Tuesday 26 May 2020

Enough with calling them ‘vulnerable’ – how about we treat senior citizens with dignity?

This column first appeared in Malta Today

It is not a good time to be of a certain age.

Not only is the Coronavirus more potentially dangerous for those who are older (as well as for those with weak immune systems because of underlying health conditions), but it seems all you hear every day in the news is the dreaded term ‘vulnerable’.  This is not to detract from the timely decisions taken by the health authorities which took immediate measures to ensure that the older demographic is safe.  One of the reasons we have thankfully not had a large number of critical cases or deaths is because swift action was taken. Churches were closed, homes for the elderly were put under lockdown with carers sleeping there to avoid too much outside contact and those who are 65+ were advised to stay home as much as possible and to not have contact with their grandchildren who might be carriers. 

For the most part, everyone has obeyed, because as I have written before, one glance at news emanating from Italy was enough to chill us to the bone.  The fact that, two months down the line, the number of active cases is 65 with no patients in ITU, is further proof that we got it right so far, because if we hadn’t, believe me I wouldn’t be writing this.    

However, there is a whole generation out there which, while dutifully taking each directive to heart, still deserves to be treated with respect. Post Covid-19, we are going to have to learn how to be active members of society again, and this holds true for all age groups. So why the constant message that those who are 65+ have been lumped in the ‘vulnerable’ category, which is now starting to take on the connotations of being frail and invalid?  As well-meaning and well-intentioned as it was, ‘vulnerable’ is started to sound very condescending.  

I don’t know about you, but I have a number of friends, family members and acquaintances who are 65+ and the last adjective that comes to mind when I think of them is ‘vulnerable’.  Instead they are vibrant, physically active, independent, fun to be with, interested in current events and generally living their life to the full. They may be retired but they have certainly not been put out to pasture.  Again, I am not refuting that the older we get, the more high risk we are when it comes to Covid-19 (or any virus for that matter), because this is a fact. However, after two months of hearing the word vulnerable, I think we now need to find a way to talk about high risk groups without making it sound like their lives are basically over and they might as well lock themselves up indoors and throw away the key. 

The attitude of Maltese society towards those who are older fluctuates between genuine endearment, to over-the-top sickly sweet phrases, to resentment at having to ‘put up’ with one’s older relatives and, at the extreme end of the scale, complete neglect once they are dumped in residential homes. Now with this virus, there is the temptation to write off anyone who hits the magic number which defines them as ‘old’, treating them like they are passed it. I believe in respecting those who are older but not in treating them with pitying phrases such a ‘jaħasra’ and ‘miskin’. I have in mind the type of child-like, patronising voice some people use when speaking to a senior citizen, as if they have suddenly become dim-witted because of their advanced age. This happens all the time when I accompany my mother to her various appointments and errands (of course, this was before Covid-19 confined her indoors). She is 85 and sharp as a whip, whose only drawback is that she suffers from glaucoma, so I often feel irritated on her behalf by the baby voice some insist on using, and it takes a lot of self-control not to snap back at them, “she’s visually impaired, not an imbecile”.   Over-familiarity also grates on my nerves: when serving an older client whom you’ve just met, please don’t use their first name. What is worse is when the person serving us addresses me about her needs and ignores her completely, at which point I tell them that she is quite capable of answering the question and to please address her accordingly.   We may slow down as we get older, but it is highly insulting to treat older people who are still a part of the community as if their mental faculties are no longer there.  

It is for this reason that I bristled at the news this week that non-essential retail shops were asking for ID cards and turning away those who are 65+.  I was informed that retail shops had been sent a letter by the health authorities to not allow those who are vulnerable inside the shop, but since this is (a) not legal and (b) impossible to enforce, it created understandable outrage.  With the same reasoning, why not ask those who are under 65 but are in the vulnerable category because of a health condition, for proof that they are healthy?  It sounds preposterous, right? That’s because it is.  It was later clarified in a Malta Today report that, while the public health recommendation for this group of people to stay home still holds, the onus of responsibility is on the individual, not the shops, and there is no penalty involved. 

The anger which spilled out over this issue is because, after two months, there is only so much those who are older can take. They have been deprived of seeing their children and grandchildren, they can no longer follow the pursuits they love, and as they see certain measures being relaxed, it is becoming highly exasperating and frustrating for them to look out their windows and balconies as life goes on without them.  I repeat, I am not blaming the health authorities for taking drastic action to avoid the tragic scenario we have witnessed elsewhere, where hospitals could not cope with the critical cases, and even worse, where doctors had to choose whom to save. 

However, I think it is now time to come to some form of compromise to allow the 65+ age group to resume some semblance of normal activity which is crucial for their dignity and to restore their sense of independence.  There can be specific times of the day set aside for them to do non-essential shopping for example.  Time slots should also be applied for them to be able to go out for short walks without having to worry about bumping into too many people (a measure which has been implemented in Spain).  It worries me that as more measures are lifted, that the 65+ will still be treated differently – are we going to end up telling them, for example, that everyone can get back to their normal routine, except them?  How is that even possible without crossing over into the realm of infringing on personal liberties?  

Although there is nothing legally binding which prevents this age group from going out, the message which has been hammered home daily has worked on their psyche and now it could perhaps do with a bit of toning down. Otherwise we are not only facing the possibility of a whole generation which has become clinically depressed and whose spirit has been crushed at being called vulnerable day in, day out, but they might also have become unnecessarily agoraphobic, fearful of the outdoors. Of course, some older people have completely ignored all the warnings and stubbornly continued their way of life, saying that they are too old to be told what to do, these are the last years of their life and if they had to stay indoors all the time they would rather die.  A video I watched about the mental health of people in Italy who are only now emerging from a strict lockdown, points to the psychological toll it has taken on many senior citizens who have been isolated and cut off from their families and usual lifestyle for too long. Those delivering food to them have often been  their only source of human contact; a situation which is too sad for words. 

Like everything about this virus, it is a fine, delicate balancing act, which needs to be handled in the best interests of public health but also with sensitivity.

I feel there must be more attention paid to how we address those who are 65+ and how we refer to them in the media (even the terms ‘anzjan’ and ‘elderly’ can jar for those between 60 – 75 because they conjure up a very negative image). What must be borne in mind is that even after many decades have passed, most people still feel the same way inside. The person they were in their 20s and 30s is still there, although the physical appearance says otherwise.  We cannot dismiss the feelings of those in a certain demographic purely because of their chronological age and the date of birth on their ID card. Human beings are multi-faceted and are certainly defined by much more than their age.  It is useless talking about active ageing if, after all this passes, too many people feel marginalised as if they are no longer part of this society.

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