Sandra Patricia Silva Preciado is a physiotherapist in geriatric psychomotricity and palliative care in Bogotá, Colombia. Moved by the plight of older people in a town in Colombia, she volunteered to set up two training workshops, one for caregivers and health professionals and the other for older people to raise awareness of the needs of an ageing population and palliative care.
The town of Buriticá in Antioquia, northwest Colombia, is a gold mining hotspot. Since the time of the conquistadors, it has suffered the duality of the richness of the gold mines with the many misfortunes that entails: rising crime, a nightlife culture, alcohol and prostitution. Most of the young people have migrated to other parts of the country, leaving a mainly older population who must deal with the conflict of mining, both illegal and legal.
Aware of this sad reality, I made a proposal to provide volunteer support to Buriticá’s programme for seniors, ‘Centro Vida’, by offering training. I developed two workshops: one targeted at family caregivers and healthcare professionals, and the second for older people who are part of ‘Centro Vida’.
The first workshop lasted two hours and 32 professionals and caregivers participated. The main objective was to create more awareness of palliative care and the ageing process in adults. To begin the conversation about palliative care, I started with an experiential exercise. I guided the participants by saying:
“Close your eyes and remember the last time you were sick. Remember where you were, how you felt, who took care of you or helped you.”
Then I asked them to share their experiences and finally asked them what they knew about palliative care. Most were not familiar with the concept and had many questions, so I shared information and messages of encouragement. The most important message was that palliative care could generate quality of life by reducing suffering.
This had a great impact on participants. Some were moved to tears because remembering past illnesses and vulnerability generated empathy with these life circumstances. We all agreed to be more sensitive and aware. Participants felt that they had gained a better understanding of growing older, the importance of adapting behaviour and treatment, and establishing relationships with older people, and they promised to put this into practice. The group also committed to sharing what they had learned with family and friends, and to raise awareness of the need to care for older people and their inclusion in society.
We reflected on the importance of recognising that everyone would reach old age, hence the importance of encouraging participation in appropriate interventions to increase social activity for older people in order to avoid isolation, suffering and loneliness.
‘I am not old – I have life’
Directed at older people, the second two-hour workshop was attended by 50 participants. Here, my objective was to understand the needs of older people and translate these to the professionals, as well as to raise awareness of palliative care. The workshop began with a video about ‘teamwork’. Participants shared their needs and we concluded with the message that ‘union is strength’ – that to achieve their goals they should work together and take care of each other. This was followed by a presentation called ‘I am not old, I have life’, which motivates and empowers the viewer. The video invites us to reflect upon our realities and undertake new projects using wisdom with the experience acquired over the years.
Some of the problems faced by older people were: a poor health service, abuse by public officials in the delivery of pensions and other services, lack of resources for their wellbeing, psychological and physical abuse generated by family members, malnutrition, lack of medication, homelessness and abandonment. Additionally, some also faced problems particular to this region, such as being run over by motorcycles of miners and being forced to remain in their homes, or invasion of their homes, by illegal miners.
Outcomes of the workshops
Seniors expressed that they had not heard anything about palliative care before attending the workshop. (These are mainly people from rural areas who had previously held only very basic health posts in the countryside). After the workshop, they understood the importance of empowering themselves. They agreed to make a list of workshop attendees in order to create a local support network enabling people to check on each other’s wellbeing, to solve any emergencies as well as to reduce loneliness. The support network is supervised by recently retired, and committed, volunteer leaders. All participants expressed their fear of not wanting to die alone and said that if nobody has cared for them when they are alive then it’s unlikely they will when they die. Finally, they stressed the importance of a dignified death and burial.
The workshops were important in raising awareness about specialised and optimal care for older people among those who care for them. A lack of knowledge can sometimes lead to mistreatment of older people, hence the importance of training for caregivers and health professionals and raising awareness throughout the country. This must also be supported by workshops for older people themselves, so that they feel their voices are being heard, that they can have an impact on the programmes that exist in their villages, and that they know their rights will empower their quality of life and wellbeing.