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Care…Do We? Can We? Should We?

I am back on semantics, and again on the word CARE. Yesterday I spent the day with my wonderful friend Alhena Curreri – half Italian, half Dutch, totally crazy. We walked the streets of Glasgow, had a terrible meal followed by wonderful Chinese food, and talked for hours on end about our shared passion – Older People.

The more I think of the word CARE and the way in which we use it, the more I am convinced that we should seriously rethink our approach to “Aged Care”. We are spending millions across the globe to find the magic wand, and fail miserably, most of the time. Ageing is still something that scares most people, and the thought of having to move into an institution (whatever this might mean – old age home or retirement lifestyle complex) is frightening for most. And yes, I often hear the counter-argument – how happy people are that they made the move.

I want to argue that this “happiness” is often just a relief that they no longer have to worry about mowing the lawn, house maintenance, grocery shopping etc. It soon starts deteriorating into a downward spiral which is called “ageing”, which in my opinion has a lot more to do with the environment than it has to do with physiological ageing. Athul Gawande, in his seminal work “Being Mortal”, elaborates on how the “assisted living” communities started in the USA. No worries, we do it for your type of community. Good idea. Is it? Not really…

The idea of ‘retirement’ is complex. Very few people are prepared for this phase in their lives, where it is assumed that they should “stop working”. For many, it is often a red light at which they stop living. We see a trend of people who die very shortly after retiring, especially men. Suddenly there is a health problem that never existed before. Trouble sets into a long marriage where a wife is suddenly confronted with a husband who was never at home. Relationships deteriorate to the extent that health is affected. What is supposed to be the best time of their lives for which individuals worked very hard, saved money, and made plans, turns into a miserable nightmare.

Going from a full-time, stressful employment scenario to playing golf and gardening is problematic. Add to this the move to a retirement facility where everything is laid on, stripping people of their autonomy, and for many their sense of purpose. We now see the classic scenario where especially men start “interfering”. They become a member of the Trustees of the complex and nd fault for every single decision made. Wives become more and more disgruntled by everything from the food to the garden services, and before you know it, a toxic, even malignant social environment is created. Sooner than later, we will nd more and more serious complaints around physical health, mostly caused by a state of emotional discontent and disconnect.

Whilst many people in South Africa ock to retirement complexes for reasons of safety and security, I do believe that we should reconsider this housing model in favour of more intergenerational communities which are managed and staffed by those who live in the village. The “Madam and Eve” scenario that most of us in South Africa grew up with is not conducive to healthy ageing. Whilst many an Eve becomes a con dante of Madams, the fact that they often do all the hard work means that Madam might be at risk of not staying as t and healthy as she would have had she done her own housework…

Institutionalisation goes beyond the hospital feel of so-called “frail care”. Many people become institutionalised as a result of the setting of a retirement village where they simply do not have enough to occupy themselves, worry about or keep actively engaged with. Staying active is more than going to the gym or water aerobics once a week. It means being engaged, taking an interest, making a difference, having a purpose, getting upset, and being involved. We need to create communities that are inclusive. of everyone. Especially for people living with different abilities. That is where the real meaning of the word CARE comes in – creating inclusive communities where CARE goes in both directions, not just from the stronger to the weaker.

CARE – in the institutional setting – is about a power imbalance. I, the stronger, care for you, the weaker. This transaction means that the weaker will just get weaker, and the carer will take more power. In a community where everyone is included, where people have a role to play, and where there is support, there will be less of a need for this kind of care. People will support each other without a power imbalance – they can barter, do mitzvahs, do good deeds, charity. This is what civil society aims to be – “a community of citizens linked by common interests and collective activity”. But more than that, if we can add working towards a greater good, we will truly see how people start flourishing. Because they will feel that they matter. That they are significant, and not just “the lady with the hip problem in cottage 4”.

We must stop thinking that retirement villages are the answer to a life worth living for older people. It is not. The answer is in creating communities where people can thrive, human habitats.

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