Our city of migrants has a different kind of migrant today - the one who moved to Kochi in the 50s, 60s and later. They came from nearby towns making Kochi home, bringing up children and along the way losing ties with ‘ home’. The children grew up, and moved out of the city, leaving them who are now in their 70s or 80s.
These couples often have to fend for themselves, ‘company’ is a home nurse or house help. “Even if it is a couple they need help. However, there are more widows living alone. The children are working either abroad or elsewhere in the country,” says Dr. Boby Sarah Thomas.
She, along with a team, runs Cancare, a home-based healthcare service that conducts home visits for senior citizens. “Senior citizens, when they are alone, tend to neglect themselves. They hesitate to consult a doctor or even go to a hospital. For us, a visit to the hospital is a one-day affair. And what if tests/investigations are asked for? The solution? Not go at all,” she says. Boby Sarah got the idea of starting a home care service after visiting a couple of senior citizens in her apartment building. This form of home care is an established, accepted system abroad.
Cancare, short for ‘we can care’, was formed this July and three months into its existence, there are around 40 registrations. The family (read children) are given regular updates via email. “This way the family is aware of the status of the patient and the course of treatment, there is the advantage of accountability. A related aspect is that we create a rapport with the family,” says Boby Sarah. The family is reassured that there is somebody keeping track and not just medical. A doctor on a visit tends to be observant. The visits are scheduled as per the requirements - some may need weekly visits, others monthly or once in three months.
The doctor’s visits aside, the aim is to provide medicines, laboratory services (for basic tests) and medical devices such as wheel chairs or water beds - in short, a hospital at home. There is help to be had with skilled nursing services like nebulisation, injections and catheterisation as well.
Boby Sarah did her post-graduation in radiotherapy and has worked in the oncology department of Amrita Hospital. The Cancare team has, besides her, Dr. Mathew Varghese, former Additional Director Health Service (Tamil Nadu) and a three-member nursing team. The accent is on providing relief at home. Often the service assumes a palliative role, in managing a disease.
“An octogenarian patient has endometrial cancer. She doesn’t want to treat it, she prefers the consequences of the disease to that of the treatment. She says, ‘I am this old. I don’t want to suffer more pain.’ In this case treatment cannot be forced on her, there is a moral dilemma. I’d prefer that she undergoes treatment and have been trying to convince the family also, but she chooses not to.” The disease is now managed at home, Boby Sarah says.
“When we talk of such a service, people wonder about the catch, about which hospital I am affiliated to. I am not. Neither do I ‘recommend’ hospitals (in case of hospitalisation), that’s a decision the patient and family makes,” she adds.
What if, when brought home, there is an emergency? “The family is prepared for eventualities too. We recently received a request from family members of a 65-year-old lawyer who had liver cancer in its terminal phase. His son said that his only wish was to be at home and asked if we could do something to fulfil that wish. Our team prepared the family and he passed away peacefully at home surrounded by his family members.”
This also brings us to the question of senior citizens being indefinitely put on life support. “It is a conversation that we ought to have. It puts to rest apprehensions, doubts and fears,” she says. An educated, informed decision would help a senior citizen die peacefully, with dignity for there is the quality of life question to be considered. It is a moral question, best settled by the family.
Timely support
Dementia is a commonly seen affliction among senior citizens, Dr. Boby Sarah says. Another factor is depression factored by loneliness. Through Cancare, the team wants to help seniors engage with society. “The activities would keep them busy and engaged so that loneliness and depression can be kept at bay,” she says. They are in touch with a few NGOs in order to work out possible programmes.
Contact: 9497380999
