• 55% of households have at least one elderly member
• SL will need more resources to look after ageing population
• Nutrition of elderly persons, particularly women, neglected
• CoL increases have disproportionate, adverse impact on ageing population
• Depreciation makes pensions ineffective
• Strengthen geriatric care system, introduce community care initiatives

By Skandha Gunasekara Antoinette Irangani Wickremesinghe (84) is a mother of three and grandmother to eight and she says the current crisis has her worried like never before. “There is so much turmoil and uncertainty in the country right now and that is my biggest concern. It is very stressful to think about what is happening and what could happen.” Wickremesinghe, who has been retired for the past two decades, lives alone at home with her full-time caregiver, whom she is dependent on. However, many are not as fortunate as Wickremesinghe to have help and the resources to afford it. Centre for Poverty Analysis Senior Researcher Gayathri Lokuge told The Sunday Morning that Sri Lanka had a large and growing elderly population and that in the future the workforce population would reduce as a result. “Our population is leaning more towards the aged. As per our calculations based on the Census data, in about 55% of Sri Lankan households there is at least one member who is above 60 years old. One of the interesting things in terms of proportion is that there are more women in this group, so the elderly population is also feminised. What is happening is that our fertility rates are going down while our life expectancy rates are going up as a result of our healthcare system. This is why our population composition is changing. “In the next 20-30 years, the working age population is also going to decline because people are increasingly going to be older and won’t be able to work anymore. That means that there will be more people in the working age cohort who will have to take care of our elderly.” Impact on the ‘young old’ She noted that those aged between 60-70, known as the young old, while contributing to both the national economy as well as the household economy, were vulnerable, as once they reached the age where they had to live with their children, they were not prioritised when it came to food and supplementation as the current economic crisis had constrained the purchasing power of an average household greatly. “The group that is known as the young old are those between the ages of 60 and 70. Most of them, especially in the rural areas in the informal sector, contribute to the economy. These are the ones who are seen as both more economically and physically active. On the one hand they contribute to the economy, both household and country, and they also contribute to reproductive work inside households, like looking after their grandchildren. This group also prefers to live on their own as they have the financial means and it’s only when they become frail that they join their children’s families or go into an institution.  “But this is increasingly becoming complicated because household economies are shrinking in the current context, so people are prioritising what they spend on and the first instinct is to prioritise the children and the male members in the family. The elderly, especially females, won’t get priority or will step back, so their nutrition and supplements are going to become minimal.” Healthcare issues Lokuge said that healthcare aspects of the elderly were also an issue, noting that dependency on Government clinics was high among the elderly, but such clinics were now facing issues providing services. “A bigger issue is the health of the elderly. Our rate of Non-Communicable Diseases (NCDs) is very high, so there is a lot of dependency on Government clinics. The clinics, as far as we know, are functioning, but they are slowly starting to cut down on the medicines that are available for free. Even when these clinics stopped operating during Covid, they used the postal service to send the medicines, but this time that option isn’t available.” Transport problems have also resulted in the elderly postponing or delaying clinic appointments as they are unable to travel.   With regard to income, she said that those receiving a pension were faced with the issue of high cost of living, particularly medicine, due to the drop in the value of the rupee. “With the depreciation of the rupee, what they earned last year as a pension, which would have been sufficient to at least buy their medicines, will now be insufficient because the medicine prices have more than doubled. Pensions are becoming increasingly devalued and pension amounts won’t increase, so their capacity to purchase is greatly reduced.” Elderly in informal sector Commenting on the elderly in the informal sector, Lokuge said that it had come to the point where they could never stop working and retire as they needed an income to survive despite their age and weaknesses.   “If you look at the elderly in the informal sector, there are big concerns because they don’t have a cushion like the pension. What is happening in the fisheries sector, for example, is that by the time they hit their 50s, people who worked on the multi-day boats cannot do it anymore because of health issues, so they start doing one-day operations. That is how they keep families going and they don’t stop. They can’t afford not to work.” Care system needed She said the current crisis was a good opportunity for the Government to put in place a better geriatric care system, especially at the local level.   “We believe that this is a good chance for the Government to come up with a system, because even the IMF has mentioned securing our welfare system. We should at least explore the feasibility of setting up a community-based care system for the elderly and this should be attached to the public health sector. It will be quite similar to what we have with the public health midwives. Even the clinics can be decentralised.” She also stressed on the need to train more qualified staff to handle geriatric care centres and the elderly. “The Elderly Societies under the National Secretariat for Elders too can be developed better with more trained staff and facilities, then an elderly person can be left there for a short period even if the family is busy or going out of town or something like that. In terms of policy, I feel that it is important to widen the field of specialists in geriatric care. We need specialists as well as skilled medical personnel.” To help the informal sector, especially in the short term, Lokuge said that financial assistance was essential. “When it comes to the informal sector, the Government needs to step in and give a substantial amount in cash, especially for the elderly. The Rs. 7,500 proposed by the Government will not be adequate. This amount should be given for at least three to four months.” Elderly in trouble Meanwhile, member of the National Council for Elders and HelpAge Sri Lanka Executive Director Samantha Liyanawaduge too said that the aged population in Sri Lanka was facing dire circumstances. “The elderly are really in trouble. We are doing a study at the moment and we have found that a lot of the elders are really suffering. Starting from food security – they don’t have enough food to consume – a lot of elderly people are missing multiple meals a day and there are some elders who are unable to get even one meal a day. The next issue is medicine, where treatments are not given on time and medicine costs have tripled or quadrupled. ” He said those with pensions were finding it inadequate, while daily wage earners were faring even worse. “When it comes to the pensionable elderly, the issue is with the prices, because food prices have gone up three- to fourfold while their pensions have remained the same. Other than pensioners, a lot of elders who are over 60 years old are still working, such as daily wage earners who are unable to get an income at all under these critical conditions.” He said the Government must take steps to provide care through the National Secretariat for Elders and that a stable government was essential in this regard as currently there was no minister in charge and the secretaries were failing in their duties. Noting that more than three quarters of the aged population in Sri Lanka was facing hardships, he called on the Government to provide financial assistance as soon as possible. “The Government must immediately give a relief allowance to the elderly to survive; nearly 75% of elders are facing these issues.”