Journal of Medical Sciences
Journal of Medical Sciences
Journal of Medical Sciences
Research Article
Abstract
This study examines the aging problem in theoretical perspectives
with their relevance in the case of elderly population in Bangladesh
highlighting the needs and problems encountered by the elderly. At
the same time this study reviews the services for the elderly and
their limitations in Bangladesh. The latest section of this article
recommends some guidelines with the emphasis on social worker`s
roles for the welfare of the elderly in Bangladesh.
INTRODUCTION
A man is borne infant but dies old if he lives up to the expectation
of his life. A man’s life is passed through some predestined stages in
a natural process namely: infant, childhood, adolescent, youth and
old age. So in this case we can say that aging is an evitable
socialization process that starts at birth and ends at death. Now in
the world of modern era aging has become a social problem as with
the change of society due to industrial revolution leading to
capitalist social formation. Ageing is considered to be one of the
social problems as the elderly feel solitary due to multifarious
reasons, one of which is disengagement. Besides, people’s attitude
and behavior towards the elderly people in the society are held so
differently. So, now in today’s world, ageing as a social problem has
got momentum and come into focus as a field of study in social
sciences. Bangladesh is one of the developing countries with
approximately 80% population living rural areas, some of them are
inflicted with absolute poverty, where kinship ties are very strong,
social relations are based on collective interactions. But the
increasing rate of urbanization in Bangladesh has given different out
looks and cultural values with regard towards their lives causing
break in traditional family system, e.g., joint family has been broken
down due to urbanization and industrialization giving birth to
nuclear family. Moreover urban life is bound up with individual and
formal relations condemning elderly people to isolation and
unlimited leisure time. Furthermore, due to innovation of modern
technology and improvement in medical sciences death rates are
controlled in many countries and Bangladesh as well. As a result,
the number of aged people is increasing gradually and substantially
day by day. So in this backdrop, this paper attempts to examine the
elderly problems in theoretical perspectives with especial emphasis
on elderly needs highlighting the limitations of the services in the
context of Bangladesh.
Aging: A conceptual context: The term aging refers simply to the
process of growing older. It is the aggregate result of the decrement
processes at cellular, sub-cellular or organ level that are associated
with the passage of time. It is the end of life cycle. It is of course a
biological reality which (despite medical intervention) has its own
dynamic largely beyond human control (Gorman, 1999). Aging
causes a functional deterioration and vulnerability that also creates
physical changes as well. With the increasing of his age, older
people become incapable to carry out his normal functioning as he
did before. Thus, aging is a social process that involves individual
and population aging, biological and psychological aging, individual
and social change, individual and cultural differences within and
between age cohorts and cross-cultural and sub-cultural differences
in values, beliefs and norms (Mcpherson, 1991). Social thinkers are
mostly concerned about social factors of aging that is termed as
social aging, because they can contribute to the aged in this context.
Social aging is a multidimensional and dynamic force. It includes
the transition into and out of roles, expectations about behavior,
societal allocation of resources and opportunities, negotiation about
the meaning and implications of chronological age and the
experience of individuals’ traveling the life course and negotiating
life stages (Morgan and Kunkel, 2001).
MAJOR THEORETICAL PERSPECTIVES OF SOCIAL
PROBLEMS AND ITS RELEVANCY TO AGING
Sociologists have typically studied social problems from five
perspectives, e.g., social disorganization, social pathology, deviant
behavior, conflict and labeling (Weinberg and Rubington, 1973). As
a field of study, an analysis from theoretical perspectives is
necessary and helpful for complete and comprehensive
understanding of aging in Bangladesh.
Social disorganization perspective : Society is made up of
interrelated parts, social institutions and each institution has a
function or role to play in keeping the society running smoothly and,
together the institutions operate to meet the society’s basic needs
which are referred to functional requisites (Curran and Renzetti,
1996). If there causes any change, society becomes unregulated,
unpredictable and uncoordinated and fails to make corresponding
adjustments and demands of the people go unmet. This situation is
termed as social disorganization. Major theorist of disorganization
perspective, Thomas and Znaniecki (1918) define social
disorganization as a decrease of the influence of existing social rules
of behavior upon individual members of the group. Social
disorganization involves a break down of social structure so that its
various parts no longer work together and norms lose their influence
on particular groups or individuals (Coleman and Cressy, 1990). It
happens especially in situations of rapid social and technological
change.
According to this perspective, aging appears in the society from the
changes in institutional system. This perspective is pertinent to
understand the aging in Bangladesh because modernization causes
great changes institutional system that leads the elderly in to crisis
in meeting their needs, like, breaking down the extended family to
nuclear family, institutional and technological development in
medical and health care system.
Conflict perspective: According to conflict theorists, for example,
Marx and Engels (1965) society is always in conflicting situation
since the group in the society frequently come in to conflict with
other groups pursuing their own interest. When groups have
confronted one another about those conflicting interpretations, the
conditions for the development of a social problem have emerged.
According to this perspective, young and old people are in constant
conflict due to the difference in culture and values. This conflict
leads the older people in to crisis and faces multiple problems in
their later life.
Labeling perspective: Another major perspective of social problem
analysis is labeling. This perspective, developed by Becker (1963)
focuses on social reality that men create. This reality rests rather
heavily and some times shakily on the process of social definition
whereby men such for create and sustain meanings and then live by
them. Here, if men define situations as real, they are real in their
consequences. The groups with greatest power do the job by making
the rules and imposing it to others. According to this perspective,
aging is a social construction because our society labels them as old
that denote unproductive, degenerative and liable though very often
they are free from such myths. Such labeling damages older
people’s self-concepts and may cause them to feel ashamed or
embarrassed. They have to face many difficulties from these
prejudices (Curran and Ranzetti, 1996).
Deviant behavior perspective: Deviance is non-conformity to
social norms. Deviance refers to behavior or characteristics that
violate social norms and expectations and are negatively valued or
stigmatized by large number of people as a result (Weinberg and
Rubington, 1973). Two popular theories in deviant behavior
perspective are Merton’s Anomie Theory (1968) and Sutherland’s
Differential Association Theory (1939). In anomie theory Merton
argues that if a person fails to meet his/her needs (cultural goals) by
structural means, he/she will try to fill the demands by taking
another ways (illegitimate means). Sutherland differs here and says,
it is not possible for man to take a way that is completely unknown
to him. He/she learns it from different associations in which he/she
interacts. According to deviant behavior perspective, when the
existing societal institutions, e.g., family, aged homes, old age
allowance, nursing homes, fail to meet the basic needs of the older
people, he commits deviant behavior, like, suicide, beggary.
ELDERLY PROBLEMS IN BANGLADESH: SOME
GROWING ISSUES AND RECENT TRENDS
A social security program has become the backbone of old age economic assistance in the
developed country. But we are far away from that sort of program. At the time of
retirement the older people get an amount from gratuity and provident fund but find
difficulties to invest it somewhere. Sometimes they have to wait more than one year for
bureaucratic complexities to get their pension and other allowances. The retired personnel
get an amount monthly and after death their wife get equal to half of the amount. About
ninety percent people are excluded from this program as they were not involved in service.
Very recent, in 1998, Government has introduced elderly allowance and widower and
destitute women allowance program from where 403110 people can be benefited from
each program but they get only taka 125 each per month certainly the amount is very little.
In 2005-06 fiscal year this amount will increase in taka 185. This amount is also too little
• to change their lives.
• Aged people mostly suffer from various complicated physical diseases and the number is
increasing day to day but the services provided through government hospitals are
inadequate in compared to needs. They have to take the services from the government
hospitals standing on a large queue. The rural poor elderly people do not get proper
medical care services from there for lack of sufficient doctors and nurses, medicine and for
other modern medical equipments. The family members also unwilling to spend money for
the elderly people because they think that the cost for elderly is meaningless, as they live
no more days. Doctors and nurses are also less interested to take their higher studies and
specialization in this field and also be reluctant to care them that also eventually increase
the sufferings of the older people.
Ninety five percent of the elderly and ninety percent of the disabled elderly live at home
and rely entirely on their family members. Institutional services are insufficient here.
Though some institutions have been set up by the government initiative, these institutions
often face a crisis in absence of the elderly. Most of the older people and their family are
not aware about these services. On the contrary, the institutions that are working for them
are most often proprietary that is run for profit, they hold high amount of service charge
that make the people far from these institutions. This institution also experiences the
shortage of skilled manpower to care for the aged. Professional knowledge is mostly
unavailable among them. There is also found lack of motivation and counseling in both of
• the government and non-government agencies.
• Community care services (service arranged by the community itself) should be expanded
to care for the elderly. To ensure these services, we have to take proper steps to re-arrange
or set up new and alternative institutions that can take care to the aged, such as, aged
homes, nursing homes, health complex, day care center, recreational center and so on. In
doing so, Government can make a dialogue with individual solvent donors and voluntary
organizations and should provide them technical and logistic support in this regard.
Micro and macro level counseling can be a more effective initiative to give up the myths
and prejudices of the community people towards their elderly and to inspire them to initiate
more elderly care services and also the elderly people can be persuaded to take the services
• from the newly introduced institution.
Government should take some programs for making them involvement through using their
inner potentialities and experiences to reduce their mental sufferings resulting from
loneliness and isolation. Meanwhile a large scale social security programs, like, pension,
old age allowance, health insurance can also make them free from anxieties in later life.
The amount of old age allowance and beneficiaries should also be increase at satisfactory
• level VGD (Vulnerable Group Feeding). Programs can also be effective for elderly people.
Elderly people mostly suffer from some physical diseases. At that time; they need
comprehensive medical care services. But in some cases it becomes impossible for them to
stand in a queue to avail the services from general out door services in government
hospitals and to get in to the bus due to their physical inability. In this regard government
should take initiative to devise special free out door service units in government hospitals
• and special free transport services for the elderly.
As the elderly people feel free to stay in their own residence, home-based care can be more
effective service instead of institutional care. In this regard, local self-government can
recruit ‘Paid Home Helper’ who will serve the aged people in their home. Some developed
• country like, Norway, Sweden, Finland, Denmark, have already introduced such programs.
We need to revise our academic curriculum and include such issue that would teach and
direct our new generation to respect our senior citizen and awaken them about their duties
• and responsibilities towards the older people.
References
Aziz, K., 1979. Kinship in Bangladesh. International Center for
Diarrhoeal Disease Research, Dhaka.