Eldercare: Wellness = Awareness

I have started writing a series for The Dignity Foundation – an organization focused on senior citizens. Here is the first in the series that got published in the September issue of their magazine.

The best gift that we can give ourselves and our families is to live in good health until we leave this planet. As someone with several senior citizen relatives including some near and dear ones, i want to highlight some observations that i have collected about Elder Care.

To my utter shock and dismay, i find 2 broad patterns of behavior from doctors when it comes to treating senior citizens. And I am talking about doctors from reputed hospitals. One pattern is – doctors don’t seem to order basic diagnostic tests that are necessary, possibly under the pretext of saving money or because they have not kept themselves updated about the latest diagnostic tools and techniques. The other pattern is – doctors order surgical procedures aggressively when other treatment options are available.  Let me explain with some pertinent examples.

One of my senior citizen relatives recently started having blurred vision in one of the eyes. The doctor diagnosed it correctly as a damage to the retina due to high blood pressure  and left it at prescribing some medication for hypertension. Another doctor was consulted for a second opinion and that doctor immediately ordered an angiogram and it showed that there were some blocks in the arteries in the heart.  Armed with this information, consulted another opthalmologist, who decided to order an Eye Angiogram. It showed the areas that are damaged in the retina precisely.  I didn’t know such a test was available and i was impressed by the doctor who ordered it. With the results from both the Eye Angiogram and the Heart Angiogram, sufficient information was available to create a proper treatment plan. Why didn’t the first doctor order these tests?

In another instance, we took a senior citizen relative, who was complaining of a painful inflammation in the anal tract, to a reputed hospital. Several specialists got involved and they recommended an emergency surgery to fix the problem. We then took a second opinion from another doctor who simply gave some medication and the inflammation dissappeared in a few days.  I shudder to think what complications could have arisen if the surgery had been done.

There are many such examples i have noted which led me to the conclusion that there are serious issues with elder care in this country. My advice to elders, please try to understand what health condition you have and ask your doctor to explain the diagnosis and the course of treatment. Don’t be afraid to ask questions. If you don’t get convincing answers, go to another doctor.  Do some research on the Internet about the illness and be armed with information so that you can have a meaningful dialogue with your doctor.  Your health is too important to be left to the experts.

Although, it is easy to blame the doctors for these problems, i find that many elders have abysmal awareness about health issues. Many even hold outdated views such as:

– “In my family, there is no history of XYZ illness, so i will never get it”.
– “Oh! I am 70 years old, i am expected to have these problems, right?”

Everyone will agree that early detection of illnesses is critically important in effective cures and in the case of elders, this is even more important.  Here are some basic tips I strongly recommend that all elders follow:

1. Be very aware of your body – how much time you sleep, how many times you pass stools, urine – the consistency, color etc of the stools, urine. Frequently monitor these to make sure there are no dramatic changes in either the frequency or the color/consistency etc.

2. Check your weight atleast once a week and note it down to identify any sudden deviations.

3. Check your blood pressure frequently

4. Once a year do a master health check that includes your eyesight. If that is expensive, talk to your doctor about ordering some basic tests that are inexpensive but help you monitor the critical indicators.

Next month, we will cover how to research health issues on the Internet. Stay tuned.


  1. Quote
    venkateswarlu poondla said November 3, 2008, 1:29 pm:

    I have gone thro the writings about seneior citizens health ailments and the responses of doctors,. prior to that it is 100% correct the patient should diagnoise him self about his body condition,. but my advice is do not go for self-medication it is most importentent,. I know many cases where it is fatal,. to quote an example it is me,. I was in the opinion of having isnophelia/asthama ,. till October 2005,. for my TOTAL KNEE REPLACEMENT I was admitted in KIMS hospital Hyderabad Andhrapradesh India,. to my surprise the bronchiast who made some tests confirmed that Iamnot aasthmatic,. and treated me with vapours of Idoine for 10days,. to my dismay I never suffered asthma till the above period I used to carry Ventroline inhaler and used to puff it when ever I feel some irritation of throat or some discomfort,. for nearly 3 decades I was illusioned asthamatic,.. many doctors before this used to treat me for asthama even I was on deriphiline injections,.. betnesol tablets and hetrazon ,. so a correct diagnosis by a good doctor certainly get rid of your discomfort,.
    coming to my another pain of me I suffered a hell due to my osteio-orthrities of both knees,. I am forced to take voulantary retirement from company where I used to get a good salary of 5lacs per anum,. I got rid of this in 2005 one Dr,.Guruvareddy got operated both mmy knees fixed titanium knee joints ,. now I am in fit postion to walk an hour perday,. drive my car at a run nearly 200miles ,. made a good tour of most lovely places in USA,. so one must take proper advice from a doctor,.
    the next best thing is going for HEALTH INSURENCE it certainly helps any senior citizen,. okay bye,.

  2. Quote

    Thanks Venkateswarlu Sir. You must be Vamsi’s father?

    You are right. A good doctor makes all the difference. All i am trying to say is that Senior Citizens need to develop some more awareness of health issues so that they can understand the doctor’s advice.

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    Harish Dorai said November 4, 2008, 9:28 am:

    Sukumar – Thisis a good article and very informative. I certainly agree with you on your observations and the self awareness that is needed. I also wanted to share my experience with my parents and their health situation. My parents have the habit of concealing their health issues under the fear that it will create unnecessary expenses in the form of medical tests and lab work. It is extremely dangerous to do that and it will create more problems financially and physically if the health issues grow beyond treatment. One other argument that I often hear from my parents is that they are more closer to the earth than the current younger generation and hence more immune to diseases. I am not trying to criticize the elders, but these are some of the beliefs and prejudices that can cause issues in the long term. One other tip that I would add to the list of basic steps is to do some basic exercise (at least walking daily in the morning).

  4. Quote


    Thanks for the post and the recommendations as well. I would add 2 more to the list –

    1. When in doubt, do not hesitate to take 2nd or 3rd opinion, which is possible in India especially if you
    can financially afford it. Of course, be aware of conflicting information that you may get, but at least
    you will have the data to make an informed decision

    2. Do not be afraid to ask the doctor questions. I have seen that this is more difficult in India for 2
    * Doctor’s, at least the reputed ones, are sometimes treated like god and patients feel a sense of
    disrespect if they ‘question’ the doctor. We need to get away from this mindset
    * Doctor’s do not feel obligated to divulge the information to the patient’s too. I believe this could be
    due to – assuming patient’s cannot digest, consume or understand the information or because they
    think patient’s should not be burdened with such information or plain old superiority complex that
    they do not owe an explanation to the patient

    I have seen the above 2 happen first hand with my parents interaction with their doctor.


  5. Quote
    Ramesh Ramaswamy said November 4, 2008, 4:43 pm:

    Very informative post Sukumar. I agree with Ganesh – doctors are sometimes treated like God and reverse is also true – some doctors consider themselves as God. In my dad’s case, a doctor detected parkinson’s in 2 minutes without any formal methods. When I questioned he didn’t bother to give a valid explanation..he just said I have written everything to the referred doctor.
    May be since number of patients they see is very high everyday…they can’t explain everything to everybody?

    – Ramesh

  6. Quote

    Thanks Harish. You are right, elders unfortunately do have some illfounded beliefs about health. The tip on exercise is a good one.

  7. Quote

    Thanks Ganesh. You are right, we do need to encourage elders to take atleast a 2nd opinion when the recommended action is a surgery or some other complicated form of treatment. And yes, i have observed these traits of doctors and patients in India.

  8. Quote

    Thanks. Yes, doctors do seem to make quick diagnoses without proper explanation. Yes, i think the workload on popular doctors is quite high, but they should give the elders a bit more time and explain things patiently.

  9. Quote

    Sukumar – Good post. Hope it serves as a wake-up call to the senior citizens.

    Everytime a new ailment is in the news, I hear Indian citizens – senior & junior, across all age-groups – simper – “You know, with our lifestyle, we Indians won’t get it”. And every single time they’ve been proven wrong. AIDS, Diabetes, High BP, Cholesterol, Alzheimer’s, Cancer, Aortic Aneurysm – its a long list.

    Such unscientific attitudes are irritating. Many Indians lead sedentary lives, don’t have basic hygiene, are worry warts & eat large unbalanced meals full of empty calories. What is needed is a change in our lifestyles. Rather, we seem to be busy deifying it.

    I think more awareness would help our country.

  10. Quote
    Sukumar (subscribed) said November 5, 2008, 7:23 am:

    Thanks Priya. You are right, better awareness is what all of us need. Senior Citizens need the awareness more urgently.

  11. Quote

    Sukumar, I read your article. Did not know it was you! I am a senior citizen as you know, and I am happy that young people like you are taking up cudgels on our behalf.

    I can tell you stories about the medical profession that will make your hair stand up. On the other hand, I can also tell you stories that will make you believe that humanity in all its glory still exists.

    The point is that like everything else in life, there are whites and blacks but mostly the grey prevails.

    I look forward to your further actions on this noble endeavour.

  12. Quote

    Ramana Sir,
    Thank you very much for visiting. Nice to see that you read the article in print. I haven’t received my copy yet.

    You are right, it is mostly grey nothing is black or white. My purpose is to help some of our senior citizens who are not putting much effort to improving their awareness. By no means, am i generalizing either the Senior Citizen community or the Doctor community.

  13. Quote


    First off, what you are doing is a great cause. Instead of talking about it in a blog post, you are reaching more senior citizens by publishing it in Dignity foundation. It’s a small step, but one that produces better results. Hats off.

    Secondly, I think this problem is prevalent even in younger generation, hence I like you bringing this up in your blog post. Two examples – My neighbor is in his 40s. During a routine yearly check-up, they found that he has cancer in his prostate. It must have been there at least a couple of years before, but fortunately, they found it out this year. He is doing fine now. The reason this is because – how many of us go through routine check-up and watch for tell-tale signs. We take our cars and bikes for regular check-up / maintenance once in a while, but we treat our body far worse than a piece of metal.

    Second example – A friend of ours who live down the street went to the emergency room because he was feeling “tired and weak”. After little persuasion, the doctors checked and found 5 major blocks in his arteries and he went through a by-pass / re-grafting. How many of us get alarmed by these tell-tale signs and go to the emergency room. We tend to ignore our symptoms more often than we should. His thought process that there’s something wrong in his body, helped save his life and much grievance to his family.

    I am not trying to rattle everyone’s cage and have them get to the doctor tomorrow, but we should watch out for change in pattern in our body and do regular preventive check-ups.

  14. Quote

    Great Article. I think yearly check up for younger ones (say above 30) also now required. We have to come out of issue-then-see-doctor pattern. I know lot of my indian buddies(who are high risk of cholesterol) in US are without even some basic insurance, i don’t know whether they are going for yearly check up or not. We have to go for check up at least once a year for full body check up and 6 month once cholesterol screening. Once we formed this check-ups as habit, we can eliminate 90% of illness later stage.


  15. Quote
    Sukumar (subscribed) said November 7, 2008, 10:29 pm:

    Thanks NK and Subba for the kind words. You are right all of us especially the ones that are 40+ need to go through routine medical checks and make sure major illnesses are detected early.

  16. Quote

    I have two extreme cases.. my maternal grandma was suffering from knee and joint pains for long, and we consulted quite a few doctors in my native.. almost all of them gave the same answer.. “Elumbu theinchu poiduchu”.. and gave pain killers..

    Recently we took her for a full health checkup and found that LDL cholestrol is high.. (they term it as borderline).. and later doctor prescribed thyroid test, and there was a problem there.. now he gave medicines for thyroid problem, to be taken for life time.. (if thyroid problem is not there, then tablet for reducing cholestrol has to be taken for life time..)

    A health checkup revealed all these details..

    But for my paternal grandpa, the medical checkup shows everything normal, but he always complaints of dis-comfort, fatigue, and other symptoms.. we took him to various doctors and the response was not encouraging.. they told, all these are due to old age.. he became very depressed at his condition now..

    BTw, i would like to know, if we can make a doctor accountable for his decision or findings? Unlike other fields, a person’s health/life is involved, and a doctor should have some form of validation thru feedback, or monitoring to confirm, what he suspects is correct.. i feel, presently, this doesnt happen..

    In most of the cases, only 5-10 minutes are alloted per patient, and the doctor instantly comes to a conclusion, prescribes medicines..

    In my own case, i spent more than 1 lakh so far, but no one was actually ready to spend time to investigate.. money is the only focus for most of the doctors.. more than that, there is no analytical mindset among the medical professionals.. if a patient describes about his case, the doctor just recollects if he had studied those symptoms.. If not, then immediately the patient was recommended to a psychiatry..

    There needs a total revamp of the medical field.. healthcare should be universal to all, and should not be dependant on money power.. i think, it has been existing in many of the european countries where health care is provided free of cost..

  17. Quote
    pk.karthik said November 10, 2008, 4:16 pm:

    Great Post Sukumar,

    But i feel wellness/awareness is required for all ages and should be uniformly adopted for general health care , as the present life style for all is bad.

  18. Quote

    i have just become a member of dignityfoundation and received their december issue yesterday
    i found your article”how to research health topics”very very useful
    i really followed your step by step instructions to get the desired information and was totally satisfied with the result
    i will be looking forward to your articlesin dignity magazine
    thanks again

  19. Quote
    Sukumar (subscribed) said December 4, 2008, 8:11 pm:

    Thanks Karthik. I agree.

    Wow! I was hoping atleast one reader of the magazine would take my instructions to heart and come to this blog. I am so happy to see your comment here. I am elated to see that you found my article useful.

    I am looking for inputs on what other technology related topics i should cover. Please let me know if you have any ideas.

  20. Quote

    Dear Mr.Sukimar it is indeed welcome move by a no medical senior citizen to have created elders wellness awareness blog..Most of the comments posted highlight the unpleasant experiences faced with the doctors and the treatment given. It is true that that highly efficient doctors don’t spend enough time with the patient due to paucity of time and as such some important clues may be missed. But such doctors are few and we cannot generalize with all doctors. It is a very sad era for medical profession that young doctors are materialistic after having paid handsome capitation fees..

    The citizens are well-informed, knowledgeable about the diseases drugs,sugeries etc. and as such there expectations are high from the doctors which is justifiable. They are aware of recent tecnology, investigative modalities, therapeutic procedures etc. with half baked knowledge they tend to choose the specialist themselves. Often when the doctor asks them about their complaint the patient immediately gives the diagnosis and place the scan, blood reports etc..This is absolutely wrong for it does not give a chance for the doctor to talk, question, examine every system and make his provisional diagnosis and latter order for only relevant investigations. People with headache walk in and ask for a C.T. scan brain. Head ache may well be due to constipation,sinusitis,hypertension,defective vision, ear problem etc.when the doctor declines a c.t.scan the not satisfied and seeks a second opinion and he has the money power . Today even the agricultural laborer are aware and ask for a laparoscopic surgery for a swelling at the back which in fact a lipoma..Newer investigative and therapeutic modalities like C.T.scan.M.R.I, P.E.T.SCAN are fabulous pinpointed some early diseases and guided the doctors to eliminate the problem. Keyhole surgery with LAPAROSCOPE has come a long way in the last decade facilitating the surgeons to operate with precision and for the patient to resume duty at the earliest. These investigative and therapeutic modalities are reallyBOON for the medical fraternity but he T.V. and the print media publicizing unwontedly I am afraid these should not become a BAN.
    Aging is inevitable biological process .By adopting a healthy life style with food,exercise,habits we can postpone metabolic diseases. Yes senior citizens should be aware of disease pattern for elders as pointed out by Mr.Sukumar and other viewers.
    Be frank regarding your sufferings,habits,past illness, family history and let him examine you thoroughly and order relevant investigations. don’t change your doctor especially if you are diabetic,hypertensive,asthmatic,cardiac ailment ,ophthalmic problem..pregnant ladies If you change the doctor, the drugs will certainly change and you are confused as who is correct.
    ,Befriendly with him and if you feel a second opinion is needed entrust the responsibility to him.
    This will amount buying unwanted things and stealing your own bank
    Wondering who this guy is? I am 70 years retired surgeon perfectly healthy and acting as a P.R.O{Patient Referral Officer] for my long term clients

  21. Quote

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