Future of long-term care of elderly discussed
Should we be adding years and years to the lives of older people? Do we need to keep treating certain conditions such as high cholesterol beyond a certain age at the risk of overloading the person concerned with medication? Do we need to speak to older people, particularly those in care homes, as if they are children? Do we need to make them do things they do not wish to do – such as going out when they don’t feel like it? Why should a person die still hooked up to a drip when, according to experts, at a certain stage these become useless?
These were some of the poignant questions asked during a seminar organised by the Caremalta Academy within the Caremalta Group as part of the company’s events to mark the International Day dedicated to older people celebrated on 1 October. The seminar, facilitated by PBS journalist Mario Xuereb, focused on the future of long-term care of the elderly and was attended by various stakeholders, including doctors, nurses, public officers, managers of homes for the elderly, elderly people themselves and academics.
Last year, Malta saw the launch of national minimum standards in the care of the elderly, the result of a new concept regarding standardisation after years of operating outside a formal regulatory framework. The aim of the seminar was to examine whether there was a need to look beyond adhering to standards, policies and regulations and begin really getting to know the people who need care, to see what their real needs and wishes are. By doing this, the elderly would be provided with the person-centred care they deserve.
Caremalta CEO Natalie Briffa Farrugia explained that the seminar should serve as an opportunity for all those involved in the care of the elderly sector to reflect whether current practices are elderly-friendly and respectful to the full dignity of the person concerned. She posed the question: What about involving them and seeing things from their point of view and their experience as the journey we can make together.
The keynote speaker at the seminar was Professor Pierre Mallia, who touched upon a number of ethical issues related to old age and the care of older people. He asked whether the human being is being helped to live beyond the natural lifespan with consequences such as the growing risk of treating the elderly as a number rather than as a human being.
Prof. Mallia also touched upon the issue of the dignity of the older individual, asking whether elderly people are usually treated and spoken to as if they were children. Here he mentioned how vulnerable older people are sometimes shouted at and made to do things such as having a wash when, in fact, they do not feel like doing so at that particular moment. It often happens, he reiterated, that caregivers and relatives end up taking decisions for them rather than letting them participate in the process. Prof. Mallia suggested that, ideally, the older person should take certain decisions that would affect them later in life when they are still relatively healthy.
He also said that allowing someone to die with dignity is not tantamount to killing them. At a certain point it would be more beneficial to the older person to cease giving them treatment but to ensure they receive the tender love and care that becomes so necessary at that point in life.
Prof. Mallia asked whether or not it isn’t high time to think about extending insurance cover to community care, which could encourage and facilitate the older person’s stay at home, even at a certain stage. However, he also asked if certain community services that have been in place for almost 25 years are still working. He pointed out that loneliness can be a sad reality and that, for this reason, professionals who deal with elderly people would do well to go the extra mile to spend some time talking to them, despite their busy schedules.
His speech undoubtedly raised a lot of comments when the discussion was opened to the floor. Participants spoke about the need to have trained and qualified staff providing service to older people – especially those in care homes. Other participants spoke about the importance of being more flexible when dealing with the elderly residents of care homes.
One of the participants, with years of experience working in the sector, pointed out that there should not be a one-size-fits-all attitude but person-centred care that is important in a care setting to really get to know the person and provide him or her with the service he or she needs.
Professor Pierre Mallia