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| LETTER TO EDITOR |
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| Year : 2015 | Volume
: 2
| Issue : 2 | Page : 118-119 |
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Do Indian social norms curb freedom of our elderly in an old age home?
Avinash De Sousa
Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| Date of Web Publication | 18-Jan-2016 |
Correspondence Address:
Avinash De Sousa
Carmel, 18, St. Francis Road, Off S.V. Road, Santacruz West, Mumbai - 400 054, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2348-9995.174284
How to cite this article:
De Sousa A. Do Indian social norms curb freedom of our elderly in an old age home?. J Geriatr Ment Health 2015;2:118-9 |
Sir,
I am writing this letter to highlight a unique situation faced by me in clinical practice where the dilemma was neither ethical nor clinical but rather caused by existing social norms that tended to curb the freedom of our elderly in old age homes in India. I received a call from an old age home that I used to visit periodically as a psychiatrist to treat geriatric patients with complaints suggestive of either geriatric depression or in cases of dementia with psychiatric phenomenology. They mentioned that I needed to visit the home and counsel an elderly male and female occupant, as both had no regard for Indian social norms and other people living in the old age home. When I visited the home, I was faced with a problem created by the primitive fears of those running the old age home and was dismayed at the travesty of freedom meted out to the elderly there. A male and female occupant of the old age home used to speak regularly to each other and share conversations on various topics.
The male was 76-year-old and the female was 74-year-old. Both were living in the old age home as their spouses were dead, and their children were living abroad. They had no one to look after them and had opted for the old age home voluntarily to enable them to have a better quality of life in their twilight years. During the course of their conversations which were now regular over a 3-month period, the inmates developed a liking for each other and even professed their love for each other. They both felt that they would like to spend as much time as possible with each other and however did not wish to make their relationship formal in marriage as they felt no need for the same due to their age.
They approached the management of the old age home and requested that they are allowed to share the same room as they liked each other. The management flatly turned down their request stating that they should feel ashamed for having feelings of love and affection like adolescents and that shifting them to the same room would violate the rules and norms of the old age home where male and female inmates usually stay separate. The only case where male and female inmates are allowed the same room are in the case of a matrimonial relationship. They were also told that granting them permission to do so would set a bad example for other inmates and would spoil the name of the old age home. They were even mocked at by the staff saying that they had both lost their minds due to aging of their brains. They were very upset when this happened and told the management that they were consenting mature adults and had the right to choose how they wished to stay in an old age home. They were even candid to mention to the management that old age home authorities had no right to curb their relationship and sexual freedom in old age. The management wanted a psychiatric opinion on the same and even asked me whether they should inform the children who were abroad about what had transpired.
Both of them were single as their spouses had expired and had no commitments binding them. They were also very sure that they did not need to ask their children, as in fact the children who were abroad were quite open minded and would, in fact, be happy that they found companionship in the twilight years of their life. After interviewing both of them and finding no evidence to suggest any psychological problems in both inmates, I requested the management to allow them to stay together but the management thought otherwise and in fact wanted me to give an opinion in writing stating that there was no need for such a move as it was morally and ethically wrong in an old age home setting. I refused to do so and left the old age home. In fact I advised the couple concerned to inform their children (they are allowed to make phone calls from the old age home) and move out of the old age home and stay independently with some help if their wishes did not comply with.
The above situation is reflective of the reservation and taboo associated with relationships, sexuality and freedom therewith in the elderly. Sexuality and love relationships without marriage in old age have been a topic of debate and discussion in the geriatric scientific literature. [1],[2] In fact, many surveys have reported that geriatric nurses, social workers, and mental health professionals may at times have reserved views about sexuality and new relationships in old age. [3],[4] In India, cultural and moral values, as well as stringent upbringing, plays a role in a rather reserved and nonopen attitude toward relationships that fall outside the sibling and marital realm. [5] This may carry over to geriatric populations as well. There is a need for geriatric mental health experts in India to educate the masses with regard to sexuality and relationships in old age. [6] There is also a need to educate and sensitize old age home staff and nursing staff to be receptive and empathetic when such feelings may arise within inmates in their settings. [7] It is important that geriatric medical and paramedical staff quell their fears related to these issues and help in providing holistic care to the elderly, particularly in the golden years of their senescence.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Weg RB. Sexuality in the Later Years: Roles and Behaviours. UK: Elsevier Publications; 2013.  |
| 2. | Taylor A, Gosney MA. Sexuality in older age: Essential considerations for healthcare professionals. Age Ageing 2011;40:538-43. |
| 3. | Elias J, Ryan A. A review and commentary on the factors that influence expressions of sexuality by older people in care homes. J Clin Nurs 2011;20:1668-76. |
| 4. | Mahieu L, Gastmans C. Sexuality in institutionalized elderly persons: A systematic review of argument-based ethics literature. Int Psychogeriatr 2012;24:346-57. |
| 5. | Victor CR. Old Age in Modern Society: A Textbook of Social Gerontology. UK: Springer; 2013. |
| 6. | Fernández-Ballesteros R. Quality of life in old age: Problematic issues. Appl Res Qual Life 2011;6:21-40. |
| 7. | Williams J. Intimate relationships between older people in institutional settings: Ageism, protection or fear? Ethics Med Public Health 2015;1:194-202. |
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