People who read my blogs will know that I try to bring an international perspective to what is happening in the world of social care. in India changes are afoot with a recognition of the increasing value of social care.
Unlike in the West, where geriatrics is a well-recognised speciality, the Indian health sector has just begun to realise its value. Of late, the number of older persons homes, day-care centres for elders, and home-care service agencies is increasing. But observers note that either they are urban-based and expensive or poorly run by ill-equipped NGOs. More importantly, they are focused on home care provided by nurses and paramedical staff who are not formally trained in care of the elderly. The need is for qualified medical professionals who are specially trained in geriatrics.
Moving away traditional disease-oriented approach
Geriatric care extends beyond the traditional disease-oriented approach to include the cognitive, functional and social well-being of the elderly. Their importance lies in their association with the common problems faced by the elderly, such as falls, fractures, depression and delirium. Though these problems are often attributed to ageing and overlooked by care-givers, they can be corrected when recognised early.
Prevention of falls
Nearly 30–40 per cent of community dwelling people aged above 65 fall each year. The frequency of falls increases with increasing age and frailty. Though most falls are trivial, 10 per cent can result in serious injuries — bone fractures and head injuries. Even where there is no bodily harm, the psychological impact can be significant, leading to “fear of falling “. This fear may lead a person to cut down on his or her everyday activities, resulting in muscle weakness, which increases the risk of falling. However, this vicious cycle can be broken with planning and preventive steps.
Reduction in falls as a result of home safety measures
In a meta-analysis of six studies, conducted by Dunedin School of Medicine, New Zealand, home safety assessment and interventions decreased the rate and risk for individuals at a higher risk of falls. In a subsequent trial, a standardised set of home safety measures resulted in a 26 per cent decline in injuries caused by falls over a three-year period.
Stanford Medicine researchers spotlight approaches to late-life care that include peer support, occupational therapy, home repairs and telephone conversations about healthcare goals — services that fall outside the traditional definition of medical care.
Social isolation can lead to cognitive and physical decline
When they started their research, the team noted the increased risk of social isolation for older adults and how it often leads to cognitive and physical decline. They identified a pilot programme by Age Well Global that employed well-functioning older adults to visit chronically ill peers after hospitalisations, offer companionship and screen them for needed services. That programme reduced 30-day readmission rates by 25 per cent.
Technology is leading to improvement in care of elderly
Advances in technologies are disrupting the healthcare sector, especially post the pandemic.
Internet of Medical things (IMoT), telemedicine platforms, GPS services, wearable devices, CCTV, mobile apps and virtual assistants are helping to improve elder care. In the area of falls prevention, Safely You is a technology that uses wall-mounted cameras enabled with artificial intelligence (AI) to evaluate resident falls in long-term care. Similarly, a pilot programme in the UK marks a success story in home setting.
Elderly adults, under this programme, were given wearable devices to detect early signs of frailty. These included factors that are not easily visible like low grip strength, hydration levels and muscle mass. These devices deployed Microsoft machine learning tools to raise warning flags a month prior to a potential incident.
While the growing number of senior citizens in India is a testimony to the advances in healthcare that the country has achieved, it also poses a challenge to society. As the number of elders increases, falls and injuries too will increase correspondingly.
A global study reveals that falls account for 40 per cent of all injury-related deaths. Therefore, fall prevention has to be addressed by all stakeholders.
If lessons are to be learned from the studies cited in this blog, health and social care agencies in the UK will need to adapt a more proactive and preventative approach to the prevention of falls.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy