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Ok I'm back...

Before I wax lyrical about Geriatrics, I realized I missed out on one core aspect of Geriatric medicine.

Paediatrics isn't the only specialty where you have to treat the patient as well as the caregiver. It's the same in Geriatrics, just that the ages of the patient and caregiver are reversed. Also, caregiver concerns are different. in Paediatrics, parents are more concerned on whether the child's illness affects his/her long-term development. Caregivers of elderly patients are concerned instead with how the patient's illness affect his/her quality of life. In Geriatrics, like paediatrics, patient welfare indefinitely impacts on the welfare of the caregiver. Patients with dementia, especially the spouse, are distressed by their loved one's gradual but noticeable change from someone dearly familiar to a total stranger, even a nuisance, an outcast. Like children with debilitating illnesses, Geriatricians aim to palliate the patient as best as they can, and offer comfort and respite to the caregivers where possible. I have personally witnessed the sheer outpouring of gratitiude of a family to a geriatrician who helped them cope with their father who was ailing due to both cancer and dementia. The scene touched my heart.

And therein lies the beauty of Geriatrics. One wonders why it isn't given the same appreciation as Paediatrics, given their similarities. One need no more than look at societal priorities and biases to see why. And yet in this same society, Geriatrics is needed more than ever. The ageing population and the shrinking of family size forces us to confront the inevitable elderly dependant burden on society and forces us to decide the place of elderly in society. More and more families are casting their elderly out to nursing homes. The reasons for doing so include many genuinely distressing ones, but what is worrying is how some people can leave their mothers and fathers in the home and never return.

Can we accept this? I urge all to take a good look at your mothers and your fathers and think hard: will you want to take care of them in future? Will you shelter them in your home for as long as they live, or will you cast them out at the slightest bit of inconvenience? Will you bathe them when they are dirty, clean them when they soil themselves, feed them when they too weak to feed themselves, comfort them when they cry from sorrow of depression or worthlessness? We shy away from this, yet we were once given that amount of care by our beloved parents. Instead we care not about dirtying our hands when we tend to our young ones- but even that practice is now slowly being handled by strangers-maids. Unsurprisingly, children now also hand their elderly parents over to maids, even though I accept that increasing work demands may force the hand of even the most dedicated of children.

When I walk in the wrads of Renci, all around me are old men and women, frail and beaten down by age and disease. But look harder and the years roll back- see the construction worker whose hands grew coarse from the rough work in the day but still lovingly cradled his baby son at night. See the virtuous wife whose now-heavily varicosed legs covered every inch of the house floor as she cleaned, swept, cooked, cried. See the political leader whose heavily-creased brow underlined all his years of servitude to the nation. See the young man or woman who was once not very different from us- full of hope and promise, yet full of trepidation at the challenges of life that awaited them. Above all, see the collective effort of an entire generation that has taken this country from the slums that they inhabited to the skyscrapers we now admire- an effort that has caused their backs to grow crooked, their bones to grow brittle, their knees to stiffen, their bodies to become weak.

Truly, they deserve better.