Prolonged hospital stays detrimental to seniors
Based on statistics from the Ministry of Health, one-third of all hospital admissions in Singapore were of those aged 65 and above.
For many seniors, a hospital stay can lead to mental and physical deterioration that persists long after discharge.
According to a study in the Journal of the American Medical Association, about a third of hospitalised patients older than 70 lose the ability to perform at least one activity of daily living.
Studies have shown the rate of cognitive decline in senior patients can more than double after a hospital stay.
Up to 20 per cent of hospitalised patients can experience delirium, resulting in confusion, disorientation, agitation or withdrawal. Hospitalised seniors with delirium have a tenfold increased risk of death if left untreated.
Elderly patients also do not get out of beds enough as they are tethered to intravenous drip stands, catheters and oxygen tanks. Prolonged bed rest is detrimental to all systems in the body, leading to de-conditioning and subsequent functional decline.
We need to improve health outcomes for the elderly and work towards reducing hospital admissions. A first step would be to make it easier for patients to access appropriate and affordable care within their community.
Every elderly patient should also have a trusted family physician they can turn to for regular consultations, which will help minimise the risk of excessive medication.
A sustainable model of care for the elderly requires a shift towards earlier detection of diseases. Early assessment and intervention of frailty and dementia are particularly important in this regard.
As much as physical health is important, so is their mental and social well-being.
Many seniors suffer from loneliness and isolation. Joining a senior activity centre is one way to keep engaged in community and make new friends, lowering the risk of depression.
Having a dedicated professional caregiver at home can help encourage exercise, ambulation and healthy eating.
The approach taken to care for the elderly needs to shift to a more holistic one that takes into consideration their home situation and access to medical and social services. That way, our elderly will have the support to live the rest of their lives well.
The writer is the medical director of Active Global Caregivers, which operates subsidised home care services and senior care centres. Dr Rao is also an emergency medicine specialist.
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