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Abandoning the elderly

Monday, June 4, 2012

Dr Fuad Khan, Minister of Health, has acknowledged that the care of elderly people forsaken in the healthcare system was costing the Government $15,000 per month per patient. Many of these geriatric cases are not, in the truest sense of the term, patients. They have been wilfully abandoned by their families and left in the care of the state. Dr Khan did not share specific numbers, but noted that out of 800 elderly patients admitted to St Ann’s Hospital, 600 were what he described as “social cases” — people left to fend for themselves.


Some geriatric residents at the St James Gerontology Centre, technically a hospital specialising in the ailments of the aged, have lived there for the last two decades. This is a situation likely to prompt emotional responses, but the formal government response to the situation must be as cool and calculating as the impulse that leads people to leave the elderly at hospitals so that they can party at Carnival.


The fact that large numbers of elderly people have been allowed to live out their days in environments where their needs have been met by the State speaks well of at least this arm of the public healthcare system. But compassion alone will not manage this problem.


There may be legitimate instances, among the hundreds of elderly people left behind in local hospitals, of families who are genuinely unable to care for their aged, but it’s possible that the public healthcare system, with the best of intentions, may be abetting scams to cheat infirm citizens out of their pensions and property.


In the current situation, the government is issuing payments to pensioners and the disabled, but these people are already in government-funded care and the pension and disability payments are being used by their relatives. The Health Minister put a firm finger on the issue when he said that he planned to lodge an appeal with the Ministry of the People and Social Development to stop distributing pension and disability cheques to pensioners warded for more than 30 days. 


Let doctors and social workers make the exceptions after investigation of the circumstances and move with dispatch to end this double-spend on geriatric support. It’s also clear that there is a need for formalised public-sector geriatric care and residency.  Director of the Division of Ageing Dr Jennifer Rouse notes that the population is greying and the 156,000 people now listed as elderly will rise by one percent each year.


Dr Rouse anticipates a need for greater capacity in residential care. Of the 131 homes for the elderly in Trinidad and Tobago, 85 are functioning and there is a need for greater capacity to manage the needs of the growing elder population. Dr Rouse envisions government and private-sector collaboration on residence-care model homes and more growth in the elder-care sector over the next few years.


These new facilities might be purpose-built or adapted from existing structures and offer a real home for older, infirm citizens who find themselves without the support systems necessary to continue a dignified life. The window for creating these improved facilities and for establishing a viable, well-monitored geriatric-care sector in both the public and private sectors is rapidly closing as the numbers of elderly people who will need care steadily increase beyond existing capacity.


What’s clear is that the current situation is intolerable and Dr Khan’s commitment to making changes puts some commonsense behind the compassion that’s led us to this unfortunate situation.


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