Concerns of the ElderlyEngaging with life and

surroundingsDeepika Nair

Executive Director SAFP nairdeepika1@gmail.com

Deep rooted beliefs – Indian mind

Old age is an age of ailments and physical infirmities

So most physical troubles within curable limitations are accepted as natural and inevitable - by the elderly, the younger population and the medical fraternity!!

General perception in society that not much can be done about the health problems of old age

In reality, most illnesses are minor and curable at the initial stage. Most neglect and postpone seeking medical aid/education leading to aggravated problems.

Issues compounded by social values

Some health problems of the elderly - attributed to social values also

General perception in the community - since the old lead a sedentary life, they should eat less food, have more rest and develop more religious interest to occupy them.

The differential ageing phenomena, both physical and mental, depend on environmental and social factors such as diet, type of education, adjustment to family and professional life, and consumption of tobacco and alcohol

Contd…

At an advanced age, due to restricted physical activity, majority of elderly change their living habits, especially their dietary intake and duration of sleep

Several factors like lack of physical movement, absence of a work routine, ill-health, etc. are observed to be responsible for irregularity in the sleeping schedule of the elderly

Isolation and lack of fun – emotional issues Community members - to be sensitized about the

problems of the elderly for greater commitment and involvement to include "care for the elderly“

Health problemsPsychological problems – emotional, suicidalSocial problems – isolation, poverty, loneliness,

dependency, elder abuse, generation gap

Healthy and active aging is a process to achieve

physical, mental and social well being throughout

one’s life particularly in the later years

Disability among the Elderly

As reported by a few medical studies, were difficulty in walking and standing, partial or complete blindness, partial deafness and difficulty in moving some joints, indigestion and mild breathlessness

Prevalence of various types of physical disabilities was found high among the elderly

Among the elderly, the older ones (80 years+) growing at fast pace. They are usually weaker, more frail, insecure, dependent and suffer more often from age-related diseases

 

Frequently encountered in the elderly

Fraility - In functional terms, frailty is defined as dependence on others for activities of daily living (ADLs)—bathing, dressing, feeding, continence, toileting and mobility. Both frailty and disability frequently coexist. Impaired cognitive function adds to the complexity of the situation.

Anorexia/Malnutrition/Weight Loss - Normal aging is associated with anorexia, which is more marked in men than in women. Anorexia in elderly is due to decline in energy demand, which in itself is due to lower physical activity, decline in lean body mass and slowed rates of protein turnover. Loss of taste sensation, reduced stomach compliance

Contd…

Malnutrition is a consequence of anorexia, since in elderly, the food intake decreases to a level below the energy demand.

Monotonous diet, lack of sufficient fresh food/fruits and vegetables, inadequate intake of important micronutrients, contribute to malnutrition.

The adverse health consequences of malnutrition are impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognition, delayed wound healing, delayed recovery from surgery, increased risk of falls, disability and mortality

Awareness in the patients, caregivers and physicians related to this often neglected issue is important

irritability/aggression!!

Contd…

Gait Disorders - Unstable gait serious issue in elderly since they lead to injury, restricted activities, increased indoor stay

Osteoporosis - progressive bone loss leading to increased risk of hip and other fractures

Urinary Incontinence - The involuntary leakage of urine is highly prevalent in elderly, particularly females

Focus on Education, Prevention and Safety

Contd…

Pressure sores - skin breakdown occur frequently in elderly/disabled

Prolonged immobilization, inactivity in or outside bed, fecal/UI, malnutrition and altered sensorium are the risk factors for development of pressure sores in elderly.

Healing gets delayed because of - anemia, infection, diabetes, peripheral vascular diseases, edema, paralysis, dementia, alcoholism, fractures and malignancy.

Frequent change of patient’s position, keeping skin and body folds clean and dry are essential.

 

Dementia - decline in cognitive, intellectual and memory function

Clinical features include slow onset of forgetfulness, loss of interest in surroundings, impairment in social skills and personality. Depression is an early feature of this disease. Disorientation in time and space, followed by language impairment, aphasia and paralysis are common features

Alzheimers/Dementia

Cognitive impairmentMemory lossResulting confusionSelf image – sexual problems (infidelity, advances)Resulting irritation, suspicion, aggression Side effects of medication – sluggish, bladder and

stool controlDiagnosis – nutrient deficiencyEducation – medical, police, family, publicWrite name and address on clothes; wrist band,

gadgets

What to do?

Environment we live in – find joy in small things, bring in colours…

Keep brain active – continue with hobbiesGames, reading, theatre, singing, art,

cooking, gardening, outings….Nutritious food – small meals, frequent

mealsCleanliness and hygiene in surroundings Engagement with life and surroundings a

must