MEDICARE
Caring touch at home
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With the number of elderly people increasing, home nursing will become an important issue in the years to come. Prema Manmadhan
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Photos: Vipin Chandran
Big role: Sini with her patient Clara Scaria.
ATTY LOBO had come all the way from Goa to the Red Cross Society at Kottayam. She needed a home nurse for her 82-year-old mother-in-law. “Ten years ago, I got a home nurse for my father-in-law from here. Now, my mother-in-law needs company and I need someone to look after her and give her the medicines on time,” she says.
There are 24 people sitting in the huge hall. All have come to get home nurses; some are from Kerala, others are from Tamil Nadu, Karnakata, Andhra Pradesh, Mumbai and Delhi. Twenty-five home nurses, dressed in white, are sitting in another section of the hall waiting for their next assignment.
Rules
“We insist that those who want home nurses must come here and take them home themselves the first time. Inside Kerala, they stay in a house for three months, but outside the State they can stay for six months, after which another nurse must take over,” says K.T. Ouseph, honorary secretary of the Red Cross Society, who started the concept of home nurses 20 years ago under the aegis of the Red Cross.
About the same time, the Self Employed Women’s Association (SEWA), the biggest women’s trade union in Asia, also began to help women find work collectively as nursing assistants. Kerala, with its high literacy rate and increasing number of working women, was the first State to feel the need for home nurses.
Today, there are 6,000-odd agencies in Kerala who recruit home nurses but, barring a few, most do not follow any norms. Supply and demand seem to be the only two criteria that govern institutions from where home nurses can be employed.
Says one woman who runs a home nurse service in Kochi, “Yes, it’s a very good business. You can make a lot of money. You don’t have to register anywhere. Very little capital is needed. All you do is give an ad in a paper and see that you have enough home nurses. The registration fees are good. You only act as a middleman.”
Adds Louis P.J., of St. Teresa’s Nursing Services, Kochi, “There is no need to register. We have been asking for some sort of norms or Government control so that bogus agencies will close shop, but nothing has been done.”
The Health Department corroborates this. There are no governmental checks though, time and again, State health ministers have promised it. But the services that home nurses provide cannot be undermined. If not for them, who would look after the many old people who are all alone in many homes? Old age homes would be the only alternative.
There are two sides to everything. So too with home nurses. “I will never forget how Devu looked after my father, who had Alzheimer’s. I had reconciled myself to the fact that he would die on the streets but, thanks to my home nurse, he had a peaceful end,” says Annie Philips from Kottayam.
Anandam Nair from Kochi gives the other side of the picture. “I sent back the home nurse after two days, because we had to get non-vegetarian food from the hotel for her and she would sleep when my mother was calling for help to go to the toilet at night.”
Bigger roles
Complaints notwithstanding, with longer life spans expected with better medical care, home nurses will have a bigger role in society in the years to come. The first-generation nuclear families have become the first ‘victims’ of going ‘nuclear’. With both men and women working and children in schools, old parents have to fend for themselves.
But fewer people are willing to be home nurses now, say the agencies. “When we started 15 years ago, we had fully trained nurses who were paid well to be home nurses. Now, we don’t get fully trained nurses. We don’t even get enough nursing assistants. Today, we have hardly 400 though we pay them well,” says Dr. Prathapan of Lifeline, Thrissur.
The Red Cross Society, Kottayam, has 23,000 home nurses on its rolls but Ouseph says, “We could do with 23,000 more. The waiting list is that long.”
Very few of the home nurses are happy to be there. “Nobody wants to marry a home nurse, though society needs us,” says Rani, now six years into the job. Twenty-year-old Sharwani, from Karnataka, has just completed a stint in Chennai, looking after a 95 year old man.
“He was bedridden and I had to do everything for him. I massaged him thrice a day, made him do exercises and gave him his food. He would read a lot and the folks in the house were very kind to me. Now, I am going to Hyderabad.”
There are male home nurses too, but they never stay long. Asha Sudhakaran is 18 and she has been a home nurse since she was 15. Her mother was a home nurse and so were her sisters.“Most of the people are good. I was in Anantapur last,” she says.
Rohini has been in the field for nine years. “I have always had bed-patients (bedridden) but I am happy to be of service to the old,” she says. Her patients included a 110-year-old woman and she is not scared of seeing people die either, she added.
Salaries
The salary ranges from Rs. 2,800-5,000. Half the salary of the Red Cross nurses has to be deposited in a bank account. “At least they will have that when they quit,” says Ouseph who insists on it, as many of them give all they earn to their families.
Male home nurses get paid more. They see the job as an interim arrangement before they get a ‘real job’. Most nurses, male as well as female, come from interior places like Idukki and Wayanad. Red Cross rules stipulate that males must be at least 5ft 6in tall.
Sarat (22), from Wayanad, is studying for his M.A. He was looking after 84-year-old Sreenivasa Murthy in Anantapur district, Andhra Pradesh. “He was a doctor in the U.S. and after coming back, never got over the jet lag. He would sleep during the day and watch car racing in the night. I had to prop him up from sleep in the afternoon to give him lunch. His people were nice and I could study in the night while he watched racing videos,” says Sarat.
Problems
However, one bad egg is enough to create a big stink. Thus home nurses got a bad name when a few indulged in theft and other inappropriate acts.
“But nobody looks at the other side. Many old men make life hell for these girls by behaving badly. That is why only men over 75 years are allowed female home nurses. In some houses, they make them do house work, which we don’t allow. The problem with some girls is that when they go to the city, they yield to the first temptation that comes their way. We train them for life in metros, but many elope with drivers or others in neighbouring flats,” says the owner of a Kochi-based agency.
Just as nurses did not get their due in the early days, home nurses also are not given due credit for their services, they feel. But with the demand far exceeding the supply, the day is not far when they can set their own terms.
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