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Caring For The Elderly In The Community

Gouri Banerjee. Ph.D

Friends of Indian Senior Citizens Organization, Burlington organized a seminar “Caring for the Elderly in the Community” – Nov. 9, 2021.

This second event was supported by a grant from Community Health Network Area (CHNA) 15.

Cognitive decline is inevitable with aging. For some, it is more, for others less. Compared to a few decades ago, the rate of cognitive decline among humans who have been studied is going down somewhat, but for many it remains a serious problem noted Ipsit Vahia, MD, of McLean’s Hospital in Belmont.  

What happens when gaining knowledge and comprehension begin to decline with age? Cognitive processes include thinking, knowing, remembering, judging, and problem-solving. These are higher-level functions of the brain and encompass language, imagination, perception, and planning and as you age they do decline.

These were the subject of a presentation “Caring for the Elderly in the Community,” at a recent seminar at the Burlington Council of Aging. Organized by The Friends of Indian Senior Citizens Organization (FISCO) on November 9, 2021, thirty-five seniors gathered together to hear about cognitive decline, dementia and Alzheimer’s disease in person, and ten seniors attended on Zoom. The event was followed by a hot vegetarian lunch provided by Minuteman Senior Services and Zaika Restaurant of Woburn.

Ipsit Vahia, MD, Medical Director of Geriatric Psychiatry Outpatient Services at Mclean Hospital and Assistant Professor of Psychiatry at Harvard Medical School was a guest speaker. A recipient of many awards for his work with aging and cognitive decline, he observed that mental health challenges are far worse than is generally known; however, according to his research, seniors have done better than young adults in the recent pandemic.

How did seniors fare during the pandemic? Older adults withstood isolation, lack of human interaction, and inability to move around freely much better. They used smart phones, iPads, Facetime and email to remain in touch with their near and dear ones. They used social media to enhance their human experiences. Younger people, by contrast, use social media in place of human interactions.

In another of his research studies of Skype use, text-messaging, WhatsApp and Email, Skype with video and sound was found to be superior for human interaction than other channels of communication. Many older people, living on social security, Medicare, and not a part of the labor force, or with young children in the home, weathered the pandemic better. They also had their protective experiences in India, prior to coming to the US, including the social upheaval of the Partition of India, two border wars with neighbors, and multiple economic ups and downs. These collective experiences served them well. During the pandemic, isolation was significant, but older adults were found to be more empathetic, kind, more understanding of each other, and more able to modulate their emotions.

Ms. Varsha Shah, a community member and caregiver spoke eloquently about her personal journey taking care of dementia/Alzheimer in her mother-in-law. She offered insights about how her family cares for a beloved mother and mother-in-law and how the family joined together to care for the loving and active mother as she aged.

About five years ago they had noticed that their mother asked the same questions over and over again. Prior to the decline of her cognitive abilities, she had been very active in her household work. As her memory declined, she began to forget names of people, had mood swings, became very emotional sometimes, very angry or very sad. She forgot to turn off the stove, could not find things, and sometimes did not recognize people.

The family rallied around her and had her assessed by a physician who noted that she had the onset of dementia and Alzheimer, two illnesses associated with cognitive decline. Varsha noted that her mother-in-law was started on a dose of medication to slow down decline and the family became very involved in her care. They ate meals with her, encouraged her to eat, even when she declined food. The dinner hours were particularly bad. The family watched TV together, made phone calls to loved ones in India, made food that she liked, and encouraged her to cook, serve, and cleanup under their supervision.

They set up a whiteboard in their home, listing the tasks that mother could do safely under their supervision such as fold clothes, iron them, put them away, make roti and chop vegetables. Their goal was to keep her engaged and independent with supervision. In addition, they took her to an adult day care center in Woburn to give caregivers a break from the hard daily work of a dementia-Alzheimer’s family member. They participated in Satsang gatherings with her, urged friends to visit and interact with her, but cautioned them not to discuss or deal with monetary issues with her due to her loss of memory. Varsha’s advice – give them autonomy and independence with supervision.

Sukanya Ray, Ph. D., Associate Professor of Psychology, at Suffolk University, talked about her experiences as a teenager taking care of her grandmother which fostered her interest in aging and cognitive decline. As a clinician at Cambridge Health Alliance, she saw many seniors with moderate to severe loss of cognitive functions. Her ability to speak Hindi, drew seniors to her and working with them she established useful tools that help with failing cognition.

Go back to your roots – photographs of places you have lived in, family photos, old songs, religious and spiritual practices, meditation and prayer, they help. She found that hobbies that you enjoyed, travel to places you liked, watching favorite TV shows and visits to places of worship, helped people with diagnosed dementia and Alzheimer’s.

For seniors, loneliness is common. Relationships, whether short term or long term make a difference, and the loss of a loved one can be particularly hard. Loss of pets, neighbors, and significant others, can be a major setback to mental health. After each loss, seniors asked, when am I going to pass on.

Dr. Ray observed that caregivers found maintaining rituals, habits and practices from earlier, happier and healthier years, helped a lot. Favorite foods, spiritual practices, old songs, nature walks, and trips to India, helped those with failing mental health.

Dr. Ray and her colleagues are launching an app soon in India based on the idea that images of old days make people happy. Using images, their app evokes participation, activity and joy to keep older persons happy.

The three speakers brought important information based on their research and experiences to the FISCO audience, clarified the connections between cognitive decline, which many are now experiencing, and the less know illnesses called dementia and Alzheimer’s disease. They encouraged diagnoses by medical professionals and believe that illness can be slowed down with the proper care.

Friends of Indian Senior Citizens is actively engaged in improving the mental health, nutrition and good physical health of Asian Indian seniors. We invite you to visit thefisco.org for information about our programs. The next seminar, “Dementia Awareness,” will be held on Tuesday December 14th at 10:30 – 11:30 am at the Burlington Senior Center and on Zoom. It will be presented by Jewish Family and Children’s Services as a part of the Dementia Friendly Massachusetts program. A free hot vegetarian Indian lunch will be served, please join us. For more information, write to Mr. Raman Gandhi at ram2005gandhi@yahoo.com


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