Design of a typical residence for the elderly in Morocco

The population of Moroccan elders is in full increase; their requirements for quality and quantity of services are becoming increasingly important. On the basis of this, reality and extension of many major innovative projects in Morocco (industrial expansion plan, renewable energy stations, the road infrastructure network, rural electrification, drinking water, accelerated urbanization, globalization...) gain importance. Reflection on the design of a typical residence for the elderly has become an ambitious idea possessing all the chances of its success; it is also worth noting that it is a citizen opportunity to be seized by all political decision-makers for the promotion of health and the improvement of the quality of life of a growing category of the population. The typical residence of the elderly remains not only a place of life but also an environment of therapeutic care and at different levels of autonomy and dependence of our elders

A four-year review of geriatric mental health services in a Lagos based hospital, Nigeria

Background: There is a growing global concern about the public health implications of the increasing population of the elderly. One main issue of concern is centered on how to address their mental health needs using home-grown interventions and services. We expect that important lessons on geriatric mental health issues would be brought to fore in this report.Methods: This is a four-year (2007-2011) retrospective report on the mental health services rendered to 938 clients aged 60 years and above at a Lagos based mental health treatment facility in Nigeria. Designed questionnaires were filled with socio-demographic and clinical data obtained from patients' case notes based on the objectives of the study.Results: The mean (standard deviation) age of elders was 69.6 (±7.93) years, and 65.5% were females. Majority were married, self-employed and belonged to low socio-economic status (73.1%, 63.1% and 63.2%, respectively). Close to two-thirds (62.4%) commute for at least one hour to get treatment. The commonest diagnosis was psychotic disorders (34.8%), while 5.5% had Alzheimer's dementia. Some 96.5% of the elders were solely on medications. About a quarter had past history of mental illness and 48.5% reported co-morbid medical conditions, with cardiovascular problems (53.0%) being the commonest physical comorbidity. The middle old along with very old elders (aged ≥70years), and those with at least tertiary education, were more likely to present with dementia. Elders with dementia were more likely to present with index episode of mental illness and receive outpatient care.Conclusion: The elders were managed for a wide range of treatable mental illnesses and other comorbidities and commute for hours to access care. Pharmacotherapy was the preponderant sole treatment modality. There is need for sustained development of expertise to enhance multimodal care and scaling up of comprehensive geriatric mental health services. Further research is needed on how to appropriately link and/or integrate geriatric care with services at all-tiers of health care delivery

Geriatric Injuries among Patients Attending a Regional Hospital in Shinyanga Tanzania

Abstract:Geriatric injuries pose a major challenge to surgeons and general practitioners in developing countries. The objective of this study was to determine the prevalence; injury characteristics and outcomes of geriatric injury among patients at Shinyanga Regional Hospital in Tanzania. Data was collected using a pre-tested; coded questionnaire and analyzed using SPSS computer system. A total of 94 geriatric trauma patients constituting 22.7 of all trauma admissions were studied. The male to female ratio was 1.4:1. Their mean age was 68.5 years (ranged 60-98 years). Premorbid illness was reported in 38.3 of patients. Most injuries were intentional in fifty-three (56.4) patients. Assaults; falls and road traffic crashes were the mechanism of injuries in 52.1; 19.1and 11.7 of cases; respectively. The majority of cases of assault were females accounting for 64.6. The majority of injuries (81.9) occurred at home. Pre-hospital care was recorded in 5.3 of cases. The musculoskeletal (72.3) and head (66.0) regions were commonly affected. Soft tissue injuries (wounds) (89.4) and fractures (52.2) were the most common type of injuries. The majority of patients (90.4) underwent surgical treatment of which wound debridement was the most common procedure performed in 91.8 of cases. Complication rate was 39.4. The mean length of hospital stay was 28.6 days (ranged 1 - 124 days). The length of hospital stay was significantly longer in patients with co-morbidities; long bone fractures and those with complications (P0.05). Mortality rate was 14.9 and it was significantly related to advanced age; presence of pre-morbid illness; high injury severity score; severe head injuries and the need for ventilatory support (P 0.05). In conclusion; traumatic injuries in elderly constitute a major but preventable public health problem in Shinyanga region and contribute significantly to high morbidity and mortality. Urgent preventive measures focusing at the root causes of the injuries and early appropriate treatment is highly needed to reduce the occurrence; morbidity and mortality associated with these injuries

Continuing education in geriatrics for rural health care providers in Uganda: A needs assessment

Population trends in developing countries show an increasing population of older adults (OAs), especially in rural areas. The purpose of this study was to explore the geriatrics continuing education needs of health care providers (HCPs) working in rural Uganda. The study employed a descriptive design to collect data from HCPs working in Apac district, a rural district in northern Uganda. The 240 HCPs (mean age 33.8±10.5 years) from whom data were collected were nurses (52%), physician assistants (17%), social workers (12%), laboratory technologists (10%) and physicians (10%). Self-administered questionnaires composed of the Palmore's Facts on Aging Quiz (FAQ1) and Kogan's attitude towards old people (KAOP) scale were used for data collection. Results. Most HCPs (63%) regularly cared for OAs but their professional education did not include geriatric-specific courses (69%). The majority of HCPs had a poor or fair geriatric knowledge (88%) (FAQ1 mean score 11.6±2.3), but had a positive attitude towards OAs (80%) (KOAP mean score 115.9±11.5). Positive attitude was associated with personal experiences with OAs and a desire for a future career in geriatrics (p≤0.05). Conclusion. In Uganda training curricula for health professionals have not evolved to address the changing demographic trends showing increasing numbers of OAs. Consequently, there is a significant knowledge gap in certain aspects of health care, such as geriatrics, among currently practising HCPs. There is need for tailored geriatrics continuing education programmes to bridge the knowledge and skill gaps to ensure quality health care for OAs

Profile of the Geriatric Patients Hospitalised at Universitas Hospital; South Africa

Background: The elderly population in Africa is unevenly distributed across the continent; with the highest percentage of elderly living in the Southern African region. In 1996; the elderly population of South Africa (65 years and older) was roughly 6.7; and was calculated to be 10.4 by 2025. If the latter expectation is anywhere near realistic; it stands to reason that the Department of Health should make timely provision for the care of these future patients; as the prevailing disease patterns within a population change as that population ages. Thus; there is an urgent need for profiles of elderly patients in order for adequate training to be implemented and for beds and equipment to be ready when needed.Methods: A retrospective study was undertaken of all data available from a clinical audit done at Universitas Hospital's Geriatric Unit. All patients aged 65 years and older who were admitted by Internal Medicine's Geriatric Unit over four years were analysed in order to compile a profile of geriatric patients hospitalised at Universitas Hospital.Results: The study group consisted of 791 elderly patients. Their average age was 81 years (range: 65 to 101 years of age) and they were hospitalised for an average of 11 days; with an average use of five medications per patient. Women represented 66 of the patients and the mortality rate was 17 in the total study group. The main admitting clinical problems were hypertension; heart failure; ischemic heart disease and anaemia. Most of the patients did not smoke or use alcohol. Out of a group of 523(due to the fact that it was a retrospective study; data for this criteria were only available for 523 of the 791 patients); 235 (45) were self-supporting and 32 were known to use living aids. The majority of the patients were single and an equal amount were living in old age homes and with their families. The main special examinations used in their treatment were chest X-rays; nuclear examinations of the liver; ECG; heart sonar and CT of the brain; and gastroscopies. Almost all of the patients had undergone full blood count analysis and U+E determinations; and in more than 50 of cases; creatine; albumin and glucose measurements were taken.Conclusion: For successful geriatric care at Universitas Hospital there will be a need for at least 11 days hospitalisation; and a unit with good training in internal medicine; psychiatry; urology; orthopaedy and oncology. The main supporting services will be physiotherapy; occupational therapy and social welfare. Laboratory analyses will include full blood count; urea and electrolyte measurements; urine examination; and creatine and glucose measurements. Special investigations will mainly be radiology and cardiology sonar examination. How well we care for elderly patients in the future will be an indicator of the quality of our healthcare system in general. We need to redesign our social insurance and welfare systems to fit the realities of our current situation