Aging Population in Nepal

Trends and Issues of Elderly Population in Nepal

The elderly population is a 21st-century global phenomenon. Greater specialized healthcare resources, increased rate of cost-bearing ability, and lower fertility have all contributed to a notable global increase in life expectancy.

Trends

Trends denote progress in one direction. According to time, context, and circumstance, a trend is the evolution of any phenomenon or discipline toward a new direction.

In line with the worldwide trend, Nepal is also experiencing an increase in the population's senior citizens. In Nepal, a person is considered a senior citizen if they are 60 years of age or older. In terms of the aging population, Nepal is still relatively youthful. There were 1.5 million old people in Nepal in 2001 and 2.1 million in 2011, which represents 6.5 percent and 8.1% of the total population, respectively. In addition to the fact that life expectancy has been rising, the 2018 Nepal Demographics Profile states that 71 is the average age at birth (male 70.4 female 71.6).

The number of older persons inevitably rises as life expectancy grows. An increasing number of senior persons are facing issues and difficulties in various ways.

The development and humanitarian sectors face challenges in promoting and realizing elderly people's rights as well as their well-being by addressing their social, emotional, health, financial, and developmental needs as the elderly population grows both proportionally and absolutely. Elderly people, their caregivers, and healthcare professionals, including nurses, face challenges as a result of the multiple diseases they have, the number of drugs they use, and the physiological changes they are experiencing.

Issues

Issues are differing points of view on a specific topic, circumstance, thing, or stage. Issues are final results that often contribute to the solution or resolution of problems (as of a difficulty).

Current Trends and Issues

Migrant Employee, Nuclear Family, Poverty, Health Issues

Migration

For food, education, and the acquisition of other opulent goods, people relocate to distant locations. In many villages throughout Nepal, it is considered socially acceptable to travel abroad and then return home with a certain sum of money. In the context of Nepal, younger generations are experiencing unemployment and distress because they cannot find suitable employment that matches their qualifications and because of the country's political ups and downs. Numerous young people leave the country daily, either to work as laborers (which drains the labor force) or to study and work abroad.Even inside the nation, people are relocating to established cities in search of employment or better amenities. Due to widespread migration, young people are becoming increasingly rare in villages and cities. As a result, it is difficult for senior citizens to live their lives in dignity because no one will listen to their concerns and feelings. In the majority of homes, whether urban or rural, there are only elderly people who are unable to work due to poor health. As a result, Nepal is losing elderly people day by day.

Nuclear Family (Changing Family System)

The traditional family structure has evolved. Single or nuclear households are replacing joint extended families. Sadly, the nation's culture and customs surrounding caring for elderly parents are gradually vanishing. The desire for a small, happy family, poverty, the process of urbanization, and the influence of western culture and society are all reasons why the younger generations are giving up on the traditional and becoming more interested in nuclear families and less interested in traditional values. According to the culture, family values, and traditional norms of Nepal, it is customary to be responsible for the elderly's well-being. With the passage of time and successive generations, the practices that our ancestors used to live as a single family are rapidly dwindling. In line with western culture, individualistic or emotionally nuclear family systems, historical practices of providing care to the elderly, joint family living arrangements, and familial responsibilities towards elders that were once centered around or with the patriarchal family network are changing.

Senior folks and their children and grandchildren must now be kept apart due to changes in the family structure. In today's challenging environment, individuals are more competitive, busy, and willing to put in extra effort to respond to rising costs. As a result, while they have a variety of issues, the old population lives alone away from their children and grandchildren, while the younger generation must battle to survive. Because of this, even if the younger or more productive generation wants to care for their parents and grandparents, they are unable to care for the elderly. However, despite their challenging circumstances, seniors have a right to receive care that is respectful.

Poverty

The elderly age group is the dependent age group; the majority of elderly workers retired due to their inability to do so. Few elderly people, especially those who worked for the government, get pensions. Similar to old age stipend, everyday expenses for older adults are not covered. Seniors, on the other hand, who are left alone either because their children have moved away or have been abandoned, lack all financial resources and are in a loss of money. Health care costs have grown due to the prevalence of chronic illnesses, co-morbidities, and various diseases among older people. The elements that typically have the most negative effects on older people include unemployment, underemployment, widespread food shortages, income poverty or loss of financial stability, and increased spending, particularly on health care costs.

Health Issues 

As a normal aspect of aging, the human body experiences several physiological changes. Every organ may possibly experience physical age changes, which can have an impact on a senior's health and way of life. The elderly also find it physically difficult to enter and exit their homes and nearby neighborhoods. Numerous illnesses, including heart issues, type 2 diabetes, COPD, cancer, Alzheimer's disease, etc., as well as other conditions, become more prevalent in the elderly population. The physical and mental health of older persons is frequently significantly impacted by psychological and social concerns. The biggest concern older people encounter is health-related. They are dying solely as a result of not receiving even a minimal health examination. Elderly people face challenges and experience a decline in health-related quality of life as a result of multiple disease conditions, drug use, living alone or in isolation, lack of support from others, and loss of financial stability.

Abandonment, Technology, Depression, Trauma, and Stress

Abandonment

People who feel abandoned may feel unwanted, forgotten, insecure, or rejected. In Nepal, the problem of elderly desertion is now getting worse and is projected to get significantly worse in the near future. Elderly people who have been abandoned are those whose children have ignored and neglected them, and whose family has stopped depending on them for support. Older people now tend to live alone due to changes in young people's concepts.

Most old parents in nursing homes for the elderly have relatives, including children and grandkids, yet the family still neglects them. Some senior parents don't get along well with their kids, and some kids of elderly parents live in big cities or overseas and don't help or support the old parents who are left behind. According to the study, families do not generally welcome elderly people. Not only this, but some of the economically successful older generation's or children have left their parents or grandparents to live alone in their later years.

One of the biggest problems in today's society is the plight of elderly individuals who are both homeless and abandoned. Every year, a lot of old individuals are left behind in the nation. Fortunately, some of them were able to enter an elderly care facility, but others were unable to do so and were forced to live on their own or on the streets. Due to the demands of contemporary life, Nepalese people find themselves lacking the time and energy to care for their own children on a daily basis. In that case, it may be difficult for a family to give their elderly parents the time, affection, and care they need, and as a result, the elderly parents end up being a financial and emotional burden.

Technology

The use of technology and the knowledge it provides enables the aged to deal with the challenges of contemporary life more readily, realizing their social and emotional isolation, and reaching a higher standard of living. Additionally, technology has made it possible to live longer in a variety of ways. Even though they are living alone, modern technology has kept them linked to their children and relatives via the internet, which has made them happy. Along with other aids, such as walkers, crutches, and braces, the elderly now have certain daily conveniences. But as the population ages more quickly, the elderly have to adapt to new technology and the demands of modern society. But elderly individuals have low adjustment to adapt new technologies compared to younger generations, either because they do not have the technological experience or because of their current health status.

There are several factors that affect how successfully older people utilize or adapt to contemporary technology, including: money, education, location, potential impairments, a lack of digital literacy and adequate training, as well as challenges relating to the complexity of new technology. Another frequent occurrence is the market's present underinvestment in innovations for senior consumers, such as comprehensive and user-friendly services for healthy living environments. The demands of older customers are frequently not met by numerous products and services.

Depression

The elderly may have neuropsychiatric illnesses among other health issues as they age. Depression is the most frequent neuropsychiatric condition. Brain dysfunction characterizes depression. In addition to physical ailments, the inability of children to move away from the family for work or marriage, social isolation, and lack of social interaction due to retirement are significant factors contributing to elderly depression. Losses like the passing of friends and loved ones, reductions in physical ability, declines in social status, and low self-esteem are common causes of depression.

Elderly persons are more susceptible to the stigma associated with mental illness and psychiatric treatment than are younger ones. Additionally, it's possible for elderly individuals and their family to mistakenly label depressive symptoms as "natural" responses to life's pressures, losses, or aging process. Additionally, elderly patients may be reluctant to discuss their emotions or unaware that physical symptoms can be a sign of depression. Isolation can make it challenging for elderly people to ask for assistance when they live independently.

Trauma

Trauma in older adults is a growingly acknowledged issue. Cellular function gradually deteriorates with age, impairing the cells' ability to react to harm. Some drugs that are often prescribed to this group may change or dampen the body's reaction to damage. Falls are the primary cause of trauma-related mortality in this demographic and the most frequent cause of trauma. Age is directly associated to deficits in the visual, auditory, musculoskeletal, and neurological systems as well as in the perception of pure tones, postural instability, degeneration of reflexes, and/or slowed reaction times. Comorbid conditions and medication treatments further raise the risk of trauma in the elderly. Environmental danger itself can be sufficient to trigger the traumatic event or it might even help it happen.

Trauma is a primary cause of impairment and institutionalization, which rises with age and causes morbidity and death. Traumatic head injury is the most frequent issue, followed by lower and upper limb fractures. Other issues include post-fall syndrome, visceral lesions, bruising, and wounds. The risk of secondary and tertiary associated events such as pneumonia, bedsores, thromboembolic events, etc. is raised by hip fracture, disability (which necessitates prolonged bed rest), and post-fall syndrome. Trauma also increases drug usage, social and individual expenditures (hospitalization, home care, and institutionalization), and death risk. Osteoporosis unquestionably contributes to the female fracture prevalence among common older comorbidities. Traumas to the craniofacial region are the most deadly because they have a high fatality rate.

Stress

Elderly people experience prolonged stress and psychological trauma as a result of all the above-mentioned issues or problems, including child migration, loneliness, poverty, physiological degeneration and disease conditions, loss of financial strength, destitute status, spousal or loved one death, inability to live independently, and concerns about institutionalization. Long-term stress can also lead to a variety of physiological and psychological issues in older people.

Insomnia, nightmares, loss of appetite, palpitations, frequent urination, muscle pain, fatigue, negative effects on immune system function, vision and hearing loss, dental fractures and cavities, shortness of breath, irritable bowel syndrome and ulcers, frequent diarrhea or constipation, deteriorating general health, increased dependence on others, and higher healthcare costs are just a few examples of physiological issues. anger, sadness, restlessness, and lack of focus.

Emotional and psychological Problems: anxiety, forgetfulness, loneliness, isolation, irritability, concentration, negative feelings and attitudes, and poor concentration  

Issues in Rural Areas

Many factors, such as education, health, transportation, poverty, etc., play a greater role in emerging nations like Nepal in posing difficulties and issues. For instance, poverty has long been a problem in Nepal's rural areas. Rural communities are particularly susceptible because of poverty as well as a lack of high-quality health and education facilities. No one has access to the hospital. In many areas, people must walk for more than 7, 8 hours just to get to a health post. Similar to this, poverty has caused all of the young people in rural areas to migrate to gulf countries in search of work, leaving the majority of the population in rural areas to be made up of children and the elderly. The issue with old age pensions has persisted over the years. For older persons getting 3,000 RS per month, that is insufficient. Even though they are entitled to the allowance, many residents of rural areas are unaware of it and many also lack access to the appropriate authority or local government. Another significant concern facing the elderly is health-related. Simply because they are not receiving any basic health checks, elderly people are dying. Because they have limited or no access to technology and news, they are also significantly behind in terms of current events in the major cities. In many parts of Nepal, including Rasuwa, Karnali, Humla, Dadeldhura, and many other rural districts, people must travel a long distance to purchase a sack of rice, and they must pay an additional fee for the carrier. Compared to old persons in metropolitan areas, the quality of life for rural seniors is extremely poor and terrible. Both ethnic groups with higher casts and lower casts face discrimination issues.

Issues in Urban Areas

Elderly people in metropolitan regions may appear to have more advantages than those in rural areas, yet their conditions are really worse there. The largest problem facing older people in cities is being abandoned by their kids. Elderly individuals are frequently left behind by their offspring when they approach old age. There are serious situations, such as abandoning them in a shrine or on the street. Urban children occasionally live with their parents until they transfer ownership of their property to their names. Many times, it has been discovered that children who had been given property had abandoned their parents. Some even made death claims in order to obtain the property.

Modernization and urbanization are another significant challenge for the elderly. The entire day is free of any activities for them. Most elderly children lock their parents in the house before they depart for work. They spend the entire day alone at home without nobody to talk to or activities to engage in. The main problem is that urban seniors spend their lives alone. The majority of families in metropolitan areas are nuclear families. Children are always occupied with electronics, toys, and their pals. Parents are quite busy at work. The elderly only experience this issue because they lack social interaction, a person with whom they can express their feelings, and a source of income.As a result, older urban residents are more likely to have psychological and mental health issues such despair, trauma, and stress. They also don't have a lot of company if they want to go outside, wander about, or chat with their neighbors because many urban dwellers are quite sophisticated and prefer to stay to themselves. Additionally, this makes it harder for older people to reside in cities.

The prospects for the country's older citizens seem significantly worse if considerable action is not taken in their favor, especially given the dropping population growth rate and rising life expectancy. As a result, it is necessary to implement particular policy measures to improve the challenging circumstances that the senior population of the nation is currently facing.