An Ageing Nation

Are you or a family member celebrating their 60th birthday? Congratulations! According to the United Nations, you are now part of the “golden population,” as they classify individuals aged 60 and older as part of the ageing population. The term ‘ageing’ often carries a negative connotation, evoking fear and reluctance in many because it is often associated with ‘dependence’ and being perceived as a burden.

However, ageing and growing older should not be something to fear. In fact, it should be embraced and eagerly anticipated.

Malaysia is expected to see a substantial increase in its elderly population in the coming decades. Various trends, such as delayed marriages, rising living costs, effective family planning, and improved healthcare access, have contributed to a reduction in fertility and an increase in mortality.

According to the Statistics Department, Malaysia is projected to have an ageing population of 5.6 million seniors, which will make up approximately 15% of the total population by 2035. Looking ahead to 2056, Malaysia is poised to become a ‘super-aged society,’ with more than 20% of the population aged over 65.

What is Senior Care?

In simple terms, senior care, also referred to as ‘elderly care,’ is the provision of care and support tailored to the unique needs of older individuals. It’s important to note that not every elderly person necessarily requires senior care. In reality, if you were to ask many older individuals, they would express a strong preference for maintaining their independence and might perceive having a caregiver as a symbol of dependency or a sign of ‘disability.’

It’s worth emphasising that the natural process of ageing itself is not the sole reason to consider senior care. However, as people age, there can be various physical and cognitive challenges that emerge. It is in response to these specific challenges and issues that senior care becomes a topic for discussion and consideration.

Geriatric Medicine

It represents healthcare uniquely tailored to the needs of senior individuals, much like paediatricians specialise in children’s health and obstetricians and gynaecologists focus on women’s health. The elderly have distinct and specific healthcare requirements that may differ from those of other age groups.

Geriatric medicine encompasses a comprehensive range of primary care services, delivered by internal medicine doctors. These services encompass preventive care and the management of chronic illnesses. Furthermore, geriatric medicine involves a profound understanding of the additional challenges faced by seniors that have the potential to affect their overall quality of life.

What do Geriatricians Do?

Geriatricians are specialised primary care physicians with expertise in diagnosing and treating older adults, particularly those aged 65 years and above. This demographic often presents a range of complex health issues that require specialised care.

Notably, elderly individuals exhibit distinct medical characteristics compared to the general population.

For instance, it may surprise you to know that 56.7% of those aged above 85 do not experience chest pain during a heart attack.

Furthermore, older adults are more susceptible to illnesses due to their weakened immune systems.

Even a common flu can have more severe consequences for the elderly compared to a typical young adult in Malaysia.

This is precisely where geriatricians play a vital role.

They possess the knowledge and experience necessary to identify and address these unique healthcare challenges effectively.

Your geriatric doctor may engage with you on five key components:

1. Geriatric assessment

2. Continence management

3. Balance and fall risk reduction

4. Delirium management and treatment

5. Promotion of healthy ageing

It’s crucial to recognize that there’s no one-size-fits-all approach. Every individual has a distinct set of needs and abilities. Geriatricians take into account these individual factors, as well as your preferences, to ensure the highest possible quality of life.

There are 5 pillars in caring for our elderly population.

They are:

Mobility

The ability to move and maintain mobility is not only crucial for preventing falls but also plays a pivotal role in comprehending and pinpointing the underlying factors that lead to falls. This encompasses a comprehensive evaluation of an individual’s walking pattern and overall functional capabilities. By closely examining one’s gait and functional abilities, healthcare professionals can gain valuable insights into fall risks and their root causes.

Medication

Polypharmacy, a prevalent concern among the elderly, often results from the presence of multiple concurrent comorbid conditions. Ensuring the timely and accurate administration of medications is of paramount importance in this demographic. Additionally, vigilant monitoring of potential adverse effects stemming from these medications is essential to maintain the overall health and well-being of older individuals.

Mind

In addition to addressing physical concerns, it is crucial to gain a deeper understanding of cognitive and mental limitations in older individuals. Often, conditions like depression go undetected in the elderly, while cognitive impairments such as dementia are on the rise within this demographic.

A geriatric physician is uniquely equipped to provide insights into the intricate interplay of cognitive, emotional, and behavioural aspects of mental health. They can offer valuable guidance in unravelling the complexities of how the mind is affected, helping to shed light on the cognitive, emotional, and behavioural dimensions of well-being in the elderly.

Multi Complexity

As we advance in age, the likelihood of experiencing multiple chronic diseases tends to rise. Conditions such as Type 2 diabetes mellitus, chronic kidney diseases, high blood pressure, and elevated cholesterol levels are just a few examples that come into play as part of this broader spectrum.

Matters Most

Among all the factors to consider, this “M,” which represents creating a safe environment for the elderly to express their wishes and aspirations, holds unparalleled significance. This open channel of communication plays a pivotal role in shaping the health objectives and outcomes of older individuals. Additionally, it significantly assists patients in addressing matters related to palliative care and end-of-life decisions.

What to Expect During a Geriatrician Appointment

During your initial consultation with your geriatric doctor, a thorough and all-encompassing assessment will be carried out to gain a comprehensive insight into your physical and mental capabilities, as well as any limitations you may have. Furthermore, your doctor will seek to obtain a deeper understanding of your social circumstances.

In some cases, your geriatric doctor may recommend consultations with other specialised healthcare professionals or connect you with various support services to provide more tailored assistance.

As part of this holistic approach, your geriatric doctor will work with you to formulate a customised management plan or healthcare strategy. This plan is designed to enhance your overall well-being and independence to the greatest extent possible.

Do I Need Senior Care? When Do I Need It?

The ageing process is inherently intricate and far from a one-size-fits-all scenario. It’s abundantly clear that every individual embarks on a unique ageing journey, marked by varying limitations that shift and evolve with the seasons of life.

The decision to consult a geriatric doctor should not be solely tied to reaching specific chronological milestones like 65, 72, or 85 years old. Instead, the key consideration is whether you require the specialised guidance and expertise of a geriatrician to effectively manage a confluence of health issues. This could involve addressing complex healthcare needs or coordinating the administration of various medications tailored to your specific situation.

It would be wise to contemplate a visit to a medical professional if you or a cherished family member observe any of the following indicators:

Cognitive Issues

Confusion
Difficulty speaking or finding terms/ completing sentences
Forgetting long-term memories, ie forgetting faces, people or core memories – the birth of children or marriage.
Forgetting short-term memories – leaving the kitchen stove on, misplacing items around the house.
Changes in personality or behaviour – become more withdrawn, quieter
Sudden outbursts of aggression
Struggle with simple daily tasks ie: dressing up or brushing teeth

Physical Problems

Hearing impairment
Visual impairment
Trouble or difficulty moving around or getting up.
New and rapid onset of physical limitations
Multiple chronic health conditions

Emotional Issues

Depression
Anxiety
Social withdrawal

Enhancing Quality of Life: A Path to Well-Being

Health is wealth. Some of these signs and symptoms may appear very subtle or innocent. Maintaining independence and quality of life is of utmost importance as we age and grow into our golden years.

Being healthy- physically, emotionally and mentally is one of the best blessings life can offer. The ability to gracefully age, watch our grandchildren grow, and engage in our cherished hobbies is a privilege we should never underestimate.

Don’t be afraid to seek out a geriatric doctor today- your well-being and the richness of your later years depend on it.

Senior Care 101: Signs Your Ageing Parents Need a Geriatrician