October 1st is International Day for Older Persons. To highlight this day, Sujjawal Ahmad joins in conversation with Laila Akber Cassum from Aga Khan University, Pakistan who sheds light on the important role that the older population plays in society.
Sujjawal Ahmad (SA): Tell us a bit about yourself.
Laila Akber Cassum (LAC): Hello! My name is Laila Akber Cassum. I am working as a Senior Instructor and stream lead of the Geriatric and Gerontology clinical stream at Aga Khan University School of Nursing and Midwifery (AKU-SONAM). I have been associated with my Alma Mater since 1995. After completing my undergraduate and graduate nursing studies at AKU-SONAM, I worked as a Critical Care Nurse in Cardiac Intensive Care Unit and then pursued my career as a nurse educator. I have served the institution in various capacities such as Critical Care Nurse, Senior Instructor, Academic Lead of undergraduate program (Post RN Baccalaureate Program (PRN BScN) and Post RN Baccalaureate of Science in Midwifery (PRN BScM) ) and at present as Geriatric Clinical Stream Lead.
SA: What is the area of your research?
LAC: My interest areas particularly as a teacher may possibly have begun in my childhood while playing with dolls and teaching them on house walls using chalk and duster, and this passion for teaching got nurtured when I joined AKU-SONAM as a student. With the passage of time, these bugs kept metastasizing and this absolute dream of being an educator was accomplished when I entered this institution to train the future generation of nurses. This trajectory mutated into research with a particular interest in the domain of Blended Learning (BL) and Teaching Learning Pedagogies. When the pandemic led to the closure of educational campuses and suspension of traditional teaching and rapid migration to remote learning motivated me to research in this area. The finding will be published soon. Additionally, I have another extremely important research interest which is to work for the elderly population.
SA: What sparked your interest in the elderly population?
LAC: That’s an interesting question! So, let me share, Mawlana Hazar Imam’s grave concern for the aging population during the homage ceremony address on His Golden Jubilee as he stated,
“Life span is elongating, but at the same time working life is shortening. Family bonds are being loosened and sometimes even broken by the forces of modern life. The result is that many older [Ismailis] are facing unhappy and often, lonely years ahead. We must find ways to address this problem.”
And these words became the intrinsic motivation that heralded me to select this area for my graduate studies and research about the experiences of older adults who are institutionalized by their families which ultimately affects their quality of life. The findings of the paper have been published in an international high-impact factor journal and received appreciation at the international conference. It is very important to appreciate the magnitude of the concern that Hazar Imam wants us to focus on.
Globally, every two people celebrate their 60th birthday every second. One in nine persons in the world is aged 60 years and above, and these numbers are expected to grow to one in five by 2050. Pakistan is a developing country with more than 10 million older population and this number in the age band of 60 and beyond is estimated to be at 7 percent of the current population. With the hindsight of Imam’s guidance clearly mentioned back in 2007, the quality of life of this vulnerable cohort will be highly affected in the years to come.
Since my graduate studies, I have been working for Hazar Imam’s vision for the elderly population and am now in the capacity of geriatric clinical stream lead at AKU-SONAM. Other than this, I have also been working as the core member of the Technical Working Group (TWG) for Healthy Ageing created by the Ministry of National Health Services Regulations and Coordination, Government of Pakistan. The aim of this group is to develop a healthy aging policy and chalk out sustainable plans for its implementation.
SA: As this year’s theme of the International Day of Older Persons is “Resilience of Older Persons in a Changing World”, in your view, in what ways can older people contribute to the community and society in a broader sense?
LAC: In my opinion, the older population in our local context is contributing from multiple facets irrespective of being a bread earner to a housewife or a working woman. Aging members are the strong pillars of a family and in any community. They support their family by earning a living and household work, nurturing grandchildren, employed in agricultural fields to grow crops.
In the Pakistani context, older men are the income generators, decision-makers, and heads of the family. If we speak particularly for the women, they are also the informal caregivers to their sick spouses and children and carry the burden with strength, endurance, and resilience. Furthermore, they are not rightly paid what they deserve and struggle to accumulate savings, and the majority of them are not eligible for pensions. While these older and aging people continue to contribute to their family and community their assistance should be regarded and surfaced up. These older men and women are viable and productive members of society.
SA: What do you think about the positive impact your research can have on social development in the context of Pakistan?
LAC: In our context, research in the field of aging is still in its infancy as compared to resource-wealthy countries with sound economies. To assess the impact of my or any other research study in the arena of aging, it is imperative to comprehend that in Pakistan, elderly people are still considered to be the part of late adulthood phase of developmental stages of life. As per United Nations, 60 years and above is considered the age for progression into the elderly phase (United Nations, 1980) nevertheless, in high-income countries 65 years and above is the cutoff range for older people given by WHO (UNFPA, 2012). Therefore, the elderly are a group of people having entirely distinct physical, psychological, sociocultural, emotional, and economic needs, and hence their health care requirements are different and to have cared for.
Now, coming up to your question, my study explored the experiences of older people who were institutionalized. In other words, what were the conditions or reasons they had to relocate to shelter homes voluntarily or by force? In addition, how did they cope with the situations when they were undergoing such challenges? My study revealed both positive and negative experiences however substantial findings were largely undesirable. It discovered causes like lack of family support, dissolution of family systems, migration for better prospects and opportunities, and insensitive behavior of children nonetheless loneliness and powerlessness were highlighted significantly.
The positive impact on social development can be from the perspective that irrespective of the fact whether it was a forceful or voluntary decision to live in an old age home, if their needs grounded on Maslow’s Hierarchy are being met and the physical, and psychological spheres of health are in equilibrium they will be able to enjoy long life span and can contribute as a healthy and graceful aging member of the society. In old age, social inclusion is the key to health and physical and mental well-being and literature substantiates that it neutralizes loneliness and isolation and mental health issues like anxiety and depression, and are more likely to stay happy healthy, and valued.
SA: Tell us a bit about your early years at AKU-SONAM and how you think it has left a transformative impact on your career.
LAC: I have been associated with my Alma Mater since 1995 and the inspiration came from Mawlana Hazar Imam addressed to the first cohort of the nurse’s class of 1983 on February 16, 1981. “If you fail, I have failed. If you succeed, Pakistan will be rewarded”
These words were the steppingstone in my life. I believe that I was quite fortunate enough to be surrounded by highly professional mentors and their energy field enabled me to reflect, unlearn and re-learn certain attributes to inculcate in my personal and professional – self, allowing me to glow and grow. Initially studying and then being the part of teaching force of an institution, which is a trendsetter and pioneer of the profession of nursing in Pakistan and I am reaping the fruits of the seeds that Mawlana Hazar Imam sowed in the form of the Nursing profession. I feel so proud and fortunate of being a nurse and whatever I am today is all because of the knowledge, skills, and values that my mentors instilled in me enabling me to transform into an educator and growing researcher.
SA: What will be the advice you would like to give to the younger generation who aspire to pursue their career in Nursing?
LAC: I would strongly recommend the younger generation to take up their career in Nursing. Why I say this is that nurses are the true pillars of the healthcare industry. They are there when a baby takes the first breath and are there when the last breath is taken. Their attributes were evident during the COVID-19 pandemic that nurses were the front-line workers who gave comfort and compassion without any prescription. Nurses can perform diverse and countless roles such as caregivers in various specialties of hospitals, educators, policymakers, catalysts for change, team leaders, researchers, patients’ advocators, team leaders, counselors, specialists,s and many more. I vouch for more and more younger people joining this profession.
About Laila Akber Cassum
Laila Akber Cassum is a nursing alumna of Aga Khan University School of Nursing and Midwifery (AKU-SONAM) and is associated with Aga Khan University since 1995. Her research interest areas are Teaching and Learning Pedagogies, Blended Learning, and Critical and Geriatric care. Presently, she is working as a Geriatric Stream lead at AKU-SONAM and is working for the mandate to reach out to the older population to assist them in aging gracefully.