Care of the Aged

• As I get older and when I see people around me getting older, I feel it is time we take a fresh perspective of the management of ageing and care of the aged.

The problems of the aged have always existed and we find ageing mentioned, as one of the real scourges of being born, in the ancient Tamil Texts. One of Alwar’s Pasuram states that Narayana has to remember, that it might not be possible for a person to reach out to God and call him when he is old and infirm and therefore, implores God not  to forget the prayers done in his youth !  Arunagirinathar in various hymns of Thiruppugazh, gives very graphic descriptions of Old Age which reads like a horror story to scare any of us!

There is a mention in one the ancient texts called Analysis of Joy, that there is a possibility of finding people who are not afraid of death; but finding one person who is not afraid of Old Age is nearly impossible!!

The average life expectancy in India has risen and we need to take into account, the circumstances a few centuries ago and now.   In an era, where there were numerous communicable diseases, a person who happened to survive them all would have been of quite a sound constitution. Any disability faced would have been due to the normal process of ageing.   Still, it could not have been easy, but the social and the family systems were designed to handle that.  Houses were large enough, though with fewer rooms, there were open spaces, trees and some green space, where people young and old could escape to, when they wanted some solitude.

A large family with many members must have consisted of more than one aged person and numerous kids and youngsters.  Several families lived in the same street with similar members and the loneliness associated with age could be lessened with the elders having several peers and several youngsters to mentor,  or complain about!  Minor skirmishes in most cases, help people from falling into depression!

A home was a factory in itself with so much to do.  Provisions were purchased annually in bulk; which meant there were so many chores associated with it. Taking cereals and pulses out to the open spaces, drying them out in the sun, packing them up so that they are preserved properly.Making vadams and other condiments, pickles & powders and so many auspicious days to be observed.  They had no TV, but would spend their days reading the scriptures, listening to discourses, discussing their reminiscences with each other; Escorting children in the neighborhood to a discourse in the temple and so on.

Providing for their Food and Nursing during illness was done by the daughter in law if she could be terrorized to doing all the chores , or should that not be possible, it was the widows and the abandoned wives who did all that,  grateful for the support of the family for their board and lodging.   Women were not educated and the only way they could make themselves useful were by cooking, nursing or by doing other household chores.  The Not so successful Brothers, their wives and their children would also be roped in for contribution of some labor. This might sound harsh, but economics had always had a part to play anytime, anywhere!

There was no need to monitor blood sugar, give insulin shots, monitor various other readings day to day.  God forbid, if something serious happened, they did not have the burden of making the decision of treating them in ICU and remained guilt free  as doctors those days did not promise all cures at the cost  of only a few  lakhs! Education was something that was handled only by the teacher and all that the mother was expected to do, was to provide food  and love for the children.

We now live in an era where the wife in a nuclear family though educated, is already burdened with more tasks.  With many middle class families having fewer children for a couple of generations now, there are fewer members in families. Girls are brought up with as much love and care.

Social changes have taken place and if something unpleasant happens in their lives, women have tried to forge a new world for themselves rather than expecting the family to see them through. Traditional occupations have changed and money is now earned through different vocations.  Employment at different locations, and in diverse fields have made even members of the same family strangers to each other!   More often than not, the daughter in law or the wife is chosen to be brought into the family based on her employment or profession!

Even when the wife works only at home , apart from cooking, her  role in the all round education and care of  children have gone up a hundred times.   With the huge growth in population and nuclear families, houses have become smaller and smaller.   There are fewer people available in assisting her with the chores and the cost of household help is, as everything else, high.

Even in the best of times smaller spaces as in apartments, do not augur well for the emotional well being of families.  Added to it is the TV menace.  Many old people with little else to do, spend considerable amount of time watching TV.  There is one more dimension of the parents of boys believing that they are entitled to better care as against the philosophical approach the parents of girls take.

At this point of time taking care of an invalid or a person suffering from a terminal illness is something beyond the capacity of one person.   Paid Assistance for such care comes at a very heavy cost which an average middle class family is ill equipped to bear. The credentials of such people might not always be verifiable and it is a risk for a host a stranger in the house in these times.  The nature of the job is such that, keeping such a care giver in good humor is not easy as she or he is after all another human being with their own emotions. 

Cooking for them, serving them and arranging for their entertainment in addition to paying for their services is not going to be easy.This situation is not easy to handle and this is being capitalized by profiteers who build Old Age Homes with a motive of making good money.

And on the other hand, real estate developers have started building community housing societies meant for the very rich.   They have several trappings which can be afforded only very few.  

The Real Needs of the Older Generation

A certain age need not always be a benchmark for old age, as it may vary from person to person.   When a person has completed their immediate responsibilities, while they have some energies left in them , should have the a channel to use their time and energies usefully .  

We need to create organizations at the micro level, where older people in the neighborhood can get together and engage themselves in useful activities.  Several temples have groups that recite slokams and these in a very limited way, help.

This could be expanded to encompass more areas, where the expertise of these groups can be used, without imposing a strain on the seniors.  

Where it is possible, the old houses in small villages, from where people have migrated to cities can be revived.   Ancient temples nearby could also be better cared for this way.   Having such people with diverse knowledge and experience can also benefit the village communities and their economies.

But it calls for people of similar goals to get together. 

The members of Older generation in an average middle class family need private space and dignity – either to watch their TV serials at high decibels, or to listen to music, read and interact with people to the extent they want to, with some scope for community prayer and generally lead a fruitful life.

At the next stage, where there are ailments and infirmities to contend with, instead of having them confined in a flat and then bringing over caregivers from the villages, it should be infinitely advantageous to have community homes in small towns with medical facilities, larger spaces and caregivers,   run without the motive of making huge profits.  It need not be run on charity, but with charges that are reasonable.

Moving Forward

Condemning of Old Age homes per se is not justified.  The Society needs to give up being judgmental of families who acknowledge that it is difficult to support the old and the infirm single handedly. The community needs to pool money to bring about a community settlement at least as an alternative home.

The need of the hour is an arrangement by the community in a concerted manner.  This is a country which did have tradition of Vanaprastha  where the aged adopt a detached attitude  for the material life and leave home to lead a life in tune with nature.  The ancient Tamils did have a tradition of leaving  the very old , infirm and terminally ill people in Mudhumakkal Thazhi and burying them.

Advancement  in modern medicine should not be aimed at just prolonging life.

I need not list all the ailments and disabilities one might find in an aged person. But needless to say, an aged person like anyone else wants to eat, sleep and participate in the game of life.