Who's there to take care of the aged?

SOMEONE brought sandwiches. Someone else brought samoosas and cold drinks. Sounds of gaiety came from the small group gathered in the waiting area outside the Sivananda Ghat ash disposal shrine at Clare Estate Crematorium in Durban. Thirty minutes earlier, the emasculated frame of the 85-year-old patriarch of the family, who had been bed-ridden for two years, was consigned to the flames.

As I scanned the facial expressions and body language of those in the portico, I got the sense that when the ashes of a frail or elderly person are to be disposed of, there is a collective sigh of relief from the immediate family members. Now, before I am censured for making a sweeping statement, I must submit that this is my personal contention; not all old people are regarded as a burden by their relatives.

So no need to comment on how my view is narrow-minded and based on my experiences alone. I have relatives and friends who provide total care and comfort for their aged parents and grandparents, without even for a single moment regarding them as a burden. But I also know there are those who shun the idea of having to take care of the frail and elderly within their family circle.

It is true that the older people get, the more of a liability they become. It is true human value diminishes with time. Most companies have a mandatory retirement age of 65 for men and five years younger for women. People are put to pasture when they are still at the top of their game and when they could well be mentors to newcomers.

While retiring can be a reward for years of hard work, it can also trigger depression, stress, and anxiety, especially when the future is uncertain. There was a time when as people got older, they were content in the knowledge that their children would take care of them as they became physically infirm. Those who were childless could count on other relatives for support. Hardly the case today.

A few decades ago, old age homes were unfamiliar facilities because most people lived with their extended families. Community bonds were stronger and elderly individuals relied heavily on family support. Then, more than in other communities, Indian caregiving for the elderly was deeply rooted in family responsibility. Adult children were expected to primarily care for their ageing parents at home, providing both physical and emotional support.

This was viewed as a moral obligation to repay the care received during their childhood.

My friend Dhayalan Moodley, 76, has put off visiting India to fulfil a lifelong dream, because he is loath to be away from his 99-year-old mother for any length of time.

“It will be great to go on regular holidays with my wife. But I have had to put this on hold. I consider it a blessing to take care of my frail mother at home,” he told me recently.

Traditionally, Indians would regard elders more than simply family members; they represented knowledge, experience and customs, all wrapped in one. Caregiving responsibilities were also frequently divided among siblings in families with several of them. Depending on their resources, availability, and proximity to the parents, each sibling adopts a certain role.

This collaborative effort ensured the greatest care possible for the parents.

In days gone by, it wasn’t unusual for a son and his wife to live with his parents. As time passed and the parents aged, they were in a safe family environment already and remained in their own home until they passed away.

Nowadays, caregiving by children of their elderly parents is more the exception than the rule. Many Indian cultural values regarding filial responsibilities have been obliterated. Family dynamics and lifestyle have changed significantly as a result of societal influence. The younger generation has relocated from their hometowns in pursuit of better educational and employment prospects.

Thousands of young men and women who grew up in KwaZulu-Natal now live and work in Gauteng. Many have settled overseas. The joint or extended family system is long dead. The current trend of nuclear families makes it near impossible for children living away from their parents to manage all aspects of elderly care. Some children compensate for their physical absence by sending money to their parents.

Small comfort indeed. No amount of money, fancy mobile phones and Woolies Dash one-hour drop-offs can replace the physical presence of a caregiving child or relative. But these are the times we live in. Some people may have built careers with the support and encouragement of their parents who now need help at home. But they may be people to whom patience does not come naturally or abundantly. Perhaps nurturing is simply not their strong suit. Not everyone is a natural caregiver.

Also, many children assert they have their own lives to lead with their attendant responsibilities and do not want the added weight of parents. They also believe that the parents had their times; now the children must have their times. The modern idea of a family unit now is dad, mom, kids. No place for Thatha, Patti, Dada or Dadi.Where family members are unable to provide support, professional caregivers at home are being engaged by those who can afford it.

Elderly people who can afford to pay for assisted care are moving into nursing homes in droves. The aged are found to be in the way.

“Who’s going to take care of mom?”

If nobody is willing to take her in, she’s packed off to a home. Not a great role model lesson for the grandchildren, I guess. Old folk who cannot afford home caregivers or a nursing home struggle on their own until the Grim Reaper visits. Nursing or old age homes are not that great a situation. I have experienced this with close relatives. Often facilities are short staffed; there is inadequate quality of nursing care; food is not up to standard; and hygiene and safety protocols are lacking.

Simply put, most nursing homes are sad places. Those living there make the best of a bad situation by being involved in activities. Or they just stay mum and bear it. I don’t have a solution for this crisis afflicting our older folk. As the older share of the population increases and people live longer with chronic disabling conditions, particularly dementia, meeting the care needs of the aged is becoming more challenging for families.

Those “chittis” or unmarried aunts who used to take care of old mothers and grandmothers are in short supply. So too, the neighbours who would volunteer their services to tend to the needs of the bedbound old men in the district. Paid caregivers are often more of a problem then a solution.

I have heard complaints of some caregivers not giving old people adequate care, staying glued to the TV instead. They forget to administer medicines. They get absent without a relief stepping in. They help themselves to groceries - and even money. Perhaps the joint family system will return. We could again see multigenerational households with married children living with their parents; childcare and tasks like cooking and housework shared between them; and care of the elderly or disabled also seen as part of normal life. Or am I just dreaming?

Yogin Devan is a media consultant and social commentator. Share your comments with him on: [email protected]

** The views expressed do not necessarily reflect the views of IOL or Independent Media. 

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