As our parents and loved ones get older, they inevitably start to develop challenges in their physical and mental health. The extent to which each individual parent manifests these challenges varies enormously!
Some are fortunate enough to experience relatively mild challenges and as a matter of fact, I know many people in their 80’s to late 90’s who, apart from a few aches and pains, are physically and mentally sound, can look after themselves with no need for support and are still enjoying a full active life.
In my experience in Nigeria though, such parents are in the minority and as such these changes and challenges need to be anticipated, prevented if possible and managed appropriately when they occur.
We are in a time and season in Nigeria, where the younger population are leaving the country to greener climes in droves!
Planning for your parents care as they get older is essential especially if you are of “Japa” generation. It is not easy to hop on a plane back to Nigeria from Vancouver at a whim.
So, what can happen to our parents as they age?
1. Changes in cognition and memory issues: We all associate growing older with memory or cognitive issues but that is not necessarily the case. That said, even with normal aging, there can be a decline in the “sharpness” and agility with which our parents perform certain tasks and yes, they might misplace things once in a while. When this decline becomes bothersome to the extent that it starts to interfere with their day to day lives, it has probably progressed to a brain condition called Dementia.
It is important to recognise this early and seek specialist help from a fully trained Geriatrician or a Psychogeriatrician.
2. Musculoskeletal changes: There can be wear and tear (degenerative) changes in the joints which lead to pain, reduced mobility and muscle weakness. If left unchecked, it can then lead to falls and fractures.
Women can also develop osteoporosis or softening of the bones which can exacerbate pain and make them more prone to falls.
In black Africans, Vitamin D levels can also be low because we do not absorb this easily from the sun. Low Vit D levels can manifest with muscle aches and pains and reduced mobility.
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3. Other physiological changes- Men can present in later life with prostate related urinary problems and urinary tract/chest infections can occur.
Urinary incontinence can be common, especially in women, as the bladder wall becomes lax and irritable, and the urethral sphincter becomes incompetent. Constipation also becomes more common as we age and there can be an overall reduction in muscle mass as the appetite reduces as most of our elderly ones do not participate in muscle-strengthening exercise. The metabolism of drugs changes in the elderly and many elderly people tend to be on too many unnecessary drugs.
4. Psychologically, ageing can be tough for most parents especially as they perceive their authority over issues concerning themselves are being eroded. Many parents become set in their ways and quite difficult, in an attempt to hold on to some semblance of autonomy or control. We must appreciate that, for many of them, all they can see are the little children that they brought up who are now suddenly telling them what to do! Insomnia, anxiety and depression are also common in the older age group.
5. Financial decline: how many of our parents actually planned for retirement, so the burden for their healthcare costs tend to fall on the children.
All of the above lead to frailty and the risk of this must be minimised at all costs otherwise it leads to burdensome costs and huge expenses financially and emotionally, for their children.
Decline is NOT inevitable. With a good healthcare plan, supervision and monitoring, all the possibilities listed above, can be significantly minimised so that our parents can have a good quality of life in old age. Prevention is better than cure and frailty of old age (with its burdensome costs), can be prevented or at least, minimised.
On that note, I recommend these next steps:
1. Ensure they have a good doctor responsible for their healthcare. It is best to stick one doctor and a Geriatrician (physician for older people) is the ideal. Most Geriatricians know their stuff, are very good doctors and are compassionate and patient enough with the elderly to explain what is wrong and what ought to be done about it.
2. Ensure regular checks of baseline parameters- blood pressure, blood sugar, haematological indices, renal and liver function tests- and other tests as required by individual health profiles.
3. Encourage physical activity – this increases physical strength, mental resilience, reduces the risk of Dementia and also the risk of frailty. Engage the services of a physical therapist/ physiotherapist if needed.
4. Encourage social interactions. The benefits of this are immense and there is nothing worse for an older person than to be left in semi-isolation. It is the expressway, in my opinion, to frailty. There are Senior Activity Day Units available in Lagos which are excellent for this.
5. Ensure they have nursing or homecare from reputable agencies only.
6. Visit and call them often. There is no substitute for this!
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