MedSoc Day 4: 9/11/2017
Reflective Writing:
Day Four at the Limehouse Practice was inevitably one of the best Medicine in Society Days so far! I have learnt many things which made me see the world from a different perspective; and this is what Medicine in Society has mostly taught me, that a doctor must empathize with his/her patients and put himself/herself in their shoes.
When I met an elderly carer at the Practice, I was moved by her speech, since she was telling us the problems of the ageing population. I was shocked to find out that the most common problem of elderly people is isolation. It is, in fact, very interesting to observe how physical health can interfere with mental health and vice versa. Comparing what I have learnt from her, with my home visit later on in the day, made me realise that those problems do really exist.
The experience I had with the elderly couple I visited was definitely something I will never forget! It was the first time I met someone suffering from vascular dementia, which made me search about this when I came home. What I have found, explained the reasons why he wasn’t able to speak and understand what was being said to him. I admired his wife as she has made him her first priority and tries to take care of him as much as she can.
Visiting the Somali Gardens made me realise that if there were more nursing homes of this type, the elderly people in the UK would be living better, as they are offered daily fitness courses, physiotherapy sessions and psychological support. The quality of their lives would be upgraded. Once again, this experience showed me that when I become a doctor, I will have the responsibility to direct people in need to such nursing homes!
Generally, day four at the Practice was an all-in-one day, as I came across with many inspiring personalities! I am so looking forward to the next days here at the GP Practice.
Recognise ageing as a natural, developmental process
Ageing is a gradual, continuous process of natural change that begins in early adulthood. During early middle age, many bodily functions begin to gradually decline. For example, as people age, the lens of the eye thickens, stiffens, and becomes less able to focus on close objects, such as reading materials (a disorder called presbyopia).
Describe different ways that the elderly are regarded within different groups and communities:
As both the proportion of older people and the length of life increase throughout the world, key questions arise. Will ageing population be accompanied by a longer period of good health, a sustained sense of well-being and extended periods of social engagement and productivity, or will it be associated with more illness, disability, and dependency?
Ageing is taking place alongside other broad social trends that will affect the lives of older people. Demographic and family changes mean there will be fewer older people with families to care for them. People today have fewer children, are less likely to be married, and are less likely to live with older generations. With declining support from families, society will need better information and tools to ensure the well-being of the world’s growing number of older citizens.
Describe the range of services, people and agencies that are involved in the support of the older patient in the local community:
A GP Practice aims to provide the best care to the elderly. Nursing homes, such as the Somali Gardens, ensure that elderly people get social interactions with other elderly people. Also, there are physical activities for them so that they maintain and develop their physical state.
Several societies, such as the Alzheimer’s Society, ensure that people suffering from several conditions are fully informed and know how to live with their conditions.
Social Prescribers can also help the older patient by providing psychological support.
Demonstrate appropriate communication with an older patient (with suitable empathy, respect and interest):
It is important to remember that elderly people were once young themselves, and the difficulties that they may now experience during communication were not always there. This can sometimes lead to frustration for an older person if they suddenly encounter more difficulty in their communications than they had in the past.
Empathy is essential when dealing with older patients since they may think that they are alone and no one understands them and cares about them. Hence, by being empathetic you can build trust between you and the older patient.
Respect is vital since all of them carry their memories and experiences. Respect is essential when they talk so as to make them understand you are listening to their problems.
You must show interest in what they say and allow time for them to say what they want.
Extra time must be allowed in the conversation since the older patient may speak slower than younger patients, or they may demand more information from you.
Also, you must not give them the perception that you act in any way due to their age; showing no discrimination due to their age.
Be aware that elderly people may have hearing or visual impairment. Patience is the key to allow them to understand everything in their own way.
Explain some of the implications for the health and social services of an ageing population:
There are certain health conditions that are expected to be a challenge to our health care system with the increasing ageing population. These conditions include cancer, dementia, obesity and diabetes. As life expectancy increases, there is more stress imposed on the health services; rising demand in primary healthcare, as well as in secondary and emergency healthcare; although, people aged under 65 are the most common to visit A&E departments, elderly patients often present with more complex problems and comorbidities that require further investigation, hence more time is required for their management. This, in turn, increases the waiting time for patients in the A&E.
The future need for long-term care services is also an implication.
The fact that pneumonia is one of the most common health conditions of older patients, more vaccines are needed for the elderly people; hence, more stress applied to the scarce resources available.
As there is lack of young carers, there is an increasing pressure on existing carers. Carers are now of older age and may also need care. There is definitely a need for more care homes to accommodate the elderly people and provide social care, however, there is lack of social care workforce. The home care service is under stress and carers might have many patients to deal with and hence be late to their appointments.
Identify key policy documents relating to care of older people:
• Having a clear vision: promoting awareness and changing attitudes
Example: downsizing to well designed 'care ready' homes; releasing family homes back to the market; achieving efficiencies in delivering personal home care in developments for older people.
• Planning for an ageing population
Using a mixture of demographic data, planning tools, local need plans, engaging with developers and older people and co-production
• Delivering and enabling new housing for older people across the public and private sectors
Disposing of public sector land provides an opportunity to allocate sites for older people's housing; encouraging and supporting private sector retirement housing development.
• Promoting and integrated approach to housing, care and health
Supporting older people to return to their homes after hospital care including practical assistance to reduce the likelihood of falls.
• Sustaining older people in mainstream housing
Commissioning and providing home improvement agency type services across council boundaries offers scope for economies of scale that can support and foster innovation in improving existing housing.