A sliver of silver

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A sliver of silver

Friday, 10 April 2020 | ​​​​​​​Prateep Sen/Tamojit Dutta

A sliver of silver

Prateep Sen and Tamojit Dutta say that the care of seniors has to change keeping the pandemic in mind

Juggling hectic work schedules with elderly care was always a question of achieving a fine balance. At times you wanted to go back home at regular intervals just to check on your elders because you were anxious. It was a tussle to make them feel independent while ensuring that they took every medicine on time. Well, all of this overthinking has come to a grinding halt as the world experiences the COVID-19 pandemic which demands a change in elderly care as it has given rise to anxieties of an altogether different kind.

Across the world senior citizens are more susceptible to the Coronavirus because their immunity is compromised which is coupled with co-morbidities and pre-existing conditions such as diabetes, hypertension and heart disease. A survey of the Coronavirus death has a chilling report. It says that one in every 12 elders will die from COVID-19 if aged between 70-80. This will climb up to one in seven if aged over 80.

Suffice it to say that it is not an easy time to be a senior citizen currently. It may be worthwhile to take a look at different categories of senior citizens and see how they were leading their life before the lockdown.

There are seniors in their late 60s, early 70s who enjoy an active life. They go to the local shops, watch a film at the nearest cinema hall and love going to the local market to buy vegetables and meat and hire someone to help them bring the groceries home. They have maids who cook, do the household chores and act as company. They also have relatives visiting them every now and then. They cope well and are not fully dependent on anyone, but they need help with daily activities. 

Then there are seniors who are fully dependent on people and need a support system. They are not in a position to run their households by themselves. Typical cases include those that are 80 years and older, who live alone and have attendants round-the-clock who look after the household while their children live and work in another city or are abroad. Another example is of those who live with their families and need full time monitoring and physical assistance because of health issue, leaving them semi-bedridden.

It is well known that seniors are dependent on some kind of support system, whether through a personal network of care providers — care takers, neighbours, family and friends, or on a professional healthcare provider.

With the lockdown in place, the areas where they have been affected include:

Disruption of routine activities: Most of these elders depend on local shops and outlets for their daily requirements right from groceries to medicines. Access to bank accounts is difficult given the restrictions, long queues, hygiene issues and their limited knowledge in managing ATMs and online banking platforms.

Loneliness and depression: The seniors are going through stress, anxiety and isolation as a result of being under lockdown. Their recreational activities usually include  morning and evening walks or a tea with an old friend. Low usage of technology by them has impacted their digital participation. They can’t even seek help from close family and friends.

Healthcare access limitations: The lockdown has affected healthcare delivery at hospitals and clinics, both for chronic and acute illnesses. Purchase of medicines, ordering blood tests at home, access to doctor consultations and elective surgeries — every aspect of healthcare has been impacted as a result of lockdown.  We also need to take into account that the seniors are the biggest users of these facilities and now they have lost access to these.

However, with the pandemic hitting worldwide elderly care will change, given the need of the hour where you need to stay indoors, restrict movement and limit outside contact. Whether the lockdown lasts for four weeks or two months, it is safe to assume that the lifestyle of seniors, as well as their care, will change for good. The elderly care has witnessed a massive change as they have a higher risk of getting infected. One needs to maintain the continuity of care while protecting them from exposure to possible infection. The main goal now is to create an envelope of care by a selected group of people who can provide them all the assistance required while maintaining hygiene themselves.

Keeping these in mind, the care for elders will need to change to help them in the areas that are the most difficult, and will now have to be solved differently. Some simple initial changes in care are required:

An attendant: Having a single live-in attendant who can help with daily activities and provide physical assistance will help them in their routine activities. This will help in full-time monitoring, physical assistance and limits outside contact.

Home delivery: Home delivery of essentials is an absolute must, as it is one of the main reasons why seniors go out. They go to buy staples, food and medicines. While online delivery providers can provide the basic essentials, it is better for seniors to be able to have access to local providers who can supervise the entire delivery process and ensure sensitivity towards seniors, while maintaining hygiene.

Telephonic consultation with doctors: Seniors should consult their doctor on call for basic issues or regular health updates. It is the best way to reach out to them and make payments online, thus avoiding a physical visit.

It is also important to document all aspects that need to be covered during an emergency — ambulance numbers, choice of hospital for admission, identification documents and funds required. All of this should be planned on a structured basis. It is best to get professional help for this to avoid stress or unpreparedness at a later stage.

Most importantly, be vigilant at all times about hygiene for both seniors and those living with them — washing hands, using sanitisers and maintaining social distance, even if it is a family member.

These times will also bring a new conversation-driven change. Earlier, most of us did not have enough time to sit and chat with our elders or share a cup of tea with them in the evening. We don’t even realise the amount of care they need as they grow old. Spending time with them not only helps them feel better and fight loneliness but also helps us get an insight into the past. Right from teaching us about our past values to becoming good human beings, they help us become the best versions of ourself. Many of us would realise this now as we now have enough time to communicate and spend time with them.

However, it might be different for those who are not living with their parents or elderly loved ones. For them interactions with seniors would mean being in touch with them over the phone rather than physically meeting them.  This, however, may be very cold and impersonal, and there is a huge chance of home bound seniors getting depressed, especially if they are used to an active social life where children and grandchildren visit them often. Under such circumstances, it is important to call every day and maintain contact. If they are comfortable, a Whatsapp or a Skype call, or even using Alexa to “drop in” can be helpful. It is important not to lose touch as a result of the restrictions placed on them. Making the seniors tech-friendly, even at a basic level, can go a very long way. Having conversations, introducing them to online recreational activities can actually help in combating depression and isolation.

Our elderly care platform has launched three initiatives keeping social distancing and hygiene factors in mind.

Dare to Care: a no contact grocery and medicine delivery service at home

Talk to Me: a free call service for medical and psychological support and assistance by experts.

Happy at Home: Access to recreational activities through WhatsApp groups and Zoom sessions such as crosswords, yoga, book reading, music to combat loneliness.

(The authors are Co-CEOs at TribeCa Care, an elderly care platform).

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