Research - (2023) Volume 14, Issue 1
Received: 03-Jan-2023, Manuscript No. Iptb-23-13432; Editor assigned: 07-Jan-2023, Pre QC No. Iptb-23-13432(PQ); Reviewed: 21-Jan-2023, QC No. Iptb-23-13432; Revised: 25-Jan-2023, Manuscript No. Iptb-23-13432(R); Published: 31-Jan-2023, DOI: 10.36648/2172- 0479.14.1.280
Introduction: Some common problems affecting elderly population are related to vision, movements, joint pains, knee pain, arthritic pain, bowel, bladder irregularities, sometimes, diarrhea, sometimes constipation, dehydration, feeding problems, difficulty chewing, decreased strength and vigor, decreased interest, dental carries, falls.
Method: Study was taken to analyze the efficiency of basic medical allied and palliative care, integrated care in the elderly. Some home based medical advice, clinical guidance, psychotherapy, cognitive therapy, individualized, personalized care, guidance and advice, precision medicine customized to individuals according to their preference, tastes and requirements.
Results: Diminished vision among elderly was improved with an improved diet, vitamin A, including and increasing dairy among vegetarians. Knee pain was improved by cold compress and range of motion exercises coupled with rest to the repeated movements caused by climbing stairs.
• Diabetes was improved by restricting sugar and sweet foods.
• Cholesterol levels were improved by brisk walking, exercise and decrease in oily fried food.
• Hypertension was checked by no added salt in food, restricting salt in diet, regular walking, exercise, meditation, and including beet in diet.
• Bowel movements regularized by regular diet, with roughage, fibre, green leafy vegetables.
• Bladder problems were reduced by drinking enough water through the day.
• Ambulation was improved with walking aids, company for walking.
• Psychotherapy improved happiness in life, going out, socializing, eating and feeding habits.
• Self-grooming, self-care, hygiene improved with exercise, meditation, yoga, friends and guidance and disciplined controlled life.
• Proper rest and relaxation improved sleep cycles and ability to work.
Conclusion: With improved judgment and insight of medical acumen, care, love, knowledge and better coordination of the doctor patient understanding and interactions, better outcomes on regular day to day problems were achieve and higher resolution of problems and better outcomes were demonstrated among the elderly.
Elderly; Personalized Treatment; Counseling; Care; Guidance; Clinical acumen; Judgment
Time flies. So does the days of life. Living life through each day doing the best in personal and professional life, there is a balance to make at every turn of life, keep an eye on future, old age, health and children. Old age is a tough time for all individuals, when strength wanes off; there is need for help from family, friends, and maid. Activities of daily living are not as effortless as before; house chores, grocery, banking need to be managed. Health is fine one day and dwindling the other. Life is hard after eighty years. Prevalence of geriatric population is about 7.5% at 60 years or more [1]. Some social factors that affect health are marital life, gender, age, education, occupation, income [2]. This study lists some aspects of ageing in life and how to navigate through these situations.
Health is a prime concern with increasing age. In order to keep fit it is important to be very careful of the diet and know what to eat, when, how, why, where to have meals. It is equally important that a regular schedule of exercise, yoga, meditation, relaxation, walking, aerobics, and gymnastics is maintained in the daily routine. Mindfulness or paying attention to the thoughts, actions, food we eat, take some time off for our meals and not rush ourselves while doing other chores, thanking and praying before meals, all have a scientific basis.
Maintaining optimal mental health is a prerogative. Have positive thoughts, building confidence and mental health, feeling happy in our thoughts and actions, talking to near and dear ones, friends and family, loving and giving, caring for ourselves and others so that a collegial and loving aura prevails in our minds and home and in our day to day life. Mood swings and a tendency for boredom and depression are common in old age. Loneliness set in when children find their partners and has moved on with their fast life. Amidst all the hustle and bustle of life, there has to be a peace, calm at home and of the mind to keep fit. Old age is about facing the changing situations, the fast pace of life, dynamics of relationships, struggles of life. Life is a journey and till the last day there is a need to learn and change, to adapt, to accommodate people and situations.
One possible way is to keep ones needs to minimum, limit expectations of others, be healthy and less dependent on other for survival. Tendency is to give back to nature, to love people more and to give in a measure over and above what we have taken from society, world, earth and nature. Here maturity and responsibility starts. Just being aware that there is nothing that can be taken from the world once dead, that friends and family, hatred, enemies, struggles, pains, gains, losses, challenges, regrets, limitations, property, money, disgust, despair, diseases, anger, arrogance, nothing comes along when we die solves a lot of problems and clears a lot of clutter in the mind. It somewhat frees us from our earthly attachments.
Prayers and meetings are also equally important to maintain a balance in life and sail through its ups and downs. One has to build strength to face the world while we know it is the waning phase of life. Strength building can be through regular exercise, training, talking, counseling, self-assessment, appraisals, knowing self-worth, keep a constant urge to work, meditation, relaxation, and self-care.
Being proactive is an important aspect of ageing. If we let the world pass by it will pass by. Life must have meaning, purpose and goal even to the last day. All these efforts are to be taken actively and adhered strictly to keep fit. Even so, we still will encounter the natural attrition process with advancing age. To deal with such issues we will have to take further steps keep our reserve for odd days.
With ageing, knee pain, low back pain, joint pains, arthritic pains, falls, injuries are common. Relief comes from regular slow range of motion movements, hot compresses, cold compresses, rest, regeneration, healing, use of ergonomic equipment, ramp instead of stair, use of commode, lifts, avoid lifting heavy weights, repeated use of joints may cause the synovial fluid cushion to get eroded, so to recover and protect the joints we provide rest and restrict use of those movements which induce pain until healing occurs. Activity of daily living, WHO questionnaire, are some tools to assess elderly wellbeing [3, 4].
Nutrition is a big factor in the anti-ageing process. 5The health benefits of milk, meat, poultry, fresh fruits and vegetables including green leafy vegetables and to consume a balanced diet is an important aspect of a healthy lifestyle with optimum energy and output in terms of professional and social productivity which includes physical mental and social wellbeing and not just freedom from disease. It also includes the use of less packed, packaged, frozen, junk, refined food stuffs [5, 6].
Ageing also causes diminution of vision unless precaution is taken actively well before time to circumvent these problems as eating a lot of vitamin A containing foods like carrot, pumpkin, papayas and mangoes. Vitamin B12 found in non-vegetarian foods like meat, fish, chicken, cause retinal degeneration and loss of vision, so for the vegetarian elderly need supplement of fresh cheese, yogurt, dairy in the diet [7, 8].
The study is about senior citizens ageing and cares during pre covid times and covering the covid and post covid era over four years duration located in an urban area. Sample size was 250. Method of recruitment of elderly subjects was convenience sampling, judgment based and voluntary participation. Data collection was questionnaire based, interview and clinical advice, and follow up based on symptoms and signs, general well being, physical, mental, psychosocial health.
Study design and type was descriptive study design and cross sectional case control study.
The controls were age and sex matched healthy seniors. Senior citizens 60 years and above whom could express themselves and were interested to participate in this study [9].
Mean age of population was 70 years with standard deviation of 3 years. Majority were married.
One or the other spouse has to leave first this cycle of life. So scene was varied with elderly living alone, with children, with spouse, or relatives.
List of comorbidities that were accounted were diminution of vision, walking aids, joint pain, low back pain, falls, diabetes, hypertension, bowel bladder problems like constipation and diarrhea, dehydration, decreased energy or low mood, feeding problems. Patients with diminished vision and retinitis, recovered when dairy products and fresh cheese were supplemented in diet along with vitamin B12, vitamin A rich foods. Some feeding problems in elderly can be solved by feeding them soft to semi solid or liquids in their diets, so that gulping is easier. Dental hygiene is also important. Regular brushing, combing, gurgling, keeping skin clean, changing clothes are part of daily hygiene. Elderly patients are prone to dehydration, their urine output, bowel movements, fluid intake and output need careful monitoring. Nurse or caregiver should supplement their diet with fluids, enough electrolytes, like fruits, salt, yogurt, probiotics containing foods. With age diabetes and hypertension also gets common. So the sugar content in diet needs to be restricted to keep blood sugar levels in check. The salt in the diet has to be regulated to keep blood pressure under control. Extra oil and salt needs to be avoided. Lipotropic factors like essential fatty acids, or polyunsaturated fatty acids, vitamin E, selenium, choline, need to be present in our diet protect the liver from diseases like fatty liver and NASH. A fraction of cholesterol is taken up by macrophages and this is not a regulated pathway. They get carried to the endothelial lining of arteries and deposited. This is the beginning of fatty streaks which later build up to become plaques and cause atherosclerotic heart diseases. Regular health checkups can be a supplement with routine blood tests like fasting sugar, urea, creatinine level, electrolytes, blood pressure checkups, eye check up and general check up and counseling, dietary and exercise advice about maintenance of proper weight, aerobic exercises that will improve oxygenation and circulation to the organs and tissues that are normally not much exercised due to sedentary lifestyles. The role of antioxidants like vitamin C, vitamin E, vitamin A, some enzymes like superoxide dismutase, catalase, peroxidase, cytochrome oxidase, in fighting infections and anti ageing process is also substantial. The role of capsizes and apoptosis or the programmed cell death in ageing is also contributory. Soft solid diets with green leafy vegetables and containing probiotics will also regulate their bowel movements. Regular intake of six to eight glasses of water or fluids will maintain the fluid and electrolyte balance of the body. Being ambulatory is also an important aspect of being healthy. Simple stretching exercises, breathing excercises, meditation, excercises that can cause range of movement of joints and can be done while lying down or sitting posture without too much strain can also be part of daily routine. Speaking or power of speech is a big armamentarium. For the elderly it is important that they are able to vent out their feelings. It is a safety valve they say, to maintain homeostasis and indeed very true. Loving, caring, adoring surroundings or atmosphere makes them thrive and competitive, selfish aura stifles any life. Being aware of one’s vibes and how we relate to others is also a very important aspect of life. Patient with low back pain, knee pain, recovered with Vitamin D containing foods. Elderly are very prone to falls and fractures. The fractures heal with rest, diet proper treatment with cast and immobilization if it is closed and undisplaced fracture. Patience of caregivers and family members are important. It is important that in a crisis situation the caregiver does not panic and knows to seek help and to take to a good hospital where medical care can be ensured. For elderly surgeries should be carefully appraised whether they will benefit from surgical care or they are best treated conservatively, that is one major decision to be taken. Patients with anxiety disorders and psychological problems recovered with good friends or members to talk to, or therapeutic sessions with counselors, or when proper care at home based setting was provided with balanced diet that was tailored to suit the individual’s set preferences, their tastes and likes, meals that they relished in their young age and those that were easy to chew and soft to pass through the food pipe. People with sleep problems were able to sleep even without their regular pills when they had good company, good nutritious diet, stress relief, relax and rest. Those suffering from mouth ulcers, sores, angular stomatitis, cheilosis, glossitis, feeding difficulties were able to resume solid diet and eat properly after giving diet containing B complex group of vitamins, eggs and milk in diet.
Those with irregular heartbeat, palpitations recovered somewhat with rest, diet, love, care, nearness to friends and family.
Management of elderly care includes nursing, dietary care, tender loving care, words, soft spoken respectful concerned individualized treatment. Then like plants that are nurtured with proper water, sunlight, manure, soil and nutrition they spring back to life. Another corollary is like the bird phoenix which rises from ashes; elderly do recover from a much withered condition to bloom and live a normal life expectancy. It is true that they are susceptible people. They are sensitive as much to the weather as they are to nutrition, deprivation, respect and a well-balanced life. Not just for the elderly but for young and old alike the basic ingredients for life are still the old is gold adage; fresh air, portable water, clean wholesome food, hygienic living condition, love and care. Let us try to give to each other the gift of life in whatever little way we can.
The more we give the more we get back. If we preserve a life, we actually are preserving our own.
So try to gift an elderly the gift of life, in whatever small way one may contribute, in cash or in kind, in words, in gifts, in food, in advice, by help, every small step counts. Let not our works, actions, words, or vibes hurt an elderly. Let us go a step further and give them a patient ear, let us not think them to be mad, whimsical people. Let us be more understanding and patient with them. They have lived their entire life; they are more mature and understanding than we may assume them to be at the beginning. Be it our own relatives or not, be it among those whom we don’t even know, but let us take a step in this direction, to do for elderly, to give respect, Love to them, invariably in some form they are going to get back to us. Saving one life does not always have to involve very complex medical science involving latest advancements but often times even common sense and basic medical science can save a lot of lives and that is also a wonderful work.
While the intricacies and complexity of medical science cannot be undermined, to be a good medical doctor first it is important that we become good human being. And if we give a life we get back the zest, zeal and vigor for our own life in ways we won’t even know.
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Citation: Mahata N (2023) Geriatric Life: Tips and Tricks. Transl Biomed, Vol. 14 No. 1: 101.
