Thomas Mathew, 73, started converting his 200-year-old ancestral home into an assisted senior living facility (Image Credit: Hanna Paul)
By Hanna Paul
Pathanamthitta district in central Kerala has the highest number of senior citizens in the state. In Kumbanad town, many seniors are choosing community living to overcome loneliness and depression.
From a distance, the white two-storeyed building looks like any other. A small board with pink letters announces that it is Grace Maniyattu Homes, named after 73-year-old Thomas Mathew’s late wife. “Until my wife passed away in 2015, I did not feel the pangs of loneliness,” said Mathew. Such pangs pushed him to turn his 200-year-old ancestral home into an assisted living facility for seniors in Kumbanad, a small town in Pathanamthitta district in central Kerala.
Loneliness, which has now been termed an epidemic, is widespread in Kumbanad which was infamously termed a ghost town by the media. Most people from the town moved out, leaving unoccupied homes behind.
Pathanamthitta has the highest number of people aged 60 or older in the state, according to a 2023 Kerala Migration Survey, released in mid-2024 by the Thiruvananthapuram-based International Institute of Migration and Development. Kerala’s population is aging at a rate faster than the rest of the country; by 2036, one in five residents of Kerala would be a senior.
Depression is one of the most common psychiatric morbidities among senior citizens, according to a 2024 study by Kerala-based researchers. “If a senior is exhibiting anger, depression, general dissatisfaction and ungrateful behaviour and is withdrawing from society, these are symptoms of loneliness,” said Thiruvalla-based counselling psychologist, George Mathew.
Traditionally, aging parents lived with their children, to the extent that not living with them carried shame and the offspring were considered to be insensitive or self-absorbed. However, the attitude towards seniors living on their own has seen a marked shift in recent times.
Education, exposure and financial status determine whether a senior would insist on living with their kids or not, said Mereen Punnen, a psychologist. In many other cultures, seniors do not necessarily live with their children.
“Around 15 years ago, we used to campaign to fill spaces in our facility,” said Sera Philip, an executive from Tranvancore Foundation, an assisted living facility. “Now, the second a bed becomes available, there is a waiting list of people ready to take it,” she added. Travancore Foundation charges between Rs.2,500 to Rs.6,000 per day and up to Rs.1,00,000 per month for longer term stays.
Different views of loneliness
Most seniors in Kumbanad are empty nesters, as their children have migrated, mainly for work. Mathew’s three children are settled in Melbourne, Bangalore and Chennai. “It is not fair to hold them back,” he said, just so they could take care of him.
Mathew understands, as he moved to Abu Dhabi in the 70s to work in a petroleum plant, he said.
Mathew’s neighbours, Shashikala and Dinesh Namboodiri, said they missed their grandchildren very much. However, they settle for seeing them a few months in a year when they visit them in Canada, they said. “I didn’t want to send my [only] daughter away but she insisted [she would go],” said Dinesh Namboodiri. He said his daughter was being paid her due in Canada. “That is not the case in India,” he added.
Though the Namboodaris are in their late 60s, they are not without responsibilities. Shashikala’s 89-year-old parents live with them. They are also busy taking care of five cats and half a dozen dogs.
“If you keep busy,” said Dr.Christy Abraham, a consultant psychiatrist, “you will have fewer problems.”
Seniors who are in relative health and can care for themselves, should ensure they are not idle, he said.
Views around assisted living
Rajiv Pillai and Meena Rajiv, who live in the same neighbourhood as Mathew, returned to their hometown after spending decades in Kuwait, to care for Rajiv’s 94-year-old mother who was diagnosed with Parkinson’s disease. “Just because we are bound by the societal structure, our kids need not be,” said Pillai. “They are growing up in a different world.”
Pillai’s mother is surrounded by all her kids. “She is lucky,” Pillai said.
Rajiv Pillai and Meena Rajiv told their sons, who are settled in Australia, they would eventually want to move into an assisted living facility. While they were both insulted at first, Rajiv said their elder son eventually saw value in it. “My younger son simply couldn’t accept it and responded in utter disbelief,” she said. “He asked how could we possibly think they wouldn’t take care of us!”
People look down on these institutions and feel like they have been dumped by their kids, Mathew said. “I want to change that with my assisted living facility.”
Seeking refuge in faith
For Shashikala, some days feel like a battle. “When my daughter falls sick [for instance], I get very tense because I’m not there to take care of her,” she said, adding that frustration usually channels its way through anger to her parents or her husband. If she tried to hold back the anger, she said, she could feel her jaw clench. “Eventually, I started chanting. I go to temples as much as I can.”
Mathew said his spirituality supports him through his periods of stress too. In many ways, his work for the community stems from his spirituality.
Kerala now has more than 1000 palliative care units linked to local government institutions and more than 400 units run by local community groups, according to the Handbook of Aging, Health and Public Policy.
Mathew’s only qualification to build an assisted living facility is that he is a senior citizen himself, he joked. “At 71, when I spoke about my dreams of starting an assisted living facility, people asked me why I wanted such stress so late in life,” he said. “But we need a reason to wake up every morning.”
Assisted living communities give a sense of security and might be a partial cure to loneliness. Mathew hopes to accommodate 22 people in the twelve room facility, which would be operational shortly. “Staying socially connected is crucial in old age,” said Dr. Roy Kallivayalil, a psychiatrist at Thiruvalla’s Pushpagiri Medical Hospital.
“Loneliness is a sickness,” said Mathew, “which needs to be treated,” admitting he was very lonely after his wife died. His way of dealing with it is to form his own community.
Author: Hanna Paul
Hanna Paul is a journalist based in Kochi writing on the intersection of mental health, food, economy, climate and culture.