Introduction

The geographies of care literature covers care practices in its many different forms and spatial structures (Milligan, 2017; Hanrahan and Smith, 2020; Power and Williams, 2020), including home-based care negotiations (Button and Ncapai, 2019) in everyday care practices. Recently the landscapes of care or caringscapes have started to be mapped, investigating how different spatial cares are practised and perceived by different people (Meier and Bowman, 2017; Bowlby and McKie, 2019). Care and care relationships are located in, shaped by and shape particular spaces and places that range from local to global (Milligan and Wiles, 2010). Similarly, Lawson (2008) argues that the way care is understood, experienced and practised is shaped by socio-economic and political contexts. McKie et al (2002), while defining ‘caringscapes’, brought up two important points. First, caregiving is a social practice, is gendered and it is determined by the creative strategies of caregivers (largely women) in both professional and family settings (Power, 2016; Williams and Sethi, 2020). Second, care should be viewed as a fundamentally social, economic and cultural relationship. In addition, it is important to mention that caregiving in the Asian context, particularly in India, is mainly carried out by women, especially spouses and daughters-in-law (Ajay et al, 2017; Ugargol and Bailey, 2020). Female family members, traditionally, are expected to take care of older adults and children (Pillai et al, 2012; Ugargol et al, 2016). The synergy between the gendered nature of caregiving and its spatial dimension essentially engender the contextual caringscapes.

Caringscapes are developed through an individual's involvement with varied social landscapes of care, caregiving roles, employment and social policies, and gendered and generational expectations of care and work (McKie et al, 2002). To understand ‘care’, one needs to consider all those who are involved in the care relationship because the nature, extent and form of these relationships are affected by where they take place (Milligan and Wiles, 2010). Therefore, care is not only interpersonal relations but also people–place relationships. Critically, landscapes of care are both product of and produced by the social and political-institutional arrangements for care.

Introduction

When discussing this book with colleagues and students, people were generally excited by it and said that there was a real need for such a book. Almost everyone, particularly those in the UK, had a fairly similar argument for why this was important which went something like this: i) the family has traditionally been the main source of care for older adults in India, ii) tradition mandates that daughters-in-law will move in to the family home with their husband and assume caring responsibilities (for all generations), iii) modernisation and migration are destabilising these traditional living arrangements as adult children, in particular women, move for education and/or work, iv) in the absence of any old age social security programs older adults will be unable to get the care that they need and instead face years of disability, depression and loneliness. There is definitely more than a kernel of truth in this accepted narrative about changing living arrangements and care for older adults in India. Families are mandated to take care of their older members through the Maintenance and Welfare of Parents and Senior Citizens Act of 2007. This act empowers any ‘senior citizen including parent who is unable to maintain himself [sic] from his [sic] own earning or out of the property owned by him [sic]’ to apply for support from their relatives who are then obligated ‘to maintain a senior citizen … so that [they] may lead a normal life’. Failure to do so can result in fines or imprisonment. This Act is often taken to underscore the centrality of the family in India and seen to represent the government's attempt to shore it up in the face of challenges such as migration and modernisation. Again, such concerns are not without merit. As has been noted earlier in the book the scale of internal and international migration in India is staggering. There are estimated to be 450 million internal migrants within India and a further 18 million Indians who live abroad (De, 2019; UNDESA, 2020). Alongside this, as the data presented by James and Kumar (Chapter 3) and Rajan and Sunitha (Chapter 5) show, around a fifth of older adults do not live in households with extended families. For many older Indians this represents the decline of traditional values and is something to be lamented.

Introduction

Home is a place marked by many life course events. When an older adult leaves her/his home and starts to live in a retirement home she/he has to reconfigure their sense and meaning of home. The shift in place of residence is likely to bring about changes in control over a place (home) and the sense of place attachment (Heywood, 2005). Home can be central to many well-being factors for older adults such as care and care reciprocity (Ugargol and Bailey, 2020); domestic routine and rhythm (Lager et al, 2016); social relationship; religious and cultural practices (Mazumdar and Mazumdar, 2005; Bailey et al, 2008); life course events; material possessions; memories and emotional investments (Cristoforetti et al, 2011). Home is also embedded with memories, self-identity, sense of security, cherished possessions and family relations. In the Indian cultural context, older adult care is generally seen as a duty of adult children, which means the primary caregiver is usually the daughter-in-law (Liebig, 2003). Urbanisation and industrialisation have increased the workforce participation of all members of the household. This, coupled with migration of children, results in the non-availability of caregivers within the household (Nair and Kumar, 2017). As a result of these changes, formal care services for older adults have begun to receive considerable attention, especially in urban areas. Institutions providing geriatric care such as old age homes have become a source of formal care services as an alternative for traditional informal care services (Kalavar and Jamuna, 2011; Gupta et al, 2014; Bhattacharyya and Chatterjee, 2017; Mayer, 2017; Pathania et al, 2019). According to Muller (2019) relocation of housing is a complex decision-making process as changing the housing environment allows older adults opportunities for self-reflection and emotional regulation. Unlike in the Western context, this study shows that older adults living in for-profit care homes make efforts to retain and maintain their old home, as home is culturally as well as emotionally relevant in older adults’ lives.

This chapter focuses on three questions: i) what motivates older adults to retain their (previous) home while currently residing in retirement homes?, ii) how do older adults maintain their previous homes?

Introduction

Demographic ageing and the associated changes in population health are necessitating a complex reorientation of health systems, public spending, social security and living arrangements of older adults in developing countries (Bloom et al, 2015; Goodman and Harper, 2013; Lamb, 2013). In countries such as India, the consequences of ageing are far more severe because insufficient social security systems make families the main providers of support to older adults (Bloom et al, 2010). Changing demographic circumstances, such as the increased mobility of adult children, fewer siblings and increased longevity of parents, are influencing care arrangements in Indian households (Croll, 2006; Dhillon et al, 2016). The BKPAI (2011) study on the elderly in India reports that 6.2 per cent of older adults live alone, 14.9 per cent live exclusively with their spouse and 78.9 per cent of them live with children and other family members respectively, and importantly, the proportion of older adult women who live alone is nearly four times in comparison to older adult men (Ugargol et al, 2016). The traditional Indian family is in transition and the modified extended family where parents, children and other relatives do not necessarily live under one roof or share a hearth is now becoming common (Rajan and Kumar, 2003; Medora, 2007). Simultaneously, a cultural norm exists in India that older adults will continue to live with and receive their care from family members (Bongaarts and Zimmer, 2002; Ruggles and Heggeness, 2008 ) and living alone or in old age homes is interpreted as a sign of breakdown of traditional Indian values in public discourses (Medora, 2007; Lamb, 2013).

Though migration of adult children is considered one of the most effective poverty reduction strategies for families in the developing world (Stark and Lucas, 1988; Clemens, 2011) and increased incomes from migration can provide support for parents left behind, often the physical presence of a caregiver is the most desired but missing element (Bohme et al, 2015; Dobrina et al, 2015). Miltiades (2002) found from her study of left-behind Indian older parents that migration of adult children changes household dynamics and leaves families, mainly older adults, in disarray.

Introduction

This chapter provides a theoretical framework to understand the ways in which living arrangements and the provision of care for older people in India have been affected by migration. According to the United Nations, as of 2020 nearly 18 million Indians were living outside their country of origin. Indians are the largest diaspora groups followed by Mexican, Russian and Chinese diasporas (UNDESA, 2020). The largest concentration of Indian international migrants is in the Gulf region. The international migration from India prior to 2000 was largely low skilled and more focused towards the Middle East. After 2000 rapid globalisation increased the migration of skilled workers to the developed countries. Much of this skilled migration was among middle-class households and followed a trajectory where education and employment mobility to cities fuelled further migration plans to other countries. Indian migrants also contribute a large portion of their incomes as remittances. According to the World Bank, India received close to $US84 billion as remittances in 2019, close to 2.8 per cent of its GDP. Due to the COVID pandemic the World Bank estimates that remittances could drop by between 7 and 9 per cent (Ratha et al, 2020).

However, as eye-catching as these figures are, it is important to remember that the number of internal migrants within India is far greater than those who migrate abroad. Increasing urbanisation, improvement of travel and access to travel, coupled with greater educational opportunities, has led to widespread migration within India. Migration to the cities is driven by a combination of labour migration, which can be both temporary and circular, educational mobility and marriage migration. Bhagat's (2016) analysis of the 2011 census data shows that nearly 30 per cent of the Indian population moved internally. De (2019) reports that there were 450 million internal migrants in India and much of this migration was intra-state migration. See Chapter 3 by James and Kumar on the impact of migration on living arrangements of older adults in India. The lower levels of interstate migration could potentially be due to the non-transferability of social security entitlements across state borders (Kone et al 2018).

Introduction

This chapter investigates how life course obligations, expectations and practices are linked to older adults’ sense of well-being. Linked lives, which is one of core dimensions of the life course approach, recognises that life trajectories of individuals are socially embedded and closely linked to the transitions of the significant others (Elder, 1975, 1985; Dannefer, 2003; Moen and Hernandez, 2009). The studies that have examined linked lives in the context of migration (Bailey et al, 2004; Cooke, 2008) tend to focus on western countries or on internal migration (Mulder and Hooimeijer, 1999; Thomas et al, 2017). However there are some new studies emerging on international migration (Kou et al, 2015, 2017; Statham, 2020). Some strands of work in Asia focus on transnational families (Yeoh et al, 2005), aging in diasporas (Lamb, 2002, 2009; Fluit et al, 2019) and marriage migration (Charsley, 2005; Gallo, 2006; Shaw and Charsley, 2006; Gardner, 2009; Le Bail, 2017). In non-Western multi-generational co-residential families the determinants of well-being need to be evaluated in relation to the reciprocity and support exchanged between older adults and other family members (Ugargol and Bailey, 2020). In our study the concept of linked lives is translocal and broadened to include older adults in migrant households, their adult children (co-residing or migrant children), grandchildren, caregivers and non-kin social networks. The focus in this chapter is on how the broader well-being of the older adult is linked to the life course obligations of older adults towards their families. This chapter also discusses how we can better contextualise life course decisions and trajectories in non-Western settings.

Living arrangements, migration and care

The population aged 60 years and older in India constitutes over 7 per cent of the total population (1.21 billion) and is projected to triple in the next four decades, from 92 million to 316 million (James, 2011). In the past, the family has been the major source of support in later life. However, increased mobility may challenge the continued reliance on family in the future. Jamuna (2000) finds that in the Indian ethos elder care was generally seen as a duty of the adult children, which meant the primary caregiver was usually the daughter-in-law.

Introduction

India has one of the most rapidly ageing populations on the planet. Given the change in the size and nature of the older population in India it is imperative that we better understand the situation of older people in India. However, India is a complex and diverse country made up of different states, castes, cultures, and ethnic groups. India's older adult population has now risen to 8.57 per cent, however in states such as Goa and Kerala the percentage of older adults is as high as 11.20 per cent and 12.55 per cent respectively (Census, 2011). Recent data from the Longitudinal Ageing Study in India (LASI) show that nearly 12 per cent of older adults were 60+ and that the states of Kerala, Himachal Pradesh, and Tamil Nadu had a higher proportion of older adults (IIPS, 2020). India had, in the past, a predominantly familybased elder care system. However, rapid population ageing, the decline of extended families coupled with decreasing fertility rates, increasing life expectancy, widowhood, singlehood or strained intergenerational relationships, have all raised concerns that an increasing number of older adults in India live alone. These concerns are amplified as India, like many other lower-and middle-income countries, is still struggling in setting up social security and pensions systems (Arokiasamy and Yadav, 2014; Giridhar et al, 2014; Bloom et al, 2015). However, as we show throughout this edited volume, the demographic picture is not uniform as Indian states are at surprisingly diverse levels of demographic transition and vary to a great extent in their cultural practices, social norms and socio-political contexts.

This chapter provides a general introduction to the topic by situating the subsequent chapters within the broad demographic trends already mentioned and gives an outline of the structure and chapters of the book. This chapter introduces the need for focus on living arrangements and care. It highlights the social, economic and cultural contexts that shape the provision of care for older adults. We link the different studies presented and explore the consequences of changing living arrangements on long-term care, and the economic, physical, social and psychological well-being of older people.

Introduction

The hypermobile cities of India stood still with the onset of COVID-19-induced lockdowns. Public transport services were the first to be suspended, and older adults in particular were instructed not to leave their homes (Press Information Bureau (PIB), 2020). Even with the easing of lockdown and the resumption of limited public transport, older adults were ‘restricted’ from using services as per the pandemic-related advisories issued by the state. Mobility, which is central to active aging, health status, and well-being (World Health Organization (WHO), 2007) of older adults, was affected by this exclusion in the public transport system. The short-and medium-term implications of such lockdown protocols towards the (im)mobility of older adults requires attention. Given the Indian urban transport scenario, the dependence of older adults (particularly those from low-income groups) on public transport and the inadequate public transport infrastructure is relevant to contextualize the pandemic advisories.

This chapter uses the case of Bengaluru city in southern India to highlight how transport protocols issued during the COVID-19 pandemic impacted older adults’ (im)mobility. Even before the lockdown was rolled out on March 24, 2020, Bengaluru's public transport system had been struggling to cater to passenger demand. With physical distancing norms in place, which reduced ridership and trip number, it has become more difficult for passengers in general, and older adult passengers in particular, to access public transport. In Bengaluru, a large proportion of older adults are mobile, work in the informal sector, and earn a low income. They cannot afford private transportation and are therefore dependent on public transport (Baindur and Rao, 2016). The exclusion of this group from the public transport system will have implications for their access to work, social life, and essentials such as banking, health care, and groceries.

In this chapter, we take an intersectional perspective, where we examine how events such as the COVID-19 pandemic further accentuated the already disadvantageous position of older adults in the absence of age-friendly interventions. The chapter reviews the literature, government circulars, and social media communication to understand the state's major transport-related decisions. We use data from our online survey (conducted between June 9 and June 30, 2020), in which we focused on the impact of COVID-19 lockdowns on older adults’ mobility in urban India.