• Elders’ homes operators and employees, and the Nat. Elders’ Secretariat note need for increased Govt. regulations and relief coupled with stakeholder consensus on a facility-based fee levying classification

Although the main factor of many businesses depends on a targeted revenue, in engaging in certain businesses, it is impossible to think only about profit. Such businesses, which should be carried out by giving priority to humanity over the targeted income, are not just a business but also a social mission that brings about great self satisfaction. Among them are elders’ homes that take care of the elderly who are deprived of the care of family, especially that of children, due to various reasons. However, it is unfortunate that most of the elders’ homes in today’s society, where many people give priority to the financial gain, are also focused on their revenues over the wellbeing of the elders who are under their care. The current economic difficulties in the country have also contributed to this situation, and for this reason, many parties have pointed out the need to introduce a proper mechanism to regulate elders’ homes. 

Views of elders’ home operators

“Not only with regard to elders’ homes or children’s homes, humanity should be given priority in whatever business that we do. It is true that it is not possible to run a business without thinking about the revenue, particularly in the current context where many of us have to endure difficulties, but, we can still focus on humanity. The elders who are under the care of the elders’ home which I run are like family to me. How can I ignore them just because the prices of commodities have gone up? Their family members, mostly their children, have brought them here in the belief that we will provide them with the best care. It is our responsibility to give them the maximum care despite all the difficulties,” Renuka Punchihetti, who runs the ‘Suwasahana Nikethanaya’ elders’ home in Nagoda, Kalutara expressed her views. She said that there is a huge expenditure on rentals, electricity and water bills, food items, and the salaries of employees, but that there is no possibility to increase the fees charged from the elderly to match the expenditure. She said that in some cases, considering the helplessness of the elders who come to the elders’ home, the general fee charged from them also has to be reduced. “Recently, a person who lived on the street in Galle came to our elders’ home. He was very weak when he came here. I saw the helplessness of him and his two sisters who brought him here, so, I deducted Rs. 10,000 from the usual monthly fee. However, there is no lack of care given to him because the amount we receive for him is less. We treat him the same way that we treat the other adults.” Punchihetti further said that some people without any knowledge or experience, and only aiming to earn money, running elders’ homes, has mainly affected the decline of their (elders’ homes) quality. “Because I have been working as a nurse for many years in hospitals, I have knowledge about elderly care. I can advise other nurses working in my elders’ home and ensure that they treat the elders with the best care, but, there are some people who run elders’ homes without any knowledge or experience just for the purpose of making money. They only think about the income that they get at the end of the month. It is from such institutions that incidents of the elderly being ill-treated are often reported.” She said that there is a need to regulate elders’ homes due to such situations, but that regulating them alone would not be enough to maintain the quality of elders’ homes. “A system should be developed for the regulation of elders’ homes, but, I don’t believe that this alone will correct the deficiencies in this field. For that, people and institutions running the elders’ homes have a vital role to play. As long as they only think about the income, no matter what kind of regulation is done, it will not be useful.”

An official of an elders’ home in Maharagama area, speaking to The Daily Morning, said that most of the children of elderly parents who are under the care of elders’ homes in suburbs are currently relocating their parents to elders’ homes in remote areas with fewer facilities due to the inability to pay higher charges. He said that the prices of every commodity have gone up significantly over the recent past, and that the management has therefore been left with no other option but to increase the fees. “It is our responsibility to make the elders comfortable. So, we cannot switch off the fans and lights even at night just because electricity tariffs have gone up. The prices of food items and other commodities have also gone up. If we hire an attendant to look after a certain elder, we have to pay them about Rs. 4,000 a day plus food,” he said. Under these conditions, he said, the Government should provide some relief to those who run elders’ homes, but that there has been no such relief. “It is the Government that should take care of the elderly. That is what happens in other parts of the world. However, there are no such programmes in our country. We are currently in a situation where we are almost unable to operate anymore, but, we cannot close down operations either,” he said. Despite the need to revise the fees charged to match the expenditure, he said that it is not possible to do so as those who make the relevant payments on behalf of the elders also face various financial difficulties. However, claiming that certain elders’ homes are charging exorbitant fees citing the high expenditure, he said that there should be some regulatory mechanism to decide on uniform rates for each category of elders’ homes. “It is not possible to charge the same fee for every elders’ home because their facilities are different, but, it is possible to classify them under an appropriate system and set a specific fee for each type. In doing so, it is very important to get the views of the people and the organisations that run the elders’ homes.”

Commenting on the existing regulatory systems, the owner of a leading elders’ home in Colombo said that officials from the National Secretariat for Elders, which is the highest Government agency dealing with the elderly, visit and check the quality of the elderly homes once a month. However, he noted that it has not been very helpful in solving the problems associated with elders’ homes. “Once a month, the officials of the Secretariat come and check the condition of the elders’ homes and the wellbeing of the adults, but, there are hardly any cases where proper actions have been taken regarding the elders’ homes that are not up to relevant standards and are ill-treating elders. There are certain officials who take financial privileges from elders’ homes and don’t take proper action regarding their deficiencies. The existing methods to regulate elders’ homes are not sufficient and effective,” he explained.

It is also learnt that elders’ homes are facing extreme difficulties due to the Government imposing excessive taxes on the importation of certain commodities such as sanitary items which are essential in the provision of elderly care services. According to an elders’ home manager in the Panadura area, their prices have increased by more than two-fold compared to the previous prices. “There are nearly 50 elders under our care. We provide food and medical facilities and nursing facilities to them. We have to bear a massive expenditure on them. Certain organisations and individuals helped us in the past, but, we don’t receive much support at present. It is better if the Government can intervene and support us in caring for the elders who have contributed to our country’s wellbeing for decades.”

Officials on regulating the fee

When contacted by The Daily Morning, the Director General of the Secretariat, K.G. Lanerolle said that the regulation of elders’ homes is not 100% practical, but that certain programmes have been implemented to regulate them to some extent. “Regarding the fees, it is not possible to specify that this is the fee that an elders’ home should charge. The related fees vary according to the facilities provided by each elders’ home. We know that it is not possible to set a specific fee for hotel services. The elders’ homes are of the same nature. One of them may charge a fee of Rs. 10,000 and some other may charge Rs. 300,000. We are of the position that some restrictions should be imposed on the fees, but, there is no firm idea about it and there is no agreement from all parties to date.” He further said that their officers would be directed to check the quality of elders’ homes, especially how they care for the elderly, and that the Secretariat would assist in improving their quality. “We help to improve the elders’ homes so that they can provide quality facilities to the elderly. For example, we helped financially to repair a number of elders’ homes last year (2023).” Lanerolle further said that the Secretariat, together with the other relevant authorities, has taken a decision to file a lawsuit against the elders’ homes which are found to be not complying with the proper standards during the inspections conducted this year. He said that the relevant reports on the quality of the elders’ homes would be called through the Divisional Secretary of the area in which the respective elders’ home is located.