LEGISLATION AND THE RIGHTS OF SENIOR CITIZENS IN NIGERIA

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OCTOBER 1ST of every year, which coincides with Nigeria’s independce is actually a day designated by the United Nations to examine, analyse, celebrate laudable policies and formulate new policies that center around older persons globally.

Year 2020 marks the 75th Anniversary of the United Nations and the 30th Anniversary of the International Day of Older Persons.
 
 
  •  According to the United Nations, By 2020, the number of people aged 60 years and older will outnumber children younger than 5 years.
  • United Nations has also projected, that over the next three decades, the number of older persons worldwide is projected to more than double, reaching more than 1.5 billion persons in 2050，and 80% of them will be living in low- and middle-income countries.

“The world marks the 30th anniversary
of the international
Day of Older Persons as we recon with the
disproportionate and severe impact the COVID-19 pandemic
has wrought on older persons around the world – not
only on their health, but on their rights and well-being.”

 

 

General Antonio Guterres

United Nations Secretary-General

THE SITUATION IN NIGERIA
 
The deplorable state of the elderly care and and welfare in Nigeria is beyond comprehension. When you take a look at how senior citizens in our dear country Nigeria are being treated, you cannot but think twice about your future as an individual.
 
Not many people know that in the constitution of Nigeria, old age care/elder Care is  embedded in it. It is the responsibility of the government to ensure that senior citizens are not marginalized.
 
A LOOK  AT THE CONSTITUTION OF NIGERIA
 
Fundamental human rights is clearly entrenched in our constitution and this includes the older persons or senior citizens.
 
• Section 14.2 (b) of Nigeria constitution states that “the security and welfare of it’s people shall be the primary purpose of the government.”
 
In the section quoted above, it clearly involves all the citizenry, the question therefore is, Are there systems and policies in place to protect the senior citizens, and to ensure their welfare ?
 
• Section 16 (2) (d) of the Constitution further states that “suitable and adequate shelter and suitable and adequate food, reasonable national minimum living wage, OLD AGE CARE and pensions and unemployment, sick benefits and welfare of the disabled are provided for all citizens.”
 
In section 16 (2) (d) above, you  would see that I intensionally put old age care in capital, to let you know that the care of senior citizens is well captured within our constitution. Also, the question remains, despite this constitutional provisions, what policies, systems and programmes has the government put in place, to ensure that this portion of our dear constitution is adhered to?
 
STEPS TAKEN BY GOVERNMENTS AND INDIVIDUALS TOWARDS THE CARE AND WELFARE OF THE ELDERLY IN NIGERIA
 
It is not a fallacy to say that the Nigerian government from one dispensation to another has not done much, when it comes to the care of the elderly in our society.
 
• In 1989, the Nigeria government developed the national social development policy which is aimed at providing a framework for protecting the elderly from moral and material neglect.
 
• It was recorded that Senator Ganiyu Solomon of the Action Congress of Nigeria, sponsored a bill for “an act to establish a NATIONAL CENTER FOR ELDERLY PERSONS, for general purpose of providing welfare and recreational facilities for the elderly, and the designing of developmental programmes and activities for the advancement of elderly persons in Nigeria.” This bill was passed on 14th July, 2009.
 
• Also, senator Anyim Use of the People’s Democratic Party was said to have sponsored a bill ” for an act to provide social security for unemployed graduates and the aged in Nigeria and for purposes connected thereto” in June  2010.
 
• The National Policy on the care and welfare of elderly persons is yet to be implemented.
 
President Buhari led administration signed into law a bill “National Senior Citizens Acts 2018.” This bill provides for the establishment of National Senior Citizens Centers by institutions and the three tiers of government in the country to cater for the need, care and orientation of senior citizens.
 
While we appreciate the signing of this bill into law, unfortunately, it has neither been talked about nor implemented, after the assent of the President.
 
WHY WE SHOULD HAVE POLICIES AND PROGRAMMES FOR THE ELDERLY
 
Nigeria has approximately 9.3 million elderly people according to National Population Commission (NPC). 
World Health Organization has said that between 2015 and 2050, the proportion of world’s population over 60years of age will nearly double from 12% to 22%. This corroborates the projection of the United Nations.
 
Unfortunately, Nigeria is not preparing for this. It is a crisis waiting to happen, and this is why we must begin to put policies and programmes in place to prevent this avoidable crisis from happening.
 
WHAT THE GOVERNMENT SHOULD DO URGENTLY
 
Going by the statistics from the United Nations and World Health Organization above, it is evident that time is running out, and the government needs to act on time, by doing the followings:
 
• Implementing the law establishing National Centers for senior citizens at the Federal, State and Local government levels.
 
• Having a robust database  for the elderly, this will ensure adequate capturing and it will greatly help in planning programmes and projects for the older persons.
 
• Other steps  that the government need to take can be seen here ENSURING A PEACEFUL LIFE FOR OLDER ADULTS/ SENIOR CITIZENS Kindly read it up.
 
• Also, learn your role as individuals and family members on how to ensure that your elderly ones have the best of life here : THE ROLES OF FAMILY MEMBERS IN ENSURING THE WELLBEING OF THE ELDERLY.
 
References:
Tanyi et al; Cogent Social Sciences, Care of the elderly in Nigeria:Implications for policy (2018).
 
Magnus Eze, Old Age Legislation in Nigeria, lco-cdo.org  un.org  who.int   
 
Author
 
My name is Adesuyi Adesina, the founder and CEO of  Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.

PREVENTION OF POISONS IN OLDER PERSON OR SENIOR CITIZEN

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Paracelsus once said, “poison is in everything, and nothing is without poison. The dosage makes it either a poison or a remedy”.
 
Alice Sebold said, “poison and medicine are often the same thing, given in different proportions”.
Therefore, poisons are substances that can cause damage or death in humans, after exposure, inhalation, injection and ingestion of such substances at a quantity sufficient enough to cause harm.
 
 
SOURCES OF POISON
 
I. WATER: This is a common source of poison in elderly , water in itself it’s not a poison. However, when it comes in contact with toxic or poisonous substances, it then becomes a poison.
Also, water intoxication has been referred to as water poisoning. This is a situation where one drinks too much water, which could cause a lot of damage to human health. It causes electrolyte imbalance (low sodium) in the body, this can lead to a damage of the brain, loss of consciousness, muscle weakness and even death if not quickly corrected.
This is very crucial when it comes to the older person who is more likely to suffer more from electrolyte imbalance.
 
PREVENTION
 
• Proper disposal of waste and toxic substances that could contaminate your water.
• Only drink water from reliable and well treated sources.
• Do not keep poisonous substances near the water you want to drink.
• Do not take excess water at a time. Taking about 3 litres of water at a time can lead to water intoxication, wait a minute! You doctors told us we could drink up to 3 litres a day! That is very true, however, that 3 litres is supposed to be over 24hours and not just at once .
• Wash your water storage regularly.
 
II. FOOD POISON : It is an illness caused by food contaminated with microorganisms (bacteria, viruses, parasites) or toxins.
 
This could cause abdominal pain, vomiting, stooling, dehydration, and in situation where it is caused by microorganisms it could lead to generalized sepsis if not treated on time. Although, it presents as mild cases often times, and resolves with supportive treatments.
It is also important to let you know, that as people age, their senses of smell become less acute. Hence, they might not perceive it when a food is spoilt.
 
PREVENTION
 
• Cover foods properly.
• Prevent under cooked meals.
• Meals should be prepared in a hygienic environment.
• Ensure proper storage of food and cooking Ingredients.
• Wash plates immediately after eating.
 
III. MEDICATION : Poisoning from medication in senior citizens often results from using the wrong drugs, overdose, and multiple drugs (polypharmacy). Kindly read my post on DRUG SAFETY IN GERIATRICS for adequate information on how to prevent this.
 
IV. CHEMICALS : Chemical agents used at home for cleaning, and other agricultural agents like herbicides and insecticides could be sources of poison to the elderly.
 
PREVENTION
 
• Always keep their labellings intact.
• Do not store them within the reach of senior citizens.
• Do not mix these chemicals together.
• Ensure you wear protective gears when using these chemicals.
• Do not leave door closed on senior citizens when these chemicals are being applied.
• Do not pour the chemicals out of their original container into another one. If you have to do this unavoidably, kindly label it properly.
 
V. CARBON MONOXIDE : This is a dangerous gas that leads to tissue damage and even death. It is found in fumes of cars, trucks, kerosene stoves, burning of tyres, fire places and gas ranges. When it is inhaled, it poses dangers, such as chronic heart diseases, lung diseases, low oxygen level in the body and many more.
 
PREVENTION
 
• Each home should have a carbon monoxide detector, it has an alarm system that will notify you of the carbon monoxide concentration in your home at anytime.
• If you smell any gas coming out of your refrigerator or cooker, do call a qualified technician to fix it quickly.
• Ensure adequate ventilation in your home, especially the kitchen.
• Do not burn coals indoor.
• Make sure your generator house is situated outside.
 
NOTE
 
Please, I would like you to know that all the solutions given in this write up are preventive measures. You should not at anytime treat any form of poison at home whether chemical, food, water, carbon monoxide or medication poisoning. Kindly take such patients to the hospital or call the phone number of the National Poison Centre of your country.
 
Author
 
My name is Adesuyi Adesina, the founder and CEO of  Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.
dradesina@ganathealthcare.com

ROUTINE AND SPECIFIC MEDICAL CHECK UP FOR SENIOR CITIZENS

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An inch of caution and prevention is far more better than yards of correction and curative methods.
Promoting healthy ageing is one of the things we do at Ganat Healthcare Initiative. Healthy ageing is defined by the world report on ageing and health as the process of developing and maintaining the functional ability that enables well-being in older age (WHO).
 
 
 
 
One of the ways the above definition can be achieved is through ROUTINE AND SPECIFIC MEDICAL CHECK-UP FOR SENIOR CITIZENS.
 
 
 
 
 
 
WHAT ARE THE ROUTINE AND SPECIFIC MEDICAL CHECK-UP REQUIRED IN OLDER ADULTS?
 
 
 
I. BLOOD SUGAR SCREENING
 
• Anyone above the age of 45years should routinely do this test, so it’s not just only the senior citizens.
• It helps to detect if your body is not making use of the sugar adequately. This is referred to as diabetes.
 
II. BLOOD PRESSURE CHECK
 
• This is a simple test that should be done regularly in anyone above the age of 45years, as a matter of fact, it is routinely done in the hospitals. Even if you come everyday.
• It helps to detect those with blood pressure problem early, which is known as Hypertension.
• Hypertension is a silent killer, so without this test, people might be hypertensive and be fine physically. Meanwhile, they are dying inside.
• It is not unusual to see people develop stroke ( inability to use some parts of the body and or speech loss) suddenly, this is as a result of uncontrolled Hypertension, which could have been well controlled if detected early.
 
III. BLOOD LIPID / CHOLESTEROL TEST
 
• When lipid is within normal level in the body, it helps in building the cell memebrane, insulation, energy storage and cellular communication.
• However, if the value becomes too high , especially the Low density lipoprotein (LDL) this can cause heart diseases and even stroke.
• If detected early, you would probably be advised on dietary modification, lifestyle changes and drugs if necessary.
• This is recommended for anyone above the age of 35years and not just the elderly alone
 
IV COMPLETE BLOOD COUNT TEST
 
• This test allows your Healthcare professionals to know if your blood level is low or normal. Also, it helps us to know if  there is any infection going on within the body by interpreting the parameters.
• This test is a routine test for all age group, and not just the elderly.
 
V. KIDNEY FUNCTION TEST
 
• The kidneys help in getting rid off toxic waste substances from the body . Therefore, any damage to the kidneys will lead to the accumulation of these substances in the body, and this could be very damaging to human health.
• Anyone from the age of 45years should do this once in a year.
• Also, adequate water promotes the proper function of the kidneys.
 
Vl. EYE EXAMINATION
 
• One of the organs of the body affected as people age is the eye.
• Yearly eye check is encouraged in the elderly.
 
VII. EAR EXAMINATION
 
• This is done to check for wax,dirt and hearing capability.
• The physical examination , that is checking for wax, dirt and foreign bodies can be done routinely, while the hearing capability test (Audiogram) can be done yearly.
 
VIII. EXAMINATION OF RECTUM AND COLON
 
• This involves viewing the lower part of the large intestine starting from the rectum with the aid of a camera-like flexible instrument, known as colonoscopy.
•It helps to detect any abnormal leison or polyps, and a biopsy would be taken if there is any changes for the purpose of definitive diagnosis.
•Cancer is treatable if detected early before spread. Hence, routine colonoscopy every ten (10) years starting from age 45 years to about 74years is highly recommended.
 
IX. PROSTATE CANCER SCREENING
 
• This is specifically for older men, however, people should start screening for prostate cancer from 45years old and above.
• With a simple digital rectal examination (DRE) your attending physician might suspect a prostate cancer and take a biopsy for histology which would aid in the definitive diagnosis.
• Also, prostate-specific antigen (PSA) levels can help in the diagnostic process.
• Early detection gives a very favorable outcome.
 
X. SELF BREAST EXAMINATION AND X-RAY
 
• Breast x-ray is called (mammogram) by health professionals. It helps in taking a picture of the breast for proper examination. 
Women over 55 years of age should have mammogram done every two years, while women of 45-54 years should have it done once in a year.
• Self breast examination is the ability to examine your breast on your own following an approved pattern . Every woman from reproductive age group to elderly should be able to do to this. It helps in early detection of lumps within the breast tissue.
 
XI. CERVICAL CANCER SCREENING
 
• Cervical cancer is one of the cancers that affects women. I am not going to bore you with epidemiology, my simple goal is to let you know how this could be prevented by going for the appropriate test.
• The screening for cervical cancer is pap smear.
• It is often done routinely from 25 years old.
• It is done 3 yearly from 25 to 39 years old or 5 yearly if done with HPV (Human papilloma virus) test.
• It is done 5 yearly between 40 to 54 years old.
• It is only done above 65 years if the person has never been screened before the age of 50years, or if there are symptoms suggestive of cervical cancer.
 
TAKE HOME
 
Elderly care, like I said in my previous posts does not start at 65 years . It starts from birth. Your health status at 65 years would be a direct reflection of how you have managed your health since  birth. You would realize that most of the tests I discussed in this post are often commenced from when people are at adulthood and middle age, not when they are elderly at 65years.
If you are at your adulthood or middle age and you are reading this, you would do yourself a huge favour by making this medical screenings a priority.
Likewise, if you have aged parents at home, please do take them for some of these tests.
Admittedly, some of the tests may not be necessary at some age, your physician would advice you more on this.
 
AUTHOR 
 
My name is Adesuyi Adesina, the founder and CEO of  Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.
 
dradesina@ganathealthcare.com
 

FINAL STAGE OF LIFE AND THE REQUIRED CARE

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It was Haruki Murakami who said; DEATH IS NOT THE OPPOSITE OF LIFE, BUT A PART OF IT. It is not easy losing loved ones to the cold hands of death, even when they are aged. However, the understanding and acceptance of Haruki’s statement would greatly help us through this inevitable process of life.
My focus in this post is to help you understand  what you  can do, as you watch your elderly or aged ones go through this stage of life.
 
 
 
SIGNS OF FINAL STAGE OF LIFE AND REQUIRED INTERVENTION / CARE.
 
I. LACK OF INTEREST IN ACTIVITIES : As death approaches, the elderly people at this stage of life become withdrawn, nothing seems to attract them at this point . Their attention span at this point would have greatly nosedived. Most times, they just want to be left alone.
 
INTERVENTION/CARE
 
• Do not force them into any activities.
• You can talk to them about activities they are normally interested in.
• Let them know how they have touched your life, or that of some else through such activities.
• If you have a video record or pictures of such activities you can show it to them.
• Let them know it is absolutely alright if they no longer have the strength to do these things. It gives them a sense of satisfaction and fulfilment.
 
 
II. ANXIETY : The fear of unknown would be so palpable at this point. The religious ones would probably be thinking about heaven or hell, they have not been there, but they have heard about it. Others might be thinking about their past lives, companies and families they are going to leave behind. They wish they could have a glimpsed of what would happen and not knowing this, is what actually breed the fear of unknown.
 
 INTERVENTION/CARE
 
• Be quick and don’t be tired of reassuring them 
• Be hopeful around them.
• Let your speech and thoughts be positive around them.
• Allow them to express how they feel, it makes them feel better and it will help you to understand how you can be of help.
• Don’t be judgemental in addressing any concerns raised by them.
• Respect their spirituality and grant their desire to see their clergymen or perform their spiritual rituals. It leads to a peaceful death.
 
 
III. POOR HYGIENE : During the final stage of life, the loss of personal and environmental hygiene are mostly common. Personal hygiene such as , brushing the mouth, toilet hygiene and even bathing would be affected. Some senior citizens might not be able to control their stool ( faecal incontinence). Similarly, they need help with environmental hygiene.
 
INTERVENTION/CARE
 
• Ensure their oral care by brushing for them with toothbrush or cotton wool depending on the situation if they already lack the ability to do so.
• Check and clean their anus at intervals when soiled with faeces.
• Attend to their hair by combing it.
• If they are not ambulant, carry out bed bath by cleaning the body with soap, water and a small bath towel.
• Make sure their surroundings are clean and free from objects that can injure them and cause further harm.
 
 
IV. DIFFICULTY IN BREATHING : Grunting or laboured respiration is  not uncommon  at the final stage of life. At this point, oxygen or suctioning would probably not do any good . It is mostly not necessary.
                               
INTERVENTION/CARE
 
• Put them in a more comfortable position.
• Invite a home health professional for review.
 
 
V. IMMOBILITY : Often, final stage of life can occur in combination with some ailments, which can render patient immobile or bed ridden.
 
INTERVENTION/CARE
 
• Turn elderly from side to side every 2hours to prevent pressure sore.
 
 
VI. LOSS OF APPETITE:
 
A dying elderly person would probably not be able to eat.
 
INTERVENTION/CARE
 
• Perform mouth care at least twice daily to increase appetite.
• Offer water with straw if they are able to sip.
• Do not force feed them.
 
 
VII. EXCESSIVE SLEEP AND COLD: This is very common at a dying stage.
 
INTERVENTION/CARE
 
• Do not startle them.
• Do not raise your voice at them.
• You can tap or speak to them gently , they might be sleeping but most times they still hear.
• You can play their favourite music.
• You can sit beside them and gently touch them and hold their hands, they might not be able to talk sometimes but they can feel.
 
 
SEVEN (7) GOLDEN RULES OF FAREWELL
 
When it is time to bid someone who is at the final stage of life farewell, there are seven rules you must follow:
 
1. Be physically present. This is priceless, the worth cannot be quantified. The satisfaction is enormous!
 
2. It is not a one time thing. It is what you do every time as the person goes through the stage of dying.
 
3. There are several ways of saying it. Sometimes, it is by putting a flower beside them, at other times, it might be by placing their head on your laps, and another way is by saying it. Also, you can bring their grand children to bid them farewell.
 
4. Let them know they are forgiven if they have ever hurt you. Nothing is more important at the final stage of life than reconciliation and making peace.
 
5. Let them know their last words would be cherished.
 
6. Ask or write it in a paper, asking them if there is anything they would want you to do for them. That is if they can still comprehend.
 
7. Let them know it is normal to die, this brings about acceptance on the part of the dying person and the person saying farewell.
                                                         
 
 
AUTHOR
 
My name is Adesuyi Adesina, the founder and CEO of  Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.
dradesina@ganathealthcare.com

ENSURING A PEACEFUL LIFE FOR OLDER ADULTS /SENIOR CITIZENS

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ENSURING A PEACEFUL LIFE FOR OLDER ADULTS /SENIOR CITIZENS
 
Old age is what everyone looks up to, this is a golden period for those who have served their countries, families and communities to be taken care of and to be served in return.
 
 
At Ganat Healthcare Initiative (GHI), ” Ageing is a blessing ” this is our motto. How then can we ensure a peaceful  life for the elderly?
 
This is a tripartite process, which involves individual , family and the government roles.
 
 
 
 
INDIVIDUAL ROLES
 
To change the world, it begins with you. As an individual, you are aware that you would grow old one day. Therefore, you owe yourself the responsibility of taking conscious actions towards this part of your life before it comes. There are three areas you should concentrate on:
 
I. PLANNING : Like the popular saying goes “He who fails to plan,has planned to fail.”  The best time to start planning and preparing for your old age was yesterday, but today is still another opportunity. Start a pension scheme, buy shares in companies as much as you can afford, and think of starting your own company. Plan for twenty years to come, plan for fifty years to come. Plan, plan and plan. Never leave your future in the hands of others.
 
II. LIVING A HEALTHY LIFESTYLE: This is very important because the way your body looks at a latter age is a reflection of how your body was used at your young/early age. This is the time to, cut down  on alcohol consumption, stop smoking, adequate fluid intake, and regular exercise. Failure to live a healthy lifestyle at a younger age would have a tremendous effect on you at an older age.
 
III. INVEST IN YOUR CHILDREN AND OTHERS: These are the people that will take care of you in your latter years. Investment in human beings yield the highest dividend!
 
GOVERNMENT ROLES
 
In ensuring a peaceful life for senior citizens, the government should brace up, and take the lead in this noble course, which can be done in the following ways:
 
I. ESTABLISHMENT OF ELDERLY CARE HOMES: It is obvious, that in most societies today, there are inadequacies of such facilities. If looked into, this will go a long way in making life easier for most senior citizens roaming the streets today.
 
II. FREE AND QUALITY MEDICAL CARE: This can never be overemphasized, it’s been addressed by several organisations. Yet , there is no significant improvement. Health insurance for the elderly should be covered by the government, or at least 50 to 60% of their health expenses.
 
III. RESEARCH FUNDING FOR GERIATRIC CARE: The more support  that organizations get from the  government and other donors in the aspect of funding, the better the outcome of geriatric care and programmes.
 
IV. PROMPT PAYMENT OF PENSIONS: I consider it unfair, and I mean really unfair to owe pensioners. Most of these pensioners depend on it for their livelihoods. Thus, Ganat Healthcare Initiative (GHI) is appealing to the government and other agencies responsible for the administration and payment of pensions, to kindly ensure that our senior citizens are paid promptly.
 
V. PUBLIC AWARENESS: Government, through the ministries of information and health should create more awareness and sensitization programmes that border on elderly care. This will further improve and help to change the public’s orientation towards the elderly people in our society.
 
FAMILY ROLES
 
I previously made a post on the roles of family in ensuring the wellbeing of the elderly, kind read it here
 
 
AUTHOR
 
My name is Adesuyi Adesina, the founder and CEO of  Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.
 
dradesina@ganathealthcare.com

DRUG SAFETY AND EFFICACY IN GERIATRICS

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DRUG SAFETY AND EFFICACY IN GERIATRICS

The use of medication in senior citizens or older adults should be with great caution. It is often a common thing to see elderly patients rushed into the emergency department as a result of wrong usage of drug or overdose.

It is our responsibility to ensure both the safety and the efficacy of the drugs being administered when it comes to the elderly.

DRUG EFFICACY

This is the ability of a drug to produce the desired effects. That is, if the drug is used for joint pains, the drug should be able to alleviate such pains with minimal or negligible side effects.

DRUG SAFETY

Some text has referred to this as pharmacovigilance. It is a process of assessing, detecting and preventing adverse effect of drugs. Therefore, the goal of every drug administered is to ensure proper drug efficacy and safety.

FACTORS THAT CONTRIBUTE TO HARMFUL EFFECTS OF DRUGS IN ELDERLY

1. Polypharmacy: This is the use of multiple medications to treat a patient. Most victims are senior citizens and people with multiple diseases. There are instances where this is inevitable, but the effects of drug to drug interactions should be considered before starting an elderly person on multiple medications.

2. Self Medication: This is another harmful practice by almost everybody, and not just the elderly. It is important that every medication administered is prescribed by a certified health professional to prevent unwanted effects of drugs on our senior citizens.

3. Overdose: Administration of drugs should not be done by the elderly themselves. If you leave them to administer drugs on themselves, they can either not use the drug or take overdose. To avoid this, it is good to have someone who is in charge of such an essential routine.

4. Continuous Usage: When the duration for which a drug was prescribed has been completed, it should be discontinued accordingly. Most senior citizens will keep the packs with the purpose of repurchasing such drugs. This can be very harmful, for example, there are some medications that will require proper monitoring of the functions of the kidney, liver and heart, so as to be able to determine if such drug is still safe in relation to the functions of the kidney, liver and heart. The harmful effects of using such drugs indiscriminately or continuously, when it should have been discontinued can only be better imagined.

SIMPLE WAYS TO PREVENT HAZARDS ASSOCIATED WITH MEDICATION USE IN ELDERLY

  1. Education: This aspect is often ignored by the home care nurse or whosoever is providing care to the elderly . Proper education about how the drug works, dosage,side effects, and desired effects are necessary information needed by the elderly which in turn helps to prevent hazards associated with medication. This can only be achieved when we communicate in the language they understand  best, and avoid using ambiguous medical terms  they can’t understand or comprehend.
  2. Labelling: As simple as it sounds, this is a very important step to eliminating hazards associated with medication use. Labelling includes the dosage and duration of each medication, it should be boldly written.

    3. Drug Administration: This should be carried out by a care giver who lives with senior citizens, it could also be done by a home care nurse.

i. Checks: What are the things you should check before administering a drug?

               -Name of the drug

               -Dosage of the drug

               -Time that drug is to be taken

               -Duration ( how long should it be taken)

               -Route or site of administration

               -Contraindications

               -Side effects

               -Expiry dates

ii. Beers criteria: Ensure you follow beers criteria. This is a list of drugs that are potentially harmful in older adults, it would be great if you could read it up for proper guidance, especially if you are a health worker.

iii. Medical History: Knowing the health history of our senior citizens will enhance drug therapy in them. This will equally help the health professional who is going to prescribe. However, for you to be familiar with their health history you would have to be interested in them, go with them to the clinic and follow up visits. Ask questions about their health status. This is exactly what this blog is about, to help you develop passion for older persons.

DRUG SAFETY MARGIN

Let me end this post with this, the  safety margin of drugs is usually calculated as ratio of the toxic dose to 1% of the populace to the dose that is effective in 99% of the populace. What do I mean by that jargon? Safety margin of drugs is simply the difference between the dose that will effectively give the desired outcome and the dose that can cause  life threatening adverse effects. And it is always a thin line between the two. This is why drug safety and efficacy in elderly should be paramount to us all.

Author

My name is Adesuyi Adesina, the founder and CEO of  Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.

dradesina@ganathealthcare.com

CURBING ABUSE AND VIOLENCE AGAINST THE ELDERLY

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“It is the most revered act of honour and privilege to carry in your hands; those who once carried you on their shoulders” – Adesuyi Adesina.
 
 
“Calling elder abuse a maltreatment is to take it lightly, it is an irredeemable and irremediable act” – Adesuyi Adesina.
 
 
 
 
WHAT IS ELDER ABUSE?
 
Any act of violent and non-violent maltreatment of older people, either in private or public by family members, close associates, strangers and institutions.
 
 
 
 
 
SCOPE OF PROBLEM
 
According to World Health Organisation (WHO), elder abuse was first described in British Scientific Journals in 1975 under the term “granny battering”
 
This is to let you know that it is a long aged problem.
Furthermore, (WHO) has said only 30% of the world’s elderly are covered by pension schemes. If you go through WHO fact sheet 2018 
 
You will discover that 1 in 6 people, aged 60 years and above suffered abuse within the community. 15.7% of people aged 60 years and older were found to have suffered some form of abuse in a study conducted among 28 countries with about 52 studies.
 
Let me not bore you with statistics, but it is obvious that if developed countries are having this level of problem, then it will be more alarming in the developing countries. Nigeria, for example has no health insurance cover for older persons, let alone housing for them.
 
Also, there is no system in place to protect them from abuse.  WE HAVE WORK TO DO!
 
TYPES OF ELDER ABUSE
 
Let us look at this under the following subheadings:
PHYSICAL ABUSE : This involves hitting, pushing and mal-handling them.
 
PSYCHOLOGICAL ABUSE : This is using foul, abusive and derogatory words when talking to them. It also involves hurting them emotionally.
 
FINANCIAL ABUSE : This comes as either spending their money without getting consent from them, or not giving them enough money that can take care of their need. This attitude alone can make them end up on the street as beggars.
 
SOCIAL ABUSE : When you deny them of social activities, and it is not of any health and safety benefits to them, this is tantamount to abuse. In addition, it includes any form of incarceration.
 
SEXUAL ABUSE : There has been a few report of sexual abuse in older persons. Therefore, be very sure of who you are leaving  them with. Always do due diligence before committing them to any care home.
 
CLASSIFICATION OF ABUSE
 
Abuse can be classified as follows:
 
✓ Neglect
✓ Abusive
✓ Exploitative
 
OFFENDERS
 
Who are the people that perpetrate this evil? It will interest you to know that they include:
 
FAMILY MEMBERS : I am always baffled when I see people treat their elderly parents with disdain, this is gross irresponsibility! Such a  barbaric act should be punishable under the law.
 
SPOUSE : This is likely to happen if you have your older persons living with you. It is important that you truly talk things out with your spouse before going this route.
 
STRANGERS : These group of offenders are the most dangerous, they cause harm physically, emotionally and otherwise to the elderly, and walk away with no shame or any iota of guilt. Please protect your elderly parents from strangers.
 
INSTITUTIONS : Most institutions do not have any consideration for the elderly, especially public institutions. We must begin to change this horrible act. Whether you work in a public or private institution, I want you to be an advocate for enviable and laudable senior citizens treatment. After reading this post, I want you to make a conscious decision to be nice to older persons in your society, always be ready to help and defend them.
 
NEGATIVE EFFECTS OF ELDER ABUSE
 
  • Injury
  • Hunger
  • Stigmatisation
  • Depression
  • Suicide
  • Disability
  • Death
 
SOLUTIONS
 
Seriously are there solutions to this absurd act? Yes, there are solutions, and it starts with you.
 
I. BE AN ADVOCATE FOR THE ELDERLY : The world will be a better place if we all change, one person at a time. This is one of my major goal, to create awareness, reorientate people and drive it into their consciousness, that our senior citizens deserve to be treated with respect. I am making you an ambassador for the elderly, it is your duty from today to start looking out for them.
 
II. NATIONAL ELDER ABUSE PREVENTION CENTER : Countries like Canada and Australia have what is called; Canada Network For Prevention Of Elder Abuse and Australia Network For Prevention Of Elder Abuse respectively. While in UK they have what is called; Action On Elder Abuse. With God on our side, this is the kind of policies that Ganat Healthcare Initiative will be pushing for in no distant future.
 
III. FORMULATION OF LAWS : This is highly needed, mostly in developing countries. There should be a bill containing the detailed rights of the elderly ones amongst us, of course such bill will need to be sponsored. If you have the capacity to sponsor such bills, kindly get in touch, Ganat Healthcare Initiative will be glad to work with you, and posterity will never forget you.
 
IV. UNITED NATIONS INVOLVEMENT (UN) : Ganat Healthcare Initiative is joining her voice with other NGOs and international organizations calling on the UN and WHO to ensure that their member countries prioritise senior citizens protection and keep them from abuse.
 
JUNE 15
 
All over the world, June 15, has been designated as WORLD ELDER ABUSE AWARENESS DAY.
 
This day is an international UN observance day, which came into existence as a result of the UN resolution 66/127.
 
I am using this opportunity to plead with you to reach out to the elderly people around you, touch their lives positively, even if it is one person. No act of kindness is too small, make June 15, a special day for one elderly person around you. All things being equal, Ganat Healthcare Initiative is planning to have an online broadcast looking at the legal, medical and psychological aspects of elderly persons abuse on that day.
Again, I like to thank you for reading this far. I look forward to your contributions, suggestions and questions. Thank you.
 
AUTHOR
 
My name is Adesuyi Adesina, the founder and CEO of  Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.
dradesina@ganathealthcare.com

THE ROLES OF FAMILY MEMBERS IN ENSURING THE WELL BEING OF THE ELDERLY.

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“Family provides us with the feathers with which we take our first flight in life”- Adesuyi Adesina.
 
Michael J. Fox puts in a fantastic way by saying “Family is not an important thing, it’s everything.” Family is the fundamental unit of every society. No one needs the support of family more than the elderly or senior citizens.
 
 
Most times, older persons are often neglected by their families, as a result of their pursuit of other life events, we can be busy with work, we can be far away in another country and forget to care for them.
My post today is to challenge you to do better, you can do better, and I will be sharing with you how to do that.
 
CATEGORIES OF PEOPLE THAT NEED THE SUPPORT OF FAMILY.
 
Everybody does need the support of family, we all need one another. However, I have identified three (3) categories of people that need it more. If you have anyone in the categories below, please, do whatsoever is in your power to give them the needed support.
 
– Children
– People with disabilities
– Elderly/Senior citizens ✓
 
 SPECIFIC WAYS OF SUPPORTING OLDER PERSONS.
 
1. VISITATION:  As simple as it sounds, this is the most important thing among all the things I will be sharing with you today. Visiting your aged parents, uncles, aunties and family members will help you discover a lot. Such as, their living conditions, health and well being. You will have one on one conversation with them. This is golden! I enjoy talking to my mother, just sitting by the bedside and talking to her. It always feels great.
 
2. MONTHLY UPKEEP: You have to make conscious effort to include them in your budget. Write it in your diary and be committed to it. Just like you budget for your car, home and projects. Your elderly ones should be included. Most people give their aged parents what is left after they have spent almost all the money on other things. This is wrong. I want you to write this in your diary today: MONTHLY BUDGET FOR MY AGED PARENTS = { put a figure you can keep up with every month} You will be glad you did.
 
3. MEDICAL CARE: Every senior citizens should have a primary care physician. This physician will know them personally, this is the doctor who takes care of them when they are sick, he also refers them to a specialist if they need a specialist care. I want you to look around where your aged parents live, find a primary care physician in either a private or public hospital and register them there. You can also request for home consultation for them, the healthcare workers will come and meet them at home to attend to their health needs. This can be a little expensive.
 
4. CARE GIVER: It is important to say that I know most people are busy with work, business and other projects. Some people do not even live in the same town or country with their aged parents. The option of a care giver or home assistant can be explored. This is a process whereby you employ someone to look after and care for your parents. If you are doing this, ensure you do the followings:
 
– The care giver must be screened medically
– Ensure the care giver is responsible
– Care giver must provide references
– The duties of the care giver must be clearly stated
– Care giver must have the capacity to carry out stated duties.
 
5. CARE HOMES: There are elderly care homes all around us. If you are not around, and there is no one to look after your elderly parents, please consider this option. Do not leave them alone at home, they can be left for few hours, but not days, months and years. There are good elderly homes you can put them. At Ganat Healthcare Initiative, we are waiting for this COVID-19 pandemic to taper down before we launch our Elderly Care Home, which is going to be free by the grace of God, and the help of our sponsors and donors.
 
6. SOCIAL OUTINGS: Socialisation should be encouraged among senior citizens, they should be encouraged to go to church, mosque, parks and other lovely places. This will improve their mental health status, and allow for minimal exercise. Unfortunately, this may not be practicable at the moment due to the ongoing pandemic.
 
7. NUTRITION: I have written about this in my previous post. Kindly refer to my post here to learn more about this.
 
8. EMOTIONAL SUPPORT: This is very important, and  should come from family members. The aged in our societies deserve our support in little things, apart from providing for their needs physically, their psychological well-being is equally important. This will make them live longer and stay healthier.
 
This is how to demonstrate love for older persons, let them know you care about them. I want you to cultivate the habit of loving older persons specially. Let me end with the words of Friedrich Nietzsche ; “In family life, love is the oil that eases friction, the cement that binds closer together, and the music that brings harmony.” And  Barbara Bush said ; “To us, family means putting your arms around each other and being there.”
 
Thank you for reading this far, your comments and questions would be appreciated.
 
Author
 
My name is Adesuyi Adesina, the founder and CEO of Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.
dradesina@ganathealthcare.com
 

ELDERLY/GERIATRIC NUTRITION : A PANACEA FOR HEALTHY AGEING.

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“Our food should be our medicine, and our medicine should be our food” – Hippocrates.

“The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition” -Thomas Edison.

If there is anytime that we should hold the above statements dear, it is now. Geriatric nutrition is the process of providing the food substances that are necessary for the health and wellbeing of the older persons.

Most diseases that older persons suffer from are either caused by lack of essential nutrients or have the tendencies to be modified by them.A large number of nutritional deficiencies often start from childhood.

The diminished basal metabolic rate and lean body mass in the elderly further aggravate these nutritional deficiencies at old age, thereby, leading to several forms of illnesses.

RISK FACTORS FOR MALNUTRITION IN THE ELDERLY

LONELINESS : It is reasonable to say that people eat well when they are excited. Happy life, happy appetite. Therefore, low mood can strongly affect the way senior citizens eat. It is important to attend to their psychological need, this will promote a good appetite in them.

LACK OF INVOLVEMENT : Cultivate the habit of discussing their meals with them. Check with them before preparing their meals. If you involve them in their meal time table, they are likely to cooperate better than when they are not involved.

LACK OF VARIETIES : You need to be creative with their meals, for example, instead of offering them just an apple, why not try a fruit salad. Always ask yourself this golden question; how can I prepare and present this meal in an enticing way?

ACUTE AND CHRONIC ILLNESSES : Either of these two can lead to diminish appetite. It might just be a sore at the mouth, a toothache, or  diabetes(chronic). Thus, it is good to be very observant, and you should think about this point anytime they show lack of interest in food.

MEDICATIONS : The side effect of some medications include poor appetite, be sure to ask the physician managing them for the side effects of any medication they are placed on.

LACK OF ACTIVITIES : This is also a known cause of reduced appetite, which can lead to malnutrition in the elderly. Even if they cannot move out of bed, they can still practice some passive exercises.

RECOMMENDED DIETS IN ELDERLY

PROTEIN : Just as the youths and young adults need protein to grow, also, the elderly needs protein to maintain muscle mass and strength.

There are plant and animal sources of protein.The elderly will benefit more from plant proteins. Examples are; beans, lentils and chickpeas.However, they can take white meat (chicken) and fish. But, red meat should be avoided because it has been identified as a risk factor for some cancers, obesity and atherosclerosis in older persons.

CARBOHYDRATE (CARBS) : People make a lot of mistakes by thinking that senior citizens do not need carbohydrate, especially, elderly persons with diabetes.

This is wrong, that people are aged or suffer from diabetes does not rule out the fact that they need carbs. It is the source of energy for humans because that is where we get our glucose from, which is needed before we can carry out any functions.

Nonetheless, there are some carbs that should not be encouraged in older persons. They are called bad carbs, so how do you differentiate a good carb from a bad carb?

The list is more than this, kindly read up on refined (bad carbs) and unrefined (good carbs)Do not forget, feeding older persons with refined carbs has a lot of harmful effects on their health.

FRUITS AND VEGETABLES: Previously, it was advised that we should eat five portion fruits daily, but now it has been increased to seven portions a day. Senior citizens should eat at least five portions of fruits a day.

MICRONUTRIENTS : This is very essential in the elderly, as a result of ageing, absorption of these nutrients from the gut is in reduced quantity. Therefore, foods that contain such micronutrients should be part of their diets;

° Vitamin D : This can be derived from fish, egg, and exposure to sunlight equally helps. It helps in preventing bone weakness.

° Calcium : This can be derived from soybeans. It helps in strengthening the bones and plays a role in heart contractility.

° Iron: This can be gotten from meat and bananas. It helps in blood formation.

° Vitamin B12 : Can be derived from fish, meat and eggs. It helps in blood production and nerve function. It is important to let you know that senior citizens are often placed on medications that contain these micronutrients to augment the few that are being absorbed from the gut. Please do not prescribe for your aged parents on your own, always consult a health professional.

FAT : The type of fat that is encouraged in the elderly is unsaturated fats( mono-unsaturated and poly-unsaturated), which can be gotten from peanuts, avocado, almond nuts, sesame seeds, walnuts and fish.

Essentially, fish gives omega-3-fatty acid, which helps in preventing a prediabetes state. Unsaturated fats pose no risk to the health of the older persons.

Meanwhile, saturated fats, which are commonly found in beef, coconut oil, palm oil and palm kernel oil have been linked to heart diseases, diabetes, hypertension and many more, although, new researches are emerging daily and some of them has queried this school of thought.

Overall, it has been established that unsaturated fat is far better than saturated fat. Undoubtedly, I cannot exhaust this topic in one post, but I have put it together in a way that will not confuse you and still deliver the message.

I hope the reading was worth it. I appreciate your time. I look forward to your comments and questions.Thank you. #Seniorcitizens #Olderpersons #Elderlycare #Elderlyhealth #Health #Geriatrics #Geriatricnutrition #Elderlynutrition #WHO

Author

My name is Adesuyi Adesina, the founder and ceo of Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.

dradesina@ganathealthcare.com

7 MOST COMMON FACTORS THAT ACCELERATE AGEING

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I had a conversation with a friend few days ago, he told me how he ran to the mirror just to look himself up, after meeting an old friend. I am guessing you would probably take a look at the mirror too, after reading this post.Today, in a simple manner without too much medical jargons, I will be discussing the above theme.Ageing is inevitable, and a natural process. However, there are things that can make one age faster than expected.To start with, how do you know if someone is ageing? 

FEATURES OF AGEING

It is important for you to know that ageing affects all the systems of the body, but I will mention some common signs  to look out for:

° Wrinkles° Dry and sagging skin° Easy fatigability/tiredness° Reduced immunity° Joint changes and pains° Hair loss° Forgetfulness° Chronic ailments (hypertension, diabetes)
Factors that accelerate ageing can be divided into modifiable (the ones that we can control) and non-modifiable(the ones we cannot control).                       

NON MODIFIABLE FACTORS OF AGEING

Genetics: American Academy of Dermatology called this ‘intrinsic,’ this is because we do not have control over this factor. It is largely responsible for premature ageing. For example, Hutchinson-Gilford syndrome and Werner syndrome. These are rare conditions, and I won’t be focusing on the non modifiable factors so that I do not bore you. Instead, my focus will be on the modifiable factors.


MODIFIABLE FACTORS OF AGEING

These are the factors that we have control over. Hence, knowing about them will greatly help in slowing down ageing. 

1. STATE OF MIND: The happier you are, the younger you will look. Sadness and worry accelerate ageing, and as well lead to different forms of illnesses, such as, hypertension and depression, just to name a few.

2. SMOKING: This can cause lung diseases like; chronic obstructive pulmonary disease, reduce oxygen circulation in the body and cancer of the lips, mouth and esophagus.

3. ALCOHOL: Excessive alcohol intake leads to depletion of vitamins, dehydration and production of free radicals, which are capable of damaging the cells and body tissues. Consequently, it accelerates ageing. In the United Kingdom (UK), men and women should drink no more than 14 units of alcohol per week, no more than three units in any one day and have at least two alcohol-free days a week. This is according to patient.info

4. SUN EXPOSURE: It is true that the sun helps in the process of vitamin D production, which is important for the development of bones. However, exposure to the sun for more than twenty minutes is not recommended. This is to prevent the damaging effects of ultraviolet rays (UV) on the skin.


5. DIET:  People are what they eat. Refined foods, high fatty foods and refined sugar accelerate ageing. Foods that slow down ageing are; fruits and vegetables. Also, balanced diet is equally important. Kindly note, my next post will be focusing on NUTRITION IN THE ELDERLY (what food is beneficial to them, meals to avoid in some chronic ailments of the older persons, and a lot more).

6. STRESS: Undoubtedly, stress is  part of life, but when it is beyond one’s level of adaption, it can cause so much health damage, and it makes people age faster than expected. Any level of stress that you cannot cope with should be discussed with health experts.

7. MEDICATIONS: I know you will be surprised, but really medications such as corticosteroids can make people age faster, depress immunity and cause other health problems. In addition, medications like angiotensin converting enzyme inhibitors (ACEi) and diuretics can increase the photosensitivity of the body to sun. These are just few among many, therefore, undue exposure to the sun should be avoided. I will advise that people should avoid self medication


 WAYS OF PREVENTING MODIFIABLE FACTORS OF AGEING

  • Use moisturising cream, it prevents and protects your skin from dryness.
  • Avoid undue exposure to the sun.
  • Use sunscreen for face and neck, but you must ensure that the sunscreen lotion protects against UVA(aging) and UVB(burning) rays. If you are going under the sun,an umbrella will not be a bad idea too.
  • If you drink too much alcohol vitamin B1(thiamine) might be of great benefit to you.
  • If you smoke, drink, or probably battling with any chronic ailments. The use of vitamins A,C and E will help improve your immunity and mop up free radicals from the body systems, these group of vitamins are regarded as antioxidants.
  • Adequate water intake, drink about 2.7litres and 3.7litres of fluid daily for women and men respectively. This is inclusive of water from food and beverages. It will undoubtedly help to improve your health, makes you look younger than helps with skin elasticity.
  • Fresh fruits and vegetable intake, these contain high levels of vitamins and other  nutrients needed to stay younger and healthier.
  • Exercise, it helps to promote blood circulation and keeps the body weight in check. Hence, with exercise, one can slow down the process of ageing.
  • Adequate sleep, this will allow your body to take a break from continuous stress, help in regeneration process of worn out cells and tissues of the body.


OLDER ADULTS/SENIOR CITIZENS                      

Admittedly, this group of people are already aged. Nonetheless, if we keep to the above rules while taking care of them, they will live longer and healthier. Always remember, ageing is not an infirmity. Ageing is a blessing!In my next post, I will be discussing NUTRITION IN ELDERLY.

#Seniorcitizens #Olderpersons #Elderlycare #Elderlyhealth #Health #Geriatrics #Factors that accelerate ageing #WHO


AUTHOR

My name is Adesuyi Adesina, the founder and ceo of Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.dradesina@ganathealthcare.com