Let’s keep the elderly healthy

At 27, Trinidadian McDonald Bailey was a household name. Between 1946 and 1953, his athletic prowess earned him 16 British sprint titles. In Belgrade on August 26, 1951 his 10.2-second run equalled Jesse Owens’s world 100-metre record and he remained joint holder for five years. He reached the 100-metres final in the 1948 London Olympics and won the bronze medal in Helsinki four years later.

Bailey, also a member of Britain’s Royal Air Force (RAF), returned to Trinidad in 1963. Now, at 92, Bailey’s lanky structure is stooped. He is totally blind and experiences periodic bouts of dementia. Bailey’s wife  Doris, 85, who lives in a home for the aged in England, suffers from Alzheimer’s disease.

He has to be coaxed to take short walks. Once known for his relentless training on the track, Bailey now prefers to lie in bed at a home for the aged in St James, where he has been living for the past five years. The decision to put Bailey in a home was difficult, his daughter Christine Tanker said.

“We cared for him as best as we could while he was at home, but he needed additional care,” she said. Tanker, who has been an occupational therapist for 36 years, said while there may be more people living longer, they may not necessarily be healthy. She said her father’s sight began to fail  some 20 years ago.

“He has glaucoma. It is in the family. His mother was actually blind. My father used eye drops but did not follow through with it. There are several other cases where people have to take various medication and they do not follow through it for one reason or the other...either they don’t like it or there are side effects,” Tanker said.

She said despite several operations, her father’s sight could not be restored, as the optic nerve was damaged. “His mental capacity has really gone down in the last year and a half,” Tanker said. “There are some days when he’s quite bright and alert and other days he’s not...he mixes things up, he can’t remember he’s just had lunch. Short-term memory is what goes first.”

Bailey was fortunate not to have encountered major health issues such as diabetes as he aged. Tanker said her father’s muscles  have weakened, though. “Although he has been blind all this time, his health has been pretty good until five, six years ago. “It’s a challenge for him to get around, but he’s not walking around or exercising as he should, so he would get weaker.

“I insist my father does weights, and he keeps walking even if it’s just out to the living area. At this stage, all he wants to do is just to lie down,” Tanker said. After Bailey stopped running, he tried rugby but soon gave it up. He did no exercise after that. “After running, my father never walked or jogged or anything like that.”

Increase in older population
On April 7, 2012 World Health Day was dedicated to healthy ageing. Bailey is one of about 260,000 older people living in the country. Out of that figure, ten per cent said their health was very good, 27 per cent had good health and almost 30 per cent were in reasonably good health, said Dr Joan Rawlins, senior lecturer and health sociologist of the Public Health and Primary Care unit of the Department of Paraclinical Sciences at the Faculty of Medical Sciences of the University of the West Indies.

“The others had conditions that would have bothered them. Even some of those that were well had something like high blood pressure or diabetes,” Rawlins added. There are three categories of older people. Those between 60 and 74 are called the “young old,” those ranging between 75 and 84 are termed “old,” and from 85 onwards are the “very old.”

The “young old,” Rawlins explained, are  “truly economically independent” and have  more options for living arrangements and interaction with family. Examining the Caribbean’s population of older people, Rawlins said at the start of the 21st century, the group 60 years and older was larger than ever before.

“What is most important, in terms of population ageing, is just the larger number of people we have. We have a significantly larger number of older people than we would have had 100 years ago,”  she added. An increase in the older population was caused by:
• significant decline in mortality, leading to an increase in population;
• fertility-rate decline, resulting in a decrease in the younger population and an increased population of older age groups; and
• increased life expectancy

An increase in the older population,  Rawlins said, was a measure of a country’s development. “The more developed a society, the larger the percentage of older people. “When the economic situation improves in a country, once children live on past their first year, the probability is that they would keep on living.” The ones who live on, she added,  would recognise that factors like poor lifestyles and eating habits resulted in early death.
 

Policies, minds have to change
Society, Rawlins said, was now beginning to come to grips with the increased  number of older people. Calling for adjustments in policies and programmes to cater to their needs, Rawlins urged: “People like family and community members also have to adjust their mind, because we have to cater to the needs of older persons.” She said “age-friendly” hospitals  and health centres were also needed.

The latest figures from the Division of Ageing of the Ministry of Social Development showed there 130 homes for the elderly in T&T. The average cost per month ranged from $5,000 to $10,000. What was needed, Rawlins said, were more day centres which catered to the specific needs of older people who could not care for themselves.

“I am not talking about senior citizens’ centres where the well elderly can go and play cards,” she said. “I am talking about literal care centres, where older persons who are not so well, but not sick enough to be in a hospital or old people’s home, can be in the day.”

These centres would have a positive chain reaction, because it would enable relatives to maintain their jobs and continue to contribute economically. “Some of the family members who care for older people are over 60 themselves, so we have older people caring for older people, and those people who are doing the caring sometimes may not get a chance to have a Pap smear, a mammogram, go to the dentist or take care of themselves,” Rawlins said.

She said the concerns of older people may vary depending  on their level of integration into society, their relationship with children and family and their socio-economic status: “High on the list of concerns for older people  include questions about family interaction, living arrangements, homelessness, pension, poverty and savings.

“Other important concerns would relate to health issues, such as ill health, health care cost, long-term hospitalisation and the need for reliable and efficient caregivers.” The issue of  adequately trained people to address the specific  needs of older people still remained problematic. “Registered nurses would have had training in geriatric care.

“But the people I am really concerned about are  those who work in the old people’s homes...not all of them are going to be well trained, or even trained. This is just a job they are doing to get some money. They don’t understand that older persons have special needs. Some take older people for granted and treat them badly.”

Invaluable contribution
Older people contribute  to the family by sharing their homes and to the community by caring for children. “They give care to orphans, including children whose parents have passed away because of the HIV/Aids epidemic,” Rawlins said. She said a recent study she did showed 69 per cent of older people owned homes: “Some of them, if their children have businesses, they help out in the running of the business.”