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9 - The role of cultural meaning system and place attachment in retaining home ownership while residing in retirement homes in Kerala, India
- Edited by Ajay Bailey, Universiteit Utrecht, The Netherlands, Martin Hyde, Swansea University, K. S. James
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- Book:
- Care for Older Adults in India
- Published by:
- Bristol University Press
- Published online:
- 13 October 2022
- Print publication:
- 31 May 2022, pp 161-184
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Summary
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?
6 - Care arrangements for older adults: exploring the intergenerational contract in emigrant households of Goa, India
- Edited by Ajay Bailey, Universiteit Utrecht, The Netherlands, Martin Hyde, Swansea University, K. S. James
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- Book:
- Care for Older Adults in India
- Published by:
- Bristol University Press
- Published online:
- 13 October 2022
- Print publication:
- 31 May 2022, pp 86-117
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Summary
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.
FERTILITY AMONG HIV-INFECTED INDIAN WOMEN: THE BIOLOGICAL EFFECT AND ITS IMPLICATIONS
- SHRINIVAS DARAK, FANNY JANSSEN, INGE HUTTER
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- Journal:
- Journal of Biosocial Science / Volume 43 / Issue 1 / January 2011
- Published online by Cambridge University Press:
- 12 October 2010, pp. 19-29
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In India, nearly one million women of childbearing age are infected with HIV. This study sought to examine the biological effect of HIV on the fertility of HIV-infected Indian women. This is relevant for the provision of pregnancy-related counselling and care to the infected women, and for estimating the HIV prevalence among women and children. The study used retrospectively collected data from the National Family Health Survey (2005–2006) and applied a matched case control study design to compare the effect of HIV on conception, pregnancy rates and pregnancy outcomes among HIV-infected (N=69) and HIV-non-infected (N=345) women, both unaware of their HIV status. Pregnancy rates and pregnancy outcomes were compared through non-parametric statistical tests, whereas the effect of HIV on fecundity was studied by analysing the interval between last two pregnancies using Cox regression. The pregnancy rate was observed to be lower among HIV-infected than HIV-non-infected women (RR=0.77). The difference, however, was not statistically significant (p=0.064). There was also no statistically significant difference in the interval between last two pregnancies (p=0.898). Significantly higher number of pregnancies among HIV-infected women resulted in termination because of miscarriage or stillbirths (p=0.004). Therefore, while providing clinical care and counselling to infected women, the possibility of adverse pregnancy outcomes should be considered. Due to the higher rate of adverse pregnancy outcomes, attendance of HIV-infected women at antenatal clinics might be greater, which could lead to overestimation of HIV prevalence derived from antenatal care surveillance sites.
ASSOCIATION BETWEEN AGE AT MENARCHE AND EARLY-LIFE NUTRITIONAL STATUS IN RURAL BANGLADESH
- ALINDA M. BOSCH, FRANS J. WILLEKENS, ABDULLAH H. BAQUI, JEROEN K. S. VAN GINNEKEN, INGE HUTTER
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- Journal:
- Journal of Biosocial Science / Volume 40 / Issue 2 / March 2008
- Published online by Cambridge University Press:
- 01 March 2008, pp. 223-237
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Age at menarche is associated with anthropometry in adolescence. Recently, there has been growing support for the hypothesis that timing of menarche may be set early in life but modified by changes in body size and composition in childhood. To evaluate this, a cohort of 255 girls aged <5 years recruited in 1988 were followed up in 2001 in Matlab, Bangladesh. The analysis was based on nutritional status as assessed by anthropometry and recalled age at menarche. Data were examined using lifetable techniques and the Cox regression model. The association between nutritional status indicators and age at menarche was examined in a multivariate model adjusting for potential confounding variables. Censored cases were accounted for. The median age at menarche was 15·1 years. After controlling for early-life predictors (birth size, childhood underweight, childhood stunting) it appeared that adolescent stunting stood out as the most important determinant of age at menarche. Adolescent stunting still resonates from the effect of stunting in early childhood (OR respectively 2·63 (p<0·01 CI: 1·32–5·24) and 8·47 (p<0·001 CI: 3·79–18·93) for moderately and severely stunted under-fives as compared with the reference category). Birth size was not a significant predictor of age at menarche. It is concluded that age at menarche is strongly influenced by nutritional status in adolescence, notably the level of stunting, which is in turn highly dependent on the level of stunting in early childhood. A ‘late’ menarche due to stunting may be detrimental for reproductive health in case of early childbearing because of the association between height and pelvic size.