I still think of that old lady that came in for consult because their main doctor recommended having them see a psychiatrist for trouble sleeping and increased irritability.
Trouble sleeping and increased irritability is like an unspecified complaint that could be anything and everything to my ears. It's like fever, you get sick but the treatment requires knowing what's causing the aches. She came in the office being irritable and intimidating the interns and others that me volunteering to get the short end of the stick, entertained her anyway. Sure enough, she threw a lot of complaints at first but then became receptive for a normal conversation after a while.
It turns out when you have the patience to listen and just let them rant, they'll eventually feel good and then open to hear what you got to say. She was already on her late 70s, single, living alone and retired from being a house helper from overseas, living with a chronic disease that causes her physical aches and a broken heart from all the people she supported turning their backs on her after 39 years of hard labor. The children and siblings she supported financially abandoned her, by her claim, and now she suffers alone with her disease with no outlet or anyone else to talk to at home. It didn't help that when the pandemic struck that she was just stuck at home alone through most of the time.
She came back to the Philippines because it was home despite her employers willing to shoulder her expenses outside and taking care of her throughout the rest of her life out there. She traded the good life outside to comeback to this reality and that's just my personal opinion. Now she has no stable income, sells her jewelries and properties just to get by and covered in debt she could never work to pay anymore. But her concern was having difficulty to sleeping, some joint aches, and being irritable.
Here's what you need to know about depression in the elderly, the presentation doesn't look as dramatic as the younger ones. The elderly will complain about nonspecific problems which commonly attribute to chronic diseases they may have or other minor discomforts that seem to pop up here and there. But once you start them with antidepressants, they eventually get better with some close supervision because that's what it really is on some cases. And this case was no different, given that backstory, the medical conditions she has were controlled that there's no explanation that might cause the upset other than being chronically depressed and who can blame that back story?
Sometimes bad stuff happens to good people and that's the reality of the world we live in. From what I gather, she's not a bad person and seems alright but she was too charitable that the people she fed bit her when she's no longer able to support them. And now she struggles financially and psychosocially to cope with an everchanging world.
The I lost count on the number of times I had to extend my patience for this particular case because even the simplest instructions required a few more repeats. Old people in the hospital setting have a susceptibility to stress and even more with the bureaucracy of how things are usually done. But she liked me enough to look for me the following consults even when she was faced with another physician on duty, that's what you get when you be chillin with establishing rapport in people. I know I'm tooting my own horn here but my new found skill in talking to people is how more often I can win them over to at least get them to cooperate as long as our goals align.
There's not much I could do with her situation that make a path that's the most easiest for her to avail some cheaper medications and health care. There's a limit to how much magic I can do for these cases. She made her decisions in life and placed her bets on the wrong people. I do feel sorry for her but I've got another case on qeueu.
I think when people say stuff like being fine alone during their elderly years, they usually have the idea that they'll be capable of actually living alone during those years. Picture an age where you already have a chronic disease which costs you regular maintenance medications on top of your daily living expenses that thanks to inflation, your pension funds couldn't even keep up at the times and that is IF you managed to build enough wealth.
The harsh reality, especially when it comes to living with pension in the Philippines is that everything gets eaten by inflation and that retirement you thought was worth living requires you to entertain more working years just to keep your current lifestyle to a descent levels. This is a fact for most middle class and below.
I think it's a cruel outcome to be alone when you're old, only if you didn't know what you're doing and most of the time, people don't. If you look at the dating market now, there's a lack of motivation for men and women to engage with long term relationships due to the financial costs and responsibility attached in a world where there's instant gratification and promises of never ending opportunities while single and capable of sustaining yourself economically.
For sure, I know many men and women feel empowered knowing their current abled and young bodies can still support their lifestyle to earn but ones you get at an age where your peers have died and you got no one else to talk to because everyone else that's left have their own lives to live, you're all alone. Marrying for fear of becoming lonely puts and damp on the romance, but maybe it's exactly the reason why most eventually settle down. It's hard to be alone, it's even harder to be alone, sick and broke.
So whenever I encounter a younger folk that has this confidence of being single isn't going to be a problem, I just put in the back of my head that some people need to live to regret their lessons too late because this confidence comes from a place when they are not in the situation to suffer for those consequences yet. Maybe some can actually live through it, doesn't necessarily mean their quality of life got any better. They still have to struggle feeding themselves and making a living alone at home with an aging body that's about to go out a few more years later. It's a morbid take on aging but I know I'm not sugar coating what is the reality that's been an inconvenience truth.
Thanks for your time.