Providing apt care for the elderly
Joey started noticing changes in his father’s behaviour when his dad was 81. At first, his dad started forgetting where he left things like keys, books, or even his shoes. As years went on, he forgot names of people, especially the ones whom he recently met, and events that just transpired. Joey assumed these were part and parcel of his dad’s advancing age and “pag-uulyanin.”
The health problems of his dad did not end with memory problems. He was also beleaguered by hypertension, diabetes, a fatty liver, aches and pains on his joints, and difficulties urinating. Joey also noticed his dad becoming more despondent and irritable regularly. Again, Joey assumed his dad’s condition was merely dictated by his age.
Joey’s dad’s condition illustrates how the elderly may become beleaguered by multiple health problems and disabilities, which require specialized medical attention but which get ignored by people because it is assumed that the elderly are really bound to experience these.
However, geriatric specialists are trained to meet the medical needs of citizens over the age of 65 who have varying degrees of illnesses and/or disabilities. By the age of 75 years or over, the elderly people usually start to manifest not just one but multiple problems that present a host of symptoms. Geriatric care should be made available especially for those who have complex medical issues that can cause impairment and frailty.
It’s important that the elderly, their families, and friends understand four key principles to ensure they receive timely and appropriate health care services. Regrettably, many including elderly patients themselves, assume they are only dealing with old age.
When caring for old people, family members and friends should flag the following signs and symptoms among the elderly:
1. Confusion or disorientation, especially very sudden ones, should be seen by a specialist right away. Such rapid changes in the cognitive abilities of the elderly are usually a result of pressing medical problems. An elderly person who suddenly becomes confused or disoriented may be having or may have had any one of the following acute problems: adverse reaction to a new medication, urinary tract infection, pneumonia, heart attack, or stroke. Addressing the acute problem may help the elderly patient return to his or her lucidity and rationality.
2. Gradual cognitive decline may be brought on by different medical conditions such as chronic metabolic diseases, Alzheimer’s disease, or depression.
Chronic metabolic illnesses such as thyroid problems, vitamin B-12 deficiency, Parkinson’s disease and medication side effects (see next section) may cause this. These conditions usually develop over months to years, causing a gradual “slowing down” of the patient. This could make them feel “confused” or tired and weak.
It could also be due to Alzheimer’s disease, which is a chronic, progressive dementia that develops over time. The disease impairs thinking ability and in its final stages, impairs physical functioning. A decline in physical and mental functioning, however, is not necessarily indicative of Alzheimer’s disease.
Mood problems such as depression are also often mistaken for dementia; hence, the need for proper diagnosis. Depression results from loneliness and social isolation, which can be very common among the elderly. At their age, elderly people have usually seen the demise of many of their contemporaries. They are also prone to feel alienated from people around them because they may think they are no longer useful or they feel misunderstood. Sometimes, disabilities such as hearing problems can make it difficult for them to communicate with others. Kind words of reassurance, hearing aid or glasses, involvement in activities with fellow seniors of family members, or volunteer work can help mitigate this. A big hug can have a profound therapeutic effect, too.
3. Many older adults consult several medical specialists, each of whom may prescribe one or more medications. Some patients may also be buying over-thecounter medication on a regular basis. Unfortunately, without proper supervision, medications may result to harmful drug interactions. Even one drug that’s not right for older adults can impair their ability to function and decrease their quality of life. Imagine what five contraindicated drugs can do. Older adults should avoid self- medication. They should also ask doctors about their prescriptions: “Are these medications necessary?”, “What are the side effects of these drugs?”, “Do they interact with other drugs?”
4. Ageist Attitudes or age-based discrimination can be harmful to the elderly. “What do you expect at your age? You’re not getting any younger!” Do these statements sound familiar? However, it is not only the people around the elderly who subscribe to such ageist views. Sometimes, aging patients themselves share the mindset. A 95-year-old female patient once complained of pain in her right knee. Shrugging her shoulders, she said to me, “What do you expect at my age?” I asked her about her left knee. She said it was fine. Puzzled, I said, “Isn’t that knee just as old as the other?” She smiled and understood what I meant: aches and pains are not necessarily simply because of age. Ageist attitudes are usually unjust generalizations and prejudicial statements that assume all older adults naturally become weak, sick and forgetful. However, we must all remember that older adults become sick from diseases. They don’t become sick just because they’re old. Such attitudes can stop caregivers from seeking immediate medical help for the elderly.
The elderly have distinct needs that demand special medical attention. At the St. Luke’s Geriatric Center both in Quezon City and Global City, we provide comprehensive diagnostic and treatment services that address the multiple health conditions that the elderly face to ensure that their quality of life is not compromised.