Remember how I was looking at options for OAH/RCs*? While I most certainly didn’t want to go into a depressing OAH, the RCs looked interesting. But I soon realized that I was not looking for organized fun, outings or activities, nor was I lonely, hard to care for or wanted to retire from cooking and housekeeping. ‘You can live life the way you want to,’ exhorted the ads. But wasn’t I doing just that in my own home? And when I am not able to take care of myself and my spouse, I would not need a RC or an OAH, but a care-home. So there!
Ah care homes! We will come to those later in the post, shall we?
In any healthy family, the grown up children want their elders happy, fit and busy with their lives – in their own social groups, religious/spiritual activities or pursuing other interests whether they live with them or alone. The more active they are, the happier the children, because that leaves them relatively free to pursue their own careers and hobbies, and take care of their familial matters. Elders are happy too because they have ‘got a life’ and are independent!
Of course, being fit and healthy does not preclude the possibility of a crippling accident or a deadly virus that might render an elder prone. And therein hangs the dilemma. Despite the best intentions and efforts of children, it often becomes impossible to care for such elders. Paucity of space, time, distance, resources – all, or some come in the way.
There was this online debate on caring for one’s parents in their elder years. Those who vetoed the idea were just marginally ahead of those who supported it. The reasons of those who voted for were predictable, while the ones put forth by those against it were eye-openers. For many it was payback time – for the perceived and real harm they were done as children. This is a debate in a western society, but might throw up similar results if held in India. For or against, the nagging guilt remains when they are unable to care for ageing elders.
One often hears, ‘My father/mother/FIL/MIL is getting old and beset with health issues but refuse to come and live with us.’
But think this one through. Are they merely having health issues or do they need active care? Because, if they are not in need of such care, it wouldn’t be wise to for two independent sets of families to start living together at this stage. It will be hard if not be downright impossible. And God forbid, what if the elder is a hypochondriac like the one in Piku? Or if the female elder is a control freak who wants everything done her way? Or if one or both of them plonk themselves amidst your friends and hog the conversation – er…..turn it into a monologue? Or….or….
As for the elders’ dilemma – what can they do if they have to wake up five times a night and then wake up for the day when their kids are just going to bed? Oh yes, it happens in our house! Can they change their body clock? As for eating all kinds of food, it is fine for a few weeks. For instance, I love pastas, baked potatoes, croissants, waffles, subs and more, but a few meals of those and I need to go back to my rasam and curd rice. The tongue is willing but the stomach is weak, you see! As one ages, the craving for the food one is used to, is overpowering besides being suitable to the system. And then, I might not approve of the way the youngsters do things and might be tempted to start the litany of ‘Hamare zamane mein…..’ inviting vociferous protests or deafening silences. Jokes apart, it is a very serious decision and not one to be taken in an emotional moment.
And when I hear, ‘Elders should live in OAH/RCs. It would be best for everyone,’ I shake my head. Not in disagreement, but at the thought that these are considered the panacea for all problems and anticipated problems concerning elders.
There is no point in presuming a disaster and jumping the gun to ask them move to an OAH/RC. Have you wondered how ‘unsafe’ by comparison to a strange OAH are friendly neighbourhoods where someone is at hand to help in a crisis? Unless the elder is bedridden and alone, don’t even begin contemplating any such move and then don’t stop at OAH/RCs.
My friend’s father, a widower, lives alone in the village refusing to come to live with his children. He is taken care of by his neighbours and distant relatives who live in the village and is actively involved with social and temple activities. The family has wisely let him be but is in touch with the relatives and neighbours.
Mine and the earlier ones are probably the last generations which still communicate with relatives and friends in real time and so have a reliable support group. Why not tap that group, keep in touch with them and have a firsthand source of information of the welfare of the elders? And oh, if this includes a few of those sinister ‘log’ (read Shakunis and Mantharas), learn to ignore them royally. They will neither help the elders nor be a support to you.
Here, let us not forget the elders who live in joint families – conventional and otherwise. So many of them take care of the house and properties of their children who live abroad or are pursuing punishing careers; some look after their grandchildren as their parents live in countries where education is not good; some are jet-setting global caregivers. Those living with their children also do their bit and sometimes more than a bit too – cooking, babysitting, shopping, etc. even while keeping to their routines and religious and social activities. The families are happy, the elders happy too. Would the family send off the elder for having become ‘non-productive’ if an active one suddenly becomes bedridden?
But the argument: ‘It is fine when they were together, but now that one has passed on, it is better that they live in a place where they can be cared for,’ makes me shake my head right off my neck. Come on, the elders can’t die at the same time, can they? One has to precede the other.
Generally, the older a couple grows the more tolerant they become of each other – the habits, the quirks and special needs. They find the energy and strength to care for each other out of love and a lifelong commitment. A single elder is somehow perceived as hard to care for, especially if it is a male — but not always. I know of an elder who lived independently till he died at 97. He cared for his sick and bedridden wife till his early 90s, with his only son living abroad and not involved with his parents in any way. He nursed, cleaned, bathed and fed her lovingly. After she passed on, he joined an assisted OAH, where he lived till he passed on.
Now, let us assume that both the parents are already in an OAH/RC with one of them needing care. What if suddenly one of them passed away, and unfortunately it was the healthier one who was caring for her/his spouse? What then? How comfortable would the children be to leave the surviving parent there knowing that they are so ill? For that matter how many senior homes are equipped to handle elders who can’t care for themselves as in the case of Alzheimer’s?
In earlier generations, when families had more children, elders who needed care were sometimes ‘rotated’ between the siblings. While this was a good way to ease the burden on one son/daughter, it could be traumatic for both the elder and the caregivers. Today even that luxury is not there for many families with one and two children.
Remember Sundar from my post on global families? Recently he had to rush to India when his octogenarian mother had taken critically ill and was admitted to a hospital. After her discharge, he arranged for home nursing before leaving. Apparently she had asked him to get her admitted to an assisted OAH, but he didn’t want to do it would have been difficult for relatives and friends to visit her, as it was on the outskirts of the city. He is happy that his aunt is there to keep an eye on the nurses and look after her sister.
Keeping an eye, can’t be stressed enough where paid caregivers are involved as the following story of the nonagenarian elder shows:
Being an ex-army man he was very fit and active even at the upmarket OAH he had joined. One day while on his walk, he tripped and fell into a ditch and was unable to get up or call for help as his mobile had got damaged. He remained there in pain for a whole day before his absence was noticed and a search launched! With his only son not bothered with phone calls to the facility, and with relatives who didn’t have the time to visit him frequently as it was way out of town (as most of such OAH/RCs are), the caregivers had become lax.
This is not to scare anyone off nursing homes or assisted care OAHs. But just to say that even upmarket homes like the one he was in, can slip up especially if the relatives and children don’t keep a regular check with phone calls and visits.
I read this eye-opener of a story about apathy in care-homes in the UK, which has been doing it longer than us.
Home nursing is also slowly gaining ground in India. Many opt for this as Sundar did, though it is expensive, because they can keep an eye on the elders and their caregivers. Elders often bear the cost from their pensions and savings, to help their children out.
My niece who is in the US, spoke of a new type of home nursing that is becoming popular there. An apartment with four or five rooms is rented and elders who need assisted care from that area are boarded in it with medical and nursing care, a housekeeper and cleaner. This is a very doable thing in India too, as the expenses are shared and the elders are close, leaving the children and grandchildren space enough to pursue their routine and work. Visiting them on a daily basis is very easy and the elders are happy too.
So if you are worried about your elders needing care in their later years, look for a good nursing home or for home nursing facilities in your town or the town where your elder lives, instead of asking them to move into an OAH/RC — like now! Some pointers for this can be found here.
As things stand now, since the conventional joint family system still thrives albeit with tensions galore, the very old of the previous generation are cared for by their families and extended families of my generation. The conventional and global joint family is taking care of my generation, with many of us also looking at OAH/RCs as options. These are also perfect choices for those who have no children or extended families. As for Gen Z, it is growing up with the idea of OAHs and RCs for the elderly, so no worries on that count as they will be fully prepared when the times comes!
And elders, start letting go — of children to begin with, to remain happy. A handful of sand can tell you how. Come back to read it!
In all the discussion on eldercare, we have to remember that we are privileged to be caring and cared for. Let us then spare a thought, a smile, a little time and some money if possible, for the lonely, destitute and abandoned elders – who make for a huge number in India. Next time you see a lonely elder in the park or on a bench in your colony, try to make small talk with her/him and see the difference it makes to them. I speak from experience.
*OAH/RC – Old Age Home/Retirement Community
Earlier posts in the series:
Homepage pic: Swati Maheshwari