here are several physiological problems that come with ageing. Add psychological and financial troubles, and life becomes a challenge.

Gender inequality and gender-based ageism are some of the many issues faced by older women in Pakistan. With age comes a loss of earnings that can often lead to a sense of financial insecurity and lack of agency. “I have worked all my life, but I no longer have the energy to go out and work to support myself and my family,” says Mehr Afroz, 71.

For years, Mehr Afroz has worked as a domestic help to make ends meet for her family. Age and arthritis have made it impossible for her to continue manual labour.

“I have a son who lives in Karachi. He does not earn enough to feed his family of six. I helped them for as long as I could, but this condition (osteoarthritis) has brought on pain and stiffness,” she says.

Osteoarthritis is a degenerative disease that wears out the cushions between bones where they meet. It occurs as a result of regular use of your joints over time. The joints most commonly affected by osteoarthritis are in the neck, lower back, hands, hips, knees and feet.

For someone in Mehr Afroz’s position – with no steady income, no savings and no support from the family – health was all she relied on. Now, that, too, has started deteriorating.

The geriatric population is growing at an alarming rate. It is estimated that by 2040, Pakistan will have almost 40 million older people. Healthcare delivery in the country is based on weak infrastructure. A lack of rehabilitative and residential support for the elderly presents a challenge for the healthcare system.

Most of the elderly people have one or more chronic illnesses like diabetes, hypertension and heart diseases. Many are vulnerable to various disabilities, nutritional challenges and loss of independent functioning. These problems, when compounded, can lead to depression, which is an added complication.

“I have been on anti-depressants for over a decade now,” says Rehmat, 74. “I depend on my children for support. As a young woman, I depended on my father and brothers; later, it was my husband; now it is my sons. I have never been in control of our assets; but that’s how life is for us (women). We rely on others,” she adds.

Rehmat, like many Pakistani women of her age, has never worked or had any education. “We had a primary school in our village. I went there for a couple of years. The secondary school was far away; no one would send their daughters there.”

Rehmat was not given a share of the inheritance when her father died. She received nothing after her husband’s passing, either. “It is not uncommon for women to give up their share; the practice has been going on for ages. It is expected,” says the 74-year-old. Such social norms harm older women’s economic standing and leave them vulnerable to poverty and exploitation.

Educated city women who worked in their younger years also face a number of challenges as they age. “Ageism is an issue everywhere. It is difficult to find employment as years begin to pile on,” says Rafiqa, 81. “Retired-at-sixty does not mean we are to retire from living,” she says.

After retiring from a teaching job, Rafiqa continued to tutor students at home. Over the last decade, the number of students began dwindling, until they stopped coming to her altogether. “I’m no longer young. My degrees have aged with me, but my experience has only grown. But students want younger teachers,” says the retired teacher.

Rafiqa may not be teaching now, but she has a sense of security that comes from not having to rely on her family for financial support. “I earned for me and my family. My children didn’t need to support me,” she says.

Rafiqa lives with her eldest son. “Finding opportunities overseas, my other two children have moved away. I miss them as they cannot visit often,” she adds.

For many ageing parents, the loneliness that stems from the loss of a spouse and their children leaving the nest can be difficult to reconcile with. Older women often live with their adult children to escape isolation.

“I’m glad to be living with my son. With age, I have developed several ailments. It is a relief to know that I’m not alone. If I need medicine in the middle of the night, my son and his family arrange it for me,” says Rafiqa.

Age brings challenges that can be difficult to shoulder alone. In a country with little to no rehabilitative and residential support for the elderly, they depend on the extended family system. That, too, is changing now.

The writer is a staff member