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Caring for the elderly

October 22nd, 2014


Caring for the elderly

More than half of my heart patients are above the age of 65. This doesn’t come as a surprise since heart diseases usually come with advancing years; the older you are, the higher the risk.

But in the not-too-distant future I expect that most of my patients will be 75, or older, because people are now living longer and this increased longevity means that our society contains a greater proportion of elderly citizens.

Life expectancy is now higher than ever before. The average life span of a Thai person back in 1997 was about 70 years; that figure rose to almost 80 in 2005

In the US, senior citizens (65 and older) now make up 12% of the population and statisticians have estimated that by 2030 there will be over 70 million elderly people worldwide. In Thailand, the number of people aged between 60 and 79 is about 6.2 million, and in excess of 755,000 people are above the age of 80. So, 11% of Thailand’s population is now older than 60.

The reason why we are now living longer is partly due to technological advances, especially in medicine. In the past, a lot of people died from infectious diseases such as cholera and tuberculosis. Once drugs were discovered to fight the pathogens that give rise to such contagions, the main cause of death changed to illnesses that stem from our own lifestyles, such as coronary artery disease which is caused by bad diet, lack of exercise and smoking.

Doctors and scientists have tried to find ways to extend our lives as much as possible. Maybe, three decades from now, average life expectancy will have reached 100, but that still won’t alter one absolute certainty: that we all have to leave this world at some point.

In the past, doctors and scientists didn’t pay a lot of attention to elderly people, partly because there weren’t that many of them. Most people passed away before reaching old age. Another reason was that medical practitioners used to think it was too late to try and save the lives of people once they had passed a certain age. However, if we take a closer look at the matter, we will realise that a whole quarter century separates people aged 65 from 90-year-olds. Just as a 25-year-old is different from a 50-year-old, so too are there differences between 65-year-olds and 90-year-olds.

It is never too late for the elderly to start looking after their health. Apart from good food, exercise is also important for a longer, healthier life. Sitting around the house doing nothing (or being waited on, hand and foot, by your kids) could be bad for your health.

I am particularly interested in the topic of exercise for the elderly, mainly because most of my patients are in that age group. Even if I try my best to save their hearts, I can’t change their lifestyles for them. If they have an unhealthy lifestyle, they won’t have the energy to get involved in activities. Exercise can improve the health of those who are 90 years old as much as it can benefit those aged 50.

A study was conducted in which 90-year-olds were asked to do resistance exercises (such as lifting light weights) under supervision to see whether exercise could improve their muscle tone. It was found that eight weeks of daily weight-lifting _ three times a day, eight repetitions per session _ boosted the strength of their leg muscles by 174%. Almost half of the people who took part in the study said they were able to walk faster afterwards, while 20% of them no longer needed the assistance of a cane. And isn’t that what you’d want if you were to reach the grand old age of 90: to be able to retain a measure of mobility and independence?

For older people, nothing is more important than a healthy lifestyle because this will allow them to continue engaging in the activities they enjoy without having to rely too much on others for help. Apart from resistance exercises, another important practice is balance training; this minimises the risk of accidental falls which are a major cause of death among the elderly.

Good food, regular health check-ups, proper medication and a contented mind are also important, but the best medicine of all is the love and care of one’s family.

Taking care of elderly people is, in some ways, a bit like caring for a baby. They should be given the chance to do things for themselves and should call on us for assistance as little as possible. We can watch over them to guard against the possibility of accidents, but if they are allowed to do things on their own, they will be able to lead better and longer lives.

We are born, grow old, get sick and leave this world _ that is a fact of life. However, given lots of love and care, life can still be beautiful no matter what age one has reached. Love your parents as much as they loved you and cared for you when you were just a helpless little baby.

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.



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