In Pakistan, geriatrics remains a neglected branch in education and medical practice
Humans have battled age and accompanying physiological and psychological degeneration from time immemorial. Over the last few decades, the senior population in the developed world has been getting medical and preventive support. Among other facilities in the West, there are dedicated geriatric care centres and nursing homes. In Pakistan, however, geriatrics remains a neglected branch in medical education and practice.
Dr Shahid Malik of the Pakistan Medical Association says there are no dedicated geriatric care facilities in the country. “Ageing and disease run parallel; several physiological issues accompany old age and require specialised attention,“ he tells The News on Sunday.
The first, Dr Malik says, is the realisation that age itself affects the working of the human body.
“There are several challenges that need to be addressed. These include physical, psychological and economic limitations of the geriatric population,” says Dr Haseebullah Ammad, principal of the College of Rehabilitation Sciences, Pakistan Society for the Rehabilitation of the Disabled.
“We must think ahead and focus on developing geriatric care facilities. Today’s young, the forty-somethings, are going to require these in the two decades. Building supportive care systems would then be burdensome for the state,” says Dr Ammad.
Caring for the elderly has traditionally been considered their families’ responsibility. There has existed a consensus that the doctors’ job is to provide medical care to all persons of all ages; families are supposed to care for elder family members and provide assistance for their healthy living. With changing family dynamics, the need for specialised geriatric care facilities, including medical and rehabilitative care centres, is being felt like never before.
“Fortunately, in Pakistan, many older persons receive care from their own, if needed. However, there is certainly a selective need, if not a dire one, for geriatric care facilities in the country,” says Prof Dr Javed Akram, the University of Health Sciences vice chancellor.
“As life expectancy is not very high in Pakistan, the adult care physicians taking care of geriatrics can easily diagnose and treat most patients in adult care wards. The only thing missing is the support staff,” says Dr Akram. “Elderly care is significantly determined by diseases like dementia, Alzheimer’s, Parkinson’s and disabilities caused by disease. They often need physical, occupational, and speech therapists. Rehabilitating the elderly requires teamwork.”
The lack of dedicated care facilities is particularly frustrating for Dr Shahid Malik, who says that rehabilitation of the elderly is the need of the era. “For that, we have to build geriatric care clinics and teach preventive medicine at the state level.” According to Dr Malik, not only do doctors require specialised training in geriatrics, there is a need also to teach basic supportive care to family members and caregivers.
Consigning elderly family members to care centres or old homes is still frowned upon. “An important component of geriatric care is providing a space to live,” says Dr Ammad. “We do not have enough nursing homes and old age centres. We will need more of those in the future.”
There is also a need to redefine senior or geriatric care. “As a society, we tend to limit our older population,” says Dr Ammara Fayyaz, PT, who provides elderly citizens supportive care at a public hospital. More seats must be created for supportive care practitioners as geriatric care primarily comprises supportive and preventive healthcare, she says.
“We must revisit our concepts of age and ageing. Making every 60-year-old feel old is a disservice to our elderly. Yes, there are physical health issues that come with age, but it is our job to motivate and support the older people and ensure that they live a fulfilling life. Instead of limiting or asking too little of them, we should help them stay active and feel useful – that is the essence of geriatric care.”
Geriatric care is complex and requires serious attention. The local healthcare system is already under pressure. It is time to reconsider the need for geriatric healthcare facilities, as experts suggest, and provide the senior population the much-needed care and attention they deserve.
The writer is a staff member