Christian Brothers redefine elderly care through compassionate housing solutions

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OPINION

By Dr Simon Peter Katongole

Every October 1st, the Catholic Church commemorates the feast day of St Theresa of the Child Jesus, the Patron Saint of the Brothers of Christian Instruction Uganda-South Sudan Province. This year, the feast day also marked the start of the Brothers' 100th anniversary celebration in Uganda.

The event, held at Mount St Theresa Chapel, Kisubi Compound, included the launch of a fundraising campaign to build an elderly house that will serve as a centennial monument to the Brothers' presence in Uganda.

Drawing from my background in the Brothers of Christian Instruction as a student at St. Henry’s College Kitovu and personal family connections within the same congregation, I found myself truly inspired by the construction of this house.

My uncle, the Late Bro. Michael Butoolwa, who dedicated 67 years to serving the congregation, passed away at age 90. During his funeral, I delivered a eulogy where I emphasised the importance of elderly care from a healthcare viewpoint. As a lecturer, I have taught a module focused on promoting health among special groups.

Among these groups, the elderly, often overlooked in the past but increasingly populous, stand out. While Uganda’s healthcare system provides services for children, pregnant women, and women generally, the elderly still lack adequate consideration.

Old age brings various challenges. Initially, individuals often become incapacitated and unable to care for themselves. Additionally, physiological changes can make routine tasks difficult, potentially causing mental health issues like depression and anxiety.

For instance, my elderly uncle at the Brothers of Christian Instruction developed basophobia, a fear of falling, also known as bathophobia or postural phobia.

This fear can lead to inactivity, which in turn can result in other health problems. Furthermore, ageing is associated with non-communicable diseases such as Parkinsonism, characterised by tremors, stiffness, and slowed movements, memory decline, including Alzheimer's and other dementias, age-related hearing loss, and genitourinary disorders like urinary incontinence, more common in women, and benign prostatic hyperplasia (BPH) in men, and many others. Addressing these conditions requires specialised social and healthcare services to support this age group.

Unfortunately, this issue has not been a priority for our country or society. When the Brothers of Christian Instruction chose it as their centennial project, I saw it as a positive example for the government and society to follow.

It is now common for those close to the government to seek or be referred abroad for elderly care, with popular destinations including Aghakan Hospital in Kenya, India, and South Africa.

For middle-income families, it is now typical for elderly relatives to be relocated from villages to cities to access healthcare, primarily due to the lack of suitable medical and social care services in rural areas.

Although Uganda’s healthcare system claims to be free, most elderly care services are not included in the minimum healthcare package. Even in public health facilities, when needed, patients often have to pay high fees.

In some societies, such as religious groups like the Brothers of Christian Instruction, old-fashioned elderly care services are still provided, often failing to meet optimal standards. Typically, a dedicated house with helpers, often including younger religious members or servants, who lack proper geriatric training.

These workers may become overwhelmed when faced with demands that exceed their training or when facilities are not adequately equipped to meet their needs.

They continue working due to financial gain or obligation. As a result, common issues like bed sores and other complications arise.

For example, elderly individuals might need a specially designed toilet with enough space, at least 1.5 m² of clear floor area for movement or wheelchair access, wide doorways (32–36 inches or 80–90 cm), non-slip flooring such as tiles or vinyl, a raised toilet seat (17–19 inches or 43–48 cm) labeled “chair-height” or “elderly-friendly,” and sturdy grab bars on both sides. Unfortunately, these features are rarely properly implemented. Consequently, elderly residents often do not receive the quality of care they deserve.

I hope that the proposed centennial house will incorporate these considerations into its design and potentially train the Brothers' staff in geriatric care to work in this house, making it a model for adequate elderly care in society and the community in Uganda. The public, primarily alumni of the Brothers of Christian Instruction schools, should support this initiative to ensure our mentors receive proper services as they age. This house will also serve as an example for providers, geriatric and public health learners, educators, and advocates committed to improving care for older adults, promoting the dignified care befitting old age.