The old adage, “Give a man a fish and you feed him for a day, teach a man to fish and you feed him for a lifetime” seems to be the driving force behind a specialized elder health facility in Hyderabad I had the opportunity to visit. Rather than thinking of this health facility as an old-age home (a term that carries tremendous stigma in India), the founder CEO thinks of it more as a rehabilitation center, where patients get specialized care and therapy focused on motivation, and building self-esteem as ways to overcome physical disability. Over the course of a lengthy conversation I had with Dr. Gangadharan, I learnt of the medical aspect to elder care and the state of training future generations of qualified caregivers in the country.
The physiotherapist on staff insisted on not investing in state of the art technology or equipment for the center, but instead, insisted on the lowly walker. He contends that old people cannot be managed by sedatives and painkillers, but exercise. So effective is his technique that “rehabilitated” patients who were thought never to be able to walk again, were not just walking, but had regained some level of fitness.
More than anything else, I was impressed with the quality of care provided by the nurses and nursing assistants. They are mostly young women and have been trained by the CAP foundation- which prides itself on providing vocational training to at-risk women from the most marginalized communities in India. These women are smart, attentive, and most importantly- companions to the patients- something that is more valuable than medical care. During one of the interviews at the facility, a nurse insisted on being present for the duration (IRB, pay no attention to that part!) at the insistence of the lady being interviewed. The patient could not remember a lot of details from her married life, experience of widowhood, or relationship with children. The nurse filled in details so specific that I considered interviewing her instead. In retrospect, I think my narrative would have benefited from some caregiver interviews, since they are really the glue that holds such facilities as well as the mental state of the elderly the care for, together.
Legal protection and rights for themselves are something not many elders are aware of. While the government has a specific law designed to protect elders, The Maintenance and Welfare of Parents and Senior Citizens Bill, implementation is at the locus of the state, which is where things go out the window. The wording of the Bill is very telling, and inherently problematic. The government shifts responsibility from themselves to children, by calling it “the parents bill”, thus washing their hands clean of the legal responsibility they have to protect all individuals, including the elderly. Picture this: In the sparkling 35 bed facility, the biggest problem is not medicines, staff, or electricity outages. Instead, it is the falsification of documents (wills, asset transfers) while the elderly patient is sleeping! It is apparently not uncommon for children or relatives of the elderly individual to enter the room and take thumb impressions of the unknowing patient, leading to the implementation of tight security and round the clock nursing staff. Along with elder health and caregiving, it is increasingly important to alert and educate them on legal rights, and mechanisms in place to help them avoid such circumstances.