By Ila Ananya
Anita wakes up at least seven times every night. Four times it is because the 82-year-old woman she looks after wants to go to the bathroom. Three times it is because the woman, whose legs are heavily swollen with a blown vein, wants Anita to make sure the blanket is covering her legs. “Amma’s legs are always covered,” Anita says, “I don’t know why she thinks they aren’t.”
After two months, the whole process of taking amma to the bathroom at night begins to stretch to eight minutes each time. First, Anita helps her sit up, takes off her bed sheet, and lowers her feet to the floor. Then she holds her under her arm, pulls her up, and walks her to the bathroom. When she is done, Anita pulls her up from the commode, and once she reaches her bed, she lifts her legs up onto it so that she is lying down.
Mary, Anita’s cousin, had helped her find this job when Anita’s husband was injured in an accident. He worked as a watchman in Chennai, but they the needed money, so 25-year-old Anita left him in his mother’s house, packed her small bag, and moved to Bangalore. Now, she doesn’t plan to move back when her husband gets better, “I like having my own money,” she says. She also prefers Bangalore to Chennai.
“Four months ago I’d never have thought of being here, waiting for Mary at Safina Plaza on the Sunday before Easter to buy new clothes,” she says excitedly. She bought a red kurta from the exhibition-sale in the plaza corridor for herself, and sent a white block printed bed sheet home.
When she first took up the job, Anita told the amma’s son that she would not clean toilets. He had not been happy, “You are paying us, or are we paying you?” he had asked, but she was adamant. “I didn’t come from Chennai to Bangalore to clean toilets,” she says. Her mother, who works as a domestic help in two houses in Chennai, now thinks there will soon be a name for Anita’s in-between job. After all, she’s not a domestic help, but she isn’t a trained nurse either.
In fact, thousands of women across India now go by a new name: home nurse.
In the last five years, there have been a growing number of organisations beginning to offer home-based healthcare in India. The Indian Express reports that PricewaterhouseCoopers (PwC) estimates “that India’s home healthcare industry, which consists of home-based medical devices and home services, is worth $2 billion and growing 20 percent annually”. In Bangalore, the healthcare that those like Portea and Nightingales provide, for instance, ranges from palliative care and physiotherapy to full-time nurses living at home. Others say that nurses who previously worked in private or government hospitals have begun to join the home nurse industry (that was previously unorganised) instead. And a sizeable chunk of this industry are women like Mary and Anita.
Priya Anant, the Director of Life Circle Health Services Pvt Ltd, which provides nursing and professional caregiving services to a growing senior population in Hyderabad and Delhi, says that the main reason for this growth is that people live longer. This also means that we are seeing health conditions like dementia occur much more. It’s also true that home healthcare is more affordable than hospitals, and there is the growing sense that people would be happier staying at home. The government even offers a two-month long training to those who want to be caregivers. Most women who opt to undergo this training are from Jharkhand, Orissa, Assam, Andhra Pradesh, and Kerala, and have studied only until class 8. Ninety percent of the caregivers in Life Circle Health Services are women, and Anant says that some of them aspire to be qualified nurses.
“Everyone wants someone like us before they get a trained nurse to take care of an old or ill family member,” Mary had once told Anita. “We can give them that.” Mary has taken care of three different women — a young woman with cancer whom she learnt to use a bedpan with, an old woman with Alzheimer’s, and now, a 75-year-old woman with whom she stays and whose daughters live abroad and don’t want their mother to be alone.
Both Mary, and Anita’s mother are right.
I’ve been living with my grandmother and aunt in Bangalore for the last four years. In the last few months, my grandmother has stopped colouring her hair, finds it difficult to walk, and imagines herself in heated arguments with men and women who don’t exist. “But she doesn’t need a nurse yet,” my aunt insists. She needs a caregiver.
Three different women have come to take care of my grandmother in the last five months. Sneha, whom my grandmother described as having a nagu mukha, a smiling face, left in two days because she missed her sister. Then there was Rina, from Assam, who made my grandmother watch MTV Splitsvilla, and left in a month to join a beauty parlour. Every time my grandmother argued with Rina and expected her to apologise for something she hadn’t done, Rina would simply stare at her before politely saying, “Nahi, maine kuch nahi kiya.”
Now, Shaila has been helping us since the last three months. She is 39 and speaks Telugu, and in all the confusion, my grandmother, who has dementia and varicose veins, has started talking to all of us in Tamil. I’m the only one who understands Telugu, so when I’m not at home, nobody understands each other.
On a normal day, Shaila makes my grandmother tea and breakfast, applies warm oil on her legs before she gives her a bath, holds her every time she needs to walk, and gives her the eight tablets she must take at different times during the day. My grandmother’s medicine box has four drawers, and Shaila has stuck a small piece of green paper with numbers on each of them. One is for the four tablets in the morning, two is for the one in the afternoon, and three is for the tablets at night. On days my grandmother cares about the medicines she’s being given, these numbers have helped her remember which she needs to take.
Before Shaila moved to Bangalore, she lived in Chittoor. She had grown up with her aunt, and every Sunday, she would give free Telugu tuitions to four girls at her house. One of the girls would teach her English. “That is how I speak to your dog so easily,” she says. When I pause for a moment to register her saying ‘nee kukka,’ (your dog), Shaila calls out to him, “Banja, come here, where is your ball?” before throwing it down the corridor and laughing as he tears after it.
Shaila came to Bangalore with two black bags (one was her husband’s), and a pink purse that she held in her hand all the way from Chittoor. “My aunt bought it just before I left so that I had a purse to put my first salary in. You must have seen it around the house,” she says smiling. It’s in my grandmother’s room when they are watching a Kannada serial together, it’s above the washing machine in the kitchen when she is making breakfast, and it’s next to the medicine box when Shaila is waiting for my grandmother to finish eating.
Until she moved into the third house, Mary, Anita’s cousin, never had her own room. She grew up in a two-room house in Jeevanhalli, a small neighbourhood in eastern Bangalore. Her father owned a kirana store there, and on Sundays, she’d sit and count the money, until her mother insisted she find a job of her own. She was 24 years old when she started the home nurse gig, and now she’s 26.
The two women Mary had worked for before this had wanted her to sleep in their room. They gave her mats, two bed sheets, and a pillow to put on the floor. Her friends at church were surprised, “Rani used to sleep in the kitchen,” one of them said. Everybody at church knew Rani’s story. She’d worked as a domestic help for couple who gave her stale food, shouted at her all the time, and didn’t let her speak to her family. Last year, she ran away from their house. “They hadn’t paid her for two months after she had said she wanted to leave, because they thought it was the easiest way to stop her from leaving,” Mary says.
So when Mary got a room of her own, she put up a photo of Jesus on the wall, and kept a shoebox in the corner. It has all the small things she brought from home: Vicks, a comb, three pairs of earrings, a broken figure of Santa Claus on a reindeer that she had found on the road when she was 10, her mother’s scarf, and a pair of broken orange scissors that she has fixed with tape. “I don’t know why I’m calling it my room,” she says, 10 minutes later, “After all, it’s someone else’s house.”
“This is the only feeling I haven’t gotten used to,” Anita says about living in somebody else’s house. She’s been particularly nervous since her third month, she says, when amma turned to her son in the middle of breakfast and told him Anita had stolen the key to her cupboard of saris. “He believed me, though. He told me she’d done this before, even with him, and that it was because of her illness,” Anita says. But sometimes, when she overhears amma accusing her of stealing something again and her son calming her down, she wonders what would have happened in another family, where nobody had dementia, and something got lost.
Sujata came to live with us in Hyderabad when I was 12. My mother had cancer, and Sujata from Shimoga, as she introduced herself, moved into our house on the day my mother was prescribed a medicine she hated. Kahi ide, it’s bitter, my mother would say, and Sujata, who had come to take care of Mama, would have to force her to drink it before she took her morphine.
Sujata looked miserable every time she had to do this. She gave the medicine to Mama in a steel cup, and we soon found out that on some days, she would let her drink just a sip of the medicine instead of the whole glass. My father was furious. Later, when I secretly told her I thought it was a nice thing to do, Sujata’s cheeks became the colour of the pink cotton kurta I always remember her in. But she never did it again.
I have a memory of dropping her at the bus station back to Shimoga some months later, but I don’t know which house she went to next. Mama had known she wasn’t getting better, and decided it would be best if we were on our own at home.
I remember Sujata telling my mother about a couple she used to take care of. They lived in a large house in Bangalore, and on her first day, the old woman had pointed to a photograph of her son and told her how he did not talk to them anymore. On the second day, she had pointed to the mug Sujata had made her kashayam in, and told her it was 27 years old. It was the only mug remaining from a set of four that she and her husband bought together when they had moved into the house.
That was how Sujata began to feel comfortable in the house of the old couple that she looked after before she came to look after my mother.