Elderly Emiratis a key part of family life

As a geriatric specialist, Dr Salwa Al Suwaidi has spent all her working life caring for other people's older relatives.
But today her work is much closer to home, as she sits by her 80-year-old father's bedside while he recovers from a fall. The specialist senior registrar does not want her father to remain in hospital for long and is keen to bring him back to the family home, without compromising his care.
"It is important for him to be with the family. Because when they start losing their independence, even the ability to go in and out of the washroom, it will cause them psychological stress, which can turn into depression.
"We as a family are more efficient at giving them the support and helping them relax after the break. It is also less costly for the government to have older people with their families."
Dr Al Suwaidi, a specialist senior registrar at the geriatric unit in Rashid Hospital in Dubai, is continuing a strong Emirati tradition in which older relatives remain in the family home their whole lives, rather than entering any sort of residential-care home. But this tradition is likely to put increasing strain on families as the number of older people steadily increases over the next few decades.
The over-60s in the UAE represent just 4 per cent of the local population, but in another 40 years it will be closer to 20 per cent.
The vast majority of these people will stay in the family home for the remainder of their lives, sometimes putting significant emotional and physical pressure on their relatives and caregivers.
But the tradition is such an important one it is unlikely to ever change.
"The main focus is we need to care for people living with their families rather than making other set-ups like hospitals or elderly homes. This is not a solution. This is not what happens here," says Dr Yasser Al Nuaimi, the director of the RAK Medical District, which falls under the Ministry of Health.
In light of the population forecasts, health authorities are focused on expanding and improving the home-care model to make sure families are equipped to deal with the growing numbers of over-60s.
Nursing or elderly residential homes are few and far between, with one in Dubai, one in Sharjah and one in Ajman. Only those with no living immediate family and no communicable diseases or psychological illnesses are allowed to live in them.
"Yes, the number of elderly people is going to go up, so we are looking at the needs of these people and the types of diseases they may suffer," says Dr Al Nuaimi. "Part of this is educating everyone to expect that the numbers will be higher."
Ras Al Khaimah already has a busy home-care programme, which was set up in 2008 after an investigation found that one in two patients in hospital beds could be treated sufficiently at home.
It involves three teams of nurses and geriatric specialists, who travel to homes helping families adjust to coping with an older relative.
Where necessary, they are taught to perform minor nursing procedures such as changing a urinary catheter bag or dressing a pressure wound, Dr Al Nuaimi says.
"Here in Ras Al Khaimah, previously people were afraid of taking care of their elderly and doing small things like changing blister dressings," he explains.
"They wanted us to keep the elderly in the hospital, occupying a hospital bed. With the help we provide, many of them accept that they can keep their relatives among the family and help them and given them medication.
"We need to help families to cope."
A policy brief from the Dubai School of Government, published in February, acknowledges that the older population in the UAE requires better protection.
Those without living family do not always receive enough care and may suffer mentally, physically and financially in their old age, the report states. The facilities that do exist are also not adequately prepared to support and deliver effective care because of a number of challenges linked to budgets, growing numbers of older patients and a lack of specialists.
"The public policies focus on youth development and child protection, but the focus needs to change to include older people. The future policy should support and include the current social policies, such as protection of the elderly in the social security law."
To that end, Mariam Al Roumi, Minister of Social Affairs, said last week at a conference marking the International Day of Older People that new legislation would be introduced to better protect the rights of the elderly.
It would help in "unifying regulations and efforts across the country", Ms Al Roumi said.
Having a vulnerable older person in the family home can be stressful on a family, Dr Al Nuaimi says, so it is imperative that families are given enough support by the Government. Without it, the older people could be at risk. Private home nursing can cost tens of thousands of dirhams a month, so care is often delegated to home helps, much like childcare.
Investing in 200-bed residential-care homes would be a waste of the Government's money and the beds would likely remain empty, according to Dr Mahmoud Jaloudi, the chief of medical oncology at Tawam Hospital in Al Ain.
"We have to set up proper home-care facilities or home-care agencies where the elderly could stay at home but have visiting nurses that go out on a regular basis," he says.
"The idea of nursing homes and putting people elsewhere is not ingrained in the local culture and will never be accepted."
Last week, the international NGO HelpAge International released its first index measuring the well-being of older people in 91 countries. It did not include the UAE in the list, but instead created a country profile.
It estimated that 1.4 per cent of the country's population - expatriates and Emiratis - is older than 60, putting the UAE in last place on a list of 195 countries. But by 2050 it is likely to be in the 20 top because of the much larger numbers of the curent working generation.
"The UAE is a relatively young country, and it is filled with young workers. However, in the recent years we have noticed that the percentage of older people is increasing," says Dr Al Suwaidi.
"But old age is not a disease. They can get healthy and still be active with the right help."