Tending to the elderly: Caregivers who become family members

Seventy-five-year old Selim Uddin (not his real name) is a former government official who has been suffering from dementia for the last five years. During fits of anger and confusion, which are frequent, he cannot recognise his own family members and refuses to eat or take medicine. 

When his daughter appointed a caregiver for him, Selim did not allow the person to enter his room. But the caregiver, 32-year-old Md Aminur Rahman, refused to give up. He sat in the dark outside the room for four days until Selim let him come near him. 

"I told his daughter, Apu, give me some time and let me try some more," recalled Aminur.

Little by little, Aminur found ways to gain Selim Uddin's trust. "When he would go to the bathroom, I would try to help him by holding his hand. When his daughter fed him, I would try to give him the water and so on," he said.   

Unlike registered nurses, caregivers like Aminur, who mostly work with senior citizens, try to form a bond with patients and in many cases, they become almost like family members. 

"I lost my father when I was eight years old. My patients remind me of him. If he were alive today, I would have taken care of him the same way," said Aminur. 

Aminur has been a caregiver for six years. He works under an organisation called Sir William Beveridge Foundation. He received caregiver training for six months but does not hold a certificate. However, he can operate simple machines to check blood sugar, etc. 

Fifty-year-old Gul Nahar has been a caregiver for nearly seven years. She works under an agency called Lifeline. Although she has received some basic training, she cannot administer medicine or push insulin like Aminur.

Quiet in nature and deeply religious, Gul Nahar believes, "It was Allah's wish that I take care of the elderly and so I happily do it. I earn from my work, true, but I also know it is my duty to help those in need."  

Most of her patients are elderly women who are bed ridden. She has also worked in families where children live abroad and the house is empty and Gul Nahar's duty was to simply give the elderly couple some company. 

"There are so many houses in Dhaka where everyone lives outside of Bangladesh and there is one mother or father living alone, most of the time suffering from various age related ailments," she said. 

"In such cases, we become their caregivers and a part of their lives," she went on. 

Caregivers like Gul Nahar and Aminur work in 8 hour or 12 hour shifts. If a patient requires 24-hour care, two caregivers stay with them in two shifts. 

Clients pay the agencies directly. The caregivers are given a monthly salary. If clients wish, they can give extra payment or a festival tip to the caregivers, but it is not mandatory.

Some agencies have per day rates while some have a monthly payment structure. Per day rates usually vary between Tk600 and Tk1,000 and monthly cost can go upto Tk25,000. 

Gul Nahar's agency, Lifeline, has 120 caregivers, male and female, at the moment. The organisation is owned by a group of senior doctors and the trainers include diploma and non-diploma medical professionals. 

"Those who have previously worked at medical centres do not require much training. But our monthly training is currently on hold due to Covid-19," a senior official from the organisation informed us. 

Aminur works for Sir William Beveridge Foundation, who have a government-approved training centre run by medical experts. Currently, the organisation has around 300 caregivers.  

Paid to become family

In 2020, Gul Nahar was staying with a patient in Gulshan. She could not leave the house because everyone in the family became infected with Covid-19.  "The daughter locked herself in her room; the relatives were nowhere to be seen and only I was there with the khalamma [the patient]," Gul Nahar said. 

The house help and cook were also Covid positive, so Gul Nahar cooked and took care of everyone in the house. She could not leave the house until all of them tested negative, and stayed with them for more than a month. 

"Unfortunately, that khalamma passed away from Covid related complications. She died in my hands," said Gul Nahar.          

Have you ever had a young patient? Aminur replied, "I have had patients as young as 12 years old. The boy had autism and needed regular exercise so I was there to help the physiotherapist."

While Gul Nahar has not had a patient who became better, yet, Aminur had a few who eventually became healthier and no longer needed caregivers to look after them. 

But there are some particular deceased patients that Aminur cannot forget because he became really emotionally attached with them as well as their families. 

There was a patient in Mohakhali DOHS that Aminur looked after for months. It was Ramadan when he first came to the house and Aminur was carrying a box full of instant noodles to eat for Sehri. "When the uncle heard I had noodles, he forced me to go to the kitchen and cook something for myself."  

"Who expects such kindness on their first day at work?" said Aminur. 

"When he died, I fell into a daze. I often think, how did the person I bathed, changed clothes, fed, and had long conversations with, stop to exist within minutes?" he added, stifling tears.  

People like Aminur and Gul Nahar are clearly very heavily in demand as more and more young people struggle to find time to personally look after family members with special needs.

"I have not had a single day without work," said Aminur.   

All of Gul Nahar's family members, including her husband, earn, so, no one is entirely dependent on her income. Her children are married and live with their spouses. 

Yet, she prefers working and staying out of the house. "I earn and enjoy my freedom. Tending to the sick and elderly also works as a reminder that we all have to leave this life on earth one day," she said.    

Aminur has a four-year-old at home. His wife also works as a caregiver. His mother also lives with them. He dreams of going back to his village in Chandpur and opening a pharmacy one day.  

"When my 80-year-old mother fell and broke hip, she became completely bed ridden. We appointed two caregivers who did everything for her. Being a diabetic patient, she needed to use the bed pan through out the night and the caregivers handled all that with very well," said Minhaz Masum, a lecturer at a private university in the city. 

He added, "We were satisfied with the overall experience with the caregivers and how they took care of her, who could not do anything by herself." 

However, he mentioned one thing, which was slightly inconvenient for them. 

"We had to give them breakfast, lunch and dinner, which became a hassle for our cook. The agency that gave us did not clarify this with us so in terms of food that we had to provide them, the per day rate became more than what we agreed upon," he said.  

Lifeline

Established in 2003, Lifeline provides comprehensive home-healthcare services to patients at home. Caregivers can be hired on a daily basis and the per day rates vary between Tk600 and Tk900. Their office is Lalmatia and their contact number is 01977557555.

Sir William Beveridge Foundation 

Sir William Beveridge Foundation is a UK-born international charity founded in 2006 by Dr Rahman Jilani. Along with providing homecare services, the organisation also addresses the need of diagnosis, care and treatment of people with dementia. Monthly cost of caregivers is between Tk20,000 and Tk25,000. The office is in New Eskaton and their contact number is 01730057405.