New challenges of the modern world! 

Western World and the Japanese have been handling the challenges with ageing population for some time. In India, this challenge has started coming up slowly. The current generation, those who were born around India’s independence in 1947is ageing well, trying to take care of healthand in general gungho about life in general. Technology is helping them in getting in touch with each other using WA, Facebook, Instagram and such apps.  

India has an old tradition of handling the aged relatives in the family. In my young age, in many families there used to be one or two grannies, lovingly called aajjies! In those times most of the families were joint families. From the “post-independence” generation, people started getting better opportunities for education. A small percentage of the population went to foreign countries and stayed back there. Over a period, this percentage started increasing. Computerisation made technology more democratic; more and more people began getting opportunities to work and live abroad. 

Along with this, opportunities for education and work, jobs became abundant. Pan Indian migration started in a big way. All these things resulted in the formation of nuclear families. The ladies too were not far behind. After education ladies became  career oriented in a big way. Steady and better incomes inculcated a new thought process in families. All this gave birth to a new term, space; everybody wanted their space. It has become the requirement of grandparents, parents and children. But this space created voids in the family. The effect of voids was not understood, initially. The family kept helping and supporting each other in the short term. Better medical treatments and diagnostics helped longevity. All these events together have now created a new requirement in society.  

What happens when someone in the family falls ill and needs long time support. The requirement of long-term support arose when people of the golden generation became old but could not handle many things, physically; and in some cases mentally. There are two distinctive supports available. One is palliative support, and the other is like home support. Those who are seriously ill with cancer, heart issues, renal problems, chronic obstructive pulmonary issues, cerebrovascular accident need palliative care; such treatment cannot be handled at home. But general ageing related issues can be dealt under home care.  

In western countries, especially in the US, palliative care facilities are available. In Japan, there is a shortage of such facilities. In India, these facilities, compared to the needs, are almost non-existent. In India, as a society, we are prepared to provide space to each other, but while this change happened, we had not budgeted for parents who can live longer due to improved longevity. The confluence of all this created turmoil in people’s mind about handling the situation. In the year 1981, Jaya and I were in Ottawa as Jaya was taking some training. During one long weekend, we went to an island on a lake with a Canadian friend of ours; he was almost twenty years senior to us. 

On the way back, the friend said, “Hey folks, is it ok if I take a bit of detour?” We said, “Absolutely no issues.” When we reached a destination, the friend said, “It is an old people’s home, my mother is here. I come and meet her every 2/3 months.” We were sitting at the back-side of the car and were confused. We did not know what we were supposed to do. But our problem was solved by his wife. In the parking lot, she said, “I will wait with Jaya and Pramod; you go and see your mother.” Problem solved. In 1981, our friend was ok with the idea of meeting his mother every 2/3 months, because she was within 50 km from Ottawa. As a society, we are not mentally prepared with this idea. The older people’s homes available are not providing facilities that people have at home.  

There is some progress in creating facilitiesBut compared to India’s population, this number is lowIt is about creating facilities; it is also about young and old getting mentally prepared for such arrangements. Hospices need doctors, trained nurses, and medical facility to handle day to day critical requirements. Whereas in older people’s homes, the need is to create facilities which suit all the pockets. Some may need fivestar facilities, and others may be ok with a couple of stars. But there is a significant need for affordable facilities.  

Some people will ask me why am I writing about all these things. The simple reason is it is a need of times like we have schools, colleges, gardens and so on. I hope people have managed to create a corpus which will last them till they are around. 

I will tell you about some facilities in India that I know. According to me, there is a worldclass facility but I will explain it in the end. Please let me know if you know about such facilities in India. In Pune, there is one facility developed by Paranjape builders called Athashri. It is well developed and within Pune city limits. To my knowledge, they have couple of locations. In these facilities, one can buy a condo or rent it from someone who has bought it. I have heard about similar facility in Talegaon near Pune. In Lavasa near Pune, similar facilities are there. I have read something about such facilities near Dehradun, and I am sure there must be more such facilities.  But they do not provide what is provided by Dignity Foundation.

The best of such facilities for me is one in Neral. It is on a hillock, with gradually sloping covered but open corridors. Golf carts are available for those who need them. The place is called Dignity foundation. 

https://www.dignityfoundation.com/Contact-Us.aspx 

The rooms that I saw were like a standard hotel room, with bath and toilet. It had a small cupboard and kitchenette too. They also provide round the clock nursing service if required. I know all the details because someone very close to us lived there for her last few years. They had an arrangement with Reliance Hospital if hospitalisation was required. When she needed an eye treatment, they sent their person with her for a couple of days to Mumbai for treatment. She used to paint, so they had provided her with a small room. Besides joint celebrations, they used to show movies and had many activities. 

When she died, the family suggested cremation in Mumbai. But their manager suggested that if there were no specific reason to do it Mumbai, they would arrange everything in NeralWe all went to Neral for cremation. After everything was completed, the manager suggested a small tour of the facility because some of the people had never seen it before. In the end, he took us to their dining area.

He said, “Sir, it is already 1.30 pm. The management has suggested that all of you should have lunch with us and know what kind of food the residents is served.” It was a standard home type food for lunch. But what impressed all of us was the gesture they showed and took part in the cremation as if someone from their family had died! We knew her last twothree years must have passed the way she wanted. It is not the facilities but the human touch that is important. After all, people who live there are far from their family.  

Bonsai of Relationship ..

Bonsai

How is the relationship between humans formed? Does the relationship depend on values? There are legal relations which are by birth or by marriage. There are other relationships which happen. Closest relationship is between mother and child. Then come husband and wife and so on! I am not talking of relatives, but I am speaking of relations. One may be a close relative, but we may not have much association with that person. I am taking a look at the connection between two persons as friends, whether they are relatives or not, even if there is an age difference between them and maybe they are of different sex.

Years back we visited Canada. It was our first visit outside India and our knowledge about personal interactions was limited. We had gone on a holiday for a couple of days with our Canadian friend Ed and his wife, Dorothy! We were in the early thirties, and they were in fifties. On the way back to Ottawa, Ed asked me whether it was ok if he took a small detour. I said, “Ed, we have absolutely no issues.” Ed said, ” My mother lives in an old people’s home. I want to meet her for half an hour!” While we were reaching the old people’s home, Jaya and I were trying to judge if we should also offer to meet his mother! Our problem was solved by Dorothy when we reached the parking lot. Dorothy said, “Ed, you go and see your mother; we will sit in the car!” After, so many years of marriage, for Dorothy “It was Ed’s mother”! We were surprised that she did not feel like meeting the old lady! We were surprised by the relationship between the two ladies!

We have been lucky that most of our close relatives are more of friends than relatives. It is said that the father and son must become friends once their shoe size matches. A similar thing can happen with grandfathers, uncles and other similar relationships, but for this to happen, the onus is on the senior partner. The age difference can come in the way. Relationships are a thing that cannot be explained. They simply happen. Two people simply hit it off on day one. In Bollywood jargon, it is called chemistry between two people. Chemistry occurs. Sometimes two persons are poles opposite in their backgrounds, their thought process. Still, they can be close friends.

During my engineering college days Sharad, Nayan and I were room partners. The only common thing between us was our mother tongue. But even today after more than 50 years we are very close to each other. The main reason I feel is that there never were any expectations of each other. We were very much aware of milestones reached, progress made or difficulties faced. We shared everything, all the time. But discreetly, we had made efforts to nurture the relationship. In the case of Nayan, we were lucky that our relationship went even one step further. Nayan’s parents continued to live in India after Nayan moved to the US. After that, we suddenly realised that we had the third set of parents, Opa and Omi! We had such lovely times with them whenever we could meet. It naturally happened as Nayan moved abroad, and we could spend time with Opa and Omi! Now whenever Nayan and I respond, we share memories of Opa and Omi!

Deepti and Raju have become family for us. Again, as destiny would have it, Deepti joined my business at the tender age of 26, and we have been together through the thick and thin of my company for the last 25 years. When they became family, it is not very easy to say. There is an age difference between us, but it just happened. When Deepti’s mother became our Aai, we do not know. The funny part is Aai calls me, “Sir” and Jaya “Madam” but she is Aai for us.

I will share how these relations get matured and cultivated. A few years back, I was to go for my checkup with Dr Sant, for my sore throat. My granddaughter was one month old at that time. Priya had a high fever, and hence Jaya was managing Rhea. She called and told me the situation; I said her not to bother as I could quickly go alone. This conversation happened while I was in the office. Five minutes later, Deepti simply told me, ” Sir, don’t worry. I have called Raju. He will go with you to the doctor; you don’t go alone.” Again, the destiny was such that I was detected with cancer during that visit and Raju was there to support me. Raju had simply come out of whatever he was doing, going with me!

On the other side, I have a friend, who is a charming person, always smiling, always enthusiastic, always keen. But he tends to keep relationships on/off. In the initial phase, he lived outside Pune. He would pass through Pune very often but would communicate very rarely. Like all of us do, he also went through ups and downs in life. Some of these were very serious up and downs. But as expected he came out of these tough times, with flying colours and became a great professional. We were always on the periphery except when he needed close support. As friends, we kept on giving him support. But later we realised that we were his friends only when he needed help! To me, friends are there when needed, especially if you live in the same city. They are like shadows, and they take up what is required to be done. But alas, in this case, it is not to be so!

Another case is of a college mate, whom I met recently, after 45 years of gap. He was a pleasant person in college days, but soon after college, he moved to foreign shores. He used to come to Pune like all migratory birds always do, but he never met me during this period. He has an added qualification of “NRI” which he displays proudly.  Our friend needs small help these days as he has acquired some property in Pune. His experience with his “friends” was not good. I was a little upset when he informed me about his experience but in the same note his rant about change in Pune culture, change in friends not keen to support etc. made me think a little more. When I came to know the other side, it looks like our “NRI” friend has a different set of friends for fun and getting work done! It looks like our friend is riding a big white horse! With shining armour! So, his “friends’ simply ignored his requests. He forgot that any relationship needs nurturing. Nothing is constant in this world including relationships unless cultivated. Our NRI friend forgot that relationship is like a balloon; you need to pump the gas very slowly and check, pump and check. One must get the feeling of knowing when the balloon will burst.

Give and take in a relationship is not like an accounting ledger. You don’t need to create a credit entry, immediately after a debit entry is created. But at some stage ledger needs to be balanced. At the same time, you cannot merely create a significant debit entry too! Nurture, coax, help each other to become closer and closer. There is nothing in life like a lovely relationship.

I could go on and on! While writing this, I have become nostalgic, but friends don’t forget that the beauty of this world is enhanced by great relationships. But you need to nurture them, cultivate them like a Bonsai. The purposes of bonsai are primarily contemplation for the viewer and the pleasant exercise of effort and ingenuity for the grower. We can compare the relationship with Bonsai.

Bonsai is a Japanese art form using a cultivation technique to produce small trees. Bonsai is not intended for the production of food or medicine. Instead, bonsai practice focuses on long-term cultivation and shaping of one or more small trees growing in a container. Similarly, the relationship between two individuals is cultivated for a pure relationship, friendship. There are no expectations. Create a Bonsai of friendship, between two individuals; these are grown with care in a container made up of love! Like Bonsai plants relationship can go on and on, living in their meandering path.

Checklists

My dear friend Vijay, sent me a book by Dr. Atul Gawande, “Checklist Manifesto” and I read it right away. Dr. Gawande thought of the idea about the book, based on the errors/ mistakes that happen during surgeries. http://atulgawande.com/book/the-checklist-manifesto/

These errors are sometimes avoidable, or some steps are simply missed out. Then there are some issues/problems that may crop up unplanned, during or post-surgery. In our lives also, such things can happen. But in my experience, I have found that issues/problems can crop up also because “problem statements” are not defined correctly.

Dr. Gawande has also discussed examples from construction industry as well as aviation industry. As usual, everywhere when humans are involved actions, decisions and reactions become too individual. Different persons react differently to the same problem. Additionally, real experts in any field can have large egos and/or may be over confident, about their abilities to take “correct” steps or decisions than those suggested by others. This sometimes leads to disastrous situations. In surgery for example, in rare cases it does happen that wrong patient may come on the table, wrong side of the patient may get operated upon, left instead of right! Dr. Gawande felt that such and many other errors, mistakes are avoidable by introducing “Check Lists”.

How to define a Check List? A Check List, is a list of items required, things to be done, or points to be considered, are used as a reminder; this is to be checked in sequential manner. In anything and everything that we do, there can be a check list. What is the need for this, you may ask! It is needed or not needed based on one’s view point. I am an expert in my field, I have been doing this for ages, why do I need a check list? But we forget that this is not the only thing that we do in life. Sometimes we may be in a hurry, sometimes we may be doing a few additional things in parallel! Sometimes we may have some other important stuff going on in our mind. All this can lead to avoidable errors. Ok! Check List may not be cure all for all the problems in the world! But they do help.

During surgery, many a time, antibiotics are given to the patient. The correct time for it to be effective is sixty minutes before start of surgery. It can so happen that correct procedure is followed, and the antibiotic is given 60 minutes before the starting time of surgery. But Surgery can get delayed sometimes as previous one may not be over. 60 minutes can become 120 minutes! So, the checklist for giving antibiotics during & before Surgery says, ask this question before patient is given anesthesia! This means that patient is already on the table and chances of delay are minimal! 

In every situation Professional, Personal, home, office or for that matter anywhere, problems do crop up! Creating check list for anything and everything may not be necessary but can be useful. When we work, we do create our checklist for things to be done and how to do. We have our own methods. With computers and cell phones creating and managing check lists has become much easier.

I can tell you that in today’s times why check list is essential. Maybe in day to life checklist maybe same as to do list!  We are now expected to link our Aadhar card to Bank Accounts, Credit card Account, Cell phone numbers, Investments and so on!  It is mandatory to do so before 31st March. Linking these is not as easy as it sounds. So, making a check list for these makes sense. We have passports, licenses, paying the bills and many such things to do. Wont check lists help us tracking them?     

I will share an incident where not having proper check list, could have led to a disaster. A Boeing was flying on Toronto- Ottawa-Vancouver route. When it got down at Ottawa for quick check for the long-distance flight, dip stick was used to check fuel volume as an additional check since pilots had some doubts about instruments on board.  Thumbs up was given and flight took off. At approximately half the distance, the fuel alert indicators started buzzing for all tanks. The theory is that a plane can glide 16 times the height at which it is flying, without fuel. The pilot sent Mayday signal. They were flying at the height of 7 miles. Luckily, he was from the same area where this incident took place. He remembered an abandoned airport about 70 miles away. He took the clearance for landing and was cleared asap. It was a Sunday and at the airport some fun stuff was going on including car rallies. Suddenly, the guys below saw a huge plane coming in for landing. People ran helter-skelter and somehow moved out of the harms way. The expert pilot managed to land safely. Inquiry was conducted, and it was found that there was an error in using dipstick. Those were days when people were just switching from FPS to MKS system. Dipstick was FPS but people measuring thought that it was MKS, so they gave green signal to the flight. Hence the issues started at midway distance of the flight! Checklist about type of dip stick to use would have avoided this error.   

I feel that in life there are two types of lists, checklist and to do list. It is possible that we may swap these two lists in personal life. Check list is detailing of to do list. Or it could be doing certain procedure or following a process; we need to have a checklist. I have seen an accident almost happening in front of my eyes, while working in factory. An electrician was working on a 440-volt circuit. I asked the electrician, who was working on the issue, if he had followed the checklist. He said of course. He used a big screw driver to open a screw in the box; in an instant the screwdriver melted fully. Though he told me that he had followed the check list he had not done it. There is a simple check; when working on high voltage circuit, remove the fuses for that area and keep them in your pocket. This can avoid such incidents. The electrician almost got electrocuted.

Check lists followed are mainly for safety and to ensure quality of work. I am sure women know how to mentally use them during  cooking. Though cooking looks easy, it is the proportion of ingredients, timing, sequence, temperature and many variables that need to be checked all the time. Ladies look to do things automatically, but they do have their checklists.

Friends, in our day to day lives also, we have many things which we should follow. There are birthdays, anniversaries. Then there are marriages, opening ceremonies. There are events galore in our lives. There are deaths and funerals. Of course, we are busy with our work and family and our financial planning. So, it is a good idea to have to do lists/ cum checklists. All of these points may not be life threatening but they do have effect on relationships. Ultimately, series of mistakes and errors with same group of people can lead to catastrophic results. Try forgetting your wife’s  birthday for two consecutive years! You know what I mean!