Healthcare needs of elderly call for upgrade

A debate has been raging in the media about whether the lockdown saved millions from falling prey to the deadly contagion or it was a ‘draconian’ measure to curb the legal and human rights of certain communities. While a verdict on this issue can wait, the fact remains that the older people were the most harassed, deprived and neglected, especially with respect to healthcare.

Vulnerable: The older people have been hit hard by the lockdown restrictions.

Dr R Kumar

President, Society for Promotion of Ethical and Affordable Healthcare

SENIOR citizens are facing a harrowing time during the lockdown due to the Covid pandemic. Not only are they more susceptible to getting infected with a fatal outcome, more often due to pre-existing conditions — like heart disease, diabetes and obesity — they are also among the sections of society worst hit by the closure of public and private hospitals.

Hospital services have been curtailed by 90 per cent for indoor as well as outdoor patients. None can ignore the fact that the elderly are more prone to get non-Covid infections as well as non-communicable ailments. As many as 6.3 million people are expected to develop TB during the Covid period, and one million people are likely to die from the disease.

Also, in most cases, a six-month delay would lead to more sick patients and a dramatic increase in death rates for major illnesses related to heart, lung, kidney, brain, liver, cancer or psychiatric ailments like depression. Why were leading hospitals closed in the first place? They still don’t want to open the outpatient facility to non-Covid patients.

A debate has been raging in the media about whether the lockdown saved millions from falling prey to the deadly contagion or it was a ‘draconian’ measure to curb the legal and human rights of certain communities. While a verdict can wait, the fact remains that the older people were the most harassed, deprived and neglected, especially with respect to healthcare. Leaders have to courageously and decisively advance to mitigate the sufferings of the elderly, not only during an epidemic, but through all times by upgrading the geriatric-care services.

Nearly 70 per cent of the elderly have health problems that get exacerbated during a disease outbreak. Covid has hit them hard. Besides physical ailments, senior citizens suffer from emotional and psychological problems like anxiety, depression, dizziness, insomnia, stress, anger, restlessness, hopelessness, lethargy and suicidal thoughts. As per a survey of the Age-Well Foundation, 65 per cent of the elderly complained that due to the lockdown, they have lost their independence, self-esteem and even dignity, as they have to depend upon others for their basic needs.

Despite the prospects of a long national hibernation coming to an end, the restrictions for persons above 65 still hold, that they will not venture out. Hence, no succour is in sight in terms of medical care or preventive health through morning walk etc. The mandatory use of mask, though protective, has made matters worse since most seniors have pre-existing respiratory problems.

Since the elderly were confined to the house, they remained glued to TV, computer or mobile, resulting in eye strain, redness, watering, blurred vision, itchy eyes, burning sensation and severe headache at the end of long sessions. Broadly, it is called computer vision syndrome. Devoid of any exercise, nutritive food, sufficient water and sunshine and sitting for long hours in one posture, they suffer multiple pain and defects in posture and gait. Excessive use of smartphones increases the risk of brain cancer, as per a study by IIT-Bombay.

The elderly are marginalised even in their own homes, due to the innate fear of ‘ageing’, ‘losing vitality’, ‘abandonment by kith and kin’ and the ‘fear of death’. Society equates ageing with loss of ‘charm and beauty’ and that many a time, triggers old-age abuse. Media blitz or talk that the elderly are dying of Covid or infecting others is not a benign remark. It smacks of reproach and stigma. The elderly are prone to chronic bronchitis, obstructive lung disease and common cold leading to chronic cough, sore throat and flu-like symptoms. These can be mistaken for Covid-19, leading to segregation, neglect and stress. Stress impacts immunity and can increase proneness to infections.

Frailty strikes the elderly with movement restriction, malnutrition and poor immunity, if the lifestyle is unhealthy. With most children not living with old parents or not supporting them or dumping them in old age homes, loneliness, neglect, isolation and poor nutrition are natural. The onset of low vision and poor hearing prevents them from communicating with others. Impaired memory, thinking and expression prevent them from comprehending and adhering to precautionary instructions.

The elderly might not be aware of authentic information on infection, amidst misinformation. Use of multiple medicines, increased health-care need and cost may baffle them. Psycho-social vulnerability results in loneliness, anxiety and uncertainty, which can give rise to depressive disorders, insomnia and chronic stress. Grief and bereavement due to loss or distancing from loved ones can be major and prolonged. They are also at risk of post-traumatic stress syndrome, if the stress is prolonged.

Government agencies, NGOs, families and caregivers can consider providing support — social, emotional, medical and wellness. Their daily needs and requirements need to be optimised. Additional effort is necessary to ensure their hand and respiratory hygiene and fitness. Hospital visit should be the last option. Elective surgeries like cataract, hernia or knee replacements are better postponed. Digital screen time should be reduced to two hours daily. Medical advice is the best choice for any clarification. Self-medication or missing medicines can be life threatening. It is natural to be stressed, but signs of excessive panic, depression, sleep problems or suicidal tendency need urgent attention from a qualified mental health professional. The elderly need to be involved in decision making even in crisis. Their rights, self-respect and dignity must be preserved and protected at all costs.