Mission Monet House. It takes me less than 5 minutes to locate the spot where Epoch’s Assisted Living facility is centrally located in Kondhwa, Pune. I expect a cottage because, well it’s a ‘house’. To my pleasant surprise, I find myself gaping at a high-rise building instead within a secure, posh and gated society.
A building worker rushes in as I enter the lift. I quickly enquire about Epoch, she says 8, which I realise is her floor, not mine! A quick deduction from the apartment number rightly leads me to Floor 11. Of the two flats, the more secure looking one is my destination.
As I check the unfamiliar name plate and reach for the doorbell, I presume it’s the owners’ from whom Epoch have rented. A female carer opens the door. Viji Varghese, the facility manager, peeks from behind. We exchange introductions. She is expecting me.
A calm and unassuming atmosphere envelops as I enter the spacious 4.5 bedroom apartment.
Monet House is home to 4 elderly residents; three long-term Dementia patients and one temporary resident recovering from a skin ailment.
“We specialise in Dementia Care,” informs Viji, which explains the need for security and anonymity.
The team is super-protective of their residents. Both, Viji and Delhi-based manager Kavitha Vinod who organised my visit, emphasise that we must protect their identities. Families, finicky about privacy, can be reassured on that front when they choose Epoch. I assure them only relevant information, in the context of this piece, will be shared.
We start with a tour of the space. The vibe is homely and efficient. Just at the entrance, on the left, is the first bedroom, occupied by a single, permanent resident, 76-year-old *Vijay Shinde. He is mostly independent, except for provision of food. Still a male carer steps in, when needed. The room has all the necessary elements of comfort though sparsely furnished with a bed, cupboard, side-table and a mounted TV. Vijay decided to move here after becoming aware of his condition; his brother visits him often and bears the expenses.
Next on the left, as we walk along the corridor, is the living room which doubles up as an activity area. I spot sofas, a side unit, mounted TV and a dining cum activity table. The room opens out to a gorgeous, large-sized and breezy terrace. It overlooks some beautiful scenery and is bare, except for some plants and a clothes drying stand.
A little ahead on the left is the second bedroom, also connected to the terrace, where temporary resident *Seema, 68, lives. She is recovering from a severe skin problem on her leg. Rightaway, we start chattering in Marathi. Though not happy giving up on her home and independence, Seema appreciates the team intervention. “They ensured my recovery was fast. Before here, I was lodged on a hospital bed with no sign of progress. My son had to come down from US to look for an option. He stayed here for 15 days and only after he was convinced, did he move me here,” she says. Since there was a vacancy, Viji checked in Seema for a short stay though she was fit otherwise.
I continue ahead. Towards the right is the facility area with an office, laundry and utility space, plus the .5 bedroom (where Viji lives) and kitchen.
Third and fourth permanent residents, *Savita and *Subramaniam are situated left and right, in opposite rooms towards the end of the flat. All the rooms are well-ventilated, with good sunlight penetration and fresh air access.
Pune-based Savita is 64, with Alzheimer issues; her husband passed away. Though independent and able to manage her own work otherwise, she forgets her bearings at times and needs a female carer to monitor her constantly. Savita’s US-based son takes care of expenses. She also has three daughters, one of whom resides in Pune and visits her.
Subramaniam is the only patient who has been assigned a full-time male nurse to cover his medical needs as he suffers from multiple illnesses: hypertension, diabetes, skin and prostrate problems. His personal hygiene is looked after by Vijay’s carer. Subramaniam is from Bombay, his wife lives there and visits often. Children are in US and pay for his care.
I realise these residents are in various stages of Dementia and feel hesitant connecting or chatting with them. “You can converse. Just don’t ask them questions. Keep it casual; a conversation about immediate activity is advisable. They may not even remember what they ate this morning,” advises Viji, who has been with Epoch for seven months now.
Originally from Kerala, she completed her nursing from Bangalore in 1997. She worked in hospitals and clinics for 15 years before moving to the corporate side. Her last job was with Wipro Technology, managing 5 corporates in Bangalore area, complete with nurses, doctors, carers and lab technicians.
The Epoch opportunity arrived when she was seeking a challenge. “I came here with a lot of passion as I know Dementia care is tough,” informs Viji.
It’s a specialised task, which a typical family finds difficult to execute, “One can appoint a carer but it’s hard. The test comes when someone one turns aggressive. An action of theirs may evoke a negative reaction from the carer, when it is difficult to handle.”
It is scary to leave a loved one home alone in this scenario. All three residents have crossed the initial stages of Dementia with significant memory loss, which is why their families feel a place like Epoch is a safer option.
“Their mood changes, from shouting to depression to restlessness. Our brain gives a signal for us to perform certain tasks. That connection is damaged and they don’t get pointers anymore. That’s where we come in and guide them,” says Viji.
Sometimes the residents try to leave in the evening. Perhaps an old routine kicks into their memory. “We tell them it’s late, you will not find a taxi. Let’s wait till morning. We never say your family is not in the city or you can’t go home,” says Viji. “If they are restless or forceful, we leave them alone for a bit. Or try to talk after gauging their state of mind. Sending someone they like to chat them up helps. We use different methods to convince. Our staff is trained to handle any situation.”
The team, even the non-medical staff, is equipped with basic nursing skills. Every staff member has to undergo six months of training before they handle patients. Specialists from the main Epoch centre in Delhi visit regularly and upgrade their knowledge.
With four residents and an army of help, this Epoch facility seems well-equipped. Viji oversees everything while the Facility Nurse manages general operations. Another male nurse helps with Subramaniam’s medical care. Family physicians visit once a month or as required. Jehangir Hospital is close in case of an emergency. Two female carers are each exclusively assigned to Savita and Vijaya. One shared male carer, though mainly for Vijay, pitches in to fulfil Subramaniam’s daily hygiene duties. Plus there’s a resident chef and day housekeeper, for laundry and cleaning from 8 am to 8 pm.
Residents enjoy an exclusive and healthy menu prepared in-house. “We make sure there’s not much oil or chilli. It’s nutritious food, like today we had daliya for breakfast,” says Viji. Non-vegetarian food is provided once a week. The preference is for them to eat complete food, it is prepared according to requirement. “We know what they like or don’t like… if they don’t like something, we go for an alternative. Or supplements as the last option,” says Viji.
In terms of routine and activities, they choose options that help in brain regrowth. Residents are always addressed by name, to help remember their own.
Following a set routine also helps. Residents start their day at 6 am, with a morning hygiene routine, brush, toilet and bath. Followed by breakfast and activities. Then there is lunch and afternoon rest. All residents are encouraged to eat together. “We don’t allow them to eat them alone. All of us sit together. The idea is to create a home atmosphere, they shouldn’t feel like we serve them,” explains Viji.
Post breakfast and afternoon tea, it’s activity time. Ludo games, reading news, carom, painting, colouring, movies and some TV. It’s 11 am, Vijay is reading the newspaper and Savita playing a game. Seema is watching TV in her room while Subramaniam is resting. Residents are also taken down for walks for an hour or so, twice a day or once in the evening during summer. “We help them read news and discuss points with them. Ludo helps in counting numbers,” says Viji.
Each resident’s progress is documented, whether decline or improvement. “We monitor everything. Weekly and monthly reports are sent to family members,” says Viji. The document cover vitals, blood sugar, and weight, changes in diet or medications, details of visitors, special updates and a picture of the resident.
“Before checking in someone, we spend a lot of time understanding their situation. The facility nurse prepares a care plan with my help. We ask the family to provide all the information, their problems, ways to deal, past history for upto three years. A medical assessment is done. Either they come here, or we visit them through this whole process. We never accommodate a patient immediately.”
Weekly family visits and outings are allowed with immediate family members only. A carer is around to help them manage. Any other visitor must get a written approval from the family. The ones abroad, visit every 6 months for a week or two. The after-effects of a family visit are handled by the team. Residents do feel the difference after they depart and need help with coping.
A facility like Epoch comes at a steep cost price for family members, though they are happy to pay for the care and comfort of their loved one. As per their current pricing, single occupancy long-term stay monthly room rates are ₹80,000, short term ₹1,00,000, plus 14 per cent tax. Attendants cost extra, a 24-hour assistant is ₹30,000 monthly plus 14 per cent tax. A one-time refundable security deposit of ₹1,00,000 is charged. All other expenses are billed separately.
As I bid goodbye, I feel mixed emotions. There is a sense of reassurance, and respect, that Viji and her team are doing a great job of caring for the beautiful people I’ve just met. Yet I wonder about other such patients who would be unable to afford a place like this and the need for many more such facilities in India.
*All resident names have been changed to protect identities.