年龄真的只是数字吗？

沙克夏·昌多克

Asia is facing an impending ageing crisis， wherein the population of younger people is decreasing and that of the elderly is rising. This has had several economic and social implications， and it is imperative for countries， like China， Japan and even India， to develop high-quality healthcare facilities for elderly people. But first， it is vital to understand why populations are ageing. Meena Ganesh， CEO， Portea Medical， says there are a number of reasons for this surge， such as the common practice for people in their 20s and 30s to focus on their careers and financial stability， especially in the middle and lower-middle income groups.

This has contributed to a decline in birth rates and thus， in the percentage of the younger population. Another factor is that a drastic improvement in healthcare facilities has led to a much higher life expectancy rate compared to， say， 20 years ago， Ganesh added.

Chinas “one family， one child” policy， which was implemented in 1979， leads to a low proportion of youngsters to take care of their ageing parents and grandparents. India， compared to China or Japan， is a much younger country; however， there still seems to be a burgeoning population of senior citizens， Ganesh asserted， adding that the conventional healthcare system in India is inadequate to cater to patients who suffer from non-critical illnesses and chronic diseases.

This is where “at-home” services come into play. Portea has been providing at-home healthcare facilities for elderly people in India since 2013.

It has created a framework which involves employing “caregivers who maintain a safe environment at the patients home and handle health-related issues， like personal hygiene1 of the patient， overall sanitation2， noise control et al.，” Ganesh said.

However， most sections of Indian society dont seem open to the idea of at home care just yet. One of the biggest challenges in this regard is the “societal mindset which associates a stigma to bedridden family members being attended to by outsiders instead of family members，” Ganesh said， adding that such a stigma detrimentally affects the well-being of patients and deprives them of much-needed professional care.

Moreover， elderly care is a multipronged3 approach; while some sections of society are able to afford at-home healthcare， a massive proportion is not due to financial limitations.

However， according to Ganesh， when one looks at the long-term cost of care for elderly people suffering from chronic diseases or long-term illnesses， the overall cost usually turns out to be lower than a normal “in-hospital” treatment.

Also， professional medical care provided in the patients home environment often helps them heal faster and better and enjoy a better quality of life， she explained. Another problem that has plagued4 Indian society for years is elder abuse and abandonment. Abuse， in this regard， can take many forms， such as physical and verbal assault5， torture， mental agony and economic exploitation， like ridding elders of property rights forcefully.

It is pertinent to mention here that aged widows are one of the most oppressed and destitute sections in India who are shunned from their families and from society and are forced to live in beggarly and pitiful conditions.

Such instances of ostracization6 will only tend to proliferate7 as populations grow older， unless measures are taken to counter them.

Thus， the government has a massive role to play in this area. India is home to one out of every ten senior citizens in the world. A survey conducted by HelpAge India found that half of the elderly people that they surveyed （including 48 per cent men and 52 per cent women） reported that they had suffered abuse. Such exploitation is carried out because， after a certain age， elders are considered unproductive， dependent on others and， most importantly， a liability. What is a matter of grave concern is that most elderly people in India are not even aware about their rights and about laws implemented to protect them， like the Maintenance and Welfare of Parents and Senior Citizens Act 2007， for instance.

The government is taking measures， yes， but more must be done—in the form of awareness programmes and speedy trials to create a secure atmosphere for elders， free from the fear of abandonment and abuse.

The importance of civil society cannot possibly be overstated in this regard： a large number of NGOs has acted as a saving grace for thousands of abandoned and abused senior citizens in the country.

This years budget has announced a layout of Rs 9，000 crore8 for elderly care. What remains to be seen， however， is how these funds will be utilised.

Some positive steps have been taken to counter elder abuse in India in recent times， like amendments to the Maintenance and Welfare of Parents and Senior Citizens Act 2007—providing for an increase in the jail term for those who abuse or abandon their aged parents from three months to six.

However， as is often the case in India， there lies a wide lacuna9 between enactment and actual implementation of laws. What is needed most of all is a change in peoples mindset， a mindset nurtured by love and morality， not imprisoned by hate and greed.

亚洲正面临着迫在眉睫的老龄化危机，年轻人口数量正在减少，而老年人口数量正在增加。这一现象带来了一些经济与社会方面的影响，中国、日本甚至是印度等国家亟待发展针对老年群体的高质量医疗设施。但是首先，了解人口老龄化的原因至关重要。印度家庭医疗护理平台Portea Medical的首席执行官米娜·加内什称，有多种原因导致老龄人口数量激增，例如人们在二三十岁时习惯专注于自身事业与经济稳定，中等收入及低中等收入群体尤其如此。

这一现象导致生育率下降，因此年轻人口占比也随之下降。加内什补充道，医疗设施的大幅改善使得人口预期寿命较20年前大为提高，这是导致人口老龄化的另一个原因。

中国1979年实施的“独生子女”政策导致能够照顾年迈父母、祖父母以及外祖父母的年轻人占比很低。与中国或日本相比，印度是个年轻得多的国家。然而加内什称，印度老年人口似乎仍在迅速增长。她同时补充道，印度传统医疗体系已经不能满足那些患有非危重疾以及慢性疾病患者的需求。

在这种情况下，“家庭服务”开始发挥作用。Portea平台于2013年开始为印度老年群体提供家庭医疗帮助。

公司创建了一套体系，该体系涉及雇用“护理人员来保持患者家中的安全环境以及处理与健康相关的事宜，例如患者的个人卫生、总体环境卫生以及噪音控制等”，加内什说道。

然而，目前印度社会大多数群体似乎还不赞同家庭护理的观念。这方面一个最大的挑战是社会观念：人们认为“如果卧床不起的家庭成员由家人以外的人照顾，那是耻辱之事。” 加内什继续补充道，这种污名对患者的健康造成了不利影响，并让他们得不到急需的专业护理。

同时，老年护理是一个多方面的举措。虽然社会上一些群体负担得起家庭医疗，但大部分因为经济条件的限制而负担不起。

然而，加内什表示，从长期的护理花费来看，患有慢性疾病或长期疾病的老年人在家庭护理方面的总体花费，通常要比正常的“住院”治疗花费低。

此外，加内什解释道，在患者的家庭环境中为其提供专业的医疗护理，通常有助于患者更快更好地恢复并且享受更好的生活质量。长期困扰印度社会的另一个问题是虐待和遗弃老人。虐待有多种形式，例如身体和言语攻击、身体和精神折磨以及经济剥削，比如强行剥夺老年人的财产权。

值得一提的是，老年寡妇是印度受压迫最重及最贫困的群体之一，她们被家庭与社会忽视，被迫生活在贫穷无助的境地。

如果不采取措施应对，这种排斥老年人的例子只会随着人口的老龄化与日俱增。

因此，政府要在这方面发挥巨大作用。世界上每十个老年人中就有一个是印度人。印度助老会开展的调查显示，被调查的老年人中（包括48%的男性及52%的女性）有一半曾遭到虐待。这一剥削现象产生的原因是，当老年人到了一定年龄之后会被认为是没用的，要依赖他人生活，更重要的是他们被当成累赘。令人深感忧虑的是，印度大多数老年人甚至都不了解自身权利以及保护自身的法律，例如《2007年父母和老年人赡养和福利法案》。

政府确实在采取措施，但是还必须有更多作为——要提高老年人的认识，加快审判流程，为老年人创造一个安全的氛围，不再担心被遗弃和虐待。

在这一方面，民间团体的作用也至关重要，大量的非政府组织为该国数以千计被遗弃和被虐待的老年人提供了救助。

印度已经宣布今年的预算将900亿卢比用于養老项目，然而这些资金将如何使用还有待观察。

最近印度已经采取一些积极举措来应对虐待老年人事件，例如《2007年父母和老年人赡养和福利法案》的修正案将虐待或遗弃年老父母的刑期从3个月延长到6个月。

然而，正如在印度经常所见，法律的颁布与实际实施之间存在巨大差距。最迫切的是改变人们的观念，要用爱和道德去培养，而不是被恨和贪婪所禁锢。     □

（译者为“《英语世界》杯”翻译大赛获奖选手;单位：北京外国语大学）