Geriatrics
Chweya M Obegi
Learning Objectives
At the end of the session students should be able to:
• Recognize the demographic change in global population .
• Understand the main health problems related to elderly.
• Define the elderly population
• Understand the aging process
• Explain the meaning of healthy aging
• Discuss the health risks in aging population
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Definition of terms
• Health; A state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity.
• Healthy ageing; The process of developing and maintaining the
functional ability that enables well-being in older age.
• Geriatrics; The branch of medicine or social science dealing
with the health and care of old people.
• Geriatrics is the branch of medicine focused on health
promotion, disease prevention, diagnosis, and treatment of
disease and disability in older adults.
• Goals: Enhance quality of life, maintain functional independence, and
support aging in place.
• Gerontology; The scientific study of old age, the process of
ageing, and the particular problems of old people
• More terms?
Situation in Kenya
• Kenya has a significant and aging population, with over 2.7
million people categorized as geriatric (60 years and older),
• Of the 2.7 million people, the majority of them are female living
in rural areas.
• Above half of Kenya’s older persons are female (55%) and
rising to about 65% for those aged over 80. Majority of older
persons live in the rural areas
• About 18% of the country’s households have older persons,
60% percent of the older persons are married while more than
one-third are widowed.
• Age is the main risk factor for both acute and chronic health
conditions.
• Besides, social determinants of health (SDH) i.e., the
nonmedical factors, also influence health outcomes not only
among older persons but also along the entire life course.
• These non-medical factors are the conditions in which people
are born, grow, work, live, and age, as well as the wider set of
forces and systems that shape the conditions of daily life.
• They include economic policies and systems, development
agendas, social norms, and attitudes (e.g., ageism), social
policies and political systems.
• Geriatrics focuses on promoting the well-being, functionality and
independence of the elderly to maintain their quality of life
• Ageism refers to the stereotypes (how we think), prejudice (how
we feel) and discrimination (how we act) towards others or
oneself based on age
What issues are currently affecting the
geriatric population in Kenya?
• Poverty. As of 2018, 8 million Kenyans lived in extreme property and a
majority of our geriatric population are affected by this.
• elderly abuse. Unfortunately, with increased weakness, there's potential for
abuse not only by family members, but also healthcare workers as we
have seen in many nursing homes in other countries.
• There is also a high level of illiteracy among the elderly. Many of our
geriatric populations grew up when education was not affordable or
accessible.
• digital inequity is another issue within the geriatric population with many of
our older patients who have little knowledge on how to operate many of
our common digital appliances.
• Cybercrime -people will try to deceive these elderly people of their
finances and assets.
The challenges of population ageing worldwide
• Strains on pension and social security systems;
• Increasing demand for health care;
• Bigger need for trained-health workforce in gerontology;
• Increasing demand for long-term care, particularly in
dealing with dementia; and
• The raising of pervasive ageism that denies older people
the rights and opportunities available for other adults.
Problems that can 5) Health
impact the mental challenges/Disability
well-being and
1) Financial Problems resilience of older
adults and their
caregivers
4) Loneliness and
Isolation
2) Problems in family
relationships
3) Loss, in bereavement
and changes physical
space
What health issues usually accompany the
geriatric population?
• They suffer from multiple conditions such as
• elevated cholesterol,
• high blood pressure,
• diabetes,
• weak eyesight and
• hearing loss. In addition,
• mobility becomes a challenge with increased risk of falls and
fractures of their long bones.
• Reflexes are much slower which affects their safe driving skills
putting them at a higher risk for accidents.
• Most people of very advanced age will be needing
accessible and effective acute and long-term care.
• Developing integrated systems that provide seamless
access to the care they require is a priority for both
developed and developing countries.
Common Concerns for Older Patients
• Needs assistance with daily activities
• Multiple comorbid medical conditions
• Mild cognitive impairment
• Limited social support
• Lives alone
• Transportation issues
• Polypharmacy
• Frailty
Formal and Informal social support for older adults in
Africa
Formal Support
Pension for those
Health insurance
that worked for the
government
Old age social Unconditional
security benefits cash transfers
Formal and informal social support for older adults in
Africa
Political patronage
Informal Support during electioneering
campaigns
Families Philanthropists
NGOs, CBOs and
Friends FBOs
Caregiving and older adults in Africa
Caregiving is mostly informal by Because it is unpaid, majority of
family members and friends and caregivers have their primary job
unpaid and so they are under a lot of stress
This is can lead to elder abuse and
When it is paid for, majority of
depression on the part of older adult
caregivers are untrained in
and sense of guilt on the part of the
caregiving for older adults caregiver
Geriatric Care
• Geriatric care at its core is medical care for older patients that
centers around preventing and treating conditions, diseases,
and disabilities that are commonly encountered by older adults.
General principles of Geriatric Care
• Geriatric conditions are chronic, multiple, multifactorial
• Reversible conditions are underdiagnosed and Undertreated
• Function and quality of life are important outcomes
• Social support and patient preferences are critical aspects
• Geriatrics is multidisciplinary issues
• Cognitive and affective disorders prevalent and undiagnosed at early
stages
• Iatrogenic disease common and often preventable
• Care is provided in multiple settings
• Ethical and end of life issues guide practice
• Geriatric conditions are chronic, multiple, multifactorial
• Reversible conditions are underdiagnosed and Undertreated
• Function and quality of life are important outcomes
• Social support and patient preferences are critical aspects
• Geriatrics is multidisciplinary issues
• Cognitive and affective disorders prevalent and undiagnosed at early
stages
• Iatrogenic disease common and often preventable
• Care is provided in multiple settings
• Ethical and end of life issues guide practice
END