Healthcare for the elderly

On a bus journey to Kiphire, someone signaled the bus to stop at Losami junction. As I looked back to see who was getting down; an old man started to rise from his seat. He took his time to collect his stuff and made his way to the door. All eyes were on him because he was taking all the time in the world. But no one could order him to make it quick for he looked frail with age. I also didn’t mind that it was longer than an average NST bus’ pick and drop time although I wanted to reach my destination before dark. I closely watched his steps and studied him with admiration. What caught my attention were his glasses which I believe he just bought from Kohima. The silver colored frame was shining so brightly and the sticker label was still intact on one top corner of the lens. He had a walking stick and two loaves of bread in a polythene bag. To remind myself later write about this encounter, I typed in my mobile phone, ‘Inconvenience; a pleasure’.

 

It was just a onetime encounter and I don’t know anything about the man. Is he taken care of well at home? That is where my concern is. When I go for medical camp in the villages, what always gets my emotion is the physical suffering of the elderly. Backache, Joint pain, Blurring of vision, reduced hearing, indigestion, heartburn, chronic cough, breathlessness, non-healing wound, dental caries, giddiness, sleeplessness, stiff joint, piles, tumor, etc, etc; the ailing of the elderly are many. The saddest part is, most of them have to accept their condition and learn to live with their sufferings. As one ages, it is natural that the body becomes weak and therefore to suffer at the later stages of life is seen as natural. Families are too poor or simply do not bother to take them to hospitals for treatment. Therefore when a medical team arrives at the village with free medicines, they come out in flocks to relieve their pains. To the bafflement of the urban based doctors, when asked how long they have been having a particular symptom, these elderly patients would reply, ‘Ah, it has been a long time’. ‘A long time’ can mean more than a decade. For some, it may be too late to expect a cure; for some others, the cases may require referral for surgery which will never be carried out. The Naga village life on the surface may look attractive to a tourist: clean air, clean water, honest folks, simple lives and not much worry, etc. There is truth in this, but it is also true that our folks, especially the older ones live with a lot of pain unattended to. Until totally bedridden, they carry out the daily works to earn their daily food.

The government has no special policy to care for the elderly. It is not cost-effective to treat senile citizens who are past their economically productive years. Healthcare for the elderly is complicated and extremely costly. Care providers are very difficult to find. To care for the elderly is a difficult task for which only a few would be willing to sacrifice. It may require feeding, bathing, washing smelly clothes, pushing wheel chair, putting to bed, and dealing with all the eccentric behaviors of late childhood. 

A caring society however cares for the weaker members: the infant, the orphan, the widow, the crippled, the sick, the poor, and the elderly. Each member needs love and compassion irrespective of how much potential one has to contribute to the economy. As we would like to be cared for when we grow old, we ought to do likewise to those who now need our hands. I would rather die than be in a vegetative state for several years and burden other people; but if one should suffer, who wouldn’t want to be loved and looked after? 

How then do we care for the health of the elderly? At a personal level, each of us has the responsibility to care for our own parents. Charity begins at home. Foolish children depend on their parents till the grave, while wise children bring rest and comfort to their parents. We also need to remember that as their bodies fail, even mentally/psychologically parents need support and understanding. How do we help our parents without violating their freedom and dignity? I think this is important because in trying to help, we may be overlooking their feelings and choices, and become angry when they refuse our help. A good example is when the caretakers feel the old lady has to go to the hospital but the later refuses. The hospital may be a horrible place, especially for the elderly. It may bring to her images of injections, surgical knifes, people screaming in pain, and death itself. She might rather die on her familiar bed at home than die on a steel hospital bed. To be stripped naked and passed inside CT scan machine for investigation is something she may strongly disapprove. Multiple blood samples drawn from her arms may make her feel as if life and energy are being sucked off from her body. Therefore, even with the good intention to help, we should be careful that we do it with love and respect.

At the larger level, the government needs to design a special program for geriatric care similar to maternal and child health program. Accessibility of services, affordability of medical care, making hospitals more elderly friendly, e.g. dedicated counters, special lifts, provisions for greater privacy, training of nurses and care-givers on geriatric care, etc can be planned and incorporated into the general health care delivery system.

As we care for children because they are our future; care for the elderly is important because they are our past who made us what we are today.