Research
You will find a complete range of our monographs, muti-authored and edited works including peer-reviewed, original scholarly research across the social sciences and aligned disciplines. We publish long and short form research and you can browse the complete Bristol University Press and Policy Press archive.
Policy Press also publishes policy reviews and polemic work which aim to challenge policy and practice in certain fields. These books have a practitioner in mind and are practical, accessible in style, as well as being academically sound and referenced.
Books: Research
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.
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.
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.
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.
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.
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.
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.
Home is a place marked by many life course events. Home is also embedded with memories, self-identity, sense of security, cherished possessions and family relations. When an older adult leaves their home and starts to live in a retirement facility they have to reconfigure their sense and meaning of home. This chapter examines home ownership and residential changes and the meanings homes have for older adults in Kerala. The chapter addresses three questions: i) what motivates older adults to retain their (previous) home while currently residing in retirement homes?, ii) how do older adults maintain their previous homes? and iii) how do these motivations help to maintain place attachment? Using a unique set of qualitative interviews with residents of care homes, the authors show that health issues, a need for assistance, a lack of security, migration of children, loneliness due to loss of a spouse and a wish to live independently, are the major reasons for older adults to seek an alternative source of residence in the form of a retirement home. Cultural schemas of care and obligations towards next generation motivate older adults in retaining and maintaining homes.
Living arrangements and the provision of care for older people in India have been affected by migration. This is particularly salient given that Indian diaspora is the largest in the world. Hence, one can expect the trends in transnational migration to have a particular impact in the Indian context. However, and perhaps more importantly, the chapter will explore the patterns of internal migration within India. This is an important corrective to the focus on transnational migration as levels of internal migration far outweigh the extent of international migration. Therefore, this chapter examines both internal and international migration to understand how families establish, maintain and retain transnational and transregional care relations. In so doing, we draw on 1) theories of migration, 2) global chains of care and 3) life course theories to frame how migration decisions are related to life-course transitions and care provision. The life-course approach focuses on life events and transitions of individuals and the ways in which these events define their life trajectories. In particular, we will draw on the concept of ‘linked-lives’ to show how older people’s life-course transitions, for example going into care, are linked to the migration decisions of their offspring. With increasing urbanisation and migration we will see emerging trends of global and transregional chains of care to supplant and complement care deficits for vulnerable populations left behind, especially older adults.
India is undergoing the demographic transition at a very rapid pace. This growth in the numbers and proportions of older persons is expected to have far reaching economic, social and political implications. The government of India has acknowledged the need to address ageing issues as far back as 1999, when India became one few countries to have a National Policy for Older Persons (NPOP, 1999). As a result, various programmes and schemes for social protection, food, nutrition and health security were introduced to improve the quality of lives of older people in India. However, despite the policies, multiple programmes and schemes for older people, there is little improvement in their quality of life as revealed by various empirical studies. Poverty rates among the older population are higher than the general population. The health and nutritional needs of older people are generally greater than the general population, however their access to health care and food is limited, especially in rural areas where the majority of older people reside. This chapter enumerates the various schemes provided by the government of India for older adults and other schemes which are also open for older adults. In addition to listing these issues the chapter goes a step further to discuss the barriers in accessing these schemes. The multiplicity of schemes has resulted in wastage of resources and failure to achieve synergies. The chapter also reports that various evaluation studies have highlighted leakages, inefficiencies and ineffectiveness of programme design.
