Balancing love and health in caregiving

By Dibya Prakash

Whenever I spoke to my childhood friend Reetu, her concerns always centered around the health of her father-in-law. He was battling a host of issues—diabetes, high blood pressure, osteoarthritis, and the inevitable complications that come with age. Reetu, the ever-devoted daughter-in-law she has been, has taken on the mantle of caregiver after the loss of her mother-in-law. She and her husband poured their hearts into looking after him, determined to fill the void left behind and ensure he felt loved and cherished.

Recently, I had the pleasure of visiting Reetu and her family, a visit I had long looked forward to. As I stepped into their warm, welcoming home, I was taken aback when I finally met her father-in-law. The man before me was strikingly different from the image I had in my mind. He was now significantly overweight, carrying 38 kg more than his ideal weight, with a staggering 10 kg gained in just the last three years.

It soon became clear that this weight gain wasn’t just a matter of indulgence—it was the result of Reetu’s family’s deep love and care, though perhaps misplaced. In their eyes, restrictions in his diet or encouraging any physical activity was unthinkable. For them, the idea of asking “Papa” to eat less or exercise seemed harsh, even cruel. Instead, they focused on ensuring that he had the best of everything—his favorite foods, all the comforts they could provide—believing that at his age, he deserved to be pampered, without restrictions.

But as I observed, it became evident that this well-meaning pampering was doing more harm than good. Their desire to shower him with love through food and comfort was unintentionally feeding his health problems. The extra weight, the excessive calories, the absence of any physical activity—all these were contributing to the very lifestyle diseases they were so concerned about. In trying to protect him, they were inadvertently leading him down a path of greater health risks.

It was a poignant reminder that love sometimes requires difficult choices, and that true caregiving means understanding the fine balance between affection and well-being. Reetu’s family had all the love in the world to give, but what her father-in-law truly needed was a healthier lifestyle—a way to enjoy the best of life without it costing him his health.

Obesity is a major health challenge

The increasing prevalence of overweight and obesity, along with its associated health risks, has led the WHO to recognize it as one of the most significant public health challenges of our time.

Obesity occurs when there is a positive energy balance, meaning calorie intake exceeds energy expenditure. It is characterized by the widespread accumulation of excess fat in the body, resulting in a weight that is more than 20% above the desirable level. Being overweight refers to a condition where body weight is 10-20% higher than the average standard weight for a given age, height, and sex. Obesity is associated with increased risks of disability, disease, and premature death, and is considered a chronic disease.

Excess body weight can be a significant hindrance, causing breathlessness even with moderate exertion, and it increases the risk of various diseases such as atherosclerosis, high blood pressure, stroke, diabetes, gallbladder disease, osteoarthritis in weight-bearing joints, and varicose veins.

Good caregiving requires maintaining a normal weight for the elderly. Just like in other stages of life, an elevated body mass index (BMI) in older adults can raise the risk of developing multiple health issues. Elderly individuals with obesity, particularly those who have experienced obesity earlier in life, are at a higher risk of developing knee osteoarthritis. When combined with sarcopenia (muscle loss), this condition can lead to disability, physical impairment, and a diminished quality of life.

Some elderly individuals are obese because their calorie intake has not decreased, even though their calorie requirements have steadily declined. Contributing factors may include a decreasing basal metabolic rate and a sedentary lifestyle. Those who are obese are more susceptible to degenerative diseases, and their mortality rate may be higher. Maintaining a healthy weight supports healthier ageing and can extend lifespan. This is where caregiving plays a critical role.

Caregiving and weight control

Staying active and selecting healthy foods is an important requirement of caregiving. Caregivers must choose nutrient-rich foods and aim for at least 150 minutes of physical activity each week.

They must ensure a balanced eating pattern that includes plenty of vegetables, fruits, whole grains, low-fat dairy, and lean proteins. Here are some tips for them:

• Control portion sizes to manage calorie intake.
• Motivate them to stay as physically active as possible.
• Choose healthier alternatives to replace their usual foods.
• Make sure to keep them hydrated with water and avoid serving sugary drinks.
• Set specific, achievable goals, like encouraging them for 150 minutes-walk per week.
• If they slip up in their healthy eating or exercise routine, try to get them back on track quickly.
• Use a food diary to keep track of what they eat.

Aforesaid, in caring for the elderly, it’s essential to balance affection with practical health considerations, ensuring that love is expressed through choices that genuinely enhance their well-being and quality of life.

(The column Metamorph with Dibya appears every Friday.)

Read also:
Adapting to changing nutritional needs as we age
Ageing gracefully: Celebrating life’s later chapters