THE poem continues with — and this seems to be the line most recognized — "Rage, rage against the dying of the light." My Humanities professor in college explains this as the upshot of the Western ideal of the island individual till the very end (as opposed to the Eastern metaphor of seeing one’s death as a raindrop returning to the ocean). And I suppose people don’t very much care if they live only up to 65. That is, until they’re 64. Nevertheless, Filipinos are getting older and older. There comes a point that they’re no longer as independent. We look around us and we see our aging loved ones struggling to keep alive.

There are always better ways of taking care of them.

That starts with knowing the common problems of the elderly.

5 Common Problems. According to the The Caregiver’s Essential Handbook, these are priority issues for the aging: Depression, memory loss and dementia, vision loss, hearing loss, and incontinence. It’s somewhat unreasonable to blame aging per se as the reason that the elderly have problems. It’s like saying teenagers are troublesome because they’re teenagers.

Spot Depression. According to the manual, the symptoms of depression are:

* Lack of interest in activities that were enjoyable before

* Withdrawal from social contact

* Lack of energy

* Strong feelings of guilt or self-criticism

* Feelings of hopelessness

* Eating too much or eating too little

* Sleeping too much or too little with disruption of usual sleep pattern

* Difficulty concentrating

In older people, it’s probably more difficult to differentiate sadness from depression. Sadness is normal, depression is not — even with the elderly. Sadness is fleeting (from a few days to even two weeks) and some cause is identifiable — a skirmish with the spouse, disappointment with children, loss of property and so on. Depression develops insidiously over several weeks into what a good friend calls "staring into the Abyss." Depression symptoms can also be physicalized by Lolo or Lola into headaches, aches and pains, and digestive complaints.

What can be done. What can’t be done is talking the person out of depression. Currently, researchers believe that in depression there is an imbalance of neurotransmitters norepinephrine and serotonin. These are natural chemicals needed in the communication of brain cells with each other. Genetics has been implicated. Scientists have shown that depression like diabetes and hypertension filter through generations. Antidepressants may be prescribed by the doctor but of course it will help if the family cares.

* Take out the depressed person for short walks, to visit the mall or another relative he or she cherishes.

* Attend to chronic physical illness like diabetes, hypertension, arthritis, heart disease; being sick for long periods initiate depression.

* Don’t underestimate the positive effect of small grandchildren who are always ready to play and like their grandparents have all the time in the world to talk, eat, and to just do things together.

Another problem of the elderly is dementia, the most common being Alzheimer’s disease. The caregiver’s manual lists the following signs to watch out for: Memory loss — forgetting names, personally important dates like birthdays and anniversaries, confusion — forgetting a favorite story midway, disorientation — forgetting where one is, the day, or time, problems with self-care such as grooming and hygiene, mood swings, language problems — difficulty finding even common words, math difficulty — simple addition or subtraction capability is lost; poor judgment like avoiding another person walking directly into her path.

Even as there is no cure for Alzheimer’s, many drugs are now available to control disabling symptoms. Some of these are: Tacrine, donezepil, rivastigmine, and galantamine. All of them prevent symptoms from becoming worse. Treatment is also not just about medications. It’s about adjusting to the condition by reinforcing routine in the person’s life. This may amount to a specific time for breakfast, for bathing, and for other everyday tasks. On the average, someone diagnosed with AD lives for another 8 to 10 years and with much care, up to twenty more years.

Let’s talk about vision loss, hearing loss and incontinence next week.

Billboard. Happy Birthday to old friends from high school and college, Peter Yabut and twins Tommy and Yoohoo Villanueva! We all have friends we hardly see and it doesn’t matter because we always pick up from where we left off. Welcome back, Dr. Martin D. Bautista, old buddy from medical school who divides his time between Manila and Guymon, Oklahoma. Welcome also to fellow blackbelt, IT savant and entrepreneur Armie Abis who was in town recently and is now back in his Hongkong base.

Fact/Factoid. The World Health Organization (WHO) has shown that it only takes 30 US cents or R15.96 a day is needed to prevent osteoporosis. (HealthDay @yahoo.com)

Dr. Brix Pujalte is an orthopedic surgeon. Contact numbers: 725-3820/ 7270001 local 2175/ 711-6626/ 711-4276 and 936-5717. Write – Cardinal Santos Medical Center, MAB 3 Room 175, Wilson St., Greenhills, San Juan, Metro Manila. E-mail: jsp@pldtdsl.net