Written by Neha Sinha
“Let us try to enhance the capacity of the older people to support themselves for as long as possible. And, when they cannot do so any more, to care for them,” were Nelson Mandela’s poignant words.
There are around 115 million senior citizens (60 years and above) in India, and out of those, around 12 million are super senior citizens (80 years and above).
Human beings, at every age, have a range of needs, physical, emotional, social or spiritual. When we are younger, most of these needs get automatically taken care of by the life we choose to lead. But as the dependence of a senior citizen increases, it almost becomes the responsibility of the caregiver to break down these multiple needs into buckets and fulfill them to achieve holistic care. One needs to take cognisance that ageing is not chronological.
Seniors require specialised, person-centric care when their physical, mental, cognitive health condition hinders their ability to live safely and independently. About 50 years ago, the field of geriatrics (the specialty that focuses on healthcare of older people) was barely known and acknowledged even in most developed communities.
However, as life expectancy increased to 80s and 90s, the need for a special focus became inevitable. It is now established that specialised care can bring a change in the experience of ageing, even though it may not be huge. Concepts like quality of life or choosing comfort over longevity of life are beginning to make pathways into people’s decision-making for their elderly parents’ care.
Ageing is a poorly understood process and often used interchangeably as a chronic disease condition. Personalised and well thought out interventions can make a meaningful difference in an older person’s life. Such interventions can help by reducing risk factors, improve functioning and the overall quality of life.
The elderly want to retain their independence for as long as possible, completing their day-to-day activities such as dressing, bathing, taking medicines, etc. Caregivers could be upskilled on how to offer help without compromising functionality altogether. For instance, if there is a challenge in eating using existing cutlery because of tremors or deteriorating motor skills, the caregiver should first consider changing the spoon that gives a better grip, than switching to feeding because it may be faster or more convenient.
Caregivers need to make an informed choice when opting for anything invasive especially for super seniors. Constant focus should be on improving the current way of life and minimising discomfort. For instance, cataract surgeries are known to improve overall well-being since better vision will help maintain social connect, reduce risk of falls. However, opting for ventilator support when the known prognosis is poor may not be right from the elder’s perspective.
The presence of multiple medical conditions, deterioration in functionality or presence of other disabilities is more likely the rule than an exception. Dementia, depression and delirium are also some of the most commonly diagnosed conditions. What one must understand is that the elderly benefit from recognition of these conditions and providing suitable interventions designed specifically for them, sometimes even at no extra cost but instead bringing about a huge difference to their everyday life.
The author is a dementia specialist, and CEO and co-founder, Epoch Elder Care
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