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Sri Lanka’s elderly and assisted living

04 Oct 2020

By Naveed Rozais Sri Lanka’s elderly population is growing. Now, this is not at all a bad thing – it’s an indication of our life expectancy increasing and our healthcare services improving. But a growing ageing population does come with its challenges. As of 2019, according to a paper published by the Journal of the College of Community Physicians of Sri Lanka, 12.4% of Sri Lanka’s total population was over 60, and this number is growing. Sri Lanka is also in the world’s top 50 countries with the largest elderly populations. With the International Day of Older Persons falling on 1 October, now at the cusp of a new decade and with a new government taking the helm, it seems as good a time as any to look at some of the key issues Sri Lanka’s elderly population faces. Dealing with issues of the elderly Dr. Tilak De Silva (MBBS), who specialises in eldercare and serves as the President of the Primary Care Respiratory Group (PCRG), shared that one of the key issues elders face is quality of care. “There is a social stigma with elders. It is felt they should be kept at home in any kind of crisis. Medically, elderly communities are increasing all over the world because of advanced healthcare. It is expected that elderly communities worldwide will double by 2025.” The social pressure to look after elders at home also frequently leads to complications, be it because of unqualified attendants or lack of oversight. “When elders try to take care of themselves, there can be confusion that can lead to missed medicine or an overdose which can lead to further complications, making them less able to look after themselves. “There is also an increasing trend among elders in diseases like Alzheimer’s and dementia; this is often not diagnosed properly in the early stages in part because the public lacks awareness and also because the symptoms of these conditions – such as forgetfulness, wandering around, and aggressive behaviours – are often overlooked and lead to hostility between elders and caregivers.” HelpAge Sri Lanka, the country’s leading charitable NGO (nongovernmental organisation) working for and on behalf of Sri Lanka’s elderly, weighed in on broader issues the elderly face. HelpAge Sri Lanka Executive Director Samantha Liyanawaduge and Communications Manager Ananda Kannangara shared that many of our elderly are not of sound financial background and they are also unable to work, either because of their health or because of the workforce not being welcoming to the elderly. This leads to many elders being exploited. Elder abuse is also a significant problem, whether in the form of neglect from their families and caregivers or open hostility and violence. Combating these issues From a national perspective, Liyanawaduge shared that HelpAge Sri Lanka conducts a variety of programmes and initiatives. “Our flagship programme is to perform cataract surgeries on elders in need. The surgeries are performed at HelpAge Eye Hospital in Wellawatte and are completely free of charge. To date, HelpAge Sri Lanka has performed over 38,000 cataract surgeries. Our other initiatives include a nationwide mobile medical service for elders; programmes that disadvantaged elders; free equipment like wheelchairs, walkers, crutches, hearing aids, and other medical aid; and an Ayurveda centre for elders looking for traditional medicine.” Kannangara said that HelpAge Sri Lanka also maintains a daycare centre in Ratmalana, a novel concept where approximately 60 elders in the area visit every day and engage in various social activities before returning to their families. “We also conduct the HelpAge Youth Education Programme which visits schools around the island to educate youths on the importance of helping and caring for elders. We believe it is the duty of children and families to look after elders in their old age and we always encourage schoolchildren not to neglect them (elders) and also not to send them to elders’ homes during their twilight days and isolate them from their families.” The HelpAge Sri Lanka Programme Division also provides microfinance loans to elders to start livelihood activities such as agricultural activities, animal husbandry, home gardening, dressmaking, carpentry, vegetable cultivation, garages, and small boutiques in order to giving elders access to resources they can use to build sustainable livelihoods in their old age. Assisted living in Sri Lankan society Another way to minimise issues of the elderly while providing quality care is assisted living, where elders live in dedicated elders’ homes with round-the-clock attention and care. Assisted living is a controversial topic, particularly in Sri Lankan society where looking after the elderly is something that rests with the younger generations and is treated as a family responsibility. Dr. De Silva, who is also the Founder of the assisted living facility Jude Senior Serenity, explained that assisted living plays a crucial part in eldercare, particularly for elders who are no longer able to look after themselves. “We need to cater for elders. Health wise, sometimes it's difficult, especially when elders have specific needs, medications, and diets. The main difficulty with assisted living is the social stigma that comes with it. Elders are afraid to leave their homes and families, and families are also reluctant to commit their loved ones to assisted living facilities because of the stigma.” As a doctor who worked closely with elders, Dr. De Silva noticed there was a clear lack of professional long-term care options for the elderly, which led him to start Jude Senior Serenity 15 years ago at a custom-built facility in Negombo. “Elders of a certain age and with specific conditions need to be around professionals and other people who understand what they’re going through,” Dr. De Silva explained. “The team at Jude Senior Serenity is professionally trained, from the matron-in-charge through to the nurses and aides. Jude Senior Serenity also creates an engaging social atmosphere, with group activities as well as spiritual activities for all religions.” Dr. De Silva explained that many elders face psychological difficulties, whether it is about coming to terms with their age or psychiatric illnesses like dementia. Many elders find it difficult to explain these stresses to their families, and Jude Senior Serenity pays careful attention to mental health, organising for counsellors to visit regularly allowing elders to release their burdens. “When it comes to choosing to go into assisted living, many elders make the decision themselves,” Dr. De Silva said. “The decision is also made by families who have come to realise that their loved one is not safe at home and is better served in an environment with constant care and trained professionals who can respond effectively in an emergency, and when the time comes, make them comfortable towards the end of their lives.”

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