Common Senior Health Issues - HealthyLife

DETERMINE: 

• Disease,
• Eating poorly,
• Tooth loss and mouth pain,
• Economic hardship,
• Reduced social contact,
• Multiple medications,
• Involuntary weight loss or gain,
• Needs assistance,
• Elderly person (over 80)

In many parts of the world, the older members of the family were normally taken care of in the family itself. The family, commonly the joint family type, and social networks provides an appropriate environment in which the elderly spent their lives.  With change in the life style we can also see that generally young generation is going after their dreams in big way and elders are left behind at their home or in elder care. Never the less, elders are also want to be independent of their children – that is the present common mentality.  The advent of modernization, industrialization, urbanization, occupational differentiation, education, and growth of individual philosophy have eroded the traditional values that vested authority with elderly.

 The older population faces several problems and adjusts to them in varying degrees. These problems range from absence of ensured and sufficient income to support themselves and their dependents to ill health, absence of pension, less income, social security, loss of social role and recognition and to the non-availability of opportunities for creative use of free time. The needs and problems of the elderly vary significantly per their age, socio-economic status, health, living status and other such background characteristics.

The following issues are increasing with elders due to a change in the life style and mentality. Many times, problem is a small family with one or two children who live elsewhere for earning, living or education purposes. In these cases, when the elders have to be all by themselves they face following problems which are in turn affect their health and life style.

• Loss of a spouse or family member
• Lack of interest in cooking or eating alone
• Fear of personal safety (which affects their ability to go grocery shopping or meeting people)
• Financial concerns
• Institutionalization or hospitalizations (that do not ensure adequate nutrition)
• Clearly nutrition plays a vital role in the quality of life in older persons
• In this fast-paced world, few families make time to eat together anymore. And because eating alone-and on the go-is becoming more common, nutrition usually suffers.

If we leave our elders behind in a care or at home we must be aware of the abuse they take.

The different types of elder abuse

Abuse of elders takes many different forms, some involving intimidation or threats against the elderly, some involving neglect, and others involving financial chicanery. The most common are defined below.

Physical abuse

Physical elder abuse is non-accidental use of force against an elderly person that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.

Emotional abuse

In emotional or psychological abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress.

Verbal forms of emotional elder abuse include

• Intimidation through yelling or threats
• Humiliation and ridicule
• Habitual blaming or scapegoating

Nonverbal psychological elder abuse can take the form of

• Ignoring the elderly person
• Isolating an elder from friends or activities
• Terrorizing or menacing the elderly person

Neglect or abandonment by caregivers

Elder neglect, failure to fulfill a caretaking obligation, constitutes more than half of all reported cases of elder abuse. It can be intentional or unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as he or she does.

Financial exploitation

This involves unauthorized use of an elderly person’s funds or property, either by a caregiver or an outside scam artist.

An unscrupulous caregiver might

• Misuse an elder’s personal checks, credit cards, or accounts
• Steal cash, income checks, or household goods
• Forge the elder’s signature
• Engage in identity theft
• Stealing jewellery

Typical rackets that target elders include

• Investment fraud
• Grabbing agriculture land
• House grabbing
• Pension grabbing

Healthcare fraud and abuse

Carried out by unethical doctors, nurses, hospital personnel, and other professional care providers, examples of healthcare fraud and abuse regarding elders include

• Not providing healthcare, but charging for it
• Overcharging or double-billing for medical care or services
• Getting kickbacks for referrals to other providers or for prescribing certain drugs
• Overmedicating or under medicating

How to help those elders who are undergoing abuse? 

What you can do as a concerned friend or family member

• Watch for warning signs that might indicate elder abuse. If you suspect abuse, report it.
• Take a look at the elder’s medications. Does the amount in the vial jive with the date of the prescription?
• Watch for possible financial abuse. Ask the elder if you may scan bank accounts and credit card statements for unauthorized transactions.
• Call and visit as often as you can. Help the elder consider you a trusted confidante.
• Offer to stay with the elder so the caregiver can have a break—on a regular basis, if possible.

Protecting yourself, as an elder, against elder abuse 

• Make sure your financial and legal affairs are in order. If they aren’t, enlist professional help to get them in order, with the assistance of a trusted friend or relative if necessary.
• Keep in touch with family and friends and avoid becoming isolated.
• If you are unhappy with the care you’re receiving, whether it’s in your own home or in a care facility, speak up. Tell someone you trust and ask that person to report the abuse, neglect, or substandard care to an elder abuse helpline or long-term care ombudsman, or make the call yourself.

If  you aren’t in a position to help an elder personally, you can volunteer or donate money to the cause of educating people about elder abuse, and you can lobby to strengthen laws and policing so that elder abuse can be investigated and prosecuted more readily. The life you save down the line may be your own.

Some important questions and answers related to elders and youngsters (as appeared in http://www.seniorindian.com/seniorsandchildren.htm )

• What is the responsibility of youngsters towards the elders?
  As parents, the elders have given their children their life, educated them and most often enabled them to earn a decent living. Whatever maybe the social problem, youngsters must realize that they should care for their parents and the other elders in the family.

• What should be the attitude of the younger generation towards the elders?
  The younger generation should learn to respect the elders and their experience. The wisdom and experience of the elders may be invaluable in solving problems. However, it is important to show them affection and respect. Domestic problems could be discussed with the elders. It is not necessary to always accept what they say, listening to their suggestion can help – you never know.

• What should be the attitude of the older generation towards the youngsters?
  Elders should  try to understand the socio-economic conditions, careers and family of their children. They should try to adjust and not interfere in the day to day affairs and problems of their children’s family. Unless asked, they should patiently refrain from giving advice. They can help in simple house works. Interaction with the grandchildren most often refreshes the minds of the elders and in fact delays the ageing process.

Tips for Encouraging Seniors to Eat

1. Make sure they have a comfortable place to eat; set out a nice placemat, sit with elders and talk to them.

2. Take them out to a park.

3. Find a neighbor or friend for your loved one to eat with on a regular basis-have them take turns cooking the meal or cook together.

4. Invite their friends for a potluck dinner or lunch

5. If finances are not an issue, hire a personal chef to create a week’s worth of meals for the fridge and freezer, or contact a gourmet meal delivery service.

6. Have your loved one join a yoga or meditation program

7. Help them to select their food.

8. When cooking, make extra, then freeze in single servings. Make sure to label not only what it is, but cooking instructions as well, so no one has to go hunting for cooking or reheating instructions later.

9. Keep a list of what’s in the  fridge or in the kitchen to eat.

10. Encourage your loved one to eat fruits, vegetables

11. Discuss about their health and activities.

What diet for elders is preferred?

Nutritious food is one that contains all the essential nutrients – proteins, fats, carbohydrates, vitamins and minerals. A well balanced diet should contain all these in correct proportions and adequate amounts.

Does the quantity of food that an elderly person eats matter?

The quality, matter and not the quantity.  The requirements of essential nutrients vary with age, sex, level of physical activity and the height & weight of the individual.  Even a sparse diet can be nutritious. For example, 100 gms of wheat contains nearly 12 gms of protein, while the same quantity of rice has only 6.4 gms of protein. Similarly, 100 gms of Ragi contains 344 mg of Calcium, while the same quantity of Rice has only 9 mg of Calcium.

As people become older, do they need less food? 

The energy requirements of a person decrease with increase in age. This is because of a lowered basal metabolic rate and lessened physical activity.

How important are proteins to the elderly?

Proteins provide the essential Amino acids and the amount of Protein in the diet is an important measure of the adequacy and quality of the diet. The recommended allowance is one gm. per kg. body weight. In the elderly, up to 12 -14% of the total calories should be from proteins.

How much of fat is allowed in the diet of the elderly?

The diet should contain 30 – 40 gms. of fat  and half of it should be in the form of vegetable oil, rich in essential fatty acids. A diet with high content of saturated fatty acids tends to increase the level of cholesterol in the blood.

Are Carbohydrates necessary in an Elder’s diet?

The body needs Carbohydrate because it cannot make it for itself from other nutrients. So, it should be not less than 100 gms per day.

What are the most important minerals needed for good health?

Calcium is very essential for an average elderly person. As people become older, the bones become demineralised. This is called Osteoporosis. Calcium intake should be not less than 400 mg per day. Foods rich in calcium are Ragi, Green leafy vegetables, milk, fenugreek leaves, drumstick leaves and sea food.

Iron deficiency leads to Anaemia. So the diet of the elderly should contain sufficient amount of iron. Greens are rich in iron, cheaper than other vegetables and available easily most of the time.

What are the vitamins needed?

Vitamins cannot be made in adequate quantities by the human body. So, they should be present in the food that we eat.

They are: Vitamin A, D, E, K, C (ascorbic acid) and Vit B Complex (Thiamin -B1, Riboflavin, Niacin, Pyridoxine-B6, Biotin, Folate, Cobalamins- B12)

How important is water?

The fluid intake should be at least 1.5 – 2 liters per day in a normal elderly person.

How important is Dietary fiber for elderly?

Rough fiber is not well-tolerated by the intestine in old people. But, the tender fiber that does not create residues are good for them.  Soft vegetables, fruits and whole-grain cereals will encourage normal bowel movements. The elderly tends to use harmful laxatives and mineral oils. This should be substituted by a fiber-rich diet and adequate fluid intake. Some good sources of Dietary Fiber are: Ragi, Wheat, Italian Millet, Horse gram, Green leafy Vegetables, Plantain Stem, Drumstick, Bitter gourd, fruits like Dates, Figs, Guava, Wood Apple and Sweet Lime.

Common questions related to elders with respect to food and eating :

There are some common problems that can make it harder for older people to follow through on smart food choices. Here are some problem-solving suggestions:

Problems chewing food?

If you are having trouble chewing, see your dentist to check for problems. If you wear dentures, the dentist can check how they fit.

Sometimes hard to swallow your food?

If food seems to get stuck in your throat, it might be that less saliva in your mouth is making it hard for you to swallow your food. Drinking plenty of liquids with your meal might help. Talk to your doctor.

Food tastes different?

Realize that with age sense of taste, smell, or both has changed. Dental and medication problems can cause problem too. Talk to your doctor.

Feeling sad and don’t want to eat?

Being unhappy can cause a loss of appetite.  You might need to talk with someone who can listen to you. Make friends, go for walks in nearby parks and talk to your age group people.

Just not hungry?

Changes to your body as you age can cause some people to feel full sooner than they did when younger. Or lack of appetite might be the side effect of a medicine you are taking—your doctor might be able to suggest a different drug. Try being more physically active. Do some research on varieties of foods, talk to friends and doctor. Make a list of food that you like and cause appetite.

Trouble getting enough calories?

If you aren’t eating enough, add snacks throughout the day to help you get more nutrients and calories. Snacks can be healthy- fruits, crackers with little cheese, unsalted nuts or nut butters are nutrient-dense snacks that give you added protein. Talk to your doctor about supplements.

Physical problems making it hard to eat?

Several conditions can restrict your movements – Parkinson’s disease, stroke, or arthritis can make it harder for you to cook and feed yourself.  See an occupational therapist or helpers or maid. Ask them to help in arranging things in kitchen at your convenience.

Can foods and medicines interact?

Answer is yes! Beware of the medicines and food combination that have negative effect on your health. Write it down. For example, grapefruit juice is a common culprit when used with many drugs. Chocolate, licorice, and alcohol are some of the others. Talk to your doctor to be sure to ask about any food/drug interactions.

Lactose intolerant?

Your doctor can do tests to learn whether or not you do indeed need to limit or avoid dairy foods when you eat. It may not be because of lactose. It may be lack of vitamin or some other condition. If you have lactose intolerant condition then there are non-dairy food sources of calcium, lactose-free milk and milk products, calcium- and vitamin D-fortified foods, and supplements are available.

Weight issues?

Older people who don’t get enough of the right nutrients can be too thin or too heavy. Keep track of what you ate and what is your diet is.

How much is the quantity – confusing…? Here is the answer

1. Fruits—1-1/2 to 2-1/2 cups

2. What is the same as 1/2 cup of cut-up fruit? A 2-inch apple or 1/4 cup of dried fruit

3. Vegetables—2 to 3-1/2 cups

4. What is the same as a cup of cut-up vegetables? Two cups of uncooked leafy vegetable like spinach

5. Grains—5 to 10 ounces

6. What is the same as an ounce of grains? ½ cup of cooked rice or upma

7. Protein foods—5 to 7 ounces

8. What is the same as an ounce of meat, fish, or poultry? One egg, ¼ cup of cooked beans or tofu, ½ ounce of nuts, lentils or seeds, or 1 tablespoon of peanut butter

9. Dairy foods—3 cups of fat-free or low-fat milk

10. What is the same as 1 cup of milk? One cup of yogurt or 1-1/2 to 2 ounces of cheese. One cup of cottage cheese is the same as ½ cup of milk.

11. Oils—5 to 8 teaspoons

12. What is the same as oil added during cooking? Foods like olives, nuts, and avocado have a lot of oil in them.

13. Solid fats and added sugars (SoFAS)—keep the amount of SoFAS small

14. If you eat too many foods containing SoFAS, you will not have enough calories for the nutritious foods you should be eating.

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For more reading please visit:

• http://www.seniorindian.com
• http://www.seniorindian.com/seniorsandchildren.htm