A banker by profession, Rukhsana lives less than three miles from her ageing parents’ home and drops by almost every day to see if they need anything, from medical care or just random errands. Many times she has had to rush her parents to the emergency room on receiving SOS calls in the middle of the night. There have been times she has reached her parents’ home to find her mother crying with pain due to her advanced osteoporosis or her father suffering from a concussion due to a fall. Rukhsana shudders at the thought of what could have happened if she wasn’t around. Try as she might, she simply cannot hope to be there every time they need her.

“If only there was some kind of specialised and focused care around where I could place my parents in, I would be so relieved,” she says. Yet the very thought of putting her parents into an old people’s home is distressing to her.

Nadeem H was offered a wonderful job in Dubai which he reluctantly accepted. “My elder brothers migrated to the US after receiving lucrative offers,” he says. “After my father’s death, I decided to stay back because I couldn’t leave my widowed mother alone. She was the one who forced me to take up the opportunity, but she didn’t want to accompany me to Dubai. A former teacher, she said she wanted to spend her retirement years in her apartment in Pakistan. I come every other weekend to see her but it worries me no end as to what might happen to her while I am not around,” he says.

But his mother will not even hear about the possibility of moving into a home for the elderly, “I have a lot of family that I am happy interacting with when Nadeem is not around. Besides, if I decide to live in an old people’s home, people will think that my son has dumped me there,” she says.

Then there’s Saeed, who considered leaving his fairly lucrative World Bank job and returning to Pakistan because he was concerned about his parents. “My father always used to tell me not to worry about him and Amma because they had plenty of help around but I still wasn’t quite convinced,” he says. His father passed away three years after his return, and Saeed stayed on to take care of his mother. He’s back to working for the World Bank, but is now based in Karachi and is more than happy that he can keep an eye on his aged mother.

And so is his mother: “I am very happy that my son returned. Living in an old people’s home is out of the question for me,” she adds.These stories may not justify the need of an old people’s home or the idea of parents living in old people’s homes when children are alive or around, but Irshad Mowjee, a stakeholder of the Ida Rieu Mowjee Elderly Home (IMEH) project, believes that many children today are unable to cater to the special needs of elders.

According to informal surveys across South Asia, placing parents in old peoples’ homes is considered a matter of disgrace for the children. “The question of placing parents in old homes is quite knotty,” says Air Commodore Shabbir, a dedicated social worker.

“The parents need a great deal of care, affection and help in old age but children are unable to provide for them accordingly as they live in a world where you have to run a constant rat race.”

Mowjee insists that living in old homes should not mean that children have dumped their parents there; sometimes it is in the best interest of the elderly.

“I know an elderly person who lives on the second floor of a flat (with his son) which has no lift. For years he has not been able to go out. In case of an emergency, he has to be carried down causing discomfort to him as well as to his attendants. However, they refuse to put him in a home for the elderly.”

Despite cultural norms, according to a study supported by the UN and carried out by HelpAge International, an NGO that works globally for the rights of old people:

“Pakistan is ranked among the three worst countries to grow old in, as it is ill prepared to deal with old people. It is ranked 89 out of 91 countries included in the study.”

The elderly also do not have any age-specific rights or a government sponsored social security system that they can benefit from.

“There are no old-age specific facilities for old people,” says Mushtaq Ahmed who retired from a reputed bank. “More than letting parents live in old homes, most children want their parents to be involved in some fulfilling activity which is very important for their wellbeing.”

With the joint family system being replaced by nuclear families, many parents find it difficult to sustain themselves financially on their own.

“There certainly is a need for the elderly to be looked after at a home which has a professional approach,” says Mowjee. At IMEH, he says, “our policy is (to ask whether) by staying at the Elderly Home the residents’ life will be better or worse off.

If the answer is that it will be better, then there is a need for this sort of facility. We feel that there are many cases where the children are abroad and there is no one here to look after the parents or where the spouse has died and there are no children; in such cases a ‘home’ seems the perfect answer.”

How should the stigma attached to old people's home be addressed?

“We need to realise that we are a giving nation. You will be surprised to find the number of volunteers who are willing to render their services and give time to this noble cause. Many times the children cannot provide due to financial or time constraints; they are looking after their own kids or are busy with heavy work schedules. Life is very stressful and is becoming more so with all the law and order issues. There are a lot of pressures on young people.”

“Thus ageing parents’ care is put on the back burner, not deliberately but because of different constraints. If the children are made to see the logic of it, then I am sure they would see the reason but for this awareness is very important. They should see for themselves how the ‘home’ is being run and ask: Will my parent be better off there rather than at their house. If the answer is in the affirmative then there is no issue,” he says.

Names have been changed to protect identities