Shal­iza Has­sanali

Se­nior cit­i­zens are be­ing dumped at pub­lic hos­pi­tals by rel­a­tives-some head­ing off on hol­i­days, oth­ers un­able to cope with the pres­sure and stress of be­ing full-time care­givers. It is cost­ing tax­pay­ers $500 a day or $15,000 a month to main­tain an el­der­ly per­son ward­ed at hos­pi­tals op­er­at­ed by the Gov­ern­ment.

This is in ad­di­tion to the $3,000 month­ly pen­sion al­lo­cat­ed to these in­di­vid­u­als, but which are be­ing col­lect­ed by un­scrupu­lous fam­i­ly mem­bers while the el­der­ly, who are dumped at the hos­pi­tals, are be­ing main­tained by the State. Health Min­is­ter Dr Fuad Khan on Thurs­day con­firmed that the dump­ing of se­nior cit­i­zens is on the rise.

Khan said no one has been strong enough to ad­dress the prob­lem, which he would deal with very short­ly. "They (el­der­ly) are clog­ging up acute space and putting a se­ri­ous bur­den on our tax­pay­er." Every year, Khan said, tax­pay­ers spend mil­lions of dol­lars on med­ica­tion, ac­com­mo­da­tion, meals, linen, nurs­ing and doc­tor care for the el­der­ly, many of whom are healthy and oc­cu­py bed space, deny­ing sick pa­tients health care.

Out of 800 pa­tients ad­mit­ted at the St Ann's Psy­chi­atric Hos­pi­tal, Khan re­vealed, 600 were so­cial cas­es. The same prob­lem of aban­don­ment ex­ists at the?Port-of-Spain Gen­er­al Hos­pi­tal, the Er­ic Williams Med­ical Sci­ences Com­plex (EWM­SC), the San Fer­nan­do Gen­er­al Hos­pi­tal and at the geron­tol­ogy unit at the St James Med­ical Com­plex.

Liv­ing in hos­pi­tals for 30 years

Khan said some pa­tients at St James have been liv­ing there be­tween 20 and 30 years. "Peo­ple are just liv­ing at St James. They have free room and board. Peo­ple come and take their pen­sions and every­body hap­py ex­cept the tax­pay­ers. "St James has been a dump­ing ground over the years for el­der­ly peo­ple. These peo­ple have fam­i­lies who do not want to take care of them. They leave them in St James and dis­ap­pear."

He said the man­age­ment at St James was al­so at fault for turn­ing a blind eye. Khan said it was time the rel­a­tives of the el­der­ly live up to their re­spon­si­bil­i­ties.

De­fraud­ing the Gov­ern­ment

The min­is­ter ap­pealed to the Min­istry of the Peo­ple and So­cial De­vel­op­ment to stop dis­trib­ut­ing pen­sion and dis­abil­i­ty cheques to el­der­ly folks who are ward­ed more than 30 days. He al­so urged all re­gion­al health au­thor­i­ty doc­tors to de­sist from sign­ing any state­ments which are tak­en to the Min­istry of So­cial De­vel­op­ment and Na­tion­al In­sur­ance Board, in­di­cat­ing that el­der­ly pa­tients are un­able to col­lect their pen­sions be­cause of their ail­ing health or de­men­tia.

"They (rel­a­tives of the el­der­ly) are de­fraud­ing the Gov­ern­ment and the peo­ple who are sign­ing it are just as guilty." When asked how many el­der­ly pa­tients are liv­ing at the hos­pi­tals, Khan replied, "I can say...I have lost count. I would say load and loads of them. It is dis­gust­ing."

At­tempts are be­ing made to move the el­der­ly to com­mu­ni­ty health care ser­vices, Khan said. "A lot of peo­ple are open­ing up geri­atric homes in the coun­try. "They are get­ting mon­ey from the Gov­ern­ment and not pro­vid­ing the kind of ser­vice for the mon­ey they are re­ceiv­ing."

Khan said he was try­ing to ad­dress the sit­u­a­tion with Min­istry of Com­mu­ni­ty De­vel­op­ment since a lot of the homes come through this min­istry. "When I try to deal with the sit­u­a­tion peo­ple would say I am heart­less and would bring pol­i­tics in­to it. We need to deal with this prob­lem head on. At the end of the day we are caught be­tween a rock and a hard place."

Khan said the prob­lem could be dealt with but he need­ed the back­ing of the pop­u­la­tion, whom he claimed have been tak­en for a ride and their eyes dug out by ir­re­spon­si­ble peo­ple.

Over­load­ing the sys­tem

A source at the EWM­SC re­vealed that out of its 248 beds, five per cent were so­cial cas­es, many of which are se­nior cit­i­zens who have been dis­charged but are still hos­pi­talised. "They are just block­ing up the beds for weeks, months and even years."

An el­der­ly fe­male who was dis­charged a day af­ter be­ing ad­mit­ted, the source said, has been stay­ing at the hos­pi­tal for 800 days. Two oth­ers have been there 400 and 300 days re­spec­tive­ly. "While these pa­tients are oc­cu­py­ing bed space their fam­i­lies are col­lect­ing their month­ly pen­sions to use to main­tain them­selves. I am to­tal­ly in dis­agree­ment with this," the source added.

Once the pa­tient is dis­charged by the doc­tor, the source said, fam­i­ly mem­bers would be con­tact­ed by so­cial work­ers. "But this of­ten proves to be a te­dious task as the phone num­bers of the fam­i­lies are ei­ther dis­con­nect­ed or wrong, the ad­dress fic­ti­tious or they are un­will­ing to co-op­er­ate. This is what caus­es the de­lay in get­ting them out."

Ei­ther way, the hos­pi­tal is sad­dled with the pa­tients. The old­er the pa­tient be­comes, the greater their needs. "The fam­i­ly mem­bers know the hos­pi­tal would nev­er turn away old peo­ple and they ex­ploit that." The sit­u­a­tion has been de­scribed as a symp­to­matic over­loaded of the health­care sys­tem. The av­er­age stay for a pa­tient at the hos­pi­tal is be­tween five to six days.

Once the pa­tient ex­ceeds 30 days, long-term care needs to be pro­vid­ed. "On av­er­age it costs the hos­pi­tals $500 a day to pro­vide health care. "That is $15,000 a month. It's just not mak­ing eco­nom­ic sense to have these el­der­ly peo­ple at the hos­pi­tal when they could be placed in a geri­atric home at one third the cost. The hos­pi­tal and so­cial ser­vices hands are tied. We can't do much."

Rouse: Pub­lic un­aware

Di­rec­tor of the Di­vi­sion of Age­ing Dr Jen­nifer Rouse said she was ex­pect­ed to have a meet­ing with the Min­istry of Health soon to hold dis­cus­sions about el­der­ly peo­ple liv­ing in the hos­pi­tals. Rouse said they are be­ing called up­on be­cause most of the needs of the el­der­ly are so­cial.

Rouse said one pen­sion­er has been liv­ing at St James Med­ical Com­plex for 30 years. She said shift­ing them from the hos­pi­tal would cause dis­ori­en­ta­tion be­cause they had cre­at­ed a bond with the nurs­es, doc­tors and oth­er pa­tients. "These peo­ple have no rel­a­tives."

Every year, in the weeks af­ter Car­ni­val doc­tors put out a bul­letin in the news­pa­pers ad­vis­ing peo­ple to col­lect their rel­a­tives who have been aban­doned at the hos­pi­tal. This aban­don­ment, Rouse said, is a form of abuse. Rouse ad­mit­ted that some of the el­der­ly have been oc­cu­py­ing beds "so they are call­ing on us to see if there is room at some of the pub­lic homes. We in turn would have to call the homes to find out if there are rooms avail­able."

Out of the 131 homes list­ed in T&T, Rouse said 85 are in op­er­a­tion and that Gov­ern­ment sub­ven­tions are be­ing giv­en to nine. If there are in­suf­fi­cient rooms at the home, Rouse said, the el­der­ly would be shift­ed to St Vin­cent De Paul and the Sal­va­tion Army or would have to re­main at the hos­pi­tals, un­til bet­ter can be done. Rouse said the pub­lic was un­aware of what is go­ing on.

Res­i­den­tial care need­ed for the el­der­ly

Ac­cord­ing to Rouse, it shows that in­fra­struc­ture and long-term res­i­den­tial care are need­ed for the el­der­ly, which num­bers 156,000 in T&T. Each year, the el­der­ly pop­u­la­tion in­creas­es by one per cent. Of this fig­ure, more the 400 are cen­te­nar­i­ans. "You must have the in­fra­struc­ture when you are de­cant­i­ng peo­ple. We are en­vis­ag­ing to put down mod­el homes like res­i­den­tial care, which has to be done col­lab­o­ra­tive­ly with the Gov­ern­ment and the pri­vate sec­tor."

Be­tween 2014 to 2017, Rouse said, things will be­gin to take shape. "All now is the plan­ning stage of where we will get the land." Rouse said while pen­sion­ers ush­er them­selves in­to homes in oth­er parts of the world, our cul­ture is dif­fer­ent. "It is jar­ring to know, yes, you have a di­vi­sion you could boast is eight years. Are we reach­ing where we want to reach?" she ques­tioned.

Rouse said the In­ter­na­tion­al Mon­e­tary Fund had en­vis­aged that be­tween 2012 to 2015, there will be a grey­ing of our na­tion­al bud­get and that at least 40 per cent of the coun­try's Gross Do­mes­tic Prod­uct will be spent on pen­sions.

Dumped for the fes­tive sea­son

Geron­tol­o­gist Dr Ken­neth Niles said he was aware the dump­ing of the el­der­ly at hos­pi­tals is on the in­crease. "I could vouch for that. Fam­i­ly mem­bers would just dump or aban­don them at health in­sti­tu­tions with­out turn­ing back." The dump­ing, Niles said, oc­cur be­fore and dur­ing the fes­tive sea­sons-in par­tic­u­lar, Car­ni­val and Christ­mas, as the younger gen­er­a­tion would even trav­el abroad to en­joy them­selves, while the el­der­ly is left in the care of the hos­pi­tal.

"You can find el­der­ly peo­ple at the hos­pi­tal who are not sup­posed to be there, when­ev­er there is a ma­jor event." Some of the el­der­ly are brought in­to the hos­pi­tals and left on bench­es, nev­er to be seen by their fam­i­ly again. Geron­tol­ogy is the sci­en­tif­ic study of the bi­o­log­i­cal, psy­cho­log­i­cal and so­ci­o­log­i­cal phe­nom­e­na as­so­ci­at­ed with old age and age­ing, and cov­ers a full spec­trum of the age­ing process fo­cus­ing on the old­er per­son from the age of 60.

Age­ing is a nat­ur­al process of life, but it comes with some com­pli­ca­tions that are not al­ways easy to han­dle, Niles said. "I have seen it, not in the North, but in the South as well." Niles said fe­males over the age of 85 are aban­doned more than their male coun­ter­parts.

Niles said pen­sion­ers are dumped be­cause rel­a­tives con­sid­er them a bur­den or are un­able to cope. "The re­spon­si­bil­i­ty for some comes like a thief in the night and they don't know how to man­age. So the eas­i­est thing to do is dump them."

De­scrib­ing the sit­u­a­tion as wor­ry­ing and dis­heart­en­ing, Niles said chil­dren and so­ci­ety need to be ed­u­cat­ed about pre-re­tire­ment and post-re­tire­ment to re­duce the aban­don­ment.

Niles not­ed that while chil­dren were over­com­ing the shock­ing re­al­i­ty of age­ing, the process was ac­tive­ly con­tin­u­ing and the el­der­ly con­tin­ue to suf­fer.