Cast me not off in time of old age: Forsake me not when my strength faileth. Psalm 71:9
THE PHYSIOLOGICAL reasons for ageing and the complex medical explanation for this process is not necessarily known by the non-medical citizenry, but what is known are the external manifestations heralding the arrival of the beginnings of this phase of senescence (old age).
It is unfortunate that old age is often associated with ill health, but due to physiological and other factors, there is a general basis for this.
It is good to note though, that a healthy lifestyle, inclusive of a high degree of exercise, adequate rest, healthy thoughts and a wise nutritional programme can offset and delay the negatives associated with ageing.
Being a child born to a father in his 40's and growing up with a stepmom who was also in the late 40's at the time of my birth placed me in a very special position -- having to contend with the ageing of my parents and the attendant challenges.
It really was a great strain when viewed in retrospect, having to deal with two parents who were in and out of hospital for one reason or another, since I was nine years old. This pattern continued until their deaths in 1984 and 1989.
However, when you love, you give of yourself and try to make the ones you love happy, putting their needs to the fore.
There are many youngsters in Jamaica today, who are bravely carrying out such a noble task without anyone truly understanding the pressures they face.
The absence of easily accessible support services and a society not yet geared to properly cater to the special needs of the elderly and the disabled, made my loving tour of duty a traumatic one. What kinds of programmes or services are needed in a community to give the ageing the best chance to live useful and rewarding lives?
It is true that no definitive list can be drawn up. Local programmes will have to vary as widely as do local needs.
Outlined below are some areas for exploration and action, which are designed to prompt a response from each reader. For each area outlined ask yourself the question: "Is this service or need accessible to all Jamaicans, be they in the low, middle or upper income groupings?"
If the answer is "No", you must do something to improve it or help to put it in place. If it is, "I don't know", make it your duty to find out. When the chickens have all come home to roost it will impact on you...as long as you live to reach old age.
A reviewer of the varied needs of the elderly in a simple village society in a developing country very ably summarised them as: "There is a need for local interest in the aged who suffer loneliness and inability to perform small tasks; a need for firewood and water delivery to the homes of some aged; a need for a clinic or central place an aged person could go for help; a check to see that the old have enough to eat; financial help for elderly fathers of school age children.
What of us here in Jamaica?
Physical health
How is the community equipped with regard to effective medical and dental services, including physiotherapy, chiropody and rehabilitation?
Does the community have adequate clinics, hospitals, nursing and convalescent homes, or special geriatric services?
Does the community provide home health or home nursing services?
Are there adequate arrangements for the care of the physically challenged elderly?
Are the above-mentioned services well equipped to deal with the ageing? Are they accessible to all income groups?
Do older people know what medical services are available?
Mental health
Are counselling or social casework services available to the elderly and to families experiencing difficult caring for older relatives?
Are there crisis centres, suicide prevention services or similar agencies to which a person can turn in emergency situations?
What facilities are available for the treatment and care of older persons who are mentally ill, confused, or senile?
Do satisfactory arrangements exist for older persons for whom guardians must be appointed?
Housing
Does the community offer a variety of housing alternatives to meet the varying needs of its older population? Such alternatives might include:
Low-cost housing; units incorporating safety features, such as grab-rails in bathrooms and alarms connected to emergency centres;
Sheltered or congregate housing which provide a variety of services, such as communal dining, home help aides, etc;
Foster homes and boarding houses;
Assistance to families so they can expand their homes to accommodate older relatives;
Units linked to a larger dwelling which permit independent living on the part of both the older person and his or her family, yet provide enough proximity so each can provide the other with assistance;
Retirement homes and communities;
Institutions providing various degrees of care to the frail aged who can no longer live independently.
Aids in daily living
Do home help services exist to assist older people with housekeeping and personal care?
Is there a service to help older people with shopping or to escort them to other needed services?
Do congregate meal facilities or lunch clubs exist to assure that older people are adequately fed and have opportunities for social contacts?
Is there a meals-on-wheels programme to provide a nutritionally balanced diet to persons confined to their homes? These are mobile units that generally provide one meal a day free or at a low cost.
Are there day centres or day hospitals which provide needed care or services yet permit older persons to be at home with family members at least part of each day?
Are public facilities equipped to accommodate older and handicapped persons with, for example, ramps, elevators, special fixtures in lavatories?
Is there a "telephone reassurance" service or other daily check-up to determine the well being of an older person?
Does the community have a volunteer "friendly visiting programme" to alleviate the loneliness of older persons.
The needs are many and include other areas such as work and income security, transportation, education, recreation, leisure and volunteer services.
Other needs are also of equal importance such as the availability of a resource file or directory of all organisations and services in the community, both voluntary and governmental, that assist the elderly.
Crucial to all the above is the existence of an "Information and Referral" service to inform citizens of available services and, when necessary, to refer them to the appropriate agencies. One such agency could be legal aid services for the ageing.
Religious groups need to meet the spiritual needs of their older members and those in surrounding communities.
With all of the lifestyle and health changes taking place in the life of the elderly, counselling or assistance with the families of elderly persons must be accessible.
If your answer is, "Yes I know about all these areas and I have access to all the services and facilities mentioned in this article", I challenge you to find a community where these services do not exist or are not accessible to help to make a positive difference.
Contributed by Nadeen Campbell-Brown, director of public relations and media services, Northern Caribbean University.
