Elderly care

What is it about ?

Care specifically intended for the elderly is grouped together under the specialty called “geriatrics”. The term “geriatrics” comes from the Greek “geron” (old) and “iatros” (doctor).

Many older people suffer from different illnesses at the same time. These are often ailments from which they will no longer heal. The most common underlying conditions are memory impairment, cardiovascular disease, diabetes, recent hip fracture and / or psychiatric condition.

Geriatric care in a team, which takes into account all the ailments present, can prolong the life of seniors and their maintenance at home, sometimes interspersed with short stays in hospital.

What can you do ?

It is important to keep three things in mind:

• each patient, including senior, must know their rights as a patient and actively participate in their medical journey. This is called the ” patient empowerment “;
• if the older person so wishes, the future should be considered in the context of “advance care planning”. Information available on the website http://www.soinspalliatifs.be can serve as a common thread;
• finally, it is essential that the senior remains as active as possible in his daily life. This is called the ” reconditioning “.

Patient empowerment is a fundamental right of all patients, and therefore also of the elderly. Each patient can decide for himself on his treatment, including during the last years of his life. But sometimes the elderly are no longer able to clearly express what they want. In this case, the spouse, companion or another member of the family can intervene.

If the elderly person is still able to make their own decisions (in other words, they are able to express their will), they can be assisted by a ” trusted person (Most often a close relative). On the other hand, if she is no longer able to make her own decisions (in other words, she is unable to express her will), she can anticipate – verbally or in writing – a ” representing »(Most often a loved one), who will make the decisions for him. This representative is responsible for protecting the elderly person against any abuse by those around him with regard to financial affairs and for making decisions relating to his treatment.

If the elderly person becomes incapable of expressing their wishes without having appointed a representative in advance, the justice of the peace will do so for them by appointing an administrator of property.

One of the major goals that older people should pursue is to continue to eat well and stay active for as long as possible.

Regular consultation with all care providers is essential to organize care in an optimal way, determine who does what, define what the elderly person (still) wants and assess the arrangements to be made in the home, for example to avoid falls.

What can your doctor do?

The care providers involved will establish an individual care plan in collaboration with the elderly person. This care plan takes into account the wishes of the elderly person and the conditions from which they suffer.

The wishes of the person can often have practical consequences, which will be discussed with him and, if necessary, with his representative. Healthcare providers always make their decisions in the best interests of the patient.

In addition, the general practitioner or the geriatrician will also look at the prognosis of the diseases from which the elderly person suffers, their life expectancy and the resulting decisions. For example, it may be necessary to decide in which cases the elderly person will no longer be operated on, hospitalized, resuscitated, etc. These decisions can always be reviewed if the medical outlook improves significantly or if the elderly person so desires. All decisions are taken with all the necessary precautions and noted in the care record.

The elderly not only have the right to know (to be informed), they also have the right not to know. In addition, it is sometimes difficult to discuss topics concerning the health of an elderly person when the latter suffers from memory problems.

If the ailments from which the elderly person seems to be able to be stabilized or treated, the general practitioner or geriatrician will do everything possible to achieve this.

Health care providers will also examine the senior’s nutritional status and medications very closely. This is because older people react differently to medications and more easily develop side effects. Sometimes certain drugs are no longer useful, and others can even be dangerous (sleeping pills, for example).

If the elderly person has an incurable disease, the general practitioner or geriatrician will take the necessary steps to start palliative care.

Sources

• Foreign clinical practice guide ‘Specific issues in long-term care of the elderly in geriatric centers’ (2010), updated on 04.08.2017 and adapted to the Belgian context on 03.01.2018 – ebpracticenet

• https://kce.fgov.be/fr/position-paper-orporation-des-soins-pour-les-malades-chroniques-en-belgique
• Ellis G, Whitehead MA, Robinson D, et al. Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomized controlled trials. BMJ 2011; 343: d6553