In a nuclear family with two boys, life was smooth sailing until my mother's untimely demise. My father, 75- plus, could not be left alone. An accident coupled with his spouse's sudden death had left him shaken. We brought him over to live with us.

In his heyday, he was a dynamic person but as years went by, symptoms of old age crept in. It started off with slow memory loss; he found it hard to recollect names and repeated things over and over again. Friends and relatives quickly diagnosed it as Alzheimer's and gave it a certain respectability (thanks to Mohanlal in the Malayalam movie Thanmathra). To arrest its progression we would see to it that he kept to a regular routine of walks, yoga, reading the newspaper, and attending telephone calls. He loved going out so we would take him along when we went shopping or to dine out at hotels. We would make him collect the bill and check the balance amount received, so that his mental arithmetic was intact. But soon this became difficult for him. He was given petty tasks like cutting vegetables, peeling onions, locking the gate, placing vegetables into the refrigerator, ironing his clothes, all of which required some cognitive ability.

Signs of dementia

As he crossed his eighties, his behaviour showed signs of dementia. His activities became slower and slower while his obsessions grew stronger and stronger. He lost track of what he ate as sometimes he would finish off a dozen bananas in half a day. Worse still, he was obstinate in throwing the peels into the neighbour's yard. His world shrank to his almirah, his clothes and his books. He would check umpteen times if they were all intact. His clothes were sometimes quietly picked up from the clothes line even before they were dry. Pens went missing from the tabletop, important letters also disappeared from the mail box. Luckily, we would find them hidden in his cupboard and he would flatly refuse he had taken them. The 10-year-old's odd toys would also find their way into his cupboard and that would start a fight between them. It was not that stereotyped story-telling-loving grandfather that my son knew, but someone more closer to his age waiting to get even.

Interaction with outsiders was no better. His prejudices or hatred that he nurtured deep inside would surface now and then. We had to intervene to tone them down. Very few had the time and patience to listen to his harping. With his activities having shrunk and communication becoming incoherent, it was soon he to himself with dialogue being minimal. It is at these times that a support group is essential but it is lacking in our fast–paced society. Problems of the old are rarely seen from the caregiver's perspective.

With advanced medical care and improved standards of living, old people now have more years of age to cope with. The quality of living through old age depends, to a large extent, on sensible handling by the caregivers. People in their eighties are invariably suffering from physical immobility or dementia (still underrecognised).

Multiple needs

Their needs are many — first, physical needs like giving them a bath, clothing them, giving food and medicines at regular intervals, accompanying them for a walk and so on. Second, financial needs, like arranging for their monthly expenditures, managing their bank accounts and other financial transactions. Third, emotional needs, like sparing time to listen to them even if it did or did not make sense, or making them feel useful by assigning tasks which they can perform.

This is not all. They also have their social needs like attending functions, visiting temples, or travelling to new places. Physical and emotional needs are provided at the individual's own home but social needs imply social interactions outside home. For this, society should be ready to accept them into the mainstream. If the aged are suffering from dementia, they can at times be quite an embarrassment but this embarrassment is not for the caretaker alone but should be shared by society as a whole. The younger generation, in particular, should be educated to be more sensitive to this category of the ‘very old', whom one would put at home rather than bring out. The care and concern that we readily show to the physically and mentally challenged should be extended to these people also.

Caregivers thus need to be given all encouragement and support by society. The Income Tax department could give an across-the-board relief to all families supporting an 80-plus senior citizen and spare them the rigours of having to prove dementia in such cases. Day care centres will soon be the need of the times and surely prove a great boon to both the old and their care givers.

(The writer's email is savithaob@gmail.com)

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