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Dumping the elderly on the rise in T&T
Senior citizens are being dumped at public hospitals by relatives—some heading off on holidays, others unable to cope with the pressure and stress of being full-time caregivers. It is costing taxpayers $500 a day or $15,000 a month to maintain an elderly person warded at hospitals operated by the Government.
This is in addition to the $3,000 monthly pension allocated to these individuals, but which are being collected by unscrupulous family members while the elderly, who are dumped at the hospitals, are being maintained by the State. Health Minister Dr Fuad Khan on Thursday confirmed that the dumping of senior citizens is on the rise.
Khan said no one has been strong enough to address the problem, which he would deal with very shortly. “They (elderly) are clogging up acute space and putting a serious burden on our taxpayer.” Every year, Khan said, taxpayers spend millions of dollars on medication, accommodation, meals, linen, nursing and doctor care for the elderly, many of whom are healthy and occupy bed space, denying sick patients health care.
Out of 800 patients admitted at the St Ann’s Psychiatric Hospital, Khan revealed, 600 were social cases. The same problem of abandonment exists at the Port-of-Spain General Hospital, the Eric Williams Medical Sciences Complex (EWMSC), the San Fernando General Hospital and at the gerontology unit at the St James Medical Complex.
Living in hospitals for 30 years
Khan said some patients at St James have been living there between 20 and 30 years. “People are just living at St James. They have free room and board. People come and take their pensions and everybody happy except the taxpayers. “St James has been a dumping ground over the years for elderly people. These people have families who do not want to take care of them. They leave them in St James and disappear.”
He said the management at St James was also at fault for turning a blind eye. Khan said it was time the relatives of the elderly live up to their responsibilities.
Defrauding the Government
The minister appealed to the Ministry of the People and Social Development to stop distributing pension and disability cheques to elderly folks who are warded more than 30 days. He also urged all regional health authority doctors to desist from signing any statements which are taken to the Ministry of Social Development and National Insurance Board, indicating that elderly patients are unable to collect their pensions because of their ailing health or dementia.
“They (relatives of the elderly) are defrauding the Government and the people who are signing it are just as guilty.” When asked how many elderly patients are living at the hospitals, Khan replied, “I can say...I have lost count. I would say load and loads of them. It is disgusting.”
Attempts are being made to move the elderly to community health care services, Khan said. “A lot of people are opening up geriatric homes in the country. “They are getting money from the Government and not providing the kind of service for the money they are receiving.”
Khan said he was trying to address the situation with Ministry of Community Development since a lot of the homes come through this ministry. “When I try to deal with the situation people would say I am heartless and would bring politics into it. We need to deal with this problem head on. At the end of the day we are caught between a rock and a hard place.”
Khan said the problem could be dealt with but he needed the backing of the population, whom he claimed have been taken for a ride and their eyes dug out by irresponsible people.
Overloading the system
A source at the EWMSC revealed that out of its 248 beds, five per cent were social cases, many of which are senior citizens who have been discharged but are still hospitalised. “They are just blocking up the beds for weeks, months and even years.”
An elderly female who was discharged a day after being admitted, the source said, has been staying at the hospital for 800 days. Two others have been there 400 and 300 days respectively. “While these patients are occupying bed space their families are collecting their monthly pensions to use to maintain themselves. I am totally in disagreement with this,” the source added.
Once the patient is discharged by the doctor, the source said, family members would be contacted by social workers. “But this often proves to be a tedious task as the phone numbers of the families are either disconnected or wrong, the address fictitious or they are unwilling to co-operate. This is what causes the delay in getting them out.”
Either way, the hospital is saddled with the patients. The older the patient becomes, the greater their needs. “The family members know the hospital would never turn away old people and they exploit that.” The situation has been described as a symptomatic overloaded of the healthcare system. The average stay for a patient at the hospital is between five to six days.
Once the patient exceeds 30 days, long-term care needs to be provided. “On average it costs the hospitals $500 a day to provide health care. “That is $15,000 a month. It’s just not making economic sense to have these elderly people at the hospital when they could be placed in a geriatric home at one third the cost. The hospital and social services hands are tied. We can’t do much.”
Rouse: Public unaware
Director of the Division of Ageing Dr Jennifer Rouse said she was expected to have a meeting with the Ministry of Health soon to hold discussions about elderly people living in the hospitals. Rouse said they are being called upon because most of the needs of the elderly are social.
Rouse said one pensioner has been living at St James Medical Complex for 30 years. She said shifting them from the hospital would cause disorientation because they had created a bond with the nurses, doctors and other patients. “These people have no relatives.”
Every year, in the weeks after Carnival doctors put out a bulletin in the newspapers advising people to collect their relatives who have been abandoned at the hospital. This abandonment, Rouse said, is a form of abuse. Rouse admitted that some of the elderly have been occupying beds “so they are calling on us to see if there is room at some of the public homes. We in turn would have to call the homes to find out if there are rooms available.”
Out of the 131 homes listed in T&T, Rouse said 85 are in operation and that Government subventions are being given to nine. If there are insufficient rooms at the home, Rouse said, the elderly would be shifted to St Vincent De Paul and the Salvation Army or would have to remain at the hospitals, until better can be done. Rouse said the public was unaware of what is going on.
Residential care needed for the elderly
According to Rouse, it shows that infrastructure and long-term residential care are needed for the elderly, which numbers 156,000 in T&T. Each year, the elderly population increases by one per cent. Of this figure, more the 400 are centenarians. “You must have the infrastructure when you are decanting people. We are envisaging to put down model homes like residential care, which has to be done collaboratively with the Government and the private sector.”
Between 2014 to 2017, Rouse said, things will begin to take shape. “All now is the planning stage of where we will get the land.” Rouse said while pensioners usher themselves into homes in other parts of the world, our culture is different. “It is jarring to know, yes, you have a division you could boast is eight years. Are we reaching where we want to reach?” she questioned.
Rouse said the International Monetary Fund had envisaged that between 2012 to 2015, there will be a greying of our national budget and that at least 40 per cent of the country’s Gross Domestic Product will be spent on pensions.
Dumped for the festive season
Gerontologist Dr Kenneth Niles said he was aware the dumping of the elderly at hospitals is on the increase. “I could vouch for that. Family members would just dump or abandon them at health institutions without turning back.” The dumping, Niles said, occur before and during the festive seasons—in particular, Carnival and Christmas, as the younger generation would even travel abroad to enjoy themselves, while the elderly is left in the care of the hospital.
“You can find elderly people at the hospital who are not supposed to be there, whenever there is a major event.” Some of the elderly are brought into the hospitals and left on benches, never to be seen by their family again. Gerontology is the scientific study of the biological, psychological and sociological phenomena associated with old age and ageing, and covers a full spectrum of the ageing process focusing on the older person from the age of 60.
Ageing is a natural process of life, but it comes with some complications that are not always easy to handle, Niles said. “I have seen it, not in the North, but in the South as well.” Niles said females over the age of 85 are abandoned more than their male counterparts.
Niles said pensioners are dumped because relatives consider them a burden or are unable to cope. “The responsibility for some comes like a thief in the night and they don’t know how to manage. So the easiest thing to do is dump them.”
Describing the situation as worrying and disheartening, Niles said children and society need to be educated about pre-retirement and post-retirement to reduce the abandonment.
Niles noted that while children were overcoming the shocking reality of ageing, the process was actively continuing and the elderly continue to suffer.
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