The following are some communication strategies that family and community can put in place as a palliative care for the older person.
- Listen to their concerns, regardless of how we perceive the situation.
- Acknowledge their emotions, “I can see you are very upset/ angry.
- Invite them to tell their story, “can you tell me what’s bothering you” and listen out for goals we may be able to address.
- Reframe emotions or situations from negative or difficult to an opportunity or catalyst to further explore a situation.
- Align our body language with the intention to listen, nod, make eye contact, down-cross our arms, etc.
- Avoid interruption.
- Use skills such as, empathy, reflection and validation to negotiate a realistic goal sometimes it can be as simple as saying we will ask the doctor to give them a call.
- Empathy: “it sounds like what you are going through is really upsetting and difficult”.
- Reflection: “so I hear you saying you are very concerned that?”
- Validation: “it’s understandable that you feel angry about”.
- Negotiate: “it’s after hours now, but what I can do is–?
Maslow’s hierarchy of needs
There are other basic needs such as water, air, food and protection from environmental dangers is necessary for an older person to live. In addition to basic needs, humans also have needs of a social or societal nature such as the human
Resources available for the older person
Specific resources for older adults and their caregivers that include;
- Wellness programmes
- Nutritional support
- Educational programme about health and aging
- Counseling services for caregivers
- General assistance with housing
- Home safety
Geriatrics (care of the aged)
Geriatrics: This is the medical and nursing care of the aged.
Gerontology: Is the scientific study of the aged and the process of ageing and Involution is a slow process of cell destruction.
Old age is usually due to biological and chronological effect of the system of the body.
The physiology of ageing
A major thing to understand here is the tear and wear that the body experiences as we advance in age. A baby child that is newly born is like an acquired new machine. A new machine is known to be in a perfect sound condition. So it is with a newly born baby. With the passage of time, and as the baby grows, there is deterioration in body functions. What we find is that a person who could run a hundred metre race without panting can no longer do so. A person could recollect and remember clearly what happened some moments or years ago, can no longer do so. These are signs of tear and wear in our life.
Tear and wear in our life affect individual ability to do what that person could hitherto do. They affect the economic well being of the individual person, because, such a person cannot longer fend for himself/herself adequately. By extension, ageing affects the economy of a community, a local government, a state and the nation.
Signs and symptoms of ageing
- Reduction in height: The verbal dis gets flattened and compressed coupled with the stooping posture due to weak muscles.
- Scanty grayish hair (specially on the scalp, Axilla public hair)
- Enlarge bulvous nose and large ear lobe.
- Loose wrinkles –inelastic skins
- Poor dentition
- Sunken cheek due to loss of dentures
- Unsteady gait
- Arthritis of joint pains
- Poor posture
- Reduced mobility
- Failing sight – Blindness
- Failure in hearing (hard hearing)
- Failure in smelling
- Poor appetite
- Indigestion and constipation
- Loss of memory and mental changes-resulting in senile dementia
- Aggression, depression, instability – nervous
- Talkative and argumentative
- Diabetes: This is common with the aged person because of reduction in insulin production as a result of cell degeneration
Health problems of the aged
The health problems of the aged are:
- Physical problems medical. These are due to degenerative conditions of cells, organs, and systems of the body. They are as follows; Failing sight, Hard hearing, poor dentition, Arthritis, Cardiovascular diseases e.g. hypertension, heart problems. Hypothermia – low body temperature, they are prone to fractures, tiredness and fatigue, enlargement of prostrate glands which leads to urinary problem; bronchitis – near the lungs in the chest.
- Mental problems.
- Dementia – Loss of memory or short memory of recent events
- Depression confessional state due to loss of status. Thoughts and worries of ageing and loss of finance and health………. Depression can lead to aggressiveness and generate conflicts. All these can make the to become depressed.
- Socio – economic problems: These are associated with both physical and mental problems and are made worse after pension.
- Loneliness – due to poor mobility, aggressive attitude and loss of partners
- Inferiority complex as a result of low income
- Poor personal hygiene/environment – due to fatigue, weakness and painful joints.
- Financial problem – inadequate income due to loss of job, pension or reduced vitality
- Loss of status – due to pension or unplanned/sudden pension, ill-health etc.
- Poor housing
- Lack of Transportation – if they don’t have access to transport, they cannot get out and about, for appointment, shopping, hospital visits and social activities.
- Poor nutrition – clothing, personal hygiene: These are due to low income.
- Poor environmental hygiene: due to fatigue weakness and painful joints
- Medical problems of the aged.
- Heart problem
- Enlargement of prostate gland.
Problems of malnutrition associated with the older person
- Weight loss
Objectives of care of the aged
- To prolong their lives and make them as independent as possible
- To prevent chronic disease and accidents they need health, education, proper nutrition, sound personal hygiene, good environmental sanitation and awareness of domestic accidents.
- Make provision for very sick ones and care for minor ailments
- To limit the number of destitute on the street.
The needs of the aged
- Everybody should prepare for old age early in life by buying of share, taking of insurance policies, saving accounts, and building of houses preferably bungalows in familiar area to prevent loneliness at the time of old age.
- Encourage children to care for their old ones by paying them regular visits and providing their needs. If the children are more than one, care for the aged should be rotational among the children.
- Government should take up the responsibilities to develop rural areas e.g. building of factories where people can be employed so that the youth can stay back and work at home and care for their aged one.
- Health personnel: Should integrate the care for the aged in their health services or schedule for retired officers, treatment of minor ailments and refer serious one to the appropriate quarters.
- Arrangement for social centers where they meet at interval for socialization e.g. read simple novels, play games e.g. Ludo, knitting and making friends. Arrange for holidays and excursions to get them occupied.
- Arrangement for re-employment of the physically fit ones: Gate men, nanny, snack shop, store men or women, breaking of melon
- Encourage government: To establish institutions for the elderly infirm and those without relations to care for them, (OLD PEOPLE’S HOME)
- Diet: Health, education on balanced diet with less carbohydrate, less eggs especially the yolk which contains cholesterol that causes arteriosclerosis that leads to high blood. People with poor dentition should be, serve food in semi-solid merchant forms
- Loss of appetite: Serve food that they like most and encourage in –take of fruits, vegetable and water for intestinal mobility to prevent constipation. Give appetizers and iron tablets e.g. multi – vitamins and folic acid for maintenance. In case of impacted faeces give vegetables laxative, duleo suppository. Andrews livers salt or manual removal.
- Personal hygiene: Encourage the aged to have their bath twice daily, cut their nails short weekly, brush their mouth twice daily, cut their hairs short regularly, wash their clothes regularly and change clothes as often as possible to avoid the use of one cloth continuously.
- Prevention of accident: Encourage environmental sanitation, refuse should be adequately disposed off to prevent cuts and piercing, dangerous falls and communicable diseases. Floors should not be over polished to prevent dangerous falls. There should be railings for supports while climbing. Chairs and articles in the rooms should be arranged to prevent falls. Remember to switch of gas after use from all positions where it it expected to be switched off so as to avoid fire hazard. Fire for warmth should be well protected with fire guards to prevent burns and scalds.
- Community health aids: Health workers in the community including social workers and religious organization or societies should pay regular visit to the aged in their homes and old people’s institutions.
- Emphasis and encouragement of child immunization: To avoid handicapping conditions that will make old age a more difficult situation to cope with.
How do we prepare for old age?
- Building houses
- Taking loans for purposeful business ventures
- Buying shares
- Making useful investments
- Taking insurance polices
- Training the children
- Children should care for their old ones by paying them regular visit. If the children are more than one, the visit could be on rotation, in order to make it more regular and effective.
- Government should be encouraged to develop the rural areas by making lands available to the government for that purpose.
- There should be arrangement for social center for socialization. They can meet at interval for socialization- e.g. where they can read simple novels, play games, watch video, netting and also arrange for holiday recreation and rehabilitation.
Causes of common problems
- Lack of accommodation
- Lack of care on the side of the immediate family members
This is one of the reasons why we have to prepare for old age caring for them will prolong their life.
- Lack of care from the government.
Government ought to pay the pension of the aged on time and also provide facilities for them to keep them healthy and happy.
- Eating adequate diet.
- Training of children
- Provision of good housing
- Government should build old people home and get medical personnel to care for them
- Immediate family members should provide for their old people.
The importance of the aged
- They are good in history and story telling
- They show love and affection to the young ones
- Aged show that the person has lived a satisfied/fulfilled life
- They full of wisdom
- They are peace makers
- They are family builders
- They are care providers
- They preach morality. They put things in order when they are going astray.
- They are good community leaders
- They preserver family inheritance.