On Monday evening (Dec. 8), I arrived in Madurai on an unscheduled visit after a frenetic weekend. In the second half of last week, my father (who is 85 years and six months old) had suffered two (minor) falls and had become disoriented. His routine and that of my mother had been thrown off-gear as a result. There were no major injuries, fractures, or blow to the head. Yet, some damage has taken place. Mostly due to the age factor.
My aunt’s mother – who lived to a ripe old age – used to remark that old age was a curse. For many, it is mostly true. It is hard on them and it is hard on others. The society – especially the so-called modern society – has not evolved a proper template to deal with old age – especially ageing and passing away (or, letting them pass away) gracefully and with dignity. The lack of template is not merely an issue of health or medical care.
For the most part, modern allopathic health care in India, especially for the aged, is insensitive and is a financial drain on caregivers. Hence, there is a need to balance the ‘need to be seen as doing something’ vs. what is optimal for the care-receiver. One has to discount the potential future scenarios too, to the present. It is not easy. That is why it makes sense to have some templates, develop some principles and concepts to deal with these issues when there is no need for them.
When things begin to go wrong, even the so-called educated, the spiritually inclined and the aware people in care-giving positions are at their wits’ end. Consequently, there is a risk that they overdraw on the ‘spiritual’ or ‘good karma’ balance in their accounts. Further, no matter how inevitable death is and especially so in ripe old age, a pall of gloom descends. The mood is a bit morbid. Emotional batteries drain little faster. One needs to be aware of it and find ways to keep charging them too.
Dan Ariely’s popular TED talk reminds us that in situation involving complex decision-making, we are unprepared. Stress, anxiety, frustration and anger are our natural responses to the complexity of the decisions involved. Obviously, they are unhelpful.
My good friend Bharath Krishna Shankar came up with an excellent social intervention initiative for teaching Life skills to high and higher secondary school students. Perhaps, he should do another programme for those who are in their forties to sixties now, as to how to grow into caregivers and care-receivers, as they age. It could be called ‘Ageing Skills’. He called his Life Skills programme, ‘Thalir Thiran Thittam’ in Tamil and he could consider naming this, ‘Narai Thiran Thittam’. At the minimum, ‘Narai Thiran Thittam’ syllabus should deal with managing (to put it bluntly, lowering) one’s expectations from the world around us as we age.
Alternatively, there is ample merit in the proposition that, when we are lucid, we could write down a ‘manual’ or checklist for our children as to how to deal with us when we become incapable of deciding or articulating our thoughts, emotions and logic.
Most relatives want the sick, old person to be restored. But, the question is ‘Restore to what state?’ In Microsoft Windows, if a newly installed software or device malfunctions, there is an option to restore the system to the state that prevailed before the installation was attempted. The hope is that the system would be stable. With humans, it is not possible. But, emotionally, people want to try to do a ‘System Restore’. With humans, the new equilibrium will most likely be unstable and the next system crash could be more damaging to them and to the caregivers.
By no means does the previous paragraph suggest ‘abandonment’ of the old (the sick and the infirm) to their fates. Apparently, a friend of my friend had told him (my friend) that he would give his children the right to administer the ‘Pillow’ treatment to him, in seemingly irretrievable or impossible situations. I am not suggesting anything as specific as that or any other specific measure.
It is about having a clear idea of what one wishes to accomplish, of its execution, of the methods, of the resources, of the costs (material and other costs) and, more importantly, of the counterfactual. These are not easy things to do even in situations where no emotions are involved. They are doubly harder in emotional situations, especially in the Indian cultural context.
At a societal level, India with its huge numbers, is about to face an old-age epidemic. In a few Southern States, demographic trends are already comparable to those in greying Western European countries. There is both a business opportunity and a social need in providing for comfortable old age – whether healthy or not – with sensitivity and attention to detail. As it is, we are woefully ill-equipped.
A vital silver-lining in the cloud is the presence of a capable, confident and considerate nurse made available by Lifeline Nursing from Trisoor which is a not-for-profit institution. The service does not come cheap. But, it is worth it. Such a facility is needed for the benefit of the health of the remaining caregivers in the family as much as it is needed for the person being cared for. You can look them up here.
Tail-piece: About nine months ago, I wrote a blog post about Shanti Sadhan. This is the residential enclave in Madurai where my parents live. Perhaps, it is time to rename ‘Shanti Sadhan’ ‘Sulphur Sadhan’. The vehicle population has exploded. It will be interesting to take a reading of vehicular pollution inside the enclave. School buses picking up students could do so from outside the compound. But, Indian roads have no bus-bays. These buses are liberal polluters in the morning hours. In one way it is good that internet (with good connection speed) is not available. Children come out and play. But, the vehicular pollution is bad for their lungs. Behavioural science has recorded that humans are myopic. Are Indians more so?