Safe Living

The importance of (not) sitting

The importance of (not) sittingI read an article recently where it states that sitting for long periods is the new smoking.

Till recently, say till about 2 generations ago, people were more actively involved in manual work involving standing, walking and running. However, with more work moving to the desk, we are finding most people spending at least 9 hours a day sitting at their desk.

These prolonged periods of inactivity, according to health experts, can lead to obesity, heart diseases, muscular issues including back problems, as well as dementia. The WHO has identified lack of physical activity as one of the biggest killers on this planet.

While most of these articles and TED talks are focused on the young, this is true for the ageing population as well. Especially because many elders spend even longer hours sitting. So, if you notice that you are sitting for long periods of time, please change your life style as soon as possible. Go for short walks more often, join an elder yoga class, stand around for longer periods or join a gym. This should help keep at least some of the problems at bay.

Having said that, there is at least one time when sitting is of paramount importance. And that is when you are trying to put on your underwear and trousers. Most of us, especially the men, do this while standing. As your flexibility decreases, the chances of your foot getting caught inside and making you trip increases quite rapidly. So, always, always sit down before your wear your clothes.

Now, if you are in the habit of wearing your clothes in the bathroom, the situation is even more dangerous. Yes, I know, you have been doing it for several years, practically since you started dressing yourself. Nevertheless, times have changed and you have become older.

Get a shower bench or shower chair for your bathroom. After you wipe yourself, quickly wipe the showerchair as well and then sit on it to wear your clothes safely.

Remember, a fall can lead to a lot of complications and additional dependency on others.

Sometimes, sitting is good.

What are the criteria for finding good in-home care services?

criteria for finding good in-home care servicesWhat is home health care?

Home health care is the process of providing health care to people in their homes. This could include post-trauma care, post-operative care and elder care, and may range from supporting daily living activities to complete at-home ICU setup.  In this article we will restrict ourselves to home healthcare for elders.

The need for home health care

Of late, India has woken up to the need for home health care.

Firstly, a burgeoning population is putting a lot of pressure on hospitals to treat and discharge patients as soon as possible.  This is extending the post-hospitalization and recovery period where people who have come back home continue to require a fair amount of health care in order to fully recover.

Secondly, the elder population in India is growing steadily and small families are finding it hard to look after the elders at home without professional help.  India today is home to over 120 Million people above the age of 60 and a good 10% require some health care and support at home.

These two together are creating a new market for professional home healthcare services.

Introduction to professional home healthcare services in India

“Home healthcare services” is still a nascent industry in India.  It is also a very challenging space because the requirements and conditions in India are very different from those in developed nations. Which means that we do not have a successful model to emulate or follow.

Currently, there is no regulatory body or umbrella organization for the home healthcare sector that could regulate and set up the rules of engagement.  So, we are pretty much bordering on what can be called an unorganized, unregulated sector.

Also, most home healthcare services organizations are independent organizations not affiliated to any hospital.  This means that, more often than not, the hospital is not aware of what specific services the home healthcare agency is providing for their discharged patient and whether it is in line with what they – the hospital –  has recommended. In fact, most often, the home healthcare services are provided without any supervision or monitoring by a doctor.  This means all the due diligence in the selection process and the supervision of their work with the patient rest solely on the shoulders of family members of the patient.

This is why it is essential to learn how to select the right service partner for you.

  1. Collect the list of service providers operating in your area.  These could be individuals (freelancers), general manpower agencies, local hospitals’ outreach business arm, or dedicated home healthcare providers.
  2. Select a service partner who meets your current requirements and be prepared to switch to a different partner if the needs become more complicated (or less complicated) as the case may be.  This will give you some flexibility in managing costs.
  3. If you are selecting a freelancer or individual, there are both advantages and disadvantages. The advantages and disadvantages are
  4. (A) The cost will be low.
  5. (A) If you have the space, you can find someone who is a live-in service agent.  This will prevent sudden “no-shows” and unexpected disappearances.
  6. (D) You will have to do all the due diligence starting from the security aspect onwards.  Is this person reliable?  Where do they live?  Do we need to get them to get a police clearance?  Should I get copies of their important documents?   These are all some of the questions you will need to grapple with.
  7. You will be responsible for their personal needs in terms of food, security and shelter (in the case of a live-in).
  8. When they leave for whatever reason, either permanently or for a short/long leave of absence, finding a replacement can be challenging.
  9. If you are selecting a general manpower agency, it should be only for a companion or a nursing assistant (untrained helper).   You should not rely on a general manpower agency for professionally qualified personnel such as nurses, physiotherapists, occupational therapists or doctors.  The advantages of going to a manpower agency over an individual is that you can expect the manpower agency to do some of the due diligence (though we would strongly recommend that you do your own due diligence).  Additionally, finding a replacement for a truant caretaker may be easier.  On the down side, expect “no-shows” and everyone involved, from the agency to the actual personnel, to be “unreachable” at such times.
  10. If your local hospital provides home healthcare services also, that is ideal.  Since all the services are provided by the same organization, one can hope that they all work in unison and provide you with the right level of support whatever your needs are.
  11. Finally, there are a number of independent professional home healthcare agencies that have come up in India recently.  They are expensive, but they provide a wide range of services from house calls by doctors to 24×7 intensive care.

Bottom Line

The bottom line in all this is that the quality of service received is, at the end of the day, dependent on the quality of the individual deputed to provide that service.  As a fledgling industry, training of personnel for home health care is still not very advanced and you can expect a lot of rough edges.  Be prepared to spend time on training the deputed personnel on matters such as hygiene, empathy, kindness, caring and pleasant bedside manners.  You will also have a tough time taking them away from their phones!

All the best!

 

 

Don’t give away all to your children, doctor advises parents

A new book called the Generation Gap has been released by Dr. V S Natarajan and Ms. Hema Narasimhan to delve into various aspects of elder abuse.
Here is an excerpt from the Hindu article.

Dr. Natarajan

Make a will to protect your children but keep enough for yourself so you don’t have to depend on them in your old age. Take an active part in their day-to-day routine but never interfere in your children’s issues unless asked for. These are some of the solutions in geriatric expert Dr VS Natarajan’s new book ‘Generation Gap’ that was released on Wednesday .

The two-part English book, by Natarajan and Hema Narasimhan, delves deep into the issue of elder abuse and its various forms rampant in Indian society .

The senior geriatrician, who says he drew inspiration from his many of his patients opening up to him about their children, includes several real stories.

One of them is about a rich elderly woman in Purasaiwalkam, Natarajan’s patient for many years. She sought his advice after her only son threatened to poison her if she did not transfer properties to his name. “The reasons could be that children look at their personal happiness above the welfare of their parents .With real estate boom, children want to sell off their parents’ properties and make money . These are only my hypothesis,” he said.

Dr Natarajan, the author of 30 medical books, had penned a book with the same title in 2015, analysing the abuse of elderly at home.

Natarajan advises senior citizens to lead independent lives and be aware of laws protecting them from mistreatment, while urging at the same time children to spend quality time with their parents. “It not just food and shelter that old people need. They need love and care too,” he said.

“They have to remember that what they do to their parents will be repeated in their old age,” he added.

To read the entire article, go here.

(https://timesofindia.indiatimes.com/life-style/relationships/parenting/Dont-give-away-all-to-your-children-doctor-advises-parents/articleshow/52338625.cms? )

Choosing the right wheelchair

Choosing the right wheelchair for an elderly relative is a non-trivial activity. Wheelchairs come in many shapes and sizes, in many different materials, and designed for different uses.

Here are 15 questions for which you need to know answers in order to decide on the right wheelchair.

Is it for indoor use or outdoor use?
If it is for outdoor use, ensure that the back wheels are big. This will ensure that the wheelchair can take the ups and downs of Indian roads and platforms.

Is it foldable?
Most wheelchairs are foldable. Since wheelchairs are stored away for much of the day and through out the night (in the case of seniors), a foldable wheelchair will occupy less space when not in use.

Will it fit into my car boot?
Sometimes, you may want to take the wheelchair with you. In such cases, it is important that the wheelchair folds into a compact size so that it can be easily stowed away in the boot or back seat of the car. 

Are the armrests removable?
Removable armrests help in sliding from bed to the wheelchair and back. This can help if the user of the wheelchair is capable of moving sideways, and the bed and wheelchair are at almost the same height.

Are the footrests removable?
Removable footrests ensure that the wheelchair folds into a smaller place as well as help in making the wheelchairs less unwieldy while transporting.

How heavy is the wheelchair?
Sometimes, the person helping the user of the wheelchair may also be a senior citizen. In such cases, it is very important that the helper is able to lift and maneuver the chair. where possible, buy a lighter wheelchair.

How much weight can the wheelchair bear?
A typical wheelchair is certified for about 100 kilos. In the case that the user is much heavier, go for a bariatric range wheelchair.

What are the dimensions of the wheelchair?
In many homes, the doorways and passages can be very narrow. The bathroom doors, in particular, are usually only 2 – 2.5 feet wide in many Indian homes. Before purchasing the wheelchair, ensure that the wheelchair is able to go to all the places you plan to take it to.

Self-propelled or attendant chair?
A self-propelled manual wheelchair will have large wheels while an attendant wheelchair may have smaller wheels and brakes for the attendant to use. Choose depending on usage. If the person using the wheelchair does not have enough strength to propel themselves, go for a wheelchair designed for attendant use.

Is it for transit purposes?
If you are planning to use the wheelchair only during travel (at airports and railway stations, etc), then go for one of the very light-weight, compact aluminium transit wheelchair models.

Is reclining an option?
Some wheelchairs allow for reclining. These usually are larger and take up much more space. If a person is going to be sitting in a wheelchair for long periods, the reclining option may be useful.

Will it rust?
Wheelchairs come in different materials from mild steel to high-grade aluminium and other alloys. If you are planning to take the wheelchair into bathrooms and toilets or expect it to come in contact with the elements, go for an aluminium one. Chrome plated wheelchairs tend to rust after a while. 

Motorized or manual?
Unless you are living in a high-end gated community with smooth roads and pavements, there is usually very little value in going for a motorized wheelchair in India as most places are not conducive for motorized wheelchair use. Needless to say, Indian roads are not safe for motorized wheelchairs.

Is a commode attached?
A few models of wheelchairs come with commodes attached, so they act as portable commodes as well as wheelchairs. Under most circumstances, it is preferable to keep the wheelchair and the commode separate for various reasons. However, if you need them together, know that such models are available.

What is the cost?
Wheelchairs, like most other things, come in different price brackets. Choose one that fits your budget.

If you have more doubts, write to us at [email protected]

Accessibility issues for elders

It is indeed surprising, that despite being a culture that supposedly reveres the elderly, we don’t give the needs of the aged and the disabled in India any thought at all.

To truly appreciate how insensitive we are to the needs of the elderly (and the disabled), do this mental exercise.  Imagine yourself to be wheelchair bound.  Actually, let us not go that far yet. Just imagine you are an old person with slightly diminished reflexes and minor balance issues that necessitate you to carry a walking stick for balance. With that firmly in mind, now take a look at the world around you.

Accessibility issues for eldersOne of the few roads in Chennai with a footpath.  Notice how there is construction debris all over the pavement and the two ladies are being forced to walk on the road, risking the prospect of being run over.

We have all experienced the serious challenges involved in walking on Indian roads. Now imagine you are that old person.  Now think of walking on roads which lack pavements and have heavy and unregulated traffic driven by reckless and insensitive drivers. While you are looking both ways and dodging traffic, don’t forget to bend down and avoid all the wires and cables, thoughtlessly strung from poles, trees and buildings. Finally, remember to jump over the pits and trenches left open by various civic bodies.  All this when you are weak and feeble!

The dangers of walking around on Indian streets today prevent countless elders and disabled from leaving the relative safety of their homes.  Many of them forego their usual walks, their trips to places of worship, or even to banks and post offices to collect their pensions because of their fear of being run over or getting seriously injured.

Now take a look at the public transport available in your city.

Accessibility issues for eldersThe picture on the right shows the true story.  Look at how everyone is running to get into the bus.  Notice the slower ones struggling to reach the bus. Imagine now that you are an old person incapable of running!

Buses come swerving in at breakneck speed and stop somewhere in the vicinity of the bus stop, wait but for a few seconds and speed away before everyone has safely boarded.  With steep steps that only the young can jump onto, riding buses in India is meant only for the young and agile.

Trains are no better. Suburban trains, especially, are a challenge even for the young and nimble unless they are used to them.  If you go to Mumbai for example, unless you are a regular traveller, there is very little chance of making it on to any of the suburban trains during peak hours.  And if you do manage to get on, you may not be able to get off till the train reaches its last station! Long distance trains, though not as crowded, present us with other challenges.  Their steps are practically upright ladders that have to be negotiated to get into them.  If one is wheelchair bound, it is impossible to get on to the train at all, leave alone reach one’s seat, given how narrow the doors and passages are.

Accessibility issues for eldersThis picture with the bent over old lady is a picture of the foot over bridge at the Chennai Central Railway station.  The picture says it all.

Next let us look at the insides public places and buildings.  Many banks, post offices and insurance buildings are in old buildings with no elevators.  Most of their offices are on the first or second floor with only stair access.  Even those that are on the ground floor require navigation of a few steps before the counters can be reached. Barring a few malls and upmarket cinemas, most places have either no toilet facilities (for the visiting patrons) or have extremely dirty ones that no one in their right mind will want to step into.  The lack of a token system  and the consequent need of having to stand in a long queues for several minutes to hours compound the problems faced by the elderly in public offices and buildings.

These are just some of the problems faced by our elders in India.  If you spot more such problems please write to [email protected]

24-hour helpline for elders to be launched

helpline for elders The city may soon get a 24-hour helpline for senior citizens in an initiative taken up by Young Men’s Christian Association (YMCA), in association with Sneha Sandhya and HelpAge India.

The helpline at the YMCA, a first-of-its-kind initiative in the city, will provide medical assistance and emotional support for senior citizens. “We have discussed the issues raised by senior citizens with the YMCA management, who have shown their eagerness to come up with the much-needed helpline. The facility will be launched by the end of the month,” Ch. Venkat Rao, secretary of Sneha Sandhya, told The Hindu .

Sneha Sandhya, which has a membership base of over 500 senior citizens, is also planning to establish a day-care centre for the elderly. “We have approached government officials to look for a suitable land to build the facility. With growing issues concerning senior citizens, geriatric support systems are the need of the hour,” Mr. Rao said.
At present, Sneha Sandhya has a centre at Prema Samajam, where it offers yoga training and free medical check-up.

The HUG bridge

At a time when there is a severe disconnect between the youth and senior citizens, HelpAge India, Sneha Sandhya, AU-NCSA Centre for Gerontology, and AU Department of Social Work have joined hands to come up with a novel programme called HUG or ‘Help Unite Generations’.
As part of this, a sensitisation programme will be held at AU Platinum Jubilee Guest House on July 25 involving the youth and senior citizens.

“The programme will facilitate an interactive platform between youth and senior citizens, where the elderly can explain their expectations from the younger generations and the problems they are facing. Similarly, the youth can come up with views and suggestions to address those,” Mr Rao said.

According to a recent HelpAge India survey for ‘Elder Abuse: The Indian Youth Speaks Out’, of the 2,000 youths, including women, surveyed, 73 per cent accepted that elder abuse existed in society. However, only 4.6 per cent of them intended to report such cases to the police. Even lesser, 1.1 per cent, wanted to approach an NGO and 15.6 per cent wanted to intervene and speak to the elder about fighting abuse.

Read the full article here.

https://www.thehindu.com/news/cities/Visakhapatnam/help-at-hand-for-the-elderly/article7459558.ece  )