Backdrop:

We are all aware that India needs a large number of trained and skilled caregivers to provide comfort and basic support to the ailing elderly whose number can be as high as around 27 million by any conservative estimate. In addition to caregivers, we also need many trained “geriatric counselors”. These are educated and trained professionals who can provide counseling support to the elderly to tackle their emotional and psychological issues that are of crucial importance.

Many elders suffer from serious emotional issues like anxiety, depression, mood swing, acute feeling of loneliness, fear of death, among others. While clinical depressions need medical intervention, there is also a need to help elderly with emotional and caring support from trained counselors.

It is here that geriatric counselors supplement the efforts of families, supporting society and medical intervention. In the present-day context of withering away of extended family and elders being forced to stay alone, there is a greater need for such emotional intervention by external experts i.e. geriatric counselors.

Process of Counseling and Challenges:

The process of any counseling is, by and large, similar and comprises broadly of the following steps:

• Building of rapport: This is the first stage whereby there is an open communication between the counselor and the elderly and this results into mutual understanding, sense of togetherness and confidence. This rapport building is essential as otherwise the counselor will not be able to proceed further in terms of providing support as it might not be accepted by the elderly.

• Identification of problem: This is crucial as the intervention process / tools will depend on what the problem is. Symptoms may not necessarily be the cause, but it may be result of some other deeper issue. Understanding the emotive / psychological aspect of the fundamental issues being faced by elder becomes crucial. Knowledge / training of the counselor becomes handy to dissect core problem(s) faced by the elderly.

• Creating a roadmap: Here comes the path whereby the counselor in consultation with elderly client creates strategy to tackle problems faced by the patient. This helps the counselor to design remedial tools to handle problem(s) at hand. It must be clearly understood that the counselor is providing professional support and therefore, should not get emotionally attached with the elderly. Being non-judgmental and professional at the same time is the hallmark of a true counselor.

• Undertaking review: This is critical as it will help to assess impact of the counseling and its effectiveness. This will also assist the counselor to change track of support, if need be.

The above process implies that counseling involves a scientific way of assessing problems being faced by an elderly individual and trying to provide an emotive / psychological support system to counter the same. This is done through companionship, friendly advice, providing help to empower the elderly to become stronger and stand on his / her legs, and always giving a friendly support.

The challenges, however, are many. As elders face different types of problems both physical as well as mental, it may, sometimes, be difficult to provide solutions to all. Elders might also look at the counselors with an eye of suspicion and winning confidence is a difficult task. To sustain the results on a medium to long-term basis is the other difficult matter in the context of issues related to elderly.

These challenges become serious when counselors face elders who are suffering from serious mental diseases like Dementia or Alzheimer’s or Parkinson’s. To deal with these elderly patients, a special attitude on part of the counselors is needed besides professional competencies. The caring attitude and deep sense of empathy are two significant attitudes that any successful counselor should possess besides other practical expertise like playing games, music, basic puzzles, and other activities.

Difference between Counselor and Caregiver:

There is often a question where these two terms are synonymous in terms of their role on the ground. There is a subtle difference between the two. While caregivers work on the ground taking care of physical and sometimes mental activities of the elderly on a daily basis, counselors cater to psychological aspects through providing emotive support. Of course, caregivers become better in their role if they are groomed in basics of counseling. At the same time, trained counselors are also sometimes seen to act as caregivers. But fundamentally, they have different roles to play as far as elder issues are concerned.

Positive Impact of Counseling:

Counseling has a significant impact on the life of an elderly person. A good counseling process can help the elderly to feel better, agile, and happy. There are many cases where we have seen the elderly suffering from serious problems like anxiety or depression, recovering and leading a normal life. A good counselor is like an “angel sent by God” to the elderly and boon in process of happy aging.

Current Scenario and Way Forward:

There are very few dedicated educational programs on geriatric counseling in India. To tackle the growing psychological issues faced by elderly, the country requires a large number (maybe up to 10,000 to 15,000 per year as per some estimates) of geriatric counselors. They are needed at old age homes, day care centers, geriatric wards of hospitals, palliative hospitals, and other similar places. There is substantive scope for geriatric counselors to start their entrepreneurial set up. These “entrepreneur counselors” can provide support to “elderly on need basis” through contacts provided by various NGOs. There is also an urgent need to create sensitivity among children and youth about the problems of elderly and these geriatric counselors can play a big role in this process. India is a country where there will be significant scope for trained and skilled geriatric counselors who can provide support to needy elderly in process of their happy aging.