Chas­ing dead­lines and hap­pi­ness, we for­get our lonely el­derly

The Guardian Australia - - Opinion - Ran­jana Sri­vas­tava

An op­pres­sive win­ter has fi­nally given way to the hap­pi­ness of spring. Pretty flow­ers are in bloom and the bare trees prom­ise to be in leaf again. As I walk into the week­end round, I feel happy for my pa­tients who might be dis­charged, or sim­ply set foot out­doors.

“You can go home!”, I con­grat­u­late my first pa­tient.

“Don’t rush, love”, he replies, and I think af­ter two weeks as an in­pa­tient, he is jok­ing. Who likes hos­pi­tals?

Then I re­mem­ber. He is the wid­ower with the al­ways busy daugh­ter. He talks about her loy­ally, but also with a fi­nal­ity. “She is not the type to drop by.”

What will I write in the notes? Lone­li­ness as a cause of failed dis­charge? Disen­gaged fam­ily? He makes up my mind by de­vel­op­ing a panic at­tack. I pre­scribe an anx­i­olytic. The daugh­ter has al­ready made it clear that he is not her “busi­ness”.

It’s lunchtime. Food trays lie un­touched and drinks un­opened. We lift a lid here, open a juice there while nurses scurry from one pa­tient to another, feed­ing, clean­ing, sooth­ing. No one men­tions it but the ele­phant in the room is the nearly com­plete ab­sence of fam­ily mem­bers or vis­i­tors in spite of a week­end. Not to do the heavy work but to sim­ply sit, talk, and of­fer the great­est medicine of all, dis­trac­tion. But on this beau­ti­ful af­ter­noon, the pa­tients stare va­cantly and the cor­ri­dors are empty. We see this, but ill-equipped to help, we keep mov­ing – chart­ing an­tibi­otics, ad­just­ing flu­ids, of­fer­ing se­da­tion, un­til our hands cramp and our heads hurt at the mo­tion of treat­ing with­out truly help­ing.

We are stand­ing at the bed­side of our 94-year-old pa­tient with “all over pain”. I want to tell him that like ev­ery­one his age, he is rid­dled with arthri­tis and it’s noth­ing more se­ri­ous but his eyes have grown moist and I am bat­tling my own de­spon­dency at the fact that the long­est-stay­ing pa­tient is the least vis­ited by fam­ily. His nurse comes to the res­cue.

“What’s the mat­ter?”, she smiles. “Ev­ery­thing hurts, doesn’t it?” His arthritic fin­gers are bent and twisted, his vul­ner­a­bil­ity ev­i­dent.

“But guess what, even if no one comes, I will feed you.”

At this he bursts into tears. We stand frozen, and mor­ti­fied. To think that this hap­pens at ev­ery meal­time and that for all the dol­lars spent on largely fu­tile care, all he craves is a dose of hu­man­ity.

But the great­est shock of the day is yet to come. A wi­dow clings to my hand and sobs, “Just give me a pill to die.”

“You have gas­tro. Gas­tro is treat­able!” I ex­claim.

“I feel aw­ful.”

“Where is your son?”, I ask, long­ing for a fam­ily mem­ber who can sit with her and put her mis­ery into per­spec­tive.

“Busy.”

I sit down at the desk, re­flect­ing on an en­tire week­end of tak­ing his­to­ries, pos­tu­lat­ing di­ag­noses and pre­scrib­ing drugs when all the while, the great­est en­emy has been the lone­li­ness of pa­tients, who feel ig­nored, ne­glected, or out­right aban­doned by their fam­ily. I count that dur­ing the en­tire week­end, we met only a hand­ful of adult rel­a­tives and not a sin­gle child.

Few things con­sole the el­derly and give them more pur­pose than know­ing that they mat­ter to some­one. It’s mov­ing to see how pain dis­si­pates and anx­i­ety fades in the pres­ence of loved ones. But when you look down the va­cant cor­ri­dors of the hospi­tal or tally vain at­tempts to en­gage fam­ily, you reach the un­avoid­able con­clu­sion that as a so­ci­ety, we have stopped valu­ing our el­derly. In the pur­suit of hap­pi­ness, get­ting the kids to soc­cer, meet­ing a dead­line, and find­ing time to keep house, we have let slide our obli­ga­tions to the el­derly, and worse, rel­e­gated them to be­ing a bur­den. Aw­ful as it sounds, we deny our el­derly in­trin­sic worth.

Since hos­pi­tals are wit­ness to re­mark­able sto­ries of sac­ri­fice, we reg­u­larly meet ex­hausted, dis­ad­van­taged and dis­abled rel­a­tives who strug­gle to care for an age­ing rel­a­tive. Such car­ers are sel­dom recog­nised and de­serve our ad­mi­ra­tion and as­sis­tance. But in­creas­ingly com­mon is the story of those who ask not how they can help but how the hospi­tal can fix the prob­lem of their age­ing, chron­i­cally ill, de­pen­dant el­derly rel­a­tive. Yes, we could have more nurses, bet­ter nurs­ing homes, and ac­ces­si­ble aged care ser­vices but you just have to talk to a pa­tient to re­alise that none of it is a sub­sti­tute for the in­vest­ment of fam­ily. Fancy in­ter­ven­tions and newer drugs will never be a proxy for the at­ten­tive kind­ness which is the strong­est medicine of all.

My two decades spent on ward rounds have been a sober­ing les­son in the ero­sion of our con­sid­er­a­tion and re­spect for the el­derly. The age­ing pop­u­la­tion is not an in­vis­i­ble en­tity – it is our el­derly rel­a­tives who de­serve a pres­ence in our lives. They should be val­ued in their ad­vanc­ing years as we val­ued them when they were young, pro­duc­tive, and had a voice.

In our in­creas­ingly busy and ac­quis­i­tive lives we will all grap­ple with how best to hon­our, re­spect and care for our el­derly rel­a­tives. Many of these rel­a­tives will be­come pa­tients but of one thing I am sure – the an­swer to a so­ci­etal ill will not come from medicine. Medicine will do what it does best, treat dis­ease, of­ten around the edges. What it can­not do is in­stil pa­tients with a sense of be­long­ing and in­trin­sic worth. Treat­ing pneu­mo­nia or mend­ing a frac­tured hip is not the same as restor­ing dig­nity and mean­ing to a life. This is a dis­tinc­tion for us all to con­sider – for how we treat our elders today is how we might ex­pect to be treated by our chil­dren to­mor­row.

‘My two decades spent on ward rounds have been a sober­ing les­son in the ero­sion of our con­sid­er­a­tion and re­spect for the el­derly’ Pho­to­graph: Alamy Stock Photo

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