The Changing Nature of Home-Based Care for Older Adults in Goa’s Emigrant Households: Implications for Policy and Practice.

In developing countries such as India, the consequences of aging within underdeveloped social security systems coupled with traditional expectations on filial provision of care mean that families continue to remain primary caregivers for dependent older parents. Concerns abound regarding the increasing costs of healthcare, inadequate access to geriatric care, competing time constraints, and difficulties experienced by filial caregivers that could necessitate caregiver support to alleviate burden and provide respite. These concerns are further exemplified in emigration contexts in India where the emigration of the adult child alters traditional filial intergenerational care arrangements. Housed within strong notions of filial piety and a sociocultural reluctance to accept institutional care, this chapter focuses on Goa’s emigrant households where adult children emigration involves leaving behind older parents. We identify, describe, and reflect on the emergence of adaptive intergenerational care arrangements including the emergence of chaperoned provision of care for older parents through engagement of formal home-based older adult care services. While this could potentially offer respite to primary caregivers, it could also end up increasing family involvement in care and significantly impact family caregivers’ financial situation, lead to time constraints, and affect employability. In juxtaposing policy and practice, we abridge that while notions of filial responsibility are being redefined by processes such as modernization and emigration, the preference for home-based care prevails and is interestingly and increasingly becoming visible through adaptive intergenerational care arrangements that are effectuated through filially orchestrated home-based formal care services – an emerging area with regulatory as well as policy implications for both caregivers and care recipients.