Geriatric treatment experts stresses the need for elderly patients care
By Faruque Ahamed, KOLKATA –
Experts in geriatric care in the city felt the need for setting up of separate units for elderly patients suffering from various diseases should come up in medical colleges and hospitals so that the latter can have prompt hassles-free treatment instead of waiting in long queues in OPD clinics in public healthcare systems for hours.
At a time when the different ailments among elderly patients above 60 year-old are on the rise regularly the state healthcare services are yet to have a specialised department for geriatric care anywhere in government medical colleges in Bengal.
“It’s true that elderly people above 60 are vulnerable to get affected with different
diseases owing to their low immunity power. About 30 per cent of total patients are elderly people but we don’t have any specialised department to provide prompt treatment to them. There is a need to create awareness on geriatric care,” said a professor in
medicine associated with the geriatric OPD clinic at SSKM Hospital.
“Foreign countries and several medical institutes like AIIMS in Delhi are well ahead of geriatric care and treatment as compared with ours. We have a plan to set up a geriatric department at SSKM to give specialised treatment to the elderly people,” said a senior administrative officer of Institute of Post Graduate Medical Education & Research
(IPGME&R) as well SSKM hospital.
Elderly patients face a difficult time when they are admitted to the hospital. Most of the times, elderly patients are affected by heart diseases, infections, pneumonia, septicaemia and other chronic diseases. Elderly care is a major challenge across global hospitals and requires specialized care and treatment plans, felt Dr.Yamini Atluri, a US-based NRI doctor working at Spectrum Health Medical Group in Michigan.
She has been pioneering in her research works to command and steer the importance of elderly care in hospitals.
In an interview, Dr Atluri told this to our correspondent.
Q: How do you emphasize elderly care in hospitals?
YA: Geriatric care is a specialized care that hospitals must have, which unfortunately lacks in most of the hospitals in the United States. Elderly patients get admitted to hospital for various diseases, some minor and mostly major. Minor health problems can lead to bigger issues which can increase the hospital stay longer. Specialized care is needed which can comfort these patients with greater extent. I have raised awareness of these issues through my website elderlyhospitalcare.com.
Q: What are the major risk factors of care for the elderly patients in hospitals?
YA: Elderly care for patients above 65 is highly challenging. Most patients admit to the hospital suffer from chronic diseases like hypertension, kidney disease, heart failure.
Other organ complications like brain, lungs, liver can be more vulnerable and
challenging. Physical activity of these patients become limited causing more
complications. Other common problems are cataracts, congestive heart failure, chronic obstructive pulmonary disease, osteoporosis, diabetes, stroke, dementia, and prostate problems, which are more unique to older generation. Vision difficulty and frailty are a major issue. Falls and delirium are a major threat to elder patients. Surgery is a major
challenge in elder patients, acute care is needed the most, as they have limited movement ability. Medications dose should be given safely, preventing delirium and accidental falls, and provide them with adequate pain control.
Q: What is the risk of falls in the elderly patients?
YA: Falls can restrict to limited activity and life threating injury. Falls are common in hospitals for elderly care which can lead to more serious expensive complications.
Q: How adverse is delirium in elderly patients?
YA: Longer stay in hospital can cause delirium. It’s a situation of mental confusion, at least 10% of elderly patients who are admitted to the hospital have delirium. 15% to 50% experience delirium at some time during hospitalization. Delirium is also common after surgery. My approach for this deadly health issue in eldercare is advocated in my website knowdelirium.com .
Q: What are the care management that you maintain for elderly patients care?
YA: Specialized approach to the care of elderly patients is needed. What I do is perform physical examination to identify patient risk factors for complications during admission; Make plans for the prevention of delirium, falls; Treatment care plan for chronic disease; Hydration and nourishment is essential in this period of hospitalization; I make sure I communicate with the patients family clearly with complications and make plans for discharge and further treatment plans and care transitions.
Q: Please elaborate the clinical issues of elderly care.
YA: The types of disease in elderly is quite different from younger patients. Multiple symptoms arising from various complication can be difficult to identify the current health problems. Various emergency situation can occur during this period like heart failure can occur without chest pain. The illness diagnosis is very important in eldercare with constant monitoring. Problems of using drugs which are not required is an important aspect of the clinical assessment and active polypharmacy.
Q: How do you tackle sleep related problems in elderly patients?
YA: This is a very important point that you raise. Sleep disorders can lead to insomnia.
Insufficient sleep has been linked to the development of a number of chronic diseases and conditions, including diabetes, cardiovascular disease, obesity, and depression which is
common in elderly patients. I do not recommend the use of Benzodiazepines which again can be a major problem. The American Geriatrics Society has warned against the use of prescription sleep drugs containing any type of Benzodiazepine drug for insomnia,
agitation or delirium. Sleep disturbance problems can be addressed by behaviors and environmental factors affecting patients sleep.
Q: What is your suggestion to improve elderly care in current health care system
YA: It is evident that older people could avoid a return to the hospital if they are
managed by caregivers, physicians and therapists, along with their family members.
Hospital read missions, and cost of healthcare for patients could be reduced. Hospitals are also training their staffs who are specialized in eldercare and who can assess the risk of fall in elder patients. Fall prevention program is already a requirement for Joint Commision accreditation. With aging rapidly increasing in society the need for specially trained people who focus on elder care is the prime need of the day. These efforts can definitely ease this major crisis in healthcare system.
Thanks a lot Madam for your time and excellent informative interview for our IBGNews.com viewers.