Since Dhaka is consistently ranked as one of the worst cities in the world to live in, it isn’t much of a surprise to see Bangladesh win the distinction of being the second-worst country in the world to die in.
The quality of death index -- released by the Economist Intelligence Unit, the same folks that labelled Dhaka as the world’s least liveable city -- showed that only Iraq was a worse place in which to die.
This is hardly a shattering revelation. Bangladesh has a problem when it comes to treating its elderly. In spite of being a culture that -- superficially speaking -- insists that our elders should be treated with respect, the state in which we leave our elders to languish is woeful.
The quality, availability, environment, and cost of end-of-life care -- factors used in the Singaporean-commissioned study -- leave much to be desired. Running low on finances and physical strength, many of our elderly find that they have no place to turn to in their twilight years. Palliative and hospice care are still fairly new concepts here.
This is sad. Bangladeshis are, ostensibly, proud of their strong family values. We like living together under one big roof. Adult married children continue living with their parents long after they can afford to move out; three or more generations sit at the dinner table together and go on vacations together.
In the kind of family structure where even attempting to move out of your parental home can be seen as betrayal, the mere thought of shipping off grandma to a nursing home is seen as taboo. We take care of our own, and surely the old lady would be better off with people who love her, as opposed to some clinical environment run by professionals.
There is something very wrong with this attitude. No matter how much we care about the elderly in our own families, we are not qualified to take care of them 24/7. Even if we were qualified, the average Bangladeshi home is ill-equipped to take care of the old and frail, and the internal set-up is often an accident waiting to happen. Old people tend to accumulate a mind-numbing amount of health complications, and their lists of ailments increase every day. They need specialised care. The love of family can never be a substitute for a proper care facility.
Along with physical needs, there are psychological factors. As we age, and our physical strength and bank accounts dive south, our sense of independence gets eroded. This is never made better by the fact that grown children, who have their own share of worries, are constantly having to take care of their elderly parents, oftentimes seeing them as burdens. Nobody likes to feel like a burden, and living in somebody else’s home without being able to contribute often does exactly that.
Furthermore, how much good will really lies behind wanting to keep our elderly out of nursing homes? When a dependent older person stays with a family, it is generally the women of the family who do the lion’s share of care-giving. This limits their mobility even further, restricting their career options and social life. Under the guise of family values, the unwillingness to give professional care to the elderly really hinders the advancement of women.
We need to stop seeing nursing homes or retirement communities as evil places where only neglectful children take their parents. Once we can do that, it is time to start making sure these places give the right kind of treatment to their residents. Our health care system is notorious for malpractice, which is why those who can afford it fly off abroad whenever they need medical attention.
This won’t be feasible in the case of long-term elder care. We need quality, affordable nursing homes right here so that our parents and grandparents don’t have to suffer on their last days on Earth. Everybody gets old, and how we treat our elders now is a preview of how those of us who are still young will one day get treated, once our vital organs are no longer in mint condition.
The stereotypical view that Western cultures obsess over youth while we sub-continentals have a tradition for respecting elders hides an ugly truth -- we haven’t bothered investing in the proper infrastructure, and have left the fate of people in their golden years up to chance.
It will do us a lot of good if we can ensure that our elderly find a little peace in this life before it is time for them to finally rest in peace.