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Common health concerns among today's seniors include proneness and treatment of common infections as well as when is home care needed.
In our "Ask the Specialist" forum for May, Dr Andrew Wong, Senior Staff Registrar with the department of
Post-Acute and Continuing Care (PACC) at
Bright Vision Hospital (BVH), which is under
SingHealth Community Hospitals (SCH), a member of the
SingHealth group, will answer your questions on common infections afflicting the elderly, and the role of home care and when is it necessary.
This forum is open from
1 May to 28 May 2020.
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Kindly note: Your question will go live/appear when the doctor answers it
Mum is currently on post stroke rehab. She is impaired on left side of body. Her progress to regaining use of hand and leg seems very slow to me. What are markers I can use to check for a real progression towards regaining of function and mobility?
Answered by Dr Andrew Wong, Senior Staff Registrar with the department of Post-Acute and Continuing Care (PACC) at Bright Vision Hospital (BVH) under SingHealth Community Hospitals (SCH)
Hi Gimme, I’m sorry to hear about your mother’s stroke.
The prognosis of recovery depends on the area of the brain affected by the stroke, whether there are any secondary complications (e.g. re-bleed), what bodily functions are affected by the stroke (e.g. strength, sensation, balance and cognition) and also the extent that the patient is able to regain function after first 3 months of active rehabilitation.
There are various scoring systems or scales used to predict functional recovery. For a more accurate measurement, I would suggest consulting your mother’s regular doctor (be it her family physician, neurologist or rehabilitation specialist) and therapists who would be more familiar with her condition and progress.
Posted by J Lam
What are common infections that the elderly faces, and can they be prevented? If yes, how?
Hi J Lam, thank you for your question.
Common infections among the elderly include respiratory tract infections (including the common cold, influenza and pneumonia), urinary tract infections and shingles. There are also many infections that can potentially be more serious in the elderly, such as COVID-19. Hence it is important to stay tuned to local updates from the Ministry of Health on these infections.
Many infections in the elderly can be prevented by avoiding contact with people who are known to be ill with such infections. Good hygiene habits like regular hand washing and maintaining good cleanliness are also helpful. For urinary tract infections, it is important for the elderly to drink enough water and pass urine regularly.
Some infections such as influenza, pneumonia and shingles can also be prevented by timely vaccinations. It is also important to follow the Health Ministry’s guidelines on safe distancing for COVID-19. I will recommend our seniors to approach their regular family physician on further details of these health tips and vaccinations.
Posted by Nancy
Are there signs that I should look out for to know that I should begin preparing my elderly parents about the idea of home care? This is because my parents will require some time to accept such an idea as they may feel uncomfortable about it. Do you have any suggestions on how I should begin discussing this topic with them?
Hi Nancy, thank you for your question.
Home care traditionally refers to the provision of formal medical care at home rather than in a clinic setting. Patients who require home care are usually immobile (e.g. elderly is bed-bound) and have multiple medical and nursing needs (e.g. elderly requires care of pressure sores, feeding tubes and urinary tubes).
Usually, such patients are stable and are referred by the tertiary hospitals to either family physicians or home care service providers (including Home Nursing Foundation) who visit the patient at home every 1-3 times monthly.
Some early signs of frailty in the elderly are functional decline and increasing care needs. When we observe these signs, we should consult a doctor to promptly address and treat the conditions.
One suggestion to start the conversation on advance care planning would be to use a hypothetical scenario and understand the reasons for their responses.