care gender, proximity, and so
on.
3. How to handle stress, counselling to avoid care giver burnout.

694 An Attempt to Develop Gerontological Social Work in India
4. Building support system for providing care, self help groups,
partial institutionalisation, list of agencies who can help.
5. Volunteers who can act as respite care givers.
6. Counselling family and care giver about issues.
7. Training older persons, who are capable, as care givers.
Basics of Record Keeping and Assessment
1. How to develop a simple identification record.
2. Basic data needed for documentation.
3. Simple methods of measuring height, weight, testing vision and
hearing and so on.
4. Assessment of activities of daily living to estimate disability
5. Simple test for screening for cognitive impairment (memory,
attention, orientation).
6. Assessment of resources, social supports and needs of older
persons .
Methods of Teaching and Learning.
1. Lectures and discussions.
2. Lectures by other professionals: geriatricians, lawyers, nutri-
tionists, insurance agents, yoga experts, practitioners, re-
searchers, or older persons.
3. Field visits to institutional and non-institutional services.
4. Presentations of case studies.
5. Library study, writing assignment and class presentation.
6. Observation and visualisation.
7. Simulation games and role plays.
8. Use of newspaper cuttings.
9. Trainees could be encouraged to creatively design aids, envi-
ronments, home care and so on, using existing facilities in an
innovative way.
NOTES
1. This report is compiled and edited by Dr. Murli Desai, in consultation with Dr.
Gita Shah, Dr. Siva Raju and Ms. Rosamma Veedon, who comprised the Organ-
ising Committee of the Seminar.
2. Prof. M.S. Gore, Chancellor of Jawaharlal Nehru University and Dr. Yogesh Atal,
Ex-Director of the Coordinating Unit for the Follow Up of the World Summit on
Social Development at UNESCO, delivered the key theme addresses. Resource

An Attempt to Develop Gerontological Social Work in India 695
persons from different disciplines presented 29 papers. A total of 44 people, from
different parts of India, participated in the Seminar.
3. The sections on 'Changing Situation and Emerging Needs of Older Persons',
'Guiding Principles for Work with Older Persons', and 'Recommendations for a
National Policy for the Weil-Being of Older Persons', have been compiled by Dr.
Murli Desai.
4. The section on 'Recommendations for Voluntary Organisations' was compiled
by Dr. Murli Desai and Dr. Gita Shah.
5. The section on 'Recommendations for Curriculum Planning for Social Work with
Ageing' was compiled by Ms. T.G. Vaswani and Dr. Gita Shah, based on
the Working Papers by them and by Dr. Murli Desai and group discussion.
6. The section on 'Recommendations for Training Programmes for Paraprofession-
als for Work with Older Persons' was compiled by Prof. Indira Jai Prakash, based
on her Working Paper and group discussion.