Dr Kalyani Nityanandan, 85-year-old cardiologist, who lives independently, shares with us some valuable tips on how to prepare yourself for cardiac emergency and keep spirits up during the Covid-19 lockdown.
By the time my mother was a senior citizen she was a widow with no house to run of her own. Two of her children were local in Chennai and the other two were elsewhere in India. She split her time between them.
At each house she left a change of clothes, a dinner plate and curved drinking cup called a ‘lotta’. Whenever she decided to change residence she had only make a phone call, pick up her pooja box and a small bag and go. She was actively helping whichever household she was visiting, but had no obligations to anyone.
Alas, by the time I reached this stage in life I was widow living actively alone, but I had joined the modern Indian club one might call "SPCA". Nothing to do with animal cruelty – this is the Society of Parents with Children Abroad. But even though they were a few thousand miles separated from me, they were always only 24 hrs of travel away.
A Heart Attack Derails Plans
Then, earlier this year, I had a coronary, my third heart attack. It happened just when I was all set up to move into a nice retirement community near Chennai. I was mentally looking forward to singing in bhajan groups, playing cards with other senior citizens and generally joining the fun of community living. Okay, the health crisis caused the shift to be delayed a bit, but so what?
And then my dreams started collapsing and locking down with the coronavirus. Now many of us who live alone are facing this seemingly never-ending situation.
Children cannot reach you even if they are in India, sometimes even if they are local. Despair and tears are of no help, neither to you nor to the children who are also desperate.
Challenges of Elderly Living Alone During Covid-19
As a cardiologist myself, I had spent two decades at the coronary care unit. I had to deal with the problems of patients who could not afford the luxury of a prolonged absence from work. So I started and ran a rehabilitation clinic. This made me think every day of various ways and means of helping them to deal with disabilities and limited abilities in their everyday life.
These challenges are not just physical, they have a large psychological component. Most of us aging folk have heard the preachings about making your home safe with handrails, non-slip floors and so on. But we never had to factor in the worries of the coronavirus era: no cook available, struggling to get groceries, planning out a resource map to get help from neighbours and any local nieces or nephews.
How to Prepare for Coronary Convalescence
Yet, with some good planning, we can drive the blues away. So here are some thoughts – medical, practical and philosophical - about preparing yourself for a life of coronary convalescence in the age of corona.
- Make a list of phone numbers and display it visibly, so that anyone can find it immediately.
- Make a list of your medications, including dosage, doctor’s name and phone numbers.
- Stop bolting the bathroom when you are inside. If you have a caretaker tell her when you enter the bathroom. It is one thing to lie dead on the bathroom floor (then YOU have no worry) but to lie helplessly with a bleeding wound or an broken bone with a door that opens inwards is a terrible situation. I always tell the family who have a senior citizen to get the bathroom door fixed to open outwards.
- If you have angina keep the under-tongue medicine in ALL the rooms. Someone should always know where it is. I used to give one to my driver as soon as I got into the car when I went on trips – which of course was only in the pre-corona days.
- Assess your capacities to deal with your disabilities - be it your knees, your back or your heart. Carefully observe the level which gives you pain and keep below that level, never go over the edge.
- Know exactly what you have to do for the self-care activities, and plan your movements inside your home accordingly. If you are going from point A to point C in the house, try to think ahead if you need to collect something from point B on the way. Have chairs or stools placed at strategic points so that you can rest for a minute if you are reaching the "edge" I mentioned. Remember, it is "stupid" to be ill when you can be well with some planning!
- Keep yourself occupied with things like simple sewing - even if it is repairing a bedspread or a kitchen cloth. I do that when I watch TV. I have been stitching masks with scraps of cloth, embellishing them with coloured bits for borders. I distribute them to passers-by with the help of my apartment watchman.
- If your home is like mine, with shelves full of books brought to you by every visitor on every trip, you may enjoy re-reading some book which you read long ago. Trips down memory lane of any kind are a great comfort for times when the present has little to offer.
- If you are very computer savvy (I am not), you may want to watch interesting things on YouTube or listen to music. Consider taking up computer games, such as playing Scrabble with the computer as I do constantly. Keep your mental muscles in good shape, they are your strongest support. I also do crossword puzzles, which are a great way to exercise your brain cells.
- Call a friend or a relative every day, trying NOT to talk corona. Set an easy routine, not an arduous one, but stick to it as much as possible.
- Be careful to eat well, as tasty as you can during times of corona. If you are dependent on caterers, select a couple of different ones so that you get varied meals.
- Try to “feel good" and spread the feeling by being obviously pleasant to those who come to your door. Remember that the delivery boy, the electrician and the city health-care inspector are all people living under the stress of coronavirus; they can appreciate someone reaching out to them to ease their day. I give them my home-made masks and other small gifts and make small talk with them (from a safe social distance!) whenever I can. A namaste with a smile makes their day. But it can also make yours, because you can lift yourself up in spirits by sharing good spirits.
- Just because you are homebound and no visitors can come, don’t sit around in your nightie or housecoat. Do your hair, put on Kajal and wear a nice sari with a matching blouse. Again in the evening spruce yourself up, it will boost your morale even if nobody sees it.
Be Like a Rubber Mattress
Every problem has a solution, it’s just that we do not know what the solution is or when it is going to happen. Corona is not like other natural disasters which are intense but short-lived, where you get up and dust yourself off and get on with life. Even the Second World War, which most of us seniors experienced in our childhood, had a visible end. Today the pandemic is a new open-ended experience and we have to learn to live with it. Treat it like an unreachable itch in your back, never ignored but never forgotten, you just learn to live with it. We have to be like a rubber mattress yielding to the pressure, but always ready to regain shape once the pressure is gone. This will help us bounce back, whether the problem is Corona or a Coronary – or both!
Dr. Kalyani Nityanandan, MD, was instrumental in bringing the first cardiac coronary intensive care unit to Tamil Nadu in 1969. Soon afterwards she started the state's first cardiac rehabilitation facility. In later years also pioneered the introduction of echo-cardiography in Chennai. At the age of 85, she looks back at coping with life's uncertainties, especially those of cardiac patients in a pandemic moment.
3rd Sept 2022: With deep regret we wish to inform our readers that Dr. Kalyani Nityanandan passed away a few weeks back. We will always be grateful for her contributions to the PatientsEngage community.
