A new programme allows Kerala’s elderly to check out with dignity

It’s a problem Japan has faced for decades and addressed. In recent years, Kerala, too, has been grappling with the same problem, albeit silently. Now, Kochouseph Chittilappilly, the founder of the Rs 3,500 crore V-Guard Industries, has brought it to the forefront. When Chittilappilly decided to accept the first membership card of Vayogen, a unique programme that allows people to pre-secure the last stages of their life, he shone the spotlight on Kerala’s growing population of elderly people and the alienation they suffer. (The name Vayogen has been derived from the Malayalam word vayojanam, which means old people.)

Vayogen founder Joseph Alex, who already runs two hospices in Kochi, claims that this concept has not been tried elsewhere. With Vayogen you can advance-book the medical care needed for a specified period in 10-20 years through a payment ranging from Rs 5-10 lakh.

Chittilappilly liked the concept when Alex approached him and took a platinum card for Rs 10 lakh, which ensures total care for 700 days in the last stages of life. Besides rent, food, laundry and medical care, this includes free assistance for will creation, property and funeral management.

While the Rs 10-lakh platinum programme permits all these facilities free for four people, the Rs 5 lakh gold plan allows this for 350 days for two persons.

“Kerala is changing with a rise in the elderly population. Many of them are forced to live alone with children settled abroad. Many like me don’t want to be a burden on the children, especially while negotiating the last stages of life,’’ Chittilappilly told Moneycontrol.

The industrialist has been a champion of philanthropic and humanitarian activities. For instance, he organised an organ donation drive over a decade ago to help people in need.

Alex, who worked in the corporate sector, quit the job to start hospices seven years ago on witnessing the abuse of a woman in her 90s by a home nurse. His two hospices, called Signature AgedCare, with around 150 beds, have taken care of over 1,600 parents and facilitated a peaceful and dignified death to 300 people over the years, he said.

It was his experience of managing the hospices that prompted him to think of Vayogen.

“Invariably, towards the last stages, it is not you who decides for yourself but people around you, and that turns out to be an emotional decision rather than a practical or rational decision. Many times, much to the dislike of the patient, they are put on invasive life-saving equipment, adding to the agony,” he said.

In Vayogen you get to decide the level of treatment or care that you want in the last stages of life. For instance, it allows for a second and third opinion for treatment from a neutral panel of doctors.

Besides, the programme has the option of surrendering after a 5-year lock-in period and encashment of unutilised days. “My philosophy is whatever you pay me, I will repay in service rather than as interest by banks,” Alex said.

Vayogen’s membership is limited to 200 people, who will be housed in a new building coming up at Mulanthuruthy near Kochi.

A number of old-age care homes have sprung up in the state in the last few years, reflecting the challenge of coping with a growing elderly population. The Kerala Economic Review, quoting the ‘Elderly in India’ report of 2021, says the elderly population in the state is projected to grow from 16.5 per cent in 2021 to 20.9 per cent in 2031, the highest in the country. Kerala also has an annual elderly growth rate of 3.96 per cent — the national average is 3.28 per cent.

The old age dependency ratio, which is the number of persons aged 65 or more per 100 persons of working age of 20-64 years, is projected to grow from 26.1 per cent in 2021 to 34.3 per cent in 2031. The national average for the same is expected to rise from 15.7 per cent to 20.31 per cent. Kerala has one of the highest female old-age dependency ratios.

Are the strong social indicators that Kerala has enjoyed, such as high life expectancy and low birth rates, turning out to be its bane?

Dr Jose Jacob, former director of the Public Policy Research Institute, feels that factors such as high life expectancy and low birth rates will continue to be strong because of medical developments. The upshot will be the rising population of aged people, which will be disastrous for the state economy.

“Production in the agriculture and manufacturing sector will come down and families and the government will have to spend more on healthcare facilities. Adding to the problem is the migration of youth from the state in search of better education and jobs,” he said.