It was after a long time that my wife and I called on 86-year-old Ranjana, one of the few surviving old guards among our close relatives. She lives alone and is looked after by Shashi, a full-time nurse-cum-caregiver. She looked perplexed, rather horrified, when she opened the door for us.
“How is Mummy ji?” I asked with obvious anxiety.
“She is taking a bath for the last seven hours and not coming out despite several requests,” she replied. “Madam bolted herself inside at about 12.30pm and now it is almost 7pm but she is still bathing.”
Constantly tapping the door, Shashi had been asking her to come out. Irritated, the old lady scolded her not to disturb her again. Initially, the caregiver did not act but then got panicky. On her call, Ranjana’s daughter Sadhna rushed from her workplace to get a similar rebuke from her mother at 8pm.
After a lot of coaxing and cajoling, when the grand old lady finally opened the door, she had turned white and blue due to constant exposure to water for several hours.
It is common knowledge that the skin shrivels up like an old prune after a prolonged bath. Incidentally, a very insignificant percentage of Indians get to enjoy the luxury of having a bath tub. Most people use bucket and mug and/or shower. So, the incidence of damage to skin is very less but a seven to eight hour long bath for an 86-year-old lady could be disastrous.
Ranjana represents an old age-related problem of dementia, amnesia, Alzheimer’s or simply degeneration. She is currently under treatment for suspected dementia and the doctors are yet to be sure of the exact problem.
However, one thing has been established: Mrs Ranjana is suffering from Obsessive Cleanliness Disorder (OCD). She is all the time worried about giving herself a ‘brighter’ look. She keeps complaining to her daughter about her skin not glowing enough.
On the other hand, her forgetfulness has reached to the extent that even after having a full meal and medicines, she would blame her caregiver for not having fed her. Sadhna told me that she would often get scolded for not visiting her mother for several days despite the fact that she meets her twice every day.
Ranjana is among the innumerable men and women who have suffered from one or more of such diseases over the years but were never diagnosed and treated properly. This was due to lack of awareness and mainly inadequate medical and health facilities for the common man. As a matter of fact, affordability of treatment for somatic and psychosomatic diseases is another factor before India’s largely low-income class.
Proper medical care is beyond the reach of an average Indian. This cannot be tackled with meagre resources and inadequate budgetary allocations.
The fact remains, that like many other afflictions, psychosomatic problems are getting scanty attention in our country vis-a-vis even smaller countries like Japan, France, Netherlands and other European countries. Maybe that is because in India, being a big country with a massive population, the problems are also enormous.
Talking of psychosomatic afflictions, in India, we find every now and then cases of elderly people leaving their houses unannounced and unescorted and then forgetting their own identity and address. Imagine the plight of such a person and of his or her kith and kin. If not traced in time, such a person is lost in the oblivion, forever. Unfortunately, very often, such a patient is dismissed by the society as a mentally unsound person and left to fend for himself and roam about the streets uncared for.
Tragically, in this country, there is little social security for such persons.
I find that on the other hand, some countries have a greater incidence of this problem but they are taking care of the badly affected population.
For instance, in France, Alzheimer-related cases of memory loss affects more than one million patients with over 200,000 new cases diagnosed every year, as per France’s Alzheimer’s Association. The tragic fact remains that none of the treatments currently available can stall the diseases. Nevertheless, France is going ahead with its rehabilitation programme. By the end of 2019, it will have the first-of-its kind Alzheimer’s Village in Dax commune in South-West part of France.
This is inspired by a hugely successful project by the government of Netherlands.
On similar lines, the French Commune will have a Central Square, a supermarket, hairdressers, restaurants and the like to encourage social interaction among the inmates. That way, they do not get a hospital-like atmosphere. Interestingly, caregivers will wear plain clothes to make it look like they were anywhere else but in a hospital.
On the other hand, in Japan, where the average age is 84 — one of the highest life expectancy in the world — one out of every five elderly person is predicted to have Dementia by 2025. They, too, have a Dementia Village where the elderly pick up their requirements from shops and cafes without paying anything on the spot. The amount is debited on a monthly basis.
I do not know how long will it take for my country, India, to provide such impeccable health care facilities to the population suffering from memory loss-related issues.
Lalit Raizada is a journalist based in India.