Rites of passage

Some time in the month of December’20 Porosh received a call from an elderly lady, based abroad, seeking Aastha package for her octogenarian parents. After briefing the lady on the facilities covered under the package there was no response. It was only in the month of April that she called us up once again and immediately enrolled her parents as Porosh’s members. It is to be noted that at time her mother had just returned from a nursing home and thus needed nursing assistance apart from regular health monitoring.

During our first visit we realized that she (say, Mrs.Wilson) was indeed not keeping well and also looked quite frail. When we asked Mrs.Wilson’s husband if she was better on her return from the nursing home, he replied, “Her condition has deteriorated. Therefore, we felt it to prudent to bring her back and ensure proper care is taken at home. Now she has a swollen forehead and no explanation has been given to us as to how it all happened. When we shared the health reports of Jane with our family doctor he observed that some of the critical tests have not been performed either. At this age I am feeling so helpless. Hence, we decided to seek Porosh’s help.”

Thus, having taken stock of the situation we decided, at first, to get Mrs.Wilson checked for certain key issues which seem to have been neglected. Once we received the reports within a day, or two it was realized that medication at home would not be tenable and hence, she needed to get admitted to a better nursing home/ hospital. And our challenge started thereafter.

We were not getting beds for her admission. So we sought help from one of our empaneled doctors and managed to secure a bed for Mrs.Wilson in a nursing home in South Kolkata. The next seven days was a tug-of-war between life and death. However, situation seemed to improve from the eighth day onwards. However, destiny had something else in store for us. The same night her oxygen level started to drop dramatically and she had to be put on ventilation. Next day at 8.40 am Mrs.Wilson passed away.

The younger daughter of Mrs.Wilson requested us arrange for her funeral the very next day. She unable to organize it on her own given her age related problems. Now, this was an unique opportunity for Porosh and the whole the team swung into action. A flurry of activities followed:

1) The Peace Heaven was contacted to preserve the mortal remains of Mrs.Wilson.

2) Coffin along cross were arranged from Syed Amir Ali Avenue.

3) For writing on the cross a team member went to Mullick Bazar.

4) In parallel contact was established with the person responsible for digging the grave.

5) Timings for performing the final rites by the priest was coordinated upon.

6) Order for flowers was placed in Lake Market.

Next day Mrs.Wilson was laid to rest in the Bhowanipur Cemetery. It was an emotional moment for all of us as her husband and daughter wept profusely. There were a few other family members as well.

After all the formalities were over by late afternoon Team Porosh was offered warm thanks for minutely working on the details and seamlessly organizing the solemn event as per schedule within a very short notice.

Dealing with Dementia:

A disease that affects memory, thinking and judgement

On January 17, 2020 an article was published by the above name in The Economic Times by Teena Thacker. We reproduce the article verbatim as we found it to be not only informative but also quite engaging. We believe you too shall gain useful insights on an issue like dementia.

He walks up and down the staircase in his pyjamas and kurta, keys of his car that he once used to drive clutched in one hand and a glass of milk in another, with anxiety writ large on his face.

“Where is Mataji (mother)?” he asks his wife, and then his son. “She is not here,” comes the answer, as they look at each other in worry. His mother had died several years ago. They try to calm him down and suggest he watch television, but he is instantly on his feet, asking the same question again.

Ashok Sachdeva, 67, does not quite remember what happened a few minutes ago and when he last ate, with the result that sometimes he is overfed because he asks for food even after he has eaten a meal. At times, the situation can turn potentially dangerous, especially when he slips out of house without telling anyone. Once an immaculate man, who would drive daily to his West Delhi automobile components shop, come back home and often take his family out for dinner, Sachdeva is among an increasing number of people suffering from dementia.

According to the World Health Organization (WHO), around 50 million people have dementia, with nearly 60% living in low- and middle income countries, and nearly 10 million new cases get added every year.

India has the second highest number of individuals suffering from dementia, at an estimated 4.1 million. The figure is expected to double by 2035, as per the ‘Dementia India’ report published by the Alzheimer’s and Related Disorders Society of India. Maharashtra and Uttar Pradesh alone are expected to house more than 500,000 patients by 2026, it says.

“India is soon going to witness an epidemic of dementia,” said Dr JD Mukherji senior director and head of neurology at Max Healthcare in Delhi’s Saket. “As life expectancy increases, non-communicable diseases like cancer and dementia are going to become more and more prevalent. By 2050 the largest number of patients of Dementia will probably be in India.”

Dementia is a syndrome, usually of a chronic or progressive nature, in which there is deterioration in cognitive function or the ability to process thought beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgement. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour or motivation. In the case of Usha Kumari, 65, for instance, she even forgot her son’s name a month ago. “That was a painful blow,” said her son Sumit.

Memory loss and confused behaviour is the most common symptom in people with dementia. When PK Sharma, a retired bureaucrat who once occupied a high office and position in the government started showing symptoms, junior officers could not muster courage to encounter their senior who was making “unusual mistakes”. “He started making mistakes in simple calculations, when to take meals and would repeatedly mistake bedroom for toilet and toilet for bedroom,” said Veena Sharma, his wife. It has been even years since he retired, and problems have grown manifold. Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain, such as Alzheimer's disease or stroke. It is a disease of the elderly and is mostly irreversible. The irony of dementia is the victim’s inability to recognise it. This necessitates 24-hour care for people suffering from dementia. Patients need constant care not only because of memory issues but also with bedsores management, infection and other diseases such as hypertension and diabetes.

In the near absence of external help, family members are left to take care of dementia patients. With no professional adult day-care options or structured cognitive rehabilitation programmes available, caregivers have little time to rest, run errands or finish other tasks.

Ask Jagjeet Singh, whose father Satinder Singh has a problem controlling his urine. “He is uncomfortable with anyone else helping him, so I have to be at his beck and call. At first, he had trouble with mild leaking but as the dementia advanced managing his urine inconsistency has become unmanageable. From rashes to urinary tract infections to increased falls due to hurrying to make it to the toilet, the problems are increasing every day,” he said.

Dr Mukherji gets to see at least a couple of dementia patients every day, and about as many new patients every week. “In India, family members look after the elderly. But with the concept of nuclear family developing, elderly people are left on their own. There are not enough centres in the country where the elderly can be taken care of. They are very expensive and not very well planned,” he said. According to the WHO data the total number of people with dementia is projected to reach 82 million in 2030 and 152 million in 2050. Much of this increase is attributable to the growing number of people with dementia living in low and middle-income countries.

Although numerous new treatments are in various stages of clinical trials, there is no treatment currently available to cure dementia or to alter its progression. Dr Sandeep Vaishya, executive director, neurosurgery, Fortis healthcare said, “Normal Pressure Hydrocephalus is one of the cases of dementia which is treatable “Dementia is a devastating illness and in most cases there is no specific treatment for it. Unfortunately, this condition is often missed by physicians. The typical presentation is that patient has memory loss, difficulty in walking and difficulty in controlling urine. It can be treated by a simple surgery called ventriculoperitoneal shunt.” Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of ageing. Besides, WHO says dementia does not exclusively affect older people – young onset dementia (defined as the onset of symptoms before the age of 65 years) accounts for up to 9% of cases.

WHO has also found that dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. As per the International Health Agency, in 2015, the total global societal cost of dementia was estimated to be $818 billion, equivalent to 1.1% of global gross domestic product (GDP). The total cost as a proportion of GDP varied from 0.2% in low- and middle-income countries to 1.4% in high-income countries.

Seriousness of Covid 19 Wave II

Amidst all the din and cacophony over the Bengal election it seems we have thrown caution to the wind. An attitude of blissful ignorance and nonchalance seem to have overpowered us. It appears that we have sealed a stamp of final victory over the virus. Hence, growing reluctance to abide by the Covid norms. We appreciate it may partly be attributed to individuals revolting to the restrictions imposed on their movements and also putting on masks. True, at times it appears to be a bit suffocating but have these not been imposed for protecting us from the clutches of the virus?

The seriousness of Wave II can be gauged by a very recent experience of ours. A couple of days back one of our ailing members, who is in her late 80’s, was admitted to a nursing home. However, in line with maintaining Covid protocol she was tested for the virus. She tested positive. The nursing home informed us to admit her to a hospital who treat Covid infected patients. Yesterday our team ran from pillar to post to find a bed for her but to no avail. All the concerned healthcare centres are overflowing with patients and anxious family members standing in the queue to get them admitted. Beds are not available

Had it not been for one of our empaneled doctors we may not have been able to get her admitted either. The only option with us would have been to arrange for her treatment at home where her octogenarian husband stays. This would have made the situation very challenging for us. We avoided the nightmare due to our network of doctors and hospitals.

Therefore, it is our earnest request to the readers that in case you are away from your parents do send this message across to them and insist them not to venture outside at all. Yes, it is going to be an ordeal that they have to live through once again but is there any other option either?

If you feel Porosh can be any help to you, do not hesitate to contact us.

Call us at : +917439852047