Challenges and realities of elderly care in Goa

By Maya Rose Fernandes

I recently attended a special screening at the Entertainment Society of Goa, in Panjim, of the movie Goldfish, starring Kalki Koechlin and Deepti Naval. Apart from stunning performances by the two protagonists, this picture accurately uncovered the layers of what it is like to witness a parent with dementia.

Set in London, the absent daughter arrives at her mother’s house to assess for herself how bad her mother’s mental state has become. Her insights are tempered by the reassuring presence of neighbours who have taken to keeping a hawk’s eye on her mother.

The movie begins at a tipping point, when the daughter needs to make a decision about putting her mother into a very good care home for the elderly, or take on the responsibility to care for her herself.

Kalki’s ‘daughter’ character has a long-term partner and a job opportunity waiting for her in another life, and the movie deals with her inner conflict about putting her mother in the care home or looking after her mother herself, in spite of what appears to be a very tension-ridden relationship between them.

More interesting than the ending was the evocative journey that the movie takes us through. Viewers, with parents of a similar age, would likely be able to relate to some of the difficult emotions and tensions a child has to navigate, when their parents reach a certain age.

My close friends and I are all at that age where our parents have serious health and mobility issues that need to be managed. One of my friends commutes three hours one-way every weekend to check in on his parents and make sure that they’re taking their heart medication, eating healthy and attending their medical appointments on time.

Another friend has started spending months at a time visiting her parents in a different city, which she can do thanks to remote working in her line of work. But, she is living with the uncertainty of what the long term plan will be.

Another friend is not looking forward to the day when his parents move in with him and his wife, because they have completely different values, lifestyles and expectations. It’s a source of great anxiety for them both.

Recently, my sibling and I had to go through something very similar as in Goldfish with our parents, except that, in their case, the decision to go into a care home as a couple, was theirs, after discussing all other options with them exhaustively.

I should contextualise this saying that my parents are untypically Goan in a few ways, and this is one of them. They have always prided themselves on living independently and taken good care of their health. But, a few years ago, my father was diagnosed with Parkinson’s disease and my mother’s old age finally started to show when the endless search for home care became too anxiety-defining for her.

After a Goa-wide hunt, they settled on a well-equipped, newly opened care home, where they wouldn’t have to worry about daily meal preparations or house-cleaning and all the amenities would be provided to them. My sibling and I paid a few visits beforehand to check out the place that my parents had chosen, and we liked it.

As many will attest to, it’s hard watching your parents grow older, but there’s nothing that quite prepares you for the milestone of seeing them enter a care home for the elderly. Nevertheless, soon after they arrived, I noticed that my mother had a much more relaxed tone in her voice. I was relieved on her behalf. But, then we realised that my father required additional help and we started looking for a live-in, patient care-giver to provide support.

Anyone who has lived in Goa for a substantial amount of time is well aware of the high rate of staff turnover as far as house-help is concerned. People need to acknowledge how frustrating and anxiety-forming this is for elderly people who, as they age, have a decrease in cognitive and decision-making abilities, are often combating depression from struggling with difficult health diagnoses, and the increasing lack of mobility that even the fittest bodies can manage.

There are now a few independent senior living and decent elderly care homes coming up across Goa, which are affordable for more privileged people. A few service industries are providing elderly and patient care on demand.

But, no one is talking about how high the demand for these services actually are and how many people across Goa are actually using them. Client lists are already well in the thousands and services are oversubscribed!

As we have evolved as a society, we understand more about modern healthcare needs and provisions, and the reality is that often, our parents need and deserve more care than we can give them, in order to have a better quality of life.

In most cases, children aren’t the best providers for this, especially when it comes to caring for parents with challenging diagnoses like Parkinson’s or dementia. Unless children are willing to train themselves to provide medical assistance and nursing help on top of other types of care-giving support, at most, they are able to provide some physical and emotional support, depending on their family relationship.

The social stigma against living in a care home needs to be managed, not least because parents deserve to be better looked after, if they can, in homes that provide the kind of patient care and attention that they require.

I know of many peers who are struggling with resentment, guilt and exhaustion because they are living with the burden of expectation of care-giving for one or both of their parents. Sometimes, doing your duty and making the more responsible choice involves having the maturity to know your own limitations and supporting your parents in ways that defy society’s expectations of what care ‘should’ look like.

As these services in Goa are improving, they should be supported with more investment while being scaled up and across the state more widely. Entrepreneurs need to provide more medical and nursing training to the service staff they hire, and generally improve the service, and, hopefully the de-stigmatisation of using elderly care homes will increase in our society.