As someone who travels frequently to Pakistan and England, I can’t help but be made aware of the stark difference in the care provided for the geriatric population between the two countries. This is most likely due to how the eastern mindset varies from the western in caring for the older generation.
I had the opportunity to intern for a British nursing home, which made me realize that there may be ways that a developing country could implement improvements in geriatric care without having to completely give up their traditional norms.
In England, it is common and acceptable to place family members in nursing or residential care with there being more than 11,300 care homes in the UK; This ensures a range in price, services and quality, thus providing care for over 400,000 residents at any given time.
In stark contrast, despite all my efforts to find something resembling a care facility in Pakistan, I came up empty handed. This is probably because people are more worried about “log kya kahein gai?,” if they outsource care, instead of prioritising optimal care for their dependents. Or perhaps they just don’t understand the enormity of the care and skills professionals can provide, which is why an aspect of homecare employees’ job in Pakistan is to guide their clients to acquire the proper mindset for outsourcing care.
Geriatric home care services need to be provided at a larger scale in Pakistan, to be able to cater to a wider audience
This could be why currently there is only homecare available, rather than nursing or care homes, as the community may be opened to the idea of their family staying at home but with the accompaniment of a nurse. It is important that we normalise the idea of external and raise awareness, perhaps through physicians advising patients and their families, about the benefits of geriatric care, primarily homecare, as it sustains traditional and family values while providing a high-calibre of care.
For instance, my Tayajaan (mother’s uncle) was part of an affluent family. Having had a Pakistani upbringing, he later lived in England. When Tayajaan fell sick, he was not admitted to a rest home, despite the western culture. Rather his son administered assistant care, which supplied an at-home nurse to monitor and support their health. Even though he had spent most of his life in England, his cultural values restricted him from being in a care home, yet, in this case, enough geriatric care was provided in a different way. Geriatric home care services need to be provided at a larger scale in Pakistan, to be able to cater to a wider audience.
With an increasing number of 11.3 million senior citizens making up 5.7% of Pakistan’s population, it is imperative for the government to allocate resources to provide and improve geriatric care, and that families are made aware of the benefits of outsourcing care. As life expectancy rises and birth rates fall, this number is expected to rise to 43.3 million by 2050, according to Punjab University, which stresses the urgency of having a higher provision of services for the estimated 15.8% of our population over the next three decades.
While 70% of the elderly population in the UK receives some form of care, only 30% of the elderly population in Pakistan are cared for by trained practitioners, and it is time to see that number rise and for us to care for our growing population properly.
Something else that I have come to notice is how the perception of nurses differ between the two countries, which could be due to cultural differences. On one hand, although most nurses are immigrants and tend to be on low wages in England, they are extremely respected, and their role is appreciated and applauded. Contrary to this, the geriatric population in Pakistan struggles to grip the concept of employing nurses to purely facilitate with the upkeep of health, instead these nurses are often mistaken for domestic help, being expected to assist with other tasks around the house. I believe that this is the result of different upbringings in separate environments and cultures.
I find it unfortunate that due to people being raised in a different environment or country to others, their mindset towards caring for their elders restricts the possibility of them providing maximum care for their family members, and doing what is best for their elders rather their reputation. They should realise that as much as we care about our parents, we are not geriatric specialists and to be able to provide appropriate care when an elder needs help, they should be taken to the hospital without any thought.
Before the government issues any policies towards geriatric care, it is critical, especially with the rising older population of Pakistan, to tackle the taboo of care and nursing homes in Pakistan. Like centres already established by Edhi, the government should sponsor old-age homes to cater for the population as it ages. Apart from this, the state can allocate resources to train and recruit specialist doctors in the public sector for geriatric diseases as Alzheimer’s disease and memory dysfunction.
Finally, we can learn from the West and create community centres with day-care facilities where trained workers can also provide counselling to those in need. All of this shows that it is possible to ameliorate and refine geriatric care in Pakistan, if the right steps are taken by the government and physicians.
to be continued
The writer is a freelancer