Still homebodies after all these years
A group of doctors pioneers in home-based health care
By DONG A. DELOS REYES, CONTRIBUTING EDITOR
"Double dare you I do. Just give me a grandson, a granddaughter-that kid will go through the same weekly mountain- climbing and reforestation forays you all went through in your growing up years. I'll throw in a crash course in close- quarters combat and iron-shirt chi kung to toughen their spirits, get 'em to breathe pollution-free sylvan air to line their lungs with iron."
"They'll be introduced to the same wonderful species of plants you all got acquainted with and feasted on up there. We'll do on-site cookery and rookery. We'll catch the same bugs and critters-ah, colorful leeches, wee shrimps, lizards, frogs, nonvenomous snakes, rhinoceros beetles, fighting spiders and all-you played with. And we'll get to see Jesus Christ Superstar, Les Miserables, and all those wonderful musicals all over again. We'll rhumba and cha-cha. We'll do fishing. We'll… mind you, these are no empty threats!"
Any man or woman quite on in years would likely hurl such litany of promises to his child who has come of age, keeps a stable job, has left the family roost to strike out on his own, but is reluctant to raise -his own family. Thus, there's so much sweet anticipation for that meeting between a hoped-for apo and a grizzled old geezer of a lola or lolo.
The list of skills and the inherent fun that an elderly wannabe grandfather can lavish on the progeny of his son or daughter-such a list is endless. Wizened by time and clime and experience, the long-lived individual becomes a veritable cornucopia of tales and talents he can take it upon himself to impart sagely counsel of years to the unbridled enthusiasm and curiosity of the young. Twilight is that time of day when motley colors are arrayed in the horizon at their brightest and subtlest, shouldn't that be the hues that define the so-called twilight years?
Dr. Doris Mariebel dela Cuesta-Camagay thinks so: "Much of the limitations of the aged are imposed on them by society, and when they give in, they consequently impose these limitations on themselves. For the elderly, it is a better choice not to give up when they reach the last phase of their productive lives."
As the indefatigable Man of La Mancha sought out the unreachable star, dared dream the impossible dream, the elderly "can still find a sense of purpose which isn't tied down to material acquisitions and aggrandizement, says Camagay."
Retirement is mandatory at 65 but that doesn't mean a healthy individual over 65 is any less productive or less keener at his tasks. What about physical regimen-who says that the seniors have to stop from physically engaging workouts? Who says that the advanced in years would just have to wait for their deaths? Or demand constant attention?
Age need not turn the ageing into harried harridans or grumpy old goats. A 1959 play by Tennessee Williams, Suddenly Last Summer, recasts the archetypal "old man of the mountains" who latched like a leech upon the back of a shipwrecked Sinbad the Sailor and slowly tried to strangle him. In the play, an elderly mother feigns paralysis and a smorgasbord of body pains to keep her daughter tied down to attending to mom's every wish and whim at all times-until the daughter finds out and leaves the family abode to seek out her place in the sun.
Unlike in some western societies, Philippine culture and tradition have ingrained filial devotion and ample measure of reverence for the elderly. The Filipino family has been known to keep their elderly, in sickness and in health, within their midst until the latter's last days.
Explains Camagay: "Until today, it is customary for a member of the family-usually a female-to give up her occupational status to perform this family duty. Other built-in systems for old age support are having a large family to begin with that respects its elders, and an extended family system that is closely knit. With the extension of the life span, it will be customary to have three- or four-generation families under one roof. The discrimination against older persons is therefore out of context because of the way the elderly is cared for in the Philippines."
Even so, increasing economic pressures in recent times are impinging even on such time-honored tradition. The family member assigned to fulfill the filial tasks of caring for lolo or lola must now find employment or venture far from home grounds for better-paying jobs to supplement the family income. A declining economy and family planning provide reasons for the young to rethink marriage and having too many mouths to feed in a large family. And so the built-in and expected systems of old-age support are being eroded. Suddenly, caring for the elderly has reached a crossroads of sorts.
Caring for our elders has always been done in a home setting, carried out by family-and that might not continue to be so. But we're not about to break away from tradition by building so-called "homes for the aged" in great numbers, then, dumping our elderly in them like equipment past their usefulness.
What will be the most acceptable form of tending to the family's surviving forebears? They'll long for the familiar comforts of home, the familial ties and sights of one's home grounds, even the home-cooked meals they've grown fond of over the years-indeed, a man's home is his castle.
"But clearly, the Filipino elderly should extend the support network beyond the family. Clearly, the family must learn to adjust to and utilize community resources to continue caring for dependent elders," Camagay stresses.
Home-based health
Studies were carried out in 2003 with an eye to assembling a team of multidisciplinary experts that will provide round-the-clock, personalized assistance, home-based long-term care to meet the elderly patients' needs. By September 2004, operations went underway with a full staff of seven persons backed by 30 accredited physicians and 30 other allied health-care professionals-nurses, therapists, physical therapists, nutritionists/dieticians, and trained caregivers, among others.
The pioneer: Home Health Care (HHC), a division of Directed Business Growth Inc. that has also established alliances with home-service laboratories and medical-equipment providers including the RxPinoy Health Directory through its Doctors Online program and web-based platform.
Dr. Mary Jean Villa-Real-Guno, HHC managing director, envisions their outfit "as the premier provider of home-based health and wellness programs for the seniors in our country."
To date, the HHC has a database of some 2,000 seniors ages 60 and up mostly in Quezon City and other parts of Metro Manila. HHC also caters to individuals of any age.
The firm's home-based health and wellness programs include:
o Patient-management support services in which HHC's "army" of physicians tackle the challenges of home visits,
o Comprehensive geriatric assessment,
o Periodic health visits-medical management of bed-bound patients for long-term care,
o Vaccination for adults,
o Caregiver training module to impart skills to family members and household caregivers on proper management of patients,
o Laboratory examinations,
o Assign caregivers/skilled nurses,
o Procurement/rental of medical supplies and equipment, and
o Wellness-club membership.
Senior citizens (60 years old and up) currently account for six percent of the Philippine population. By 2020, the elderly segment of the populace is expected to hit 12 to 13 percent and ought to exert greater pressure in families, communities, and the workforce to provide needed support and manifold services. The government is nudged to ensure that appropriate health-care and support services are provided to the elderly when individuals and families cannot meet these needs without public assistance.
As of June 2003, 307 senior-citizen centers were built throughout the country while 55 are now being built, to be run by the elders themselves backed by their local governments and nongovernment organizations. No success story has trickled out of these centers yet.
Meanwhile, HHC is already setting sights on the expected influx of "healthy retirees" from developing countries seeking to avail themeselves of quality health-care services in the Philippines-as of last year, 600,000 of these retirees were drawn to Thailand, Malaysia, and Singapore. M
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