Helping the Doctors Help you

It is vital to remember that a good elicitation of the patient’s history, in his own words coupled with few leading questions from the doctor can help the latter to arrive into ‘provisional diagnosis’.

Helping the Doctors Help you

Swarna Mamee cannot withhold her tears when she saw the two nighties she got from her son. Torn and faded nighties were once used by her daughter-in-law, when she was pregnant.

Aged 84, Swarna Mamee lost her husband way back in 2004 and till few months back she used to shuttle between her sons.

Few months in Mumbai with her elder son and then at Bangalore with the youngest. Sickened by the frequent change of residence and the unwelcome attitude of both families made her to think of an alternate.

Swarna Mamee decided to move into a care home when she felt that life is not that easy in her son’s house. Torn and faded nighties portrays the attitude of a growing number of few children who is uncaring.

What responsibility do adults have for their aging parents? Majority says the answer’s simple: that adult children owe the same obligation to their elders as their parents demonstrated to them when they were children.

But for those with complicated family dynamics, or even worrying financials, things are not hunky-dory for many families when it comes to caring an aged parent. Everything else, mostly attitude matters.

In India, says Dr. Rameela Shekar, Dean at School of Social work, Roshni Nilaya, Mangalore, it is our age-old custom that children are obliged to display concern and render assistance to aged parents. Just concluded study by Dr. Rameela and her team at School of Social work points to a grave concern about the poor attitude of our youngsters because only a tiny percentage of the young people concerned with the welfare of the elderly population.

She cannot hide her dismay because only 8% of the sample belonged to any group concerned with the welfare of the aged. Predominantly negative images of elderly people prevailed among more than half of the young people. These negative images will not easily be dissipated without the provision of more avenues of communication between young and old. explained Dr. Rameela.

In the past, when few people lived into their seventies or eighties and then died, the level of help and care a parent required on an existential level was relatively small. Those elderly could largely care for themselves or the joint family system pitch in, and the cost was never a concern. Moreover, the elderly of a generation ago -who were, by and large- younger at time of death, often were able to live at home mostly a joined family.

Children could take care of infirm adults because they are under the same roof, and that eighty year-old would otherwise care for him or herself. Today, with so many more joining the ranks of the oldest old, living late into their 90s and even 100s, parents without the advocacy and intervention of children may truly be at the mercy of strangers or -worse- the charity.

The Indian government introduced a bill almost 10 years ago that would make it a legal obligation for children, heirs, or relatives to provide financial assistance to senior citizens. China implemented a law (2013) requiring adult children to be emotionally supportive of their parents, including in the form of visits.

Today every country think so, and as the population of elderly in nearly every society starts to swell, such eldercare laws are becoming more common. Such a law would take India’s traditionally strong sense of filial obligation into the stricter territory of legal statute.

But are they effective? In America, twenty-eight states currently have laws making adult children responsible for their parents if their parents can’t afford to take care of themselves. Often called filial responsibility laws, obligate adult children to provide necessities like food, clothing, housing, and medical attention for their indigent parents.

“Here in New York, children have no legal obligation at all with respect to the care of their parents, or any obligation with respect to their expenses,”

said Ms. Carolyn Gallogly, a specialist in social gerontology at Long Island. Asked if she believes there should be some sort of law enforcing such care, she said, “My own opinion is no. Adult children have obligations to their own children. As a social gerontologist, I believe it’s not something that should be legislated. Legislation will be only in paper.

Care and love cannot be enforced”

But, she added,

“Morally speaking and from my practice who deals with children of elderly parents all the time, I do believe that children have a moral obligation to do what they can to make sure their parents are as well cared for as they possibly can.”

The obligation of a ‘good’ son or daughter to show affection and care for an aged parent seems mostly straightforward and a pretty simple case of reciprocation. We as social gerontologist, often see cracks developing in the families soon the aged parent need long term support. Not surprisingly, siblings can hold fiercely different positions about what they “should” do.

Some make huge sacrifices of time and money to comfort and care for dad or mom; others rarely show their faces even when parents pine for them. Whereas some families are closely-knit, loving and supportive of one another, others are dysfunctional and merely share the same surname and little else.

If not all, in most societies of this world, the moral obligations for the assistance of older people unable to sustain themselves or to receive sustenance from an equivalent source lies with the younger generations in their families, precisely with their adult children.

This responsibility has been encapsulated in norms of ‘filial obligation’, enshrined in societies’ moral or religious codes − be they Hindu, Christian or Muslim or otherwise. Anyhow, at different times and in different ways, societies have experienced obvious shifts, especially declines.

These declines have exposed the aged to increasing poverty and deprivation; moreover they are emotionally tormented by abandonment and shame. Cold remarks, scolding, abuses and lack of love, care and financial support were found to be the main problems facing old-timers. Advanced years are difficult, more so in a country where there is no sizeable state-sponsored arrangements and amenities for its aging population.

In short, children are the only comfort and strength in twilight years and they fails, destitution looms large.

Let’s listen to Kamala Chauhan who is distraught because she thinks her only daughter has abandoned her. “You become a burden on your kids when you grow old,” Kamala laments, revealing a universal truth.

Kamala vividly remembers the proud moment when she married off her only daughter 35 years ago, because after her husband’s death it was a lone battle. But now, in her twilight years, Ms. Kamala’s pride is sobered by her perceived feelings of rejection from her own child. Two years ago, at the age of 75 and after suffering a mild stroke, Kamala was ‘admitted’ by her daughter in a care home with a promise that she will stay there only a couple of months till her recovery.

For the first two months, her daughter visited her regularly but then the visits stopped. With the money she earned as a teacher, Kamala bought the house that her daughter and family now live in but she never had any inkling that one day she will be chased out from her own house. Daughter has an array of ‘valid’ reasons from dodging the responsibility. Stroke and rehabilitation came as handy to abandon her in a care home.

“I want my daughter’s love and affection, not her money.”

She ends her story.

A child cannot shy away from such a moral obligation invoking umpteen reasons. Most of the reasons are frivolous, just an excuse to get away from the moral responsibility. Few of the adult children say space constraints, children’s education, daughter’s marriage, incompatibility with their wife or husband, financial difficulties, long distance, time constraints and the list is infinite. Many of the aged parents expect little, just sensitivity is enough.

Regardless of attitudes about the children’s role, a majority of adults from all age groups believe that adult children have an obligation to support their aging parents. Nevertheless, Indications are that families have - or will, become less able or ready to provide such care to their aged kin, and it is better the seniors accept this reality.

Living longer brings many difficulties to senior citizens in a society that is not well-prepared for ageing. It is better not to blame the children for the so-called distress in old age knowing the limitations of the children. In the coming years, seniors have only one option and it is to move forward with definitive plans for old age with lesser expectations and dependency on children. To avoid poverty, social exclusion, marginalization and to overcome the lack of family support, one must plan much early in life.

In some quarters of our society, elders are fast losing their place in the family as respected members. As the rapidly urbanizing India sees its social landscape shift away from traditional family bonds, the country’s once-revered elders are becoming increasingly vulnerable.

The newer trending allows the adult children to move out of their parents’ homes to live independently or sometimes go overseas for better employment opportunities, leaving the aged at home.

Changing family values, changing social dynamics, population ageing, insensitive children, family dysfunction, financial dependability and many more can vitiate a normal peaceful old age.

How many of our children understand the ‘payback’ concept when it comes to filial obligations? Can we dodge the moral responsibility toward our ageing parents?


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