“There are various dimensions of wellbeing, and a geriatrician works as part of an inter-disciplinary team to support healthy, fulfilled, and dignified living, beginning with a comprehensive geriatric assessment. We don’t only focus on treating the person’s disease profile and medical conditions, we look at quality of life and the complications that come with old age, such as falls and having multiple medical conditions, and put strategies in place to help prevent complications.”
Dr Kalideen, a specialist physical, geriatric physician, and palliative care practitioner, works with a team of GPs, specialists, nurses, social workers, physiotherapists, occupational and speech therapists to fulfil the person’s healthcare needs.
“Our approach encompasses not only biomedical but also psychosocial and spiritual aspects of a person’s wellbeing as a basis for a holistic care plan, either in the home, in long-term care facilities or the acute hospital setting.”
Dr Kalideen pointed out that simple interventions can address deteriorating vision, hearing loss, and incontinence, which become more common as we age and are often socially isolating for older people, increasing secondary risks of depression.
“It is not always easy for a parent or grandparent to communicate their discomfort or ailments to their younger relatives or caregivers, and we would encourage everyone to be sensitive to this and mindful that the older people in their lives may require some gentle prompting to seek help for age-related concerns.
It is often easier for a person to open up to their trusted pharmacist or GP than to their own family about these matters.
Loss of independence and decline in people older than 65 are often attributable to the ‘geriatric giants’ of immobility, instability, dementia, incontinence, and side effects or treatment interactions. These need to be assessed and identified so that management of these syndromes can start early to arrest or slow decline as far as possible.
“The goal of geriatric care is to help people enjoy a persistently good quality of life and help safeguard an older person from risk. One of the major threats to wellbeing is the possibility of having a fall, as there is very high mortality associated with this age group after a fall. An older person’s bones are more likely to fracture, especially if they have osteoporosis, and recovery can be complicated,” she says.
“It is not uncommon for an older person to have more than one chronic condition and they may therefore be taking several medications concurrently. As part of the assessment, we look at all the treatments the person is on to support the healthy functioning of their systems. Side-effects can often be mitigated through rationalising or reducing the medication regime, as appropriate to the person’s age and physical health.
“As a society, we need to look out for older people who may be vulnerable and make provision for our elderly relatives and ourselves. Elder abuse takes many forms, and we must be watchful in our communities to ensure older people are treated with the respect, kindness, and dignity they deserve.”
TIPS FOR PREVENTING FALLS
Prevention of falls should be a top priority for older people and their caregivers. Dr Kalideen has developed guidelines to practically support this in facilities for long-term care of older people that are also applicable in the home environment.
“There are both individual and environmental risks that should be considered, and preferably professionally assessed. The following simple tips provide a starting point,” she said.
- Check floors are not slippery, uneven, or cluttered.
- Install sturdy grab rails wherever they may be needed.
- Walking aids and grab rails should be used consistently.
- Remove trip hazards and ensure electrical cords are secured out of the way.
- Ensure the home is well lit.
- Keep active to maintain balance.
- Drink enough water and eat a wholesome diet.
- Wear well-fitting, non-slip shoes, don’t walk around in socks alone.
- Check beds and chairs are at a comfortable height.