Grandmother inspires a digital approach to caring for the elderly

Dr Sihle Nhlabathi, a psychiatrist sub-specialising in geriatric psychiatry at Stikland Hospital in Cape Town, is researching effective ways of getting correct and helpful information to caregivers of the elderly to improve the care they receive.

She received a Discovery Foundation Award in 2020 to measure the impact that digital information can make in this field.

"I didn't like my grandmother at all when I was growing up in Durban. She terrified me. She was difficult, aggressive and irritable at times. I avoided her as far as I could, disappearing into my room with a novel to avoid the strife this situation was causing in the home," Dr Nhlabathi says.

"My mother, who was raising six children, also looked after her elderly mother. It is only now that I am studying geriatric psychiatry that I realise that my grandmother's behaviour was the result of serious mental problems experienced by many elderly people," she adds.

Dr Nhlabathi stresses that this problem is not going away. In fact, it is going to grow as our population is ageing. That means that many elderly patients are now living longer, so that conditions associated with ageing, such as dementia, are becoming more common. She adds that our healthcare services are not really prepared for the challenges of an ageing population.

Social pressure to keep the elderly at home

"There is a huge amount of social pressure in our society to care for elderly relatives at home, and not send them to old-age homes, but this comes with its own challenges for both caregivers and patients," she says. "The truth is that the vast majority of caregivers in this situation have very little real information on how to deal with the elderly in their care, especially if they are exhibiting signs of dementia."

Her mother, a nurse, is one of the people who inspired her studies. "She is now over 65, and I know that she is entering a stage of her life where she might need care. I would like to do the best I can for her. This is not just my story, but the story of all South Africans who have an elderly person in their life," she adds.

The other person who inspired her studies is Prof Dana Niehaus, who heads up the Psychogeriatrics Unit at Stikland Hospital.

Caring for the caregivers

When she qualifies, Dr Nhlabathi will be one of only five geriatric psychiatrists in the country. She is deeply concerned about the wellbeing of caregivers. Supporting the carer, she says, ultimately benefits the person they are caring for.

"Many caregivers suffer from a combination of caregiver burden and depression, and have poor quality of life in the psychosocial domain," she explains. "There is a 30% risk that caregivers who are relatives could develop dementia themselves, because of the sheer stress of their situation, as well as a possible familial risk."

The research project Dr Nhlabathi is undertaking with the help of her Discovery Foundation Award aims to explore the potential impact that digital resources could have in improving the awareness of caregivers and providing them with support.

A website, which will be developed as part of her sub-specialisation, will provide medical and legal information, links to specific service providers and information on referral pathways to get assistance for caregivers. There will also be podcasts providing information about dementia and medicine.

The end goal is to create a service that the KwaZulu-Natal Department of Health can offer to elderly patients and to their caregivers. Digital communication will help people to access this service even in remote rural areas.

Dr Nhlabathi will encourage caregivers to access the site for six months, after which she will measure the qualitative and quantitative outcomes of the project.

So, what is the solution in a population that is reportedly averse to the concept of old-age homes? "Information and support for caregivers and the elderly, as well as day-care centres, where elderly people can take part in enjoyable activities. This will also provide much needed respite for overburdened caregivers," Dr Nhlabathi explains.

She adds that her long-term dream would be to establish a second training institution to train psychiatrists who want to sub-specialise in geriatric psychiatry in KwaZulu-Natal.

This article was created for the 2020 Discovery Foundation Awards and has been edited for the Discovery Magazine.