Kirit Mehta stopped eating over a week ago. The 82-year-old has become severely malnourished. His family members are unable to tackle the problem.
Kirit was diagnosed with Alzheimer’s last year in February. He forgets people, cannot bath on his own and confines himself to his room. If taken out he cries to go back home.
His family is running from one doctor to another to learn how to take care of him.
“Sometimes we feed him by force, to which he retaliates. Sometimes we coax him or leave food at his bedside,” said Kirit’s son Pankaj, who had to ignore his job on several occasions to nurse his father.
Kirit is not at a stage in which he is to be left for palliative care and not sick enough to be hospitalised.
“We cannot depend on a nurse or ward boy as this task requires patience. None of these nurses or ward boy bureaux is equipped to handle Alzheimer’s patients,” said Pankaj.
For many like Pankaj, a law on providing home-based care for such senior citizens could have helped. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007, has a provision for medical care for senior citizens, but no provision on giving quality care at home for elderly patients who cannot make it to hospitals.
Most hospitals do not have a special geriatric facility. Even if a hospital has one, it is usually prohibitively expensive. According to the principles of health economics, the elderly requiring treatment for longer periods are best kept at home for better resource utilization.
“Improvement in healthcare has increased life span in developing countries. People live longer but with severe morbidity. Non-availability of healthcare professionals adds to the problem of geriatric care,” said Dr Sanjay Kumawat, consultant to the state mental health authority.
“It is only in the last two years that some serious attempts have taken place in the country in this area,” said professor S Siv Raju, chairperson center for development studies at Tata Institute of Social Sciences (TISS).
In last year, the Centre announced a central institute for ageing in Yerawada. It has not yet come up The institute was to offer a post graduation in geriatric mental health.
There are no full time geriatric experts in city who can meet needs on a day to day basis.
TISS announced a one-year diploma in gerontology (a course to work with older adults) last year. “We are training nursing agencies providing medical care in communication skills to deal with elderly who need companionship, nutrition, and about dementia and how to deal with behavioural changes in it,” said Amruta Lovekar, project director, Silver Inning Foundation.
By Jinal Shah
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Monday, March 30, 2009
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