Better homes for elderly needed

YOU know you are getting older when hypertension and high cholesterol are what old friends tend to talk about at festive reunions. We wonder if we’ll break the average lifespan mark of 72 for Malaysian men, 76 for women.

Some athletic classmates, fit and fast in high school, however, have died in recent years from heart attacks. They had not even touched 60. That reminds us, the awkward nerds then, of the time we have left to enjoy with our loved ones.

After the usual “remember when” moments, we wax nostalgic. We ponder over about “what ifs” and “how old are your kids” – after guesstimating who has chosen not to, or could not have, kids. Then, we slide into pseudo group therapy. We talk about retirement, change in lifestyle, body aches, empty nests and how we cope with the sense of abandonment when children leave the comfort of home for distant cities – and different time zones – to start a blooming career and soon, a family.

“Raise them right, teach them well, let them go,” a friend quips, likening the stages of parenting to a rocket launch.

First stage: the liftoff. Or rather, the “thrust” at the moment of birth. Then, for about 18 years or more, the child relies on the parents’ guidance as it journeys forth to explore unknown territory. When our guidance has run its course, we recede. The child enters the second stage: leaving home.

The child, now 21, equipped with the values and moral compass acquired from the parents, powers up into newer experiences and realities. Parents continue to monitor the child’s orbit from the mothership, waiting for distress calls, communicating instructions only when needed.

Final stage: the child, now a mature adult, completes the orbit and catapults towards another yet unknown destination. Mission completed, the child, now past middle age, returns home. Usually, near retirement. Touch down. Life has turned full circle. The child becomes the parent, and the parent now become more like a child.

My friends and I have come full circle. We are the “sandwich generation” — still connected to our children while tending to ageing parents who need full-time care. As is the case with my 85-year-old mother, with all her six children living overseas. She now wilts away in an aged care home (often misleadingly called “nursing homes” by the operators) in Penang. Taking turns to visit, we despair at abandoning her. Our mother is now our child in need of full-time care.

We continue to look for other homes where the amenities are more geriatric-friendly and more caring. For now, she is living in a clean and bright airy beachfront home, with open visiting hours, sharing a living room-turned-dormitory with five chair-bound ladies around her age.

In my travels, I have seen geriatric-friendly homes and public amenities in Singapore, Japan, South Korea, even in Prague, where “senior citizens” are empowered to live their remaining years in “retirement villages” with dignity and a sense of relevance.

There is easy access to affordable public transport for the elderly and buses that “kneel” for those with walking frames. There are organised excursions for the old and infirm, opportunities for the more mobile ones to do voluntary work, light exercises and psychomotor activities, board games, piped-in music and reading material.

Loneliness and a sense of being abandoned by their children can cause chronic depression in many elderly folk. My mother is one of them. Hence, they are left to live in the past in their own silent world, oblivious to visitors and the cacophonic soap operas screaming from the TVs, which are turned on the moment they wake up at six or seven to when they go to bed, usually at about eight.

In providing quality care, nursing homes in Malaysia are evidently decades behind Singapore or Japan where geriatric-friendly facilities are regulated by the health and welfare departments. Aged care homes in Malaysia operate outside the Private Healthcare Facilities and Services Act 1998, which requires nursing homes and aged care to be registered.

Some operators I spoke to say they managed to escape the Act by claiming they do not provide health, medical or hospice care, but only food, board and “maintenance”, or assisted living. That exposes the elderly to exploitation and abuse by profiteering aged care providers, who employ underpaid and untrained helpers, usually foreign maids, instead of qualified nursing aides. The residents of these homes are fed, cleaned and objectified – kept alive — as a source of steady income for the operators. Monthly fees range from RM900 to RM1,300 in Penang.

From what I have seen in moving my mother to different aged care homes over the last seven years, the industry is evidently unconscionable. The authorities do not inspect these homes for minimum standards of care, cleanliness and human habitation. One home has five beds cramped into a room meant for three. Patients sleep on single beds in a room with no windows, ventilated by creaking fans, and dimly lit by fluorescent lights.

Gates are usually padlocked, grounds are overgrown with weeds and kitchens smell of food scraps. Garbage bins are soiled and uncovered, the beds are unmade, and white ceramic wash basins stained brown by leaky taps. The premises reek of incontinence problems.

The elderly are mentally and physically disengaged from their environment. These homes feel, smell and look more like a last refuge for the dying than caring homes for the old. Operators of these homes should be hauled up and thrown in jail.

As more ageing parents move from traditional family care to institutional care, the authorities must enact laws that require all aged care homes to be registered with the welfare and health departments and to be licensed and accredited with an independent governing body to ensure the care and facilities they provide meet the minimum standards. Without such regulations, we will see the old and infirm who need full-time care continue to be abused and commodified as a living source of income by unconscionable operators. – Comment by ERIC LOO

Eric Loo teaches journalism at the University of Wollongong in New South Wales, Australia. He worked as a journalist and taught journalism in Malaysia from the late 1970s to 1986.

Source: The Edge

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