Elderly care II
“To me, old age is always 15 years older than I am.”
— Bernard Baruch (1870-1965), US Financier, quoted in The Observer (London, Aug 19, 1955) on his 85th birthday
We have talked about depression and dementia in the elderly. These are two of five common problems cited by The Caregiver’s Essential Handbook. The other three problematic issues for the aging are vision loss, hearing loss, and incontinence. Perhaps one of the most difficult changes is emotional and it involves the acceptance of help from others. This is almost impossible for strong, successful, fiercely independent adults who perhaps in the past occupied high positions at work. Some have been strict, domineering parents. This transition – of giving up autonomy – is much easier if the individual is surrounded by a loving family.
Vision Loss. According to the manual, the symptoms of worsening vision are:
• Excessive tearing or watery eyes.
• Difficulty focusing on near or distant objects.
• Double vision.
• Squinting or blinking because of light sensitivity.
• Swollen or irritated eyelids.
• Loss of peripheral vision.
• Recurrent pain in or around eyes.
• Trouble adjusting vision in dark rooms.
• Cloudy vision or appearance of spots or “floaters.”
• Dry eyes with itching or burning.
What should be done when these symptoms are found? It is possible that our loved one will complain of the vision problems. Sometimes we notice it ourselves when they start to bump into furniture or, worse, slip and fall. Lolo or Lola should be seen by the eye doctor or the ophthalmologist.
Hearing Loss. The warning symptoms of hearing loss are the following:
• Ringing in the ears.
•Unusually loud TV or music.
•Asking people to repeat what they just said.
• Anger at being asked.
• Appearing to ignore questions.
• Not wanting to answer the telephone.
•Withdrawing from conversation.
Of course, there could be other reasons for such behavior. These may be screened out. The idea is to be observant and find out if the root cause is poor hearing. Bring the aging relative to the ENT specialist or the otorhinolaryngologist.
As for incontinence, this is even more difficult to discuss (or admit). Please remember that it is not part of normal aging. But it is common. You can point out that supermarkets carry adult diapers, an indication that it is a widespread problem. Leaking urine or passing fecal matter without control can be physical problems from weak muscles or infection. But they can also be caused by stress. Sometimes Lolo or Lola delays or limits going to the toilet because of the fear of falling. A urologist or a colorectal specialist should be sought out.
So caring begins by learning to become sensitive to changes in our aging loved one. Most of the time, they themselves are not aware that vision and hearing have begun failing. Incontinence is somewhat easier to see (or smell). Caregiving is, I suppose, a natural Filipino attitude. We like to take care of our own. I once asked an American doctor tactlessly (I admit now) why is it that they leave their parents in nursing or retirement homes. His more than gracious reply was: “Why I wouldn’t impose on my own children!” This makes sense, of course, in a culture where you’re out of the house at 18. It doesn’t here, where parents nurture as long as financially possible. And now, more than ever, we need to care for our frail elders as the COVID-19 pandemic rages. As I write this, the global number of cases has reached 7,000,000 and with a staggering number of 400,000 deaths. In the Philippines, we have breached 20,000 cases and almost 1,000 people have died. The mortality rate increases with age (usually above 60).
We must nurture the old and weak in this infectious, chaotic time.