Rigid stereotypes about the elderly are impeding efforts to treat diseases that harm the quality of life of senior citizens, said speakers at a symposium Dementia, Delirium and Depression in the Elderly at the School of Nursing and Midwifery (SONAM).
There is a widespread misconception that it is normal for the elderly to become confused, frail and irritable as they age. This stereotype means that caregivers, nurses and doctors often miss clear symptoms of dementia, delirium and depression that would have been noticed in younger patients, says Samina Vertejee, an assistant professor at SONAM and head of the Gerontology and Geriatric clinical stream (GAG) at the School.
The symposium, which was held to observe the International Day for Older Persons 2017, saw experts in dementia, delirium and depression highlight how caregivers, nurses and doctors could improve the identification and management of these diseases at the hospital and community level.
Dr Qurat Khan, assistant professor in the department of psychiatry at AKU, stated that her research showed that 9 out of 10 people believed that dementia, a disease caused by damage to the nerve cells in the brain, was a normal part of the ageing process. She noted that this lack of awareness about the disease meant that up to 95 percent of people with the degenerative disease were not receiving treatment.
In her presentation, Dr Khan noted that is no single test for the disease. She stated that physicians need to assess a patient’s memory and cognitive skills and to make a judgment based on the patient’s responses and information from family members. One of the local challenges in identifying the disease was the absence of an established diagnosis protocol in Urdu, she added.
Like dementia, delirium is another disease that is often ‘missed’ by clinical staff. Delirium is characterised by an acute state of confusion. However, delirium is often given lower importance by hospital staff since patients present with a range of other complications or co-morbidities.
Delirium can be caused by an infection, dehydration, environmental changes, a shortage of oxygen in the body or even as a side-effect of taking certain medications. Dr Saniya Sabzwari, associate professor in the department of family medicine at AKU, explained that the Confusion Assessment Method was an established way of detecting delirium and highlighted the steps nurses should take to manage patients displaying symptoms.
She also called on caregivers to look into the underlying cause of delirium and to pay attention to symptoms such as a poor attention spans or disorganised thinking that are often dismissed as being normal for the elderly.
In a presentation on depression, Professor Murad Khan noted that people often viewed depression as being a normal part of growing older. This is incorrect causes since factors that lead to depression such as the absence of a strong social circle, bereavement or limited physical activity could happen at any stage of one’s life. He added that senior citizens who were active in their late years and felt fulfilled with their lives were unlikely to develop the disease.
Professor Khan noted that depression had a significant impact on a person’s quality of life and highlighted how various therapies relying on medication, personal counselling, group therapy and sleep management can help treat the disease.
“It’s troubling that society fails to view the elderly as individuals with unique circumstances. The perception that old people tend to be sick, forgetful or even weak leads to people missing the warning signs of disease that require attention from specialists. Society should be treating the elderly with greater dignity, respect and care instead of ignoring their problems,” Ms Vertejee added.
Over 100 participants were present at the symposium which was organised by GAG. Shamim Mumtaz, an adviser to the Sindh chief minister on social welfare, was the guest of honour at the event. In her speech at the symposium, she called for the hosting of seminars on topics related to the elderly in order to build awareness of their needs.
Ms Mumtaz appreciated SONAM’s efforts in highlighting the crucial issues of older people in our society. She also described the passing of the Sindh Senior Citizens Welfare Act of 2014 as a promising effort towards improving the living conditions of the elderly in the province.