Special Articles / Kalpana Sampath / Old Age in an Indifferent Society
Every country strives to provide the best way of life for the children, youth, and the senior citizens. If there was a section that was just not in the purview of the Indian mind a few decades back it was the senior citizens. They came under the family structure as a natural process of aging and weren’t considered the responsibility of the community or the state. But in the recent past, the issue of elderly care in India is gaining attention with an unimaginable speeding the cities as well as the rural areas. With the increasing pace of life and the process of globalization, this issue has gained importance. Factors like the increase in the average age of the population, migration into cities thus leaving the seniors to fend for themselves, the impetus given by the government regarding healthcare services have all led to the emergence of this situation and demand immediate solutions. The private institutions and NGOs play a vital role in providing sincere and excellent services. One such institution which has made its mark is the Nightingales Medical Trust (NMT). I am very glad to share the journey and wonderful contributions of NMT through this article.
Nightingales Medical Trust (NMT) is a registered, non-profit, voluntary organization working for the well-being of the elderly in and around Bangalore since 1998 through various innovative, family-based support systems for the senior citizens of different socio-economic groups. It is a professionally managed organization that benefits over 800 senior citizens every day. Some of Nightingales’ projects have emerged as models and are being replicated in other parts of the country. Besides involving the community in all the programmes, Nightingales Medical Trust is successfully partnering with government agencies. A founder member Dr.Radha Murthy says, “When we started it was difficult to convince people that we can provide health care to elderly at their door. But over time, with our sincere effort our organization took off well and now we are recognized for our efforts, both at national and international levels. The reason for such success could be the fact that our services look at assurance of personalized care for elderly with the comfort of home and it’s cost effective”.
Personalized care is not so easy. In every nuclear household with two or three siblings, when people in the family begin to age, they move from actively managing the household to becoming senior citizens and it is an uphill task to recognize the reality that they’re aging. Usually, until there is a medical condition, the concept of aging is not recognized. When the health issues hit the family, most of them get caught in triviality rather than the priority.
The priority should be to see how the elderly can be provided with care. It is indeed a significant achievement to build an institution par excellence in elderly care. Nightingales Home Health Services (NHHS) was set up in January 1996 and led to the establishment of Nightingales Medical Trust in 1998. For any institution to be on the path of excellence it should be guided by a powerful vision. NMT’s vision is to build a society where elders are happy, healthy and secure, living with dignity as an integral part of the family and the community with appropriate care and support systems. NMT not only focuses on giving medical attention, but also emotional and societal fulfillment. To achieve this vision the key projects of NMT include the following:
Nightingales Centre for Ageing and Alzheimer’s
Currently, in India, there are about 3,20,000 elders affected by Alzheimer’s and in Bangalore alone, the estimated number is about 30,000. The centre gives priority to therapeutic treatment with less or nil priority to non-pharmacological interventions rather than resorting to sedating medication. Dr. Soumya says, “We try to maintain the treatment very culture - specific and don’t try to copy the western treatment models”. The best part of the centre is its dedicated team of psychiatrists, physiotherapists and psychologists who take care of the elders along with educating the family on the support required from them while dealing with Dementia or Alzheimer’s patients. Dr. Soumya opines that not all patients require institutionalization. It is best for the patient if they can live with the family. Therefore, they provide training, and check on them and maintain their medication and treatment from time to time. NMT also provides short term or respite care for the family having dementia person with them. This service is like a boon for the family members when they have to go out of station or just want a break from caring for a short period. They can drop the patient at the centre for the period they are away with the assurance that in their absence, the family member is well cared for by the dedicated staff of the centre. The short term care also helps in understanding their behavioural pattern, and prescribing treatment and medicines. Appropriate feedback is given to the family so that they can follow the actions required when the patient behaves in a particular manner at home.
The patients are seen experiencing a higher level of comfort at the centre. Dr. Soumya points out that “as many live in apartments where mobility is restricted and they can only see other people when someone visits the family, people feel more comfortable here because of the infrastructure which is so open and spacious. The open secured environment to meet and interact with other people and personal care by the staff add to the comfort. Also, aggressive behaviour of the patients is dealt with deftly by observing and understanding the behavioural pattern and solutions are identified to manage them.”
The centre has patients from all over India. But majority of them are from southern states of India. NMT also provides referrals to other institutions doing similar work in the respective states when the patients cannot be accommodated in Bangalore.
In addition, the centre has corporate partnerships and a lot of people volunteer in various activities. The centre also provides internships for psychology students interested in the study of senior citizens. Dr. Soumya says that media attention plays a large role in spreading the work. Besides media, the mouth to mouth publicity also enables people to access help and services.
The other services are:
Nightingales Elders’ Enrichment Centre
Nightingales Elders Enrichment Centre (NEEC, 1999) is a unique daycare centre for senior citizens. With a registered membership of over 300, nearly 50 of them are regular visitors. The beneficiaries are mostly from the middle class. There are different programmes.
Gunny Talgery, a beneficiary, says, “In a desert of loneliness, NEEC is an oasis for rejuvenation. Here, you are reminded that now is the time to do many of the things you never found the time for earlier. The centre provides the opportunity to meet and mix with people having common interests and wavelengths, apart from age. While doing so, we build relationships that are lasting and enriching.”
Rural Mobile Medicare Programme
The innovation in health care is not just for the people in the city but also for the rural community. The Nightingales Medicare van equipped with medical supplies, a doctor, a nurse and a volunteer attend to the health complaints of the elderly living in the outskirts of Bangalore. The team visits three centres on a pre-determined schedule, dispensing basic care and free medicines wherever required. On an average, nearly a thousand health complaints are tended to every month. Cases requiring specialized services are referred to nearby hospitals. The Rural Mobile Medical Programme has made a great impact on the health of the elderly in the villages. Since the services are regular, the team is now well-received by the elderly in the villages.
Nightingales Medical Trust is professionally managed by a Board of Trustees consisting of dedicated people from different fields of expertise and elders themselves on the managing and co-ordinating committees at various levels. The team also consists of medical professionals, lawyers, counsellors, social workers and committed staff.
According to Dr. Radha, the challenges faced by NMT are in terms of:
Dr. Radha reports that “the people working with us have steadily increased. We started with an urge to do something for the elderly, but never imagined that we will reach so far. At the end of the day I am very much satisfied. In the coming years, the time has come to broaden the horizon. A different model is envisaged to implement health care for the rural old with the participation of local community. We look forward to individuals or organizations to associate with us and replicate our models in their own place,” Dr. Radha adds that “it’s high time to shift our perception of elders and think of empowering them Elders’ productivity has multiple outcomes and will also instill a life of dignified independent status. Also, at the same time the elderly should understand the changing social scenario. So it is important to initiate steps to fill the gaps from both sides – children as well as elders.”
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