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This chapter investigates how life course obligations, expectations and practices are linked to older adults’ sense of well-being. It takes a life course approach with a specific focus on linked lives. Linked lives recognises that life trajectories of individuals are socially embedded and closely linked to the transitions of significant others such as family members. Moreover, it is important to see linked lives as translocal as they include older adults in migrant households, their adult children (co-residing or migrant children), grandchildren, caregivers and non-kin social networks. To explore these issues qualitative in-depth interviews were conducted with 37 older adults. The participants included couples, widows and widowers. Participants in this study include both older adults co-residing with kin and older adults residing on their own. The results show that life stages and expectations of successful transition from one stage to the next was perceived as crucial for the offspring and for the older adults. The chapter observes that economic security, social support, health and better living conditions aid in realising the life course obligations and contribute towards the overall well-being of the older adults.

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Insufficient social security systems make families primarily responsible for providing support to older adults in India. Increased mobility of adult children, fewer siblings and increased longevity of older adults are some of the demographic changes influencing care arrangements in Indian households. This chapter applies a qualitative research approach to examine the evolving nature of care frameworks for older adults in the Indian context. This is done through examining the changing household living arrangements and complexities that exist in identifying caregiving motives and primary caregivers to older adults, especially in an emigration context where older adults are left behind. This chapter serves to initiate dialogue on the negotiated intergenerational contract that seems to have evolved in the background of changing family situations and modernisation, however, serves to still make possible reciprocal support exchanges between older adults and their adult children. Findings from this study indicate that adult children from emigrant households are responsive to parental needs of support and find ways to effect supportive exchanges and care arrangements. The intergenerational care arrangements reflect the emigration event-led adaptation of family and household structure to retain traditional familial ties and enable mutually supportive exchanges between adult children and their parents.

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Living Arrangements and Quality of Life

India’s ageing population is growing rapidly; over 60s constitute 7% of the total population and this is projected to triple in the next four decades.

Drawing on a wide range of studies, this book examines living arrangements across India and their impact on the care and wellbeing of older people. Addressing access to welfare initiatives and changing cultural norms including co-residence, family care and migration, it reveals the diversity of living arrangements, cultural customs and the welfare issues facing older adults in India.

This book offers a crucial examination for practitioners, researchers and policymakers seeking to understand and develop the infrastructure required to meet the needs of older people in India.

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In the face of population ageing, governments and international non-governmental organisations (INGOs) are concerned about the ability of countries to provide social protection for ageing populations. In India, families are mandated to take care of their older members. The Maintenance and Welfare of Parents and Senior Citizens Act (MSJE 2007), states that parents, grandparents and ‘childless’ older people who are unable to maintain themselves are entitled to demand and receive income, care and support from children, grandchildren and other relatives who have sufficient resources. Cases (where support is not forthcoming) can be taken to tribunal and can result in the issue of maintenance orders with penalties for non-compliance including fines and imprisonment. Thus, there is a reliance on informal social protection. However, changes in family structures, family values, migration of family members and a rise in the number of women working outside of the home can put increasing strain on families to provide support. Traditional forms of solidarity and collectivism are eroded by market economies: increasing monetisation impacts on forms of reciprocity, and requirement for a responsive mobile labour force impacts on availability. Thus, it is important to challenge the ‘realities’ of family support systems, which may not be as robust as portrayed by policy makers. However, little is known about the choices that are available to older people around care, support and/or housing in later and the decisions that are made based on these choices. Relocating to care homes may be for personal care, but also due to the failure of legal systems to protect individuals from harm and to avoid abuse or family conflict. This chapter draws on data from 30 in-depth interviews with older male and female residents in nine care homes in three districts of Tamil Nadu and addresses the following questions:

• What are the decision-making routes leading to entry into care homes?

• In which ways do families, communities, and legal systems (fail to) support older people prior to entry into a care home?

The chapter concludes by suggesting how stakeholders (NGOs, districts, the state and national government) can contribute to remodelling care provision, social work and legal systems to meet the needs of older adults in Tamil Nadu.

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Authors: K. S. James and Sanjay Kumar

In India, the living arrangements of older adults are incredibly important as the family is often the major source of care and support. Hence, any loss of family could have significant negative consequences for the long-term care, economic, physical, social and psychological well-being of older people. Two forces in particular are impacting on the living arrangements of older people in India: 1) demographic and epidemiological transitions, such as reduction in fertility and increase in life-expectancy of adults, and 2) migration, both domestic and international. This chapter examines the various living arrangements of older adults in India, the factors associated with living arrangements and the welfare implication of living arrangement patterns on the older adults. To do so, the chapter combines datasets from the UNFPA, India-sponsored research project on ‘Building Knowledge Base on Population Ageing in India’ (BKPAI), the National Family Health Surveys and the Longitudinal Ageing Study of India (LASI). These data reveal that 1) there is an increasing incidence of older people living independently, that is not co-residing with their adult children or grandchildren, in India; 2) older adults who live alone have lower standard of living compared to older adults who live with children, spouses or with others; and 3) living arrangement pattern has no bearing on the subjective well-being of the older persons. This indicates that living alone is not necessarily seen as a burden by older people. Such analysis is new and problematises the cultural norm of co-residence as a pathway to well-being.

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Kerala is one of the states in India that has undergone a rapid demographic transition. Due to its low fertility and mortality rates, Kerala reportedly has the highest proportion of older people in its population in India. In addition, large-scale internal and international migration of the younger age groups (about 10 per cent of the population) has left many households without an adult member. This has potentially serious implications for care and living arrangements for older people in Kerala. Using an extensive longitudinal panel (2004–19) of older adults, this chapter explores how living arrangements have changed among older adults in Kerala; how the changes in family size influences the living arrangements; and examines whether this change in living arrangements or household size is associated with changes in the health and survival status of older adults. The results show that a high proportion of the population aged 60 and over in Kerala still live with their family members. The study also found that older persons who live with one other person had a lower chance of dying, while those who lived with five or more household members had an increased risk of mortality. This finding remained even after adjusting for daily living activities score, health perception, sex and age. These results are interesting and raise some crucial questions about the assumptions around the impact of demographic change on older adults in Kerala and India more widely.

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Landscapes of care/carescapes represent a recently emerging research area in geographies of care. Carescapes are both geographical settings within and across which care takes place and are subjectively experienced phenomena. However, within this field there is still relatively little research on the care needs and experiences of older men. This chapter redresses this by conducting 79 in-depth interviews of older men and their caregivers, collected from homes as well as care homes in Delhi and Kolkata. The analyses reveals that older men’s care needs, which ranged from personal, economic, health to emotional, were perceived to be inadequately addressed in rapidly transforming societies and family structures. However, the practice of intergenerational reciprocal care is strongly gendered and of involved inequalities of power. Here, the care relationships between older men and their caregivers are situated within wider socio-economic relations which influence the power of each other. Caringscapes in the Indian context are deeply rooted in filial obligation and intergenerational dependence, whereby older adults are entitled to receive care from their offspring in exchange for the care they had provided to their children.

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India has one of the most rapidly ageing populations on the planet. There is concern that this rate of population ageing, coupled with the decline of extended families, decreasing fertility rates, increasing life expectancy, widowhood, singlehood or strained intergenerational relationships, will have a negative impact on the availability of (family-based) care for older adults in India, resulting in poorer health and well-being. However, India is a complex and diverse country made up of different states, castes, cultures, and ethnic groups. Moreover, rates of population ageing are not uniform as Indian states are at diverse levels of demographic transition and vary to a great extent in their cultural practices, social norms and socio-political contexts. Indeed, while India’s older adult population has now risen to 8.57 per cent, in states such as Goa and Kerala the percentage of older adults is as high as 11.20 per cent and 12.55 per cent respectively. This introduction provides an overview of these issues by situating the subsequent chapters within the broad demographic trends already mentioned and gives an outline of the structure and chapters of the book. This chapter introduces the need for focus on living arrangements and care and highlight the social, economic and cultural contexts that shape the provision of care for older adults in India.

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The final chapter draws together the main issues and findings from the wealth of information presented in the previous chapters and reflect on what this means for researchers, social care providers and policy makers in India and elsewhere. Although each chapter makes a unique contribution to our understanding of the impact of the changing living arrangements on the care for older people in India, there are a number of common themes that connect them. The narrative that emerges across these chapters is one that challenges the assumed wisdom about the demographic, industrial and social change on older adults. The chapters in this book tell us a much more complex story about living arrangements and care for older adults in India. Rather than being a single, linear narrative it is a story about the heterogeneity of families, care and migration experiences.

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The relationship between living arrangement concordance (the correspondence between the actual and preferred living arrangement) among older people and their well-being in developing countries is relatively under-researched. This is mainly due to the assumption that the actual living arrangement is a partial consequence of preference, although there can be several constraints in achieving this perfect match. To better understand the patterns of living arrangements, living arrangement preferences and the concordance in living arrangement among older adults in India, the authors analyse data gathered from over 9,852 older people in seven states in India under the UNFPA study on Building Knowledge Base on Ageing in India. The preference data show that around one third of older Indians indicated a preference for independent living which is indicative of the likely changes in future living arrangement patterns in the country. Further, living arrangement concordance did not appear to be a significant predictor of self-rated health or better mental health status. The household’s financial condition was the most important predictor that determined health status among older persons.

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