Three truths and a lie about elder care
Senior patients are often forgotten or dismissed by family members when it comes to healthcare. We take a closer look at three truths and a lie to better understand senior elder care, especially when it’s related to dementia.
Truth 1: Growing older doesn’t mean the patient can’t participate in their care
It’s not uncommon for older patients to be left out of treatment decisions or even the diagnosis of their illness. Sometimes a relative takes charge thinking the older person cannot deal with the information, but that’s not always true.
‘It’s a misconception that elderly people cannot participate in their care,’ asserts Dr Naazim Siddi Ganie, a neurologist with an interest in elder care based at Life Mount Edgecombe Hospital in Durban.
Dr Ganie says he encourages older patients to be actively involved in their own care. ‘This is because the goal of treatment for these patients is their functional, mental and drug independence,’ he explains.
He adds that doctors shouldn’t unnecessarily prescribe an array of drugs to a senior or remove medication without proper patient consultation. ‘In fact, it is sometimes the medication itself which may be causing a problem,’ he says.
He also believes that patients can be better treated when they are able to communicate to their primary health care provider what they feel the problem is. ‘Proper engagement and communication are essential,’ he adds.
Truth 2: Forgetful seniors don’t all have dementia
As people age, changes occur in the body and the brain, which could lead to forgetfulness. This might manifest as forgetting where they put their car keys or not being able to recall information as quickly as they used to, but Dr Ganie says that it’s wrong to assume that every forgetful patient has dementia.
He adds that the following practical questions can help better assess a senior patient’s forgetfulness, as they examine its impact on daily-life activities:
- Is there inattention or impaired concentration?
- How does the patient’s forgetfulness affect daily activities?
- How is the family affected by the patient’s forgetfulness?
- Does the patient pose a danger to themselves or others?
‘When a patient presents with forgetfulness, their doctor has to look for reversible causes of forgetfulness, motivate the patient, promote good sleep hygiene, get the patient actively involved in their care and take them off drugs that could potentially be causing these side effects,’ explains Dr Ganie. ‘Often their quality of life improves as a result.’
Truth 3: It is important to be attentive to senior patients with dementia
Older patients with dementia sometimes have difficulty communicating what may be wrong with them, so it might be necessary to adapt the way of communication to avoid stress and anxiety.
‘This is where keen observation and a thorough assessment at each visit are imperative,’ says Dr Ganie. ‘Also, patients suffering from dementia may not recognise that they have a medical issue or may be fearful of going to hospital, so they will not tell you if something is wrong with them,’ he explains.
Thus they need to be reassured at each doctor’s visit that the goal is to prevent major complications to facilitate their functional and mental independence – and to keep them out of hospital.
‘Patients living with advanced dementia are also vulnerable to complications that include pain, shortness of breath, incontinence and agitation, to name but a few, and you need to be acutely aware of them to prevent severe morbidity and mortality,’ he adds.
Lie: There’s no need to see a neurologist or geriatrician if you already have a general practitioner (GP)
‘The family practitioner always plays an important role in general care, but it is important that geriatric patients visit appropriate specialists to pick up any complications or subtle symptoms a GP could miss,’ explains Dr Ganie.
‘You want to keep elderly patients out of hospital and engaged in their care as long as possible.’ This is done by not just treating illness, but also preventing disease and carefully monitoring prescription drugs.
Many of the problems associated with ageing can be linked to diminished quality of life. It’s important to give the seniors in your life the right information and support, which are essential to ensure a better quality of life in their later years.
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