A program that started in 2015 in two rural areas in Kerala, southern India, is attempting to build community from the ground up that is inclusive of older people. The so-called Elderly Inclusion Program sees older people as persons who can contribute to the society and economy in countless ways, and not merely as a dependent group in need of services. It promotes community-building as well as the provision of valuable services and benefits.  One of its core features is the creation of a community network of Neighborhood Groups (NHGs) based on the premise that all older women and men 60 years of age and older who live in close proximity to one another have the opportunity to belong to an Elderly NHG.

Most older people in Kerala today live with at least one married son or daughter and their spouse and children.  Many nonetheless find themselves home alone during the day while their son and daughter-in-law are both working outside the home and their grandchildren are in school.  Belonging to an Elderly NHG gives older people a chance to get out of the house and meet with age-mates to share stories, experiences, talents, and concerns; to participate in group activities and outings; and to provide needed assistance to each other when possible. These are valuable sources of social interaction and support that enhance health and quality-of-life. In addition, members gain access to a number of government services and benefits that help them age in community well, and to small low-interest loans for the financially destitute.

Elderly NHGs are not necessarily the only civil society organizations that older Keralans belong to.  They also may be involved in a group based in a temple, church or mosque for example, or in an association of retired professionals, or a social club.  These types of groupings however do not bring them into regular contact with people who live in the same small area as they do.

What then is the value of a place-based association of older people?

First, geographical proximity makes regular interaction easier, particularly as people age and develop activity limitations or become bedridden.  NHGs typically meet in people’s homes and members take turns hosting.  A number of groups report holding their meetings in the home of members who are bedridden or have health problems so they do not have to miss the gatherings.  Others send members to visit those who have difficulty getting to the meeting, to share information and provide an update on the group’s activities and decisions.

Second, NHG members all have a stake in what is happening in the same small town, village or neighborhood, and in the workings of the same local government.  They have the potential therefore to amplify their voices by organizing themselves collectively – at the local level where face-to-face interactions are more likely – and to be stronger advocates for better services and rights protection.  Members report that they are given more respect and consideration as a result of belonging to an Elderly NHG.  They give examples of times when the NHG made the decision to work collectively on a local issue that affects all residents such as mosquito control or clean water supply, and lodged an effective complaint with local government or created and delivered a successful petition to local government bodies.  There were also examples of times when they advocated for changes that were specific to older people’s needs.  For example one NHG was successful in obtaining a separate queue for older people at the community hospital so they would not have to wait in long lines for medical services.

I am not aware of place-based organizations or associations in the United States that mirror the core features of Elderly NGHs. There may be similar entities however that resemble NHGs in some ways.  I have in mind for example the neighborhood sites that are part of the Tallahassee Senior Center’s outreach programming.  These sites are expected to attract older people who live close by, and who may have difficulty accessing the Senior Center itself.  The programs include valuable information and activities that also provide an opportunity for regular, casual social interaction with age-mates. It is not clear however the extent to which a senior center’s neighborhood sites help build a society that is more inclusive, i.e. that contributes to increasing respect for elders, and creating a wider range of opportunities for older people to remain active in civic, economic, social and spiritual life. Older people in this approach tend to be seen mainly as dependents in need of services.

In closing, I propose a couple of questions that probe different ways that the Kerala Elderly Inclusion Program might be adapted to be useful in the United States context, in either rural or urban areas or both.

• What partnerships might be created at the local level to enhance the community-building possibilities of existing local programs in the US that tend to follow a service delivery model?
• What services and benefits might encourage older people to join a local place-based group similar to the Elderly NHGs?

Listen to Dr. Rebecca Miles’s Policy Pub on the topic here.

Dr. Rebecca Miles was on the faculty at FSU for nearly 30 years, 25 of them in the Department of Urban and Regional Planning, until her retirement this summer. She has also been an affiliate at the Pepper Institute on Aging and Public Policy, where her work focused on neighborhoods and health; rapid urbanization and aging populations; planning and public health, safety, and well-being; development and social policy.

The featured image is from the Aging Experience.