An­nual aca­demic ses­sions on Fri­day

Sunday Times (Sri Lanka) - - EVENTS/INTERNATIONAL -

The Sri Lanka As­so­ci­a­tion of Geri­atric Medicine will hold its 3rd an­nual aca­demic ses­sion on the theme ‘ To­wards Clin­i­cal Ex­cel­lence in Ge­ri­atrics’ next Fri­day (Novem­ber 17) at the Ho­tel Gal­adari, Colombo.

Dr Jaya­sun­dara Ban­dara, Direc­torGen­eral of Health Ser­vices, will be the Chief Guest and the Founder of the As­so­ci­a­tion and Con­sul­tant Rheuma­tol­o­gist, Dr. Lalith Wi­ja­yaratne, the Guest- of-Honour at the in­au­gu­ra­tion of the ses­sion.

The pre- congress work­shop on Thurs­day (Novem­ber 16) with the par­tic­i­pa­tion of doctors, nurses and al­lied health staff will demon­strate how an in­ter­dis­ci­pli­nary team will as­sess and man­age prob­lems of the el­derly. an acute medical ward. Thus, doctors are com­pelled to dis­charge patients when ac­tu­ally they are not ready to be taken home. Re­ha­bil­i­ta­tion cen­tres are few and there are no in­ter­me­di­ate care fa­cil­i­ties to look after patients un­til they are ready to go home. There­fore, at present, ed­u­cat­ing the in­for­mal care-givers in the ex­tended fam­ily and strength­en­ing them would be the best way of look­ing after the el­derly as far as long-term care is con­cerned.

The el­derly pa­tient poses many chal­lenges to the physi­cian. The pre­sen­ta­tion of dis­eases in the el­derly is non-spe­cific; they have mul­ti­ple non-com­mu­ni­ca­ble and de­gen­er­a­tive dis­eases and are on mul­ti­ple med­i­ca­tions. The evo­lu­tion of medicine has re­sulted in super spe­cial­i­sa­tion with spe­cial­ists deal­ing with dif­fer­ent as­pects of pa­tient care. It is im­pos­si­ble for a physi­cian to keep abreast of the vastly chang­ing knowl­edge base of dif­fer­ent spe­cial­ties. How­ever, the holis­tic ap­proach which is vi­tal es­pe­cially in man­ag­ing el­derly patients can be achieved best through the mul­ti­dis­ci­plinary ap­proach.

A mul­ti­dis­ci­plinary ap­proach is a ne­ces­sity in man­ag­ing the com­plex phys­i­cal, so­cial and psy­cho­log­i­cal prob­lems of the el­derly. The de­liv­ery of care by an

It was at the first an­nual aca­demic ses­sion held in 2014 that the term ‘Sil­ver Age’ (Ra­jatha Viya) was in­ter­dis­ci­pli­nary team con­sist­ing es­sen­tially of a geri­a­tri­cian/ physi­cian, a nurse, a phys­io­ther­a­pist, an oc­cu­pa­tional ther­a­pist and a so­cial worker is needed to pro­vide a com­pre­hen­sive pack­age to the el­derly. Other mem­bers such as a di­eti­cian, speech and lan­guage ther­a­pists, a po­di­a­trist and a tis­sue vi­a­bil­ity nurse would be use­ful in the care of these el­derly patients.

The as­sess­ment, man­age­ment and fol­low-up of phys­i­cal, men­tal and so­cial prob­lems of the el­derly are called the com­pre­hen­sive man­age­ment of the el­derly. Com­pre­hen­sive As­sess­ment, which is the gold stan­dard, can­not coined for old age, with its theme of ‘ To­wards the Sil­ver Age with Dig­nity’. be ac­com­plished with­out the sup­port of an in­ter­dis­ci­pli­nary team.

The re­cently pub­lished Na­tional Sur­vey on Self-re­ported Health in Sri Lanka com­prises data through­out 2014 from 25,000 house­holds cov­er­ing all dis­tricts. It is the first house­hold sur­vey on health. A to­tal of 55.2 per­cent of the re­spon­dents aged 60 years or older re­ported hav­ing at least one chronic dis­ease. In re­spon­dents aged 65 years or older, 18.1 per­cent re­ported hav­ing di­a­betes; 30.4 per­cent hy­per­ten­sion; 6.6 per­cent asthma; and 8.8 per­cent arthri­tis. The Na­tional Sur­vey on El­ders 2003-2004 showed that 83.9 per­cent lived in ru­ral ar­eas; 12.3 per­cent in ur­ban ar­eas; and 3.8 per­cent in the es­tate sec­tor. The sur­vey also showed that 65 per­cent of the el­derly had poor vi­sion and 2 per­cent no vi­sion, while 28 per­cent had poor hear­ing and 2 per­cent no hear­ing at all. Joint pains and dif­fi­culty in move­ment were the com­mon­est ill­ness among the el­derly, ac­cord­ing to this sur­vey.

The Sri Lanka As­so­ci­a­tion of Geri­atric Medicine was ini­ti­ated by a group of doctors in­ter­ested in Geri­atric Medicine in Fe­bru­ary 2014 un­der the guid­ance of Dr. Lalith Wi­ja­yaratne with the in­ten­tion of de­vel­op­ing geri­atric care. The vi­sion of the as­so­ci­a­tion is to en­sure ac­tive and healthy ag­ing in Sri Lanka, with the mission be­ing to en­sure the pro­mo­tion of geri­atric ed­u­ca­tion among the medical fra­ter­nity and the pub­lic to fa­cil­i­tate the de­vel­op­ment of an el­derly-friendly en­vi­ron­ment in health- care in­sti­tu­tions and the com­mu­nity and to in­te­grate el­derly ac­tiv­i­ties car­ried out by var­i­ous or­gan­i­sa­tions with the com­mon goal of pro­mot­ing good health and well-be­ing among se­nior cit­i­zens.

Since the in­cep­tion of the as­so­ci­a­tion, many ac­tiv­i­ties have been car­ried out to en­hance the knowl­edge of doctors in geri­atric medicine and im­prove the qual­ity of life of the el­derly.

El­ders should main­tain a healthy life­style and en­gage in ex­er­cise and have a healthy diet. It is im­por­tant to have an ad­e­quate amount of pro­tein in the diet as it is cru­cial to re­duce mus­cle-wast­ing in old age. A low pro­tein con­tent in our diet leads to the loss of strength and mus­cle mass. This, in turn, leads to falls and frac­tures in the el­derly, re­sult­ing in dis­abil­ity or death. Main­tain­ing good phys­i­cal and men­tal ac­tiv­ity with par­tic­i­pa­tion in so­cial ac­tiv­i­ties is im­por­tant to achieve ac­tive healthy ag­ing and pre­vent de­men­tia. The el­derly need spe­cial care, love and em­pa­thy. We must bring about an el­derly-friendly at­ti­tude in our hos­pi­tals, work­places, homes and so­ci­ety. We are what we are be­cause of the ser­vices ren­dered by our el­derly. Thus, the term ‘old age’ should be re­placed by the new term ‘sil­ver age’ to give them dig­nity.

The ac­tiv­i­ties of the Sri Lanka As­so­ci­a­tion of Ge­riat r i c Medicine will en­able the link­ing of all stake­hold­ers work­ing to­wards bet­ter el­derly care in the coun­try. It is our hope that all those work­ing to­wards a bet­ter qual­ity of life for the el­derly will join hands to face the chal­lenges of el­derly care. The el­derly need to be re­spected and their dig­nity en­sured. We should build a so­ci­ety for all where the el­derly will have equal rights and op­por­tu­ni­ties. After all, be­com­ing old is in­evitable and we should all do our best to make the sil­ver age hap­pier and brighter.

(The writer is the Pres­i­dent of the Sri Lanka As­so­ci­a­tion of Geri­atric Medicine and a Con­sul­tant Physi­cian at­tached to the Colombo South Teach­ing Hos­pi­tal.)

The Coun­cil of the Sri Lanka As­so­ci­a­tion of Geri­atric Medicine

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