Caring for our elderly

PHOTO: Caring for our elderly

According to the World Health Organization (WHO), the world’s elderly population (those 60 years and above) is 650 million. This is expected to increase to two billion by the year 2050.

It’s good news, really, as it’s an indicator that global health is improving.

However, an ageing population brings with it special health challenges, namely preparing society to meet the needs of an older population. This means training more doctors on care for the elderly, preventing and managing chronic diseases, and so on.

On a more personal level, ageing does bring with it changes that require all manner of adjustments to daily living, depending on the health and mobility of the elderly person.

Hence, consultant geriatrician Dr Rajban Singh’s exhortation for a more distinct focus on issues of healthy ageing. “We must pay more attention to nutrition and exercise when we are young,” he advises. “The basic foundation needs to be laid so that we can enjoy a healthy and productive life later.”

There are many issues we face as we grow older. One major problem is that of diabetes. “Currently, there are three to four million prediabetics in Malaysia, while diabetics number approximately one million,” Dr Rajbans notes.

Prediabetes means that your blood sugar level is higher than normal, but it’s not yet increased enough to be classified as type 2 diabetes. Steps can be taken at this stage to prevent full-blown diabetes from occuring, such as changes to diet and doing more exercise.

According to Dr Rajbans, the biggest danger faced by the elderly who progress from prediabetes to diabetes is the lack of any symptoms. “The elderly undergo physiological changes as they grow older. This affects the body’s homeostasis, and they react differently, or not as well, to assaults to the body. Hence, they may not show the classical symptoms of diabetes. All they might experience is a bit of tiredness, which they assume is part of the ageing process.

“Another problem is that of high blood pressure, which can be assymptomatic even in the younger age group. We have to be aware of all these potential problems,” he notes.

Hence, it’s important that the elderly have their annual check-ups to make sure that any problem can be nipped in the bud.

Another issue Dr Rajbans says is prominent in the elderly is nutrition. “For many of us, eating involves taste, sight, aroma. The elderly lose that as they have duller senses, and along with lack of chewing power, this could affect nutrition.

“In addition, a lack of appetite (which could be due to the medications they are taking), loneliness and social deprivation can affect their nutritional status. These all pile on and affects how an elderly copes,” he observes.

The sum of all these factors could lead to malnutrition in the elderly.

Dr Rajbans recounts a patient he once saw. “There was this little old lady who came in because she was malnourished. We couldn’t find out why. She said her appetite was good, and she was eating regularly.

“Then the dietitian found out that her definition of ‘eating well’ was having three meals of instant noodles every day! No wonder she was malnourished.”

Dr Rajbans notes that malnutrition is a major issue in the elderly. “As we grow older, gastrointestinal absorption decreases, so malabsorption increases. In fact, studies have shown that about 30% to 40% of the elderly are malnourished,” he shares.

To compound all these problems, the elderly tend to have multiple problems such as osteoporosis, arthritis and so on. They tend to have multiple medications, and these can interact and cause loss of appetite.

So maybe a trip to your local doctor is needed to sort out these medications so as to reduce to the minimum the amount of drugs an elderly person takes. Otherwise, taking all those medications might seem like a small meal in itself.

For the old and malnourished, Dr Rajbans says that supplements have a role to play in nursing them back to health. These nutritional supplement powders can provide some of the calories and nutrients the elderly may lack. However, Dr Rajbans warns that these should be treated as supplements, not replacement meals.

Dr Rajbans also advises about the power of motivation when one grows older. “We must have a purpose in life, an interest, the wish to learn more. It is easier to get up in the morning if life is interesting.”