With increasing number of elderly, there is a societal need to take care of the elders particularly those who are comparatively weaker in either or both physical / mental states. It is estimated that around 20 per cent of Indian elderly population needs some type of physical / mental support. In absolute terms, it comes to be around 27 million which is significant and more than total population of some of the smaller countries of the world. Many of these elders are not able to take care of themselves even for basic daily activities like walking or bathing or dressing, etc. Absence of theses fundamental support is forcing many elders to lead a life of absolute helplessness and even leading to their early death. Indian society thus needs to appreciate this emerging reality.
It is in the above background that we need to seriously think of creating a “social support system” to take of these weak elders who in their prime time had contributed significantly for the nation’s progress.
The role of caregivers in this context becomes extremely relevant.
Role and Competencies of Caregivers:
Caregiving is a serious profession. Caregivers include people who provide assistance to elders in their basic living activities like walking, dressing, toileting, grooming and taking care of their daily needs. The role could also include giving physical and mental companionship. Idea is to provide all types of physical / mental support to needy individuals so that their daily life remains happy and fulfilling and helps them to lead a semi-normal life. Caregivers thus play an extremely important role in the process of happy aging of elderly. They offer all services the elders need and could have been done by themselves and fill the void in their lives.
The problems and challenges faced by elderly are different if they are suffering from physical or mental issues. Persons who are physically incapacitate / weaker need all types of physical assistance to carry on their daily life activities. Caregivers need to take care of their minute requirements of physical support from early morning to the time they go to bed. They also need to guard against any accident / fall of these seniors. If they are bed ridden, caregivers are also required to take care of typical medical issues like bed sores, etc. Daily medical requirements are also to be provided. Physical as well as mental companionship are also important. However, the problems with elders suffering from serious medical diseases like Dementia / Alzheimer’s / Parkinson’s are more difficult. Here in many cases the patients may become violent and assume other types of aggressive behavior. They may not recognize the caregiver at all. That adds to the problem.
As stated earlier, caregiving is thus a serious job and needs specific competencies. Besides ability to provide the services, generic competencies of a caregiver would include understanding of psychology, empathy, patience, strong emotional intelligence, ability to speak to the elder in his / her language and above all an extremely caring / tender approach towards discharge of duties. This is equal, if not more, than a regular nursing job and calls for high level of training and grooming.
Who Can Be Caregivers:
We still believe that there cannot be a better caregiver than someone from close relatives / family members of the elderly. Problem often arises after passing away of the spouse. And the next generation of family members like sons / daughters or spouses thereof are usually busy with problems / difficulties of their own life. With breakdown of extended family and continued urbanization, this concept of family members playing the role of caregiver is almost becoming extinct. There are, however, isolated unique stories of sacrifice where we see sons / daughters / daughters in law acting as “ideal caregivers”. This arrangement arguably is the best possible and soothing situation.
The next ideal alternative could be providing caregiving service at home not by relatives but by “professional caregivers” but under supervision of family members. This is possibly one of the best solutions in current settings subject to availability of space and willingness of family members. We see this happening in some of the urban families in pockets of the country though this is also in declining trend.
The two most popular means of caregiving at professional level are dedicated “senior homes with assisted living” or “assisted day care centers” (that provide specific services during daytime). However, these dedicated centers are extremely few and located only in large metros of the country. Many of these are quite costly and beyond reach of elders with normal means. The other version of these caregiving is also manifested in “palliative care homes” where serious and terminal patients are taken care of. These are also rarely seen in India.
More than 90 per cent of senior homes do not admit sick elders at all. Of course, there are exceptions where we have seen extremely dedicated senior citizen homes serving the cause of physically / mentally ill elderly people with extreme sense of dedication. These people are often not recognized, and they continue to remain unsung heroes. The government hospitals have hardly any geriatric wings. Some private hospitals do have but they hardly offer any caregiving service other that palliative care we talked earlier.
Way Forward:
Population of Indian elderly will continue to increase in future for next 2 to 3 decades and so will their problem. It is high time that society appreciates need to have caregiving as one of the most important tools to tackle the issues related to problems of elderly. We need at least 20,000 to 25,000 trained caregivers every year to meet the growing demand. Caregiving should be recognized as a serious profession. All hospitals, both in public and private sector, not only need to create geriatric wards but should also develop dedicated beds to take care of senior patients who need caregiving. The amount paid by families towards caregiving should also be given IT exemptions. However, the most important aspect is that we need to change mindset of people at large and be dedicated to take care of older people who need our maximum support. This is minimum we can do for them, and it is our bounden duty to do so. Let us awake from the slumber before it is too late.
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