Ageing with dignity: Living with respect

By Lionel WIJASIRI

Maybe you buy groceries for your ageing father who has trouble getting to the store. Maybe you spend your lunch break chauffeuring your mother to a doctor’s appointment. Or perhaps you swing by their house on your way home to check if the fridge is stocked and the laundry isn’t piling up. Over time, you may do these things more frequently or take on more responsibilities such as administering medicine or providing personal care.

While caring for an ageing parent has its rewards, the stress combined with juggling the demands of work and family can take its toll. The challenges of caring for elders can result in care-givers ignoring their own physical and emotional health. Care-givers often don’t recognise the symptoms of stress they are experiencing. It could be over a period of years and the stress can be cumulative.

Care-givers may feel sad, agitated, have trouble sleeping or can’t concentrate on a project. They may think “I’m not doing anything well. I’m not being a good daughter or son. I’m not being a good parent or spouse.”

Not by choice

Chandima, a sales manager, said, “My mother can’t see well. My father was a physicist, but now can’t remember our names. I am worried.” There’s a lot of grieving and a pervasive sadness, in addition to the stress. Many become care-givers not by choice, but by circumstance - such as when a parent falls, loses his/her memory or when there’s no one else to take charge - which can exacerbate stress.

Each person’s situation is different, depending on a variety of factors: Does your parent have dementia? Do you have siblings to share the responsibility? Can you afford extra help or are you cash-strapped? Is the parent-child relationship strained or healthy?

“It’s physically taxing and emotionally draining,” said Abhilasha Mandir, an Indian elder-care counsellor who was in Sri Lanka recently. “And if you’re doing it long distance, you’re travelling back and forth. You worry about whether you’re doing enough.” Her advice to care-givers is straightforward.

• Set realistic goals. Assume a reasonable amount of responsibility.

• Take care of yourself. Get proper rest. Eat well. Pay attention to your body’s warning signs such as sleeping problems, trouble concentrating or loss of interest. If you experience them for more than two consecutive weeks, you may have depression.

• Reduce your stress. Meditate, do an enjoyable activity or delegate responsibilities.
• Don’t be afraid to ask for help. When it’s offered, accept it.

Safety considerations

According to Abhilasha, families with older relatives at home should consider ways to minimise the risks of day-to-day activity in the home.

“It’s important to listen to what your family members’ wishes are regarding care." Abhilasha said, “Many older adults would prefer to stay in their own home, and have some support with difficult tasks.”

Abhilasha recommends that families have a meeting to discuss the various aspects of caring for ageing relatives. “If you’re already in a care scenario, sit down with your siblings and find out what everybody can do to help. Sometimes you need a little professional help to mediate, because we all have sibling rivalry which continues to grow older with us.”

Research

For elders in our country, the family is an important source of support in the informal network. Interpersonal relationships are important in building networks.

Besides family, friends are also an important source of informal social support. Friends are often similar in age and can provide elders with “emotional support.”

Research has found that for elders, in addition to quality of life being associated with material well-being, there was also significant relevance for marital, family and social relationships. For this interference, the importance of family and social life must not be underestimated when looking into the quality of life of elders.

Elders frequently mention four themes regarding quality of life:

• Food, clothing and ability to work;
• Family support and independence;
• Psychological dependence (often religious);
• Health.

The importance of the family and friend networks in elders’ physical and mental health is apparent.

Cultural view

Perhaps it is time to rethink the value and positive aspects of ageing and adopt a cultural view captured by the imagery of the “Long Late Afternoon of Life.” While it is difficult to change “culture” per se and the way elders are viewed in society, there are practical steps communities, employers, and individuals can take to prepare for a society with greater numbers of healthy elders.

More than 22 percent of the population will be over 60 in about two decades. Of the rest of the population, there will be 61 dependents for each 100 adults.

As the Government promotes inclusion of all segments of society in the growth process, it should have a plan to provide for the needs of the ageing population on a long-term basis.

Sri Lanka is on the right track to meet most of the Millennium Development Goals. Life expectancy in Sri Lanka has increased by around 30 years over the past century.

Along with energy and climate change, ageing is one of the major global challenges for the 21st century. Researchers, decision makers, practitioners and carers who work in the ageing field are aware of the issues involved.

Research continues to make a major contribution to extending and improving the length and quality of people’s lives around the country. Major advances have been achieved in scientific fields and it will be important to support such research in the future.

However, we recognise that key challenges in ageing cannot be solved in research silos, but require a pluralistic approach. We must also encourage enterprising researchers who seek to combine their expertise with others to tackle the cross-cutting challenges and exploit the new opportunities associated with an ageing population.

Individual initiatives and partnerships between research funders will create and sustain environments that support multi-disciplinary and cross-sector working in ageing research. By bringing together experts from different disciplines with stakeholders and users of research it is possible to focus on where Sri Lanka is best placed to make the greatest impact.