Archive by Author | agjessica

For better or for worse

While every pharmaceutical laboratories around the world is still developing the best anti-aging formulation, Fran and Marlo Cowan  is among one of those who have  figured out the miraculous formula.  The elderly couple who are married for more than six decades  have showed  the happiness in enjoying the golden years with a life companion through this video of them playing the piano in Mayo Clinic. This video went viral last year and people from all ages, color, language and culture are inspired on how they look like 20 year olds enjoying the time of their lives.

A study in the Student British Medical Journal found out that among old married couples in European countries surveyed , the mortality rates were lowered to 10 to 15 percent compared to the unmarried elderly. According to  Professor Deborah Carr of Rutgers  University, reasons for this are that married couples are more economically stable  with a partner and they benefit from having their partners look after them.

In the similar study of Health Psychology(2011) , it was  also showed that there is a strong relationship between the physical and emotional status and functional capacities of older married couples.They have found out that depressive symptoms such as unhappiness, loneliness and restlessness are associated with functional limitations. According to that study,depressive symptoms in one spouse are also more likely to occur to their partners proving that elderly who stays together will surely live for better or for worse.

References:

http://www.voanews.com/english/news/usa/people/Elderly-Couples-Demonstrate-Benefits-of-Long-Marriage-117188268.html

http://www.psypost.org/2011/05/physical-emotional-health-older-couples-linked-5408

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Hospital Delirium- why hospitals are hazardous for the elderly?

Hospital stays pose additional hazards for the elderly and one of which is hospital delirium. This is a type of brain dysfunction characterized by sudden confusion and inattention and is considered as one of the most common complications of hospitalization for the elderly. Despite its seriousness, doctors and nurses are still not able to recognize and prevent it as effectively as it can be.

American Society of Geriatrics estimates that one third of hospitalized patients over 70 years old suffer from hospital delirium. The prevalence is even much higher for patients requiring intensive care and surgery. Its exact cause is unknown. However, primary contributing factors include a long list of sedatives, narcotic medicines, allergy and blood pressure drugs and procedures like catheterization. Sleep interruptions, changing rooms or being without eyeglasses and dentures may trigger anxiety consequently delirium. Also, Day et al.(2012) found out that isolation of patients where they are twice more likely to suffer from delirium.

Most doctors think that hospital delirium is acceptable because of the decline in the cognitive functions of the elderly. This should not be allowed since premature death often occurs among 35- 40 percent of those with delirium each year. Elderly patients who suffer from delirium also has longer hospitalization by six days and more likely to be placed in nursing homes after discharge.

The good news is that 40% of delirium is preventable. And as part of the family, we can help how to prevent or limit the occurrence of this complication by orienting the elderly to the environment, people, place and time; conducting stimulating activities such as crossword puzzles, card games etc.; making their environment familiar by taking few family photos and their favorite objects; staying close to them during the hospitalization and make them feel not isolated, insist on their use of sensory aids and simply prevent unavoidable hospitalizations.

Sources:

Hannah R. Day, Eli N. Perencevich, Anthony D. Harris, Ann L. Gruber-Baldini, Seth S. Himelhoch, Clayton H. Brown, Emily Dotter, and Daniel J. Morgan, “The Association between Contact Precautions and Delirium at a Tertiary Care Center.” Infection Control and Hospital Epidemiology 33:1 (January 2012)

http://www.nytimes.com/2010/06/21/science/21delirium.html?pagewanted=all

http://www.intermanews.com/pages/diseases/Delirium-88

How a technology savvy grandmother grabbed the Philippines’ attention

Lola Techie was phenomenal in the Philippines in the late 2009. She is the fictional technology- savvy sextagenarian created by a local exchange carrier to market their broadband services.

The first Lola Techie advertisement that was released depicts an old woman berating her grandson JR, because he only comes to her to ask how to operate the computer and how he would not even “poke” her in Facebook. This was followed closely by her second video where she announced on her “Twitter” that JR is no longer her favorite grandchild. Meanwhile, another video featured how she is too engrossed playing in an online game and getting too temperamental and disappointed with her younger team members.

“Lola Techie” became the talk of the town as she is the epitome of how the elderly should welcome change brought about by technology. Generally in the Philippines and probably the rest of the world, the elderly do not know how to use the computer or afraid to even try so. Majority also have limited access to computers and technology gadgets and do not care to learn because they do not find it beneficial.

This phenomenon not only debunked the stereotype that technology and golden years do not always go together but showed how technology could be used as a means of socialization. It also reminds us how we should not take the temperament of an elderly too lightly.

Here is one of Lola Techie’s video. Enjoy!

Sources:
http://www.bayan.com.ph/lolatechie/
http://bongaustero.blogspot.com/2009/07/lola-techie.html

The Lola Project – an elderly outreach programme

A month and a half ago, I embarked into planning a special project of doing an outreach activity for the elderly in Golden Acres Home for the Aged.  It all started when I browsed through my journal and saw my handwriting with the words: “To touch a life one day at a time”.“To touch a life one day at a time“- this is my mantra ever since.When I was a nurse working in a busy charity ward and handling 15 demanding patients, I lost track of the definition of caring and healing. I was more concerned of doing the job done and eventually I turned callous because of the workload. This is the reason I abandoned clinical nursing in hope of finding my lost calling.There were definitely apprehensions at first but when I started pursuing this “Lola” project I always reminded myself that things are always possible. It was ambitious in a sense that when I returned back from Mongolia, I had no existing source of income aside from a few research consultations for former PGH colleagues.My friends and I started raising funds for our special project and we thought of doing the easiest ways there were: solicitation and garage sale. It was hard doing the former than the latter as people nowadays would tend to think of the long list of bills and must-pays. Surprisingly, there were a few who shared their monetary contributions. On our first day of our garage sale, we could not find a table to use so we relocated to another friend’s house. A lot of our friends shared their old clothes and stuffs and we were able to raise P2, 000 (USD 48) for two days. Not bad considering that we only charge everything at P10- P20 (USD 0.45).When we arrived at the Golden Acres and headed to Sta. Rita Cottage, we found the Lolas sitting in their common room. We set the room and hanged the colorful banners and decorations that Suzie prepared. One touching part of the program was when I asked the the lolas what their Christmas wishes. Lola Lourdes Honrada of San Miguel Bulacan shared that even though she feels that she has a family with the other lolas in the nursing home, she wishes to share this Christmas season with her daughters and hopes to see them before God calls her home.

After the short program, we stayed longer and talked with them more. I had the chance to talk with Lola Lourdes and she told me her sad story. She used to work in Malaysia with her husband and when she returned to Zamboanga, her husband died without the knowledge of her daughters. She had tried writing to her daughters: Gina Jefferson and Maritess Appleby but it seems that her daughters had already moved out and that her letters were always returned. She wants to see her daughters very badly as she says : ” Hindi ko naman alam hanggang kailan ako mabubuhay. ( I do not know until when I will live)”. With the power of social media, I hope I could help her find her family.A lot of the lolas share the same story. They are thankful that they are provided with food and shelter by Department of Social Welfare and Development. But all of them long for the warmth of spending their last days with their own families.  One day, I’ll be a lola myself and when that day comes, I will always look back how I was once a granddaughter myself planning for this  ambitious Lola project.
– Reposted from my personal blog

Floods in Philippines poised greater danger for the elderly.

Philippines is home to several calamities, disasters and humanitarian crises. In fact, it is the third among the countries in Asia most frequently hit by disasters in 2010 that affected almost 4 million people (Citizens’ Disaster and Response Center (CDRC), 2010) . Especially during these inevitable disasters, our elderly are among those who are in need of extra assistance and support. At present, the roles of the older persons in relief services are only restricted to be at the receiving end and this puts them in a more vulnerable position.  Because of climate change, the wide implementation of  disaster preparedness programs and services in the country has been in the priority list of the government.

A local study by the Coalition of the Services of the Elderly (COSE) conducted among 92 elderly respondents has identified the needs of the older persons during calamities. 17%  reported that they get separated from their families which adds to the burden as they have difficulty in doing their ADL’s without a family member that could provide assistance. It was also found out that food donations from several organizations had been their sustenance after the crises. However almost half of the respondents claimed they received uncooked food and food donations were only available for a day .Water supply is also insufficient; 45 respondents had water supply but 10 had no access to water  and 26 reported water sources were submerged in flood water. Calamities put the elderly in higher risk in terms of water supply potability such that 70% in the study had sanitation related illnesses like diarrhea.

In the same study, respondents mentioned that the evacuation centers were overcrowded.They were also compelled to sleep in the cold cement floor. Most of them were also unable to travel to evacuation centers because of weakness due to arthritis or rheumatism. Medical services  were provided free however, medicines were not enough for the affected population.

Filipino communities rely in the different disaster preparedness programs of several organizations. One particular project is CDRC’s Disaster Preparedness and Mitigation for Flood and Landslide Prone Communities which from its start has contributed in educating the people in disaster readiness.

Sources:

http://www.cdrc-phil.com/philippines-is-third-country-most-frequently-hit-by-disasters-in-2010/

http://www.cosephil.org/index.php?option=com_content&task=view&id=180&Itemid=2

Zooming into the Philippines’ elderly

Filipinos are known to have a high regard for their elderly. And the reason why there are only 13 nursing homes in the 7,107 islands of the country is that we want them to age in their own homes. A country is considered to be aging if people aged 60 years old and above comprise 10% of the population. Projections show that by 2020, NCR and Ilocos Region  will be the first regions in the country to reach 10% followed closely by Central Luzon, Calabarzon, Cagayan Valley, Western and Central Visayas in 2025( Ogena, 2006) . However, if you look closely into a city’s demographics, some is just a fraction away from 10%.

Recent local data shows that  the elderly comprises 6.8% of the total population and 5.4% of them lives alone. Adding to their vulnerability, 34.9% of the total people with disabilities (PWDs) are elderly.However, an emerging issue for the Filipino elderly would be the decrease in capability of  the responsible member of the family to support them with their needs. In fact by 2040, the Potential Support Ratio of the country will decrease from 15 in the year 2000 to 7;  meaning that 7 people from working age group will support one elderly. (NCSB, 2010)

Programs that attend to the social, emotional, mental, physical, occupational and recreational needs of the elderly are readily available in the metropolitan. But still, there is a wide gap on whether these services actually reach this marginalized vulnerable population.Social dynamics demonstrate that even if a health center is accessible, a Filipino elderly rarely go to these facilities because they feel powerless with the long queue of younger people. Oftentimes, they would ignore mild signs and symptoms like cough because they do not want to disturb their children from their work to tag along with them to the center. Especially in a working city, elderly are left alone in their homes because the family members need to go to school or work.

How can we address this issue?  The use of telehealth is a cost-effective intervention that has increased the access of the population to health, developed educational opportunities, improved the quality and equity of care and enhanced the quality of life and social support (Legare et al, 2010).  Innovations on elderly health are now in place in developed countries but in a country that has not reached an aging cut-off, Filipinos still prefer the traditional trend.

Sources:

Legare E et al. Telehealth readiness assessment tools. J Telemed Telecare. 2010;16(3):107-9.

Ogena N. The Low and Slow Aging in the Philippines: Auspicious or Challenging? University of the Philippines Population Institute Publication

Antipolo J. Are we an aging country? Accessed Online: http://www.makati.uhcaction.org/2011/12/are-we-an-aging-country/ December 10,2011

Photo Credits: http://www.cosephil.org/index.php?option=com_zoom&Itemid=57&page=view&catid=3&PageNo=1&key=8&hit=1

Polypharmacy among the elderly

The use of multiple drugs in a younger and disease free individual calls for mindful consideration what more to the elderly people.  Aside from the physiologic changes, adverse drug events are more likely to occur in the elderly because they undergo several treatments under the care of different physicians.  There is a higher risk of adverse drug events as the number of medicines that an elderly patient takes in increases. In fact, estimated drug interactions can occur from 6% in patients taking two drugs a day to 50% in those taking five daily. (Lin, 2004)

Elderly are also more likely to take medications that are “unnecessary, ineffective and inappropriately prescribed”. In a study by Simon et al (2005), 29% of 150,000 elderly patients had used at least one out of 33 potentially inappropriate medicines. Aspirin (anticoagulant), Digoxin (digitalis glycoside) and lipid lowering agents were found to be the top three most inappropriate and underused medications. (Steinman, et al 2006) Meanwhile, those who use dietary and herbal products also have higher risks for drug interactions  such that  these products itself are mixtures of multiple active ingredients and some are not subject to regulatory requirements.

The simplest and most efficient intervention to this problem is to stay vigilant to any sudden change in the elderly patient. Record all the medicines and supplements that they take in and educate the family on drug risks and contraindications. Technological innovations that include electronic prescription and electronic medical records are also ways that may pose a possible solution to a “pill that overkills”.

Sources: Lin P (2004) Drug Interactions. A method to the madness. Perspectives in Cardiology 20(10), 20

Simon, S. R., Chan, K. A., et al. (2005). Potentially inappropriate medication use by elderly persons in U.S. health maintenance organizations, 2000 – 2001. J Am Geriatr Soc, 53(2), 227.

Steinman et al (2006). Polypharmacy and Prescribing Quality in Older People. J Am Geriatr Soc, 54: 15-16

http://dangersofpolypharmacy.wordpress.com/