A slide presentation on the care of the elderly population, the concept of frailty and the need for healthy ageing

1. CARE OF THE ELDERLY,
HEALTHY AGEING AND
FRAILTY IN THE ELDERLY
DR OGUZOR UNUNUMA
DEPARTMENT OF FAMILY MEDICINE
RIVERS STATE UNIVERSITY

2. LEARNING OBJECTIVES
1. Define the term elderly and different types of ageing
2. Describe the health characteristics of the elderly, including the geriatric
giants
3. Describe the concept of Frailty and its characteristics
4. Define and describe the concept of healthy ageing
5. The role of the Family Physicians in the Care of the Elderly

3. DEFINITION OF THE ELDERLY
• The United Nations (UN) defines the elderly as an individual aged
60years and above.
• The World Health Organisation (WHO) defines the elderly as
individuals aged 65 years and above.

4. Types of Ageing
• Normal Ageing: includes changes caused by the aging process as well as
the effects of disease or unhealthy lifestyle and environmental factors.
• Successful Ageing: is defined as changes due solely to the aging process
generally unaffected by disease, lifestyle or environmental factors
• Chronological Ageing: number of years spent
• Biological Ageing: physiological changes over the period.

6. Health Characteristics of the Elderly
• The elderly often present with:
Multiple morbidities
Atypical presentation of diseases
Multiple pathologies causing a particular disease
Prolonged hospital stay
Poor recovery from disease

7. Geriatric Giants(6Is)
1. Instability –Falls, Gait problems, CNS problems
2. Immobility—Arthritis
3. Iatrogenia—Polypharmacy, Adverse Drug Reaction
4.Intellectual Impairment---Cognitive impairment
5.Incontinence: Urinary, Fecal incontinence
6.Infection: UTIs, Pneumonia, Sepsis

8. Frailty in the Elderly
• Frailty in the elderly is a condition where older adults experience a
decline in physical and cognitive reserves, making them more
vulnerable to illness, falls, and other adverse health outcomes.
• It's a state of increased vulnerability that can significantly impact
an individual's ability to recover from illness, maintain
independence, and enjoy a good quality of life.

10. Key Characteristics of Frailty:
Multidimensional:
• Frailty involves a decline in multiple physiological systems, including muscle
mass and strength, energy levels, and cognitive function.
Increased Vulnerability:
• Frail individuals are more susceptible to falls, infections, and other health
issues, and they may have difficulty recovering from illnesses or surgery.
Reduced Physiological Reserve:
• Frailty is characterized by a decrease in the body's ability to cope with
stressors, leading to a diminished ability to maintain homeostasis.
Spectrum of Severity:
• Frailty exists on a spectrum, from mild to severe, and can be influenced by
various factors such as age, genetics, lifestyle, and chronic illnesses.

11. Causes of Frailty
Age-related changes:
• As people age, they naturally experience a decline in muscle mass,
bone density, and overall physiological reserve.
Chronic illnesses:
• Conditions like heart disease, diabetes, and arthritis can accelerate
the aging process and contribute to frailty.
Lifestyle factors:
• Sedentary lifestyles, poor nutrition, and inadequate social support
can all contribute to frailty.

12. Consequences of Frailty
Increased risk of falls and fractures:
• Frail individuals are more prone to falls, which can lead to serious injuries like hip
fractures.
Hospitalization and longer stays:
• Frailty increases the likelihood of hospital admissions and longer recovery times.
Disability and dependence:
• Frailty can lead to functional decline and increased dependence on others for daily
tasks.
Mortality:
• Frailty is associated with an increased risk of death, particularly in the presence of
other illnesses

13. Signs of Ageing in the Elderly
Skin:
• Skin becomes thinner, drier, and more
prone to wrinkles, age spots, and bruising.
Muscles and Bones:
• Loss of muscle mass and bone density can
lead to decreased strength and mobility.
Cardiovascular System:
• Increased risk of heart disease and high
blood pressure.
Hearing and Vision:
• Hearing loss and vision changes, such as
difficulty seeing in low light, become more
common.
Sleep:
• Sleep patterns may change, with some
individuals experiencing more difficulty
falling asleep or staying asleep.
Metabolism:
• Metabolism slows down, potentially
leading to weight gain if dietary and
exercise habits are not adjusted.
Memory:
• Some individuals may experience
changes in memory access and recall

14. Healthy Ageing
• To age healthily, older adults should focus on maintaining physical
activity, eating a balanced diet, staying socially connected,
managing stress, and engaging their minds.
• Regular health checkups and preventative screenings are also
crucial for early detection and management of any potential
health issues.

15. HEALTHY AGEING
Physical Activity
Stay active:
• Incorporate regular physical activity into your daily routine. Walking,
swimming, or other enjoyable activities can improve cardiovascular health
and maintain a healthy weight.
Focus on strength and balance:
• Include exercises like weight training and balance exercises (yoga, tai chi) to
maintain muscle mass, bone density, and prevent falls.
Move more:
• Make physical movement a part of your everyday life, such as gardening or
dancing

16. Nutrition
Eat a healthy diet:
• Choose plenty of fruits, vegetables, whole grains, and lean protein.
Limit processed foods and salt:
• Reduce consumption of packaged and processed foods, as well as
foods high in saturated fats and sodium.
Stay hydrated:
• Drink plenty of water to flush out toxins and support overall health.

17. Mental Well being
Keep your mind active:
• Engage in activities that stimulate your brain, like puzzles, reading, or learning new
skills.
Reduce stress:
• Practice stress management techniques like meditation or yoga.
Maintain social connections:
• Stay connected with friends and family, participate in social activities, and avoid
loneliness.
Prioritize sleep:
• Aim for 7-9 hours of quality sleep each night.

18. Health Maintanance
• Regular checkups: Schedule routine medical checkups and
screenings.
• Prevent falls and injuries: Ensure your home is safe and free of
hazards.
• Manage chronic conditions: If you have any chronic conditions,
work with your doctor to manage them effectively.

19. Other Tips
• Quit smoking: If you smoke, seek help to quit, as it significantly
impacts your health.
• Limit alcohol: If you drink, do so in moderation or abstain
completely.
• Embrace ageing: View ageing as a natural process and focus on
living each stage to the fullest.

20. Care of the Elderly
• Care of the elderly encompasses a wide range of services and
support aimed at promoting the well-being and independence of
older adults.
• This includes personal care, medical care, emotional support, and
creating a safe and supportive environment, both at home and in
specialized facilities.

21. Key aspects of elderly care
• Personal Care: Assisting with daily activities like bathing, dressing, and
meal preparation.
• Medical Care: Managing medications, monitoring health conditions, and
coordinating with healthcare providers.
• Emotional Support: Providing companionship, engaging in meaningful
activities, and ensuring they feel valued and supported.
• Home Safety: Making necessary modifications to the home environment,
such as installing grab bars, improving lighting, and removing hazards.

22. • Meal Preparation: Ensuring proper nutrition and healthy food choices.
• Social Interaction: Encouraging social activities and maintaining
connections with family and friends.
• Financial and Legal Matters: Helping with paperwork, managing finances,
and ensuring legal documents are up-to-date.
• Respite Care: Providing temporary relief for family caregivers.
• End-of-Life Care: Addressing the specific needs of individuals nearing the
end of life.

23. Types of elderly care:
• In-home care: Caregivers provide support and assistance in the individual's own home.
• Adult day care: Offers social interaction and daytime care in a structured environment.
• Assisted living facilities: Provide housing and support services, often for those who
need help with daily tasks.
• Nursing homes: Offer 24-hour care and medical supervision for individuals with
complex needs.
• Geriatric care managers: Provide specialized support and coordination of care for older
adults with complex needs

24. Principles of elderly care
Respect and Dignity:
• Treating older adults with respect and maintaining their dignity is paramount.
• Independence and Autonomy:
• Supporting older adults in maintaining their independence and making their own
decisions.
Holistic Care:
• Addressing physical, emotional, social, and spiritual needs.
Personalized Care:
• Tailoring care plans to meet the unique needs and preferences of each individual.
• Family Involvement:
• Recognizing the vital role of family members in providing care and support.

25. Role of the Family Physician
• Family physicians play a vital role in the care of the elderly by
providing comprehensive, ongoing, and coordinated care.
• They focus on preventative care, managing chronic conditions,
and promoting healthy aging.
• They also play a crucial role in coordinating care with other
specialists and ensuring the elderly can maintain their
independence and quality of life.

26. 1. Preventive Care and Health promotion
• Lifestyle counselling
• Fall prevention
• Screening for common age-related conditions like cardiovascular
disease and cognitive decline
2. Chronic disease Management
• Comprehensive Assesment
• Medication management
• Coordination of care

27. 3. Maintaining Independence and Quality of Life
• Home visits and community involvement
• Advanced care planning
• Promoting social engagement
4. Strengthening the Healthcare System
• Coordinating care among the various specialists
• Advocacy

28. Conclusion
• The elderly are a unique set of beings.
• Listen to their needs and preferences: Ensure they feel heard and
respected.
• Create a safe and comfortable environment: Make necessary home
modifications and provide a calming atmosphere.
• Maintain a healthy lifestyle: Encourage regular exercise, proper nutrition,
and social engagement.
• Encourage them to stay connected with family and friends: Combat
loneliness and isolation.
• Advise them to seek professional help when needed: Utilise resources like
geriatric care managers, home care agencies, and adult day care centres.
• All these will enhance their quality of life and overall well being.

30. References
• 1. Oxford Handbook of Geriatrics (1):40-41,52-53
• 2. Li C, Lin C, Lin W. Successful ageing defined by health-related quality of life
and its determinants in community-dwelling elders. BMC Pub Health.
2014:14:1013. DOI.10.1186114712458-14-1013.
• Linda PF, Catherine MT, Jeremy W. Frailty in Older Adults: Evidence of a
Yenagoa Medical Journal, Vol. 2 No. 1, Jan 2020 153 Yen Med J. Vol. 2 No.1
January 2020 Phenotype. J Gerontol. 2000:56(3):M146M146.
• World Health Organisation. What is Healthy Ageing? Available from
https://www.who.int/ageing/healthyageing/en/. Accessed November 4, 2019.