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August 16, 2016 Tuesday 12:22:49 PM IST
Elderly care: The Canadian Experince

Demographically speaking, the aged constitute a substantial segment of the modern society. Yet the flag end of one's race on the earth gets embroiled in hardship, neglect, and segregation and failing health. Instead of cursing the stars above and the offspring down here, the best thing for an individual is to prepare and plan for the final phase."Sans teeth, sans eyes, sans taste, sans everything," old age deserves youthful deliberations.

Dr. Tina Wu, faculty at Trinity Western University, Canada, an expert in elderly care and Dr. Jed Metzger, Faculty at Nazareth College, U.S.A. in an exclusive interview with Prof. N. K. Vijayan

 

The incidents of abusing the aged are on the rise, given the reports appearing in the media. Has this phenomenon got anything to do with the stress and strain that the modern life entails?

The incidents may have something to do with the stress and strain that the modern life entails. The family is one of the most important social institutions in the world; however, nowadays, families worldwide are caring for their family members without proper supporting network/ system around them. Sociologists use the term Sandwich Generation to describe families that have to care for both their young and old at the same time. As a result, the following family functions are threatened: sharing of social and economic resources with family members, offering caring and supportive relationship to family members, one’s commitment to caring for all family members.

Madam, are developed countries better off with regard to the treatment meted out to them? If yes, what makes it so?

It may seem this is the case. For developed countries, the governments take the time to formulate preventive policy and structure to support their citizens through their distributed taxation system. All citizens are responsible for working with the governments to ensure their quality of life are protected and supported in all walks of their lives. Families, the aged, the young are prepared and supported by social security system designed to maintain their basic needs for life.

Some of the reports suggest that aged women are subjected to physical abuse at some old age homes. How do you react to the disconcerting incidents ?

Physical abuse is a condition or event that causes physical harm. Physical abuse may be intentional such as hitting orpinching, orit maybe dueto neglect including overuse of restraints and lack of physical care. Signs of physical abuse may include: Broken bones or fractures, Bruise, cuts or welts, bed sores, frequent infections, signs of dehydration, mood swings and emotional outbursts, reclusiveness or refusal to speak, refusal to eat or take medications, unexplained weight loss, poor physical appearance or lack of cleanliness, changes in mental status, caregivers that do not want patient to be left alone with others. Although not all aged women at some nursing homes with these symptoms are subject to nursing home abuse, any sign should be cause for further investigation.

Society at large (at least in India) frowns upon children who admit their aged parents to old age homes. In the prevailing situation, is it totally blameworthy? Is it not better than throwing them into the streets?

In Asian countries, filial piety is a virtue of respect for one’s parents, elders, and ancestors. However, there are various reasons for adult children sending their aged parents to old age homes. It could be a mixture of motives.

Often it is because the parents have health needs that cannot be met in either their home or at a child’s home. Even relatively healthy older adults still often need to have regular check-ups or other regular medical attention that is too difficult to do in a regular home. A person with substantial dementia may simply require more care than one or a few people can give. For instance, ‘sundowning’ issues for parents with Alzheimer’s disease. During the day, the aged parent is sweet but highly disoriented at night due to a cognitively declined state. It could be hard for the family to deal with. In other circumstances, it may be incredibly disruptive to have an aging parent around when the relationship between the child (or the child’s spouse) may be too difficult for them to be in the same household. Finally, many parents may be very independent and not want to live with their children.

How can we regulate the emergence of shelter homes for the aged? What are your suggestion in this regard?

In Canada, the Shelter Aid for Elderly Renters (SAFER) program helps make rents affordable for BC seniors with low to moderate incomes. SAFER provides monthly cash payments to subsidize rents for eligible BC residents who are age 60 or over and who pay rent for their homes.

BC Housing (Canada) provides SAFER subsidies to more than 17,000 senior households renting apartments in the private market, including singles, couples and people sharing a unit.

Has the value system failed to inculcate and sustain the obligatory role of the offspring about the care of aged parents?

The value system of this modern world has failed to educate and uphold the filial responsibility of adult children caring for their aging parents. The key to restoring this critical value system will rely heavily on formal and informal education. There is a need for a curriculum well-integrated into the formal educational system and the culture of the society.

How can we incorporate proper lessons in the curriculum to set right the distortions that have undermined core living values?

Lessons to improve primary education and restore core living values.

  • The purpose of primary education is to teach students a philosophy and a chance of movement to restore values-based education, not only their academic achievement/success.
  • Values-based education offers a gentle introduction to the complexity of most of life’s moral issues, for example, respect for your parents.
  • Values-based education does not insist on one ‘right’ viewpoint of the world but encourages instead the individual to ponder, engage with, examine and explore issues, see life from different approaches and thereby develop an innate sense of empathy for different view- points and considerations, as well as an intellectual curiosity about our world.
  • Through engaging in value-based education, it has become clear that many children may have an innate sense of their own spirituality and are in the process of developing a personal morality and responsibility for the future of our society.

Silver and Gold. Modern world designs with old value system.

It is observed that exploitation of the aged in the medical field is a sad reality. How do you look upon it?

Exploitation of the aged in the medical field has been defined as “payment for items or services that are billed by mistake by providers, but should not be paid for by the system”. Some people use “medical fraud” or “healthcare abuse” to describe provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the medical program, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for healthcare. It also includes recipient practices that result in unnecessary cost to the medical program. There is a need for any organization to have a thorough corporate compliance plan to reduce/limit an organization’s risk of committing medical fraud violations.

The economic dependence the aged are subject to makes their plight pathetic. Is there any way out?

A Two-Part Solution Focused on Work

For monetary and non-monetary reasons, work is a pivotal element of one’s wellbeing. Recognizing this could be an essential part of the solution. Paid work contributes not only to material wellbeing but also to psychological wellbeing through social interactions and opportunities for personal and professional growth. And unpaid work, like volunteering, care work, and artistic work, can provide these same psychological benefits. Given these positive effects, encouraging and rewarding paid and unpaid work among the elderly could be a pivotal part of the solution to the aging-related fiscal and social challenges. To enact such a strategy, policy-makers could consider: (1) a gradual retirement scheme allowing older individuals to lower their working hours yet remain in the workforce and pay taxes until a later age; and (2) furnishing options for and rewarding volunteering, care, and artistic activities among older society members.

Part 1: Phased-in retirement, fiscal sustainability, and well-being

Encouraging older workers to remain longer in the labour force is often cited as the most viable solution to fiscal pressures and macroeconomic challenges related to population aging. Phased-in retirement entails a scheme whereby older workers could choose to work fewer hours yet remain longer in the labour force, including after they retire. And gradual retirement can be beneficial to societies, employers, and workers:

  • First, phased-in retirement allows continuity in tax revenues and reduced expenditure on pensions, which holds particular importance for fiscal and macroeconomic stability
  • Second, older workers can be valuable to organizations and younger colleagues due to their knowledge and experience
  • And third, late-life work has positive health and perceived well-being consequences for older employees.

Part 2: Promoting and rewarding volunteering, care, and artistic work among the elderly

    In cases where individuals are unable to take advantage of phased-in retirement—due to health issues, family obligations, or skills mismatch—governments could promote and reward volunteering, care work, and artistic work among the elderly. Such unpaid activities improve the quality of the social fabric, help the well-being of those engaging in them, contribute to the economy, and reduce healthcare and welfare costs.

Why don't the young understand that when life comes full circle the very same fate will befall them?

It takes time for the young to build up their wisdom towards life. Only when there is awareness, it wouldn’t be difficult for them to realize their own shortcomings.

An explicit element of ingratitude underlies the mistreatment to the aged. Have our religious text and discourses failed to deliver the right message?

I would say that the religious teachings only help. It is the need of us living humans to live in accordance with these teachings. In this regard we should care for and attend to our parents and grandparents.

Demographically the aged constitute a sizeable component and as such their wellbeing is to be a matter of concern for the rulers. What accounts for the step motherly attitude of the authorities?

I do not feel that I can answer as to the approach used by the government here in India. In America we must work and advocate for the rights for the elderly as they are not fully attended to by the government. This provides a professional pathway for the social work profession for action.

Are the offspring constrained to take the aged parents to old age homes out of career demands?


Yes, around the world, as women work both due to fiscal need and due to career need it has become more challenging to care for elderly family members in the family . This is unfortunate as this is perhaps the best place for the elderly- within their extended family.

How far is the law effective in ensuring a fair deal for the aged?

Social policy is essential for protecting the rights of the elderly. The development of social policy to meet the increasing need of the growing elderly population in India will be a critical next step.

What are the penal provisions in the law for neglecting the elderly?

I cannot speak in India, in America there are laws, often ignored, but designed to protect the elderly from abuse.

Is it merely the debility associated with ageing theta places the aged in a precarious position?

No there are social determinants of health. Factors come together and compound, it denies any simple solution or any one factor that is to blame.

Is it in conflict with the scheme of things formulated by Nature that the number of the aged swells phenomenally?

No, this is the design of the forces larger than ourselves.

What are the steps suggested for the restoration of reverence for the aged?

Love your parents, worship your grandparents, they are what has made you what you are.

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