Treating complexity in the older adult - the role of the geriatric giants

As people age, they accumulate medical conditions. Geriatric giants comprise a group of conditions that lead to significant mortality and morbidity and contribute to the complexity in treating geriatric patients. They are common and rarely occur in isolation. The 5 Is of geriatric giants are: iatrogenesis, immobility, instability, incontinence and impaired cognition. Consequences for the patient and their caregivers include loss of functional independence, institutionalisation and caregiver burnout. Primary care practitioners are often the first port of call for geriatric patients in South Africa and by asking a few key questions and performing a thorough examination; these conditions can be recognised early. Whilst there are often limitations to cure, the main aim is to maintain the older adult's functional independence as much as possible, and by following an organised management approach to each of these conditions, the quality of life of patients can be improved

Challenges Faced by Older Women in Botswana in Accessing Services that Address Sexual and Reproductive Health; and Family Planning Needs; in Botswana

Objective: This study explored the challenges that older women from selected sites in Botswana face in accessing services that address sexual and reproductive health (SRH) and family planning (FP) needs. Design; setting and subjects: Two rural and two urban health districts were randomly selected for the study. A statistically determined sample of 454 older women was allocated to the different districts (strata); using probability proportional to size. Outcome measures: The study estimated the percentage use of sexual and reproductive health services (including family planning services); unmet need for family planning and factors inhibiting use of these services. Results: The study revealed that 25 of the older women used some type of FP method. Of this number; 67.9 were aged 50-59 years; 17.4 60-69 years; 10.1 70-79 years; and 72 had unmet needs for FP. The older women used natural FP methods mainly. The main SRH services used by them were screening for human immunodeficiency virus/acquired immune deficiency syndrome; sexually transmitted infections and cervical cancer. Obstacles to accessing SRH and FP services were found to include illiteracy; lack of education; financial constraints; a perception that healthcare planners limited SRH needs to antenatal and obstetrical services; a cultural reluctance to discuss SRH in public and domestic issues.Conclusion: The study recommends comprehensive public health education for older women on human sexuality and fertility; contraceptive use; access to services; effective training programmes for healthcare providers on how to deal with older women's issues and better access to STI and cervical cancer screening services

Assessment of Oral Health Problems among the Elderly Populace of Ikibiri Community; Yenagoa Local Government Area of Bayelsa State and Possible Solutions

Background: This research work was aimed at assessing the oral health problems of the elderly populace of Ikibiri community; Bayelsa State as well as determining possible solutions to these problems.Method: A descriptive study design was carried out on 100 respondents comprising of elderly individuals of Ikibiri community; Yenagoa Local Government Area of Bayelsa State between the ages of 60 - 110 years. Interviewer - based questionnaires assessing the presence of specific oral health problems as well as delivery of oral health services were used as our instrument for data collection.Results: Bleeding gums (52); toothache (44); and oral sores (42) were found to be the major oral health problems being experienced by the population under study and these were mostly attributed to the absence of a dentist (95); absence of a dental clinic (94) as well as the absence of oral health education to the community (87).Conclusion: Oral health problems are undoubtedly present among the elderly individuals of Ikibiri community; Yenagoa LGA; Bayelsa State which was attributed to the absence of dental personnel; dental facilities and oral health education. It was however recommended that Ikibiri community be provided with dental personnel and facilities as well as the provision of oral health education to the entire populace of Ikibiri; which would indeed reduce the burden of oral health problems among the elderly in this community

Attitude of nurses towards the care of elderly patients in selected health centres in Ilorin Metropolis, Kwara State, Nigeria

Ageing is one of the national phenomena common to all races globally. Elderly individuals are always seen as giving increased burden on families and societies because most of them are incapable of performing their activities of daily living independently. This study investigates the attitude of nurses towards the care of the elderly patients either at home and work environments and especially in a selected health centres in Ilorin Metropolis; Kwara State; Nigeria. Sixty nurses were conveniently sampled for the study and the result showed differences in the nurses' attitudes in the care of the elderly; these differences were premised on their knowledge; gender; religion; age and experience in the profession. It is therefore recommended that there is an urgent need for Nursing and Midwifery Council of Nigeria to introduce and design a curriculum for Gerontological nursing as a specialty course in Nursing Education to better the knowledge and care of the aged by the nurses

Morbidity pattern amongst elderly patients presenting at a primary care clinic in Nigeria

Background: The elderly comprise the fastest-expanding age group globally, with the greatest increase occurring in developing countries. Disease and deteriorating health are implicitly assumed to be associated with ageing, as chronic medical illnesses mostly present with increasing age. Objectives: To describe the morbidity pattern of elderly patients presenting at the General Outpatients Clinic of the University College Hospital, Ibadan, Nigeria. Method: This was a cross-sectional descriptive study of 500 elderly respondents who presented at the clinic between September 2004 and April 2005. They were interviewed according to the format of the electronic, second revision of the International Classification of Primary Care (ICPC-2-E) questionnaire. Main outcome measurements were the prevalence of various morbidities, self-reported health status and socio-demographic characteristics. Body mass index (BMI) was used to assess respondents' nutritional status. Results: Respondents were found to under-report their actual health problems. The mean ± s.d of self-reported health problems was 1.7 ± 0.9 (range 1­6), while the mean ± s.d of diagnosed morbidities was 2.7 ± 1.4 (range 1­8). The most prevalent morbidities were hypertension (40.0%), cataracts (39.4%) and osteoarthritis (26.8%). The prevalence of anaemia was 8.0%(females = 11.2%; males = 2.6%), and it was significantly associated with gender (p = 0.001). Nutritional status indicated a high prevalence of overweight and obesity (51.8%), which was significantly higher amongst the female respondents than the males (p = 0.001). Conclusion: The prevalence of chronic medical illnesses was high amongst the elderly in this setting. In addition, the elderly under-reported their actual health problems. The high prevalence of overweight and obesity amongst the elderly in this setting calls for public health action that advocates lifestyle changes to manage the health of the elderly