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Working with COVID-19-affected older adults: The challenges

Working with older people is a rewarding experience.

Working with COVID-19-affected older adults: The challenges
źródło: Dailyhealthstudy

Working with older people is a rewarding experience. Geriatric medicine is, almost unsurprisingly, more diverse than any other medical specialty. Acute physicians are experts in the management of chronic diseases, rehabilitation, co-morbid mental disorders, decision-making, transitions, and end-of life care. We collaborate with families, cross-sector and in multi-professional groups. We observe how older people cope with life, and how they die. This is how COVID-19 can be viewed.

Initial reports emphasized pyrexia, cough and other symptoms. The reality quickly became clear that older adults could present in unusual or non-specific ways. Delusions, fatigue, falls and anorexia can all be caused by dehydration, diarrhoea or diarrhoea. These presentations were not often included in published case series but were quickly recognized by geriatricians who are used to complex cases. It is difficult to comprehend the wide range of severity and time courses, from mild and asymptomatic cases to severe and life-threatening cases, hypoxia, delirium, and death. This is in addition to the ubiquity and relative youth of many of the patients we see, as well as the influence and mimicry of co-morbidity. We are still not able to consider the needs and ways we can help those in recovery.

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Although a more or less unified health system has been a strength in terms of coordination and re-direction, it has also caused controversy. The system has a history of relentless efficiency, elimination of slack, and an utilitarian ethic. Many agree that chronological age is not acceptable as a basis of treatment decisions. A measure of frailty, which is a measure of how old someone is, is more useful than age per se. We would expect COVID-19 related problems to be more severe for people who are frail. The Clinical Frailty Scale and other tools have been stretched to their limits. It is a disability scale that describes functional levels, which can relate to frailty but not the same thing. It is controversial to apply it to intellectually or physically disabled persons younger than 65. The CFS and the hastily-concocted ITU eligibility score based on it have not been proven to be accurate in predicting ITU outcomes. We must also protect vulnerable individuals from unwanted interventions that have little to no benefit. This means we must use limited resources to ensure maximum health gains and equitability. Palliative medicine is a practice that avoids 'treatment burden'. However, it is important to recognize that different treatments have different costs. Our professional judgment and broad-based training are key to avoiding abuse of these tools.

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Many aspects of our daily practice are being challenged. I was part of an inter-professional communication skills program for people with dementia called VOICE. It took place a few years back. Our actors were patient simulators who had experience. They commented on how much they were touched by trainees when we debriefed them. This is a very natural observation, but it was almost subconscious. It is also becoming clear how dependent we are as older people on our ability to see our faces and move our lips when communicating. This is impossible when we wear masks. This is all swept aside and presents new challenges.

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Geriatricians have always believed in family inclusion, particularly when caring for people with dementia and delirium. It is obvious that 'lockdown" must be taken seriously during a pandemic. However, it has been especially difficult for elderly people and those who are dying. Many people have accepted video-calling and telephone conversations as an acceptable alternative.

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For women's health, tips for heart, mind, and body - https://www.mpolska24.pl/blog/for-womens-health-tips-for-heart-mind-and-body



If you want to avoid problems such as strokes and heart disease, there is an easy way.


Get more fruits and vegetables.

Whole grains are better than refined ones. Brown rice is better than white. Switch to whole-wheat pasta

Consider lean proteins such as poultry, fish and beans.

Reduce your intake of processed foods, sugar, salt, saturated fat, and other unhealthy food.

Flexibility is key to eating well, according to Joyce Meng, MD assistant professor at UConn Health's Pat and Jim Calhoun Cardiology Center. You can follow a strict diet plan if you prefer. It's okay if you don't like following a strict diet plan.


Tricia Montgomery (52), founder of K9 Fit Club knows firsthand the benefits of a healthy diet and lifestyle. Her favorite things are eating healthy food and making small, frequent meals. She says, "I don’t deny myself anything." "I still enjoy dessert, key lime pie, yum!" -- I love frozen gummy bears and moderation is the key.


Get regular checkups. Your doctor will keep track of your medical history so that you can stay healthy. If you are at high risk of osteoporosis (a condition that weakens bones), your doctor may recommend more vitamin D and calcium.


You may be recommended by your doctor to have screening tests done to monitor your health and detect conditions before they become serious.


Be open to communication. Meng said, "If you have any questions, ask your doctor." "Ensure you are satisfied with the information." Talk to your doctor if you have concerns about any medication or procedure.


Reduce Stress

It can be very detrimental to your health. It is impossible to avoid it all, but there are ways you can reduce the effects. Do not take on too many responsibilities. Set limits for yourself and others. It is okay to say no.


To relieve stress, try:


Deep breathing

Meditation

Yoga

Massage

Exercise

Healthy eating

Talking to a friend or family member.

Develop healthy habits

You can prevent problems from coming your way tomorrow if you make the right decisions today.


Brush your teeth twice daily and floss each day.

Don't smoke.

Limit your alcohol. Limit your alcohol intake to 1 drink per day.

Take your medication exactly as prescribed by your doctor.

Get better sleep. Try to sleep for at least 8 hours. Talk to your doctor if you are having trouble sleeping.

Keep out of direct sunlight between 10 a.m. and 3 p.m.

Wear your seatbelt.

Meng suggests that you take time each day to invest in your own health.


Montgomery was able to see the benefits. Montgomery says that she has overcome health issues, is happy, and has a positive outlook. She says that her life has been forever transformed.

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