Geriatrics medicine: Why your elderly parents need a family member as caregiver

Geriatrics is a field of medicine that specialises in the care of people usually over the age of 65. PHOTO | SHUTTERSTOCK

Your elderly parents need utmost care given that this is the period when most of them are either being managed for different acute or chronic diseases or being diagnosed with the same.

Geriatrics is a field of medicine that specialises in the care of people usually over the age of 65. Anyone over this age falls into the geriatric category and their needs and medicine are slightly different when compared to the younger population.

Medical conditions in the geriatric population differ from the general population.

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Furthermore, if you look at the guidelines of how we treat older people in terms of blood pressure, cholesterol and diabetes, they slightly differ from younger adults.

Here are the issues affecting the geriatric population in Kenya.

1. Poverty

As of 2018, eight million Kenyans lived in extreme property and a majority of our geriatric population are affected by this.

2. Elderly abuse

This seems to be a common problem more in the West than in Africa. Unfortunately, with increased weakness, there’s potential for abuse not only by family members but also by healthcare workers as we have seen in many nursing homes in other countries.

3. HIV

Screening for HIV remains key in this population. The more we screen the more we discover and the sooner we can intervene for a healthier life.

4. Illiteracy

Many of our geriatric populations grew up when education was not affordable or accessible.

5. Digital inequity

Given the transition to a more digital world, digital inequity is another issue within the geriatric population with many of our older patients who have little knowledge of how to operate many of our common digital appliances.

6. Cybercrime

People try to deceive them of their finances and assets.

Common health issues

As we age, more of the general health issues become more prevalent in the elderly. They suffer from multiple conditions such as elevated cholesterol, high blood pressure, diabetes, weak eyesight and hearing loss.

In addition, many times mobility becomes a challenge with an increased risk of falls and fractures of their long bones.

Reflexes are much slower which affects their safe driving skills putting them at a higher risk for accidents.

To manage their health better, they need evidence-based preventive screening, especially for cancers. Hence mammograms, pap smears, and colonoscopies are screening tests that are necessary for geriatric patients.

Elderly patients are also prone to being on a variety of medications (polypharmacy) and this can be dangerous due to the interactions of various medications including their side effects on patients.

But why is it important to take care of this Kenyan population?

We have about 55 million people in Kenya, and about 6 percent of the total population or 2.7 million people fall within the geriatric category.

If you look at the laws of Kenya, they classify geriatrics as anyone over 60 years old.

Of the 2.7 million people, the majority of them are women living in rural areas. Many of us are living longer and it is expected that our geriatric population will also grow in size in the coming years.

Why most geriatrics are female

This remains a mystery for now, but in Kenya 55 percent of the geriatric population is female. One can only assume that they have a healthier lifestyle living in rural areas, eating fresh food and always being active.

Many of the geriatric patients that usually visit our clinic look younger than their stated age and live a relatively active life surrounded by their close family members which in turn promotes graceful ageing.

Addressing polypharmacy

We do a good job in taking care of the elderly, however, there are limitations to what we do and what we understand. For example, when you have an elderly patient who comes to your clinic or gets admitted to the hospital, they usually end up being prescribed five to ten medications at a go.

Polypharmacy is risky for these elderly patients and can cause many side effects from the medications and interaction between the medications.

Fortunately, one of the fields that geriatric medicine specialises in is medicine reconciliation and medicine reduction involving the removal of medications that can be harmful to the patient.

This is harder than it sounds and needs to be done by a skilful physician.

What is the importance of having a family member as a caretaker for the elderly?

Due to busy lifestyles, families tend to move their old parents, especially in the West, to nursing or long-term care homes.

Unfortunately, the people who live in such nursing homes don’t do well because they suffer from a lot of neglect and time away from their loved ones.

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As humans, we are social creatures, and that kind of interaction is diminished when you move into a nursing home.

The beauty of Kenya is we don’t have many nursing homes, which is good. In addition, many of us living here are brought up with the reciprocity that we need to take care of our parents when they age and we are committed to this.

Preparing for geriatric years

Many of our elderly patients do much better living in their houses/setting as they find much comfort in their environment.

Many geriatric patients will often refuse to move in with their children and prefer their independence. This is certainly something that you don’t want to take for granted because autonomy is something that they value.

One of the things that I tell most of the people is just trying to invest in themselves so when they get to that age, they have enough resources to take care of themselves.

To ensure this, the elderly need to make sure that they have some sort of income or an investment that is giving back to them. An investment that ensures they’re making enough to pay bills and to purchase necessities.

Unfortunately, the biggest challenge in low-middle-income countries remains access to healthcare. As people enter the geriatrician category, periodically they have some issues that bring them to the hospital and the lack of a comprehensive healthcare plan can certainly, not only affect their health but put a dent in their finances.

Prof Karar is an Internal Medicine Specialist at Aga Khan University Hospital, Nairobi.