I stood staring at him for what could have been a couple of minutes not knowing how to react when I came across an elderly gentleman who had peed in his pants. He stood with a glazed look in his eyes as if he as not aware of it. In fact, he did not move a muscle or blink as I helped to the closest seat I could find. I had recovered my composure by now and managed to get him out of the building and into my car without attracting much attention from a couple of others waiting to withdraw cash from the ATM. All I had attempted to do was to help a friendly elder who lived down the road from my home and with whom I had become acquainted on my morning walk. Later, when I met the family members, I was told that this was not the first time that it had occurred, but they had not dealt with it as they did not know how to handle the situation…
It was on another day when I was babysitting an elderly woman with dementia in her home. Her daughter had called the night before to ask me for help as she had to go to the bank to complete the yearly ritual of getting a “Life Certificate” for her mother. This is a mandatory annual certificate which needs to be endorsed by the Bank for every Senior citizen who receives a pension before the 30th of November in India. I was happy to volunteer to be with the elderly lady as it would enable me to do my good deed for the day and it would help the young caregiver who did not have anyone to stay with her mother for a couple of hours. The young lady left soon after I arrived at her home assuring me that she would be back in an hour or two and I needn’t do anything but be in the house to keep her Mom company in her home.
The first hour was uneventful. However, the situation took an awful turn when my friend’s mother who had not uttered a word till then despite my attempts to engage her in general banter, turned to me and calmly said, “I want to go to the toilet”. I assumed she was wearing an adult diaper and replied that her daughter would be home any minute and that she can visit the toilet on her return. She responded with, “I need to go now”, this time in an aggressive tone. I tried again to calm her down but to no avail as the frequency of her demand got higher and her restlessness increased. To cut the long story short, I was a bundle of nerves by the time the daughter arrived about thirty minutes later. The daughter admitted sheepishly that she had not put on a diaper as her mother refused to do so every time she tried to and it was a real battle to get her mother to agree that eventful morning as she was already behind schedule. She mentioned that she had taken her mother to the toilet just before she left home that morning and hence did not anticipate any problem. I left the place a few minutes later as she went in to deal with cleaning up and changing her mother’s clothes…
These are just a couple of instances of what goes on in the life of an elder and his or her caregiver. More often than not in India, the caregiver is a family member or a close relative though engaging a full-time help is gaining popularity lately . The initial days as a caregiver are extremely stressful for the caregiver as they are blissfully unaware of the challenges they would have to face in the coming months and years. The caregiver takes a while to come to terms with the fact that a family member who until the recent past had been the bedrock of the family in handling all aspects of their daily lives. Statistics show that the need for caregiving to Elders is growing at an alarming rate in India.
As a caregiver to an elder, I have had to face similar challenges and am blogging on this topic of Caregiving with the hope that it will be beneficial to those who may have to face this situation sooner or later in their own lives. A few of the common concerns to be expected are given here which will hopefully trigger off a discussion with many like-minded families in the coming weeks and months.
1. Life Tasks:
A caregiver needs to be aware of any changes in the handling of life tasks of the elderly person. Identifying any changes in behavior early on is necessary to initiate action as advised by a medical professional or an experienced social worker/counselor to ensure the well-being and safety of the elders. Life tasks can be categorized under two broad categories:
Daily Living Activities: These are the basic activities an individual does for his/her own needs or is dependent on someone to do for them. For instance, walking or moving around; dressing; eating meals by themselves; bathing; using the toilet independently, etc.
Instrumental Daily Living Activities : These are activities that involve activities such as: traveling by public & private transport; shopping; handling personal finances; cooking; managing prescribed medicines; answering telephone calls, etc.
2. General Physical Condition:
Over the last three decades, lifestyles have seen many significant changes leading to chronic health challenges such as diabetes, hypertension, cardiological & neurological problems necessitating prescription medications in majority of seniors. It is imperative to observe & pay attention to the healthcare issues in the following areas: frequent falls; hearing impairment; fatigue and decline in strength; poor appetite & weight loss; increase in visits to the Emergency Room or frequent hospitalization; lack of interest in familiar activities, interests & hobbies caused by health problems; anything that is causing anxiety to the caregiver or the senior, balance issues, etc. Any such concerns should promptly be addressed with the advice of a doctor or medical professional to avoid any serious conditions in future. Pay attention to helping the elderly to be proactive in voicing any concerns they have without hesitation due to fear of ridicule or embarrassment. Getting help at an early stage can be of immense impact in slowing down the effects of memory loss in Alzheimer’s patients or incontinence, for example.
3. Mental health & moods:
Some of the common concerns among elders are memory loss, anxiety, depression & cognitive changes. You may have to take the advice of a psychiatrist and a physician to assess the underlying causes of the condition of the senior. Here are a few points to look out for: memory problems; lack of interest in activities which he or she was earlier keen to be involved in; lack of interest in family matters; feelings of loneliness & hopelessness; feelings of suspicion of family members in financial or property matters; super spirituality, delusions or paranoia; sadness; inability to perform familiar tasks such as driving; withdrawal from social activities & gatherings, etc.
4. Medications:
As mentioned earlier, prescription medications have become a part of a senior’s life due to chronic health issues such as diabetes or hypertension which need life-long medications. Though they are essential for controlling the chronic disease, they are also known to have certain harmful side-effects which may lead to other health complications at a later stage in life. Some common problems to look out for: refusal or avoidance of medication by the elderly; questioning the need for continuing a medication over many years; side-effects which are noticeable within a short period after medications are taken such as excessive drowsiness; inability or difficulty in affording the medicines due to reduction in personal income, etc.
5. Safety & security:
Concerns about the safety and security of the elders are usually about their ability or rather their inability to handle tasks which they have completed earlier with aplomb. Some of these concerns are: usage of home appliances such as a stove or electric kettle; leaving the home for an errand and being unable to find their way back home; of being robbed or scammed by predators; falls due to loss of balance momentarily or tripping; diminishing eyesight or hearing; accidents or frequent close calls while driving a four wheeler or riding a motorbike; traveling in an Uber Cab; managing their finances, etc. If you notice any of the above, a doctor can help identify the cause and advise you and help prevent any damage to the elder or his/her belongings.
6.Where to live:
One of the biggest challenges in caring for elders who are single is making the decision on when it is time for them to move in with a family member or relative or an assisted living space. Other considerations would be the financial aspects, the safety and conveniences available in the new place of residence and how if might affect the quality of life of the senior. Installing grab rails, anti-skid flooring in the washroom, a wheelchair accessible doorway to the washroom, etc are additional expenses that need to be factored in. These challenges can cause much stress in the lives of the elder and the caregiver as well.
7. Training for the Caregiver:
Training on how to care for an elder is an absolute necessity to avoid any relationship issues with the family members. It is also necessary because it involves physical, emotional, relational, logistical and financial implications. Sadly, this is an aspect that is not well researched and developed in India which poses a challenge to the caregiver who is willing to be trained.
If you would like to be in touch with us for any information, please fill in your details below and we will get in touch with you:
Affiliate Compensation Disclosure: From time to time, we promote, endorse, or suggest
products or services of others. In most cases, we will be compensated, either
as an affiliate with a commission based on sales, or with a free product to
review or use. Our recommendations are always based on (i) our personal belief
in the high quality and value of the product or service, and (ii) our review of
the product or service, or a prior relationship or positive experience with the
sponsoring person or organization.