Ageing Lines October

This is a space dedicated to caregivers and elderly patients, created with anonymous collaborations from the WONCA Special Interest Group on Ageing and Health. This section includes inspiring anecdotes for the simple purpose of adding value and quality to older patient’s lives.

Discover below the collaborations from members of WONCA Special Interest Group on Ageing and Health dedicated to International Day of Older Persons, celebrated on 1 October, 2022 under the theme “Resilience of Older Persons in a Changing World.

"A woman in her late seventies visits my clinic during my morning shift at a suburban primary healthcare center, which serves an impoverished population of many nationalities, including Lebanese, Palestinians, and Syrian refugees. "How can I help you, ma'am," I asked with a smile. She could barely raise a smile back. You could feel the intense suffering and adversity she has endured. She was an older Syrian refugee who arrived in Lebanon one month ago with her older husband. Her green eyes were the only distinguishing feature of her appearance, which comprised a black veil and a traditional abaya. The eyes are said to be the windows of the soul. Through her eyes, you could sense and admire a spirit of resilience, the resiliency of an older Syrian woman. “Since I have recurrent blood clots in my leg, I've been taking a blood thinner for the past few years. Three months ago, I stopped taking the blood thinner", she added, "There are no remaining medications in our community." This woman could have easily gotten a clot or, worse, a stroke, and may have died. "Did you seek out the medication in Lebanon?" I asked. Suddenly, she was in floods of tears and struggling to find the right words to answer. “Doctor, I don't have any money. My husband is unemployed and unable to find work. They told him that he was too old to work and that it would be impossible for him to find a job. My only son was killed in the war, and we no longer have any financial support. Could you please help us” She added. In essence, this older lady represents many older women and men in our region who continue to face years of armed conflicts and a greater threat of poverty, discrimination, and erosion of traditional support systems with no access to basic social and healthcare services. Never before in my life have I experienced such a circumstance, and it is in such moments that you realize your responsibility as a physician extends beyond medical care to encompass the social needs of your patients. Is her blood thinner a higher priority than the dinner on the table? As healthcare providers, we often have our list of priorities, while our patients have their own, which highlights the importance of effective listening and communication skills to better understand our patients' priorities. This older woman's top priority was food, not medication. With no food, survival is at stake. Malnutrition, low immunity, and the complications of infectious diseases in the cold season can be fatal. After a few seconds of silence, I reassured her that I will do everything in my capacity to assist her with all the available resources at the center. Every older patient has a hidden agenda and a list of priorities and challenges, and every older refugee has a story of perpetual struggle for survival, which we as primary care physicians should uncover in order to better address their needs."

There are many stories of older women who have made major contributions once their family responsibilities have been resolved. I have a patient like this. She was a high school teacher for many decades, but when she retired in 2001 she was able to pursue her lifelong interest in frogs. In fact she completed a PhD on frogs in her retirement. She would see me intermittently between field trips, some of which involved camping for many weeks in the desert beside anthills known to shelter frog eggs, waiting for the rains to come so she could document their emergence. In other fieldtrips, she found some frogs not previously described. Her publications on frogs run from 1974 right through to 2018. I was amazed at her resilience. As I spoke to her about this passion, so very distant from my experience, I started to realise how important frogs are as a sign of the health of our natural environment, and to welcome their croaking at night in my back garden.   She has forever changed my attitude to this important species in our environment

Our Elders, A pillar of strength for the society.
I remember my patient who is an active community worker at the age of 85. He is a known hypertensive and hypothyroid for many years and is controlled on medication. His devotion towards his community and neighbourhood is commendable. Daily he pulls out his small car and gathers a list of items people have communicated and brings all the stuff and delivers it, simultaneously providing pick and drop service for many in between. He knows people by name, their issues and the problems they are facing. People seek his guidance in matters which are difficult and he would go a long way to help them. When it comes to charity he not only donates but also collects it to help those in need. He has been doing this service free of charge for the last many years and will continue . When I see him im lost for words!

She is a 76 years lady that I have known for the past 26 years. She had hyperlipidemia and trying to manage going through menopause. She had one son who was getting ready to go to the United States for higher education. She was keeping herself busy by volunteering in several non governmental organizations who take care of sick children, especially those affected by cancer.  She went into depression few years after her son departed when her husband died suddenly and refused to take medications or go for psychotherapy. About 5 years later, she came in for check up and seemed to have recovered. She talked with great enthusiasm about an activity she has been engaging in for the past few months whereby she goes visiting older women living by themselves whose children left either to work or study. She would read them stories or converse with them and keep each company for one or two hours a day. Women were enjoying her visits and asking her to visit their friends too. As she is feeling the need growing, she was trying to recruit other women to help out. After I expressed my admiration for this community initiative, she explained that she was inspired by the words of an actress in a movie she was watching. The actress was an older woman who was having, in the movie, a rough relation with her daughter and told her “if I am alone and you are alone then we should not be feeling lonely”. This phrase triggered some reflection in my patient that made her go out and seek other women in similar situations for reciprocal support.

The last time I saw her was eight months ago when she came in to have a resume of her medical record. She was getting ready to leave and join her son who have settled in the United states. The Covid pandemic and the economic deterioration in Lebanon thereafter (with electricity cuts, poor internet and high transport costs) made it difficult for her to continue with the socializing visits. She was getting tired going on feet or going upstairs as elevators were nonfunctioning. Her son asked her to help him babysit his children and that made her feel useful again. “ I am keeping contact with them ( women she was visiting) by watsApp and will be back again, she said, to visit them when the situation get better in Lebanon. They gave my life a purpose”.