*Says Nigeria must prioritise care of older persons
By Chioma Obinna
Thousands of babies are born every day and as expected, the number of senior citizens is also expected to top millions by 2030 in Nigeria.
Sadly, despite the fact that Nigeria has one of the world’s worst life expectancy ratios, it has no functional national policy on the care and welfare of older persons.
Worst still, the changing demographics in Nigeria, in addition to the breakdown of the family structure and absence of a social security system, present unique challenges to the elderly in Nigeria.
Today, it is no longer news that healthcare in Nigeria is not where it should be. The situation is even worse for the elderly.
However, to help meet the needs of an ageing population and improve the quality of care for elderly people, the University Teaching Hospital, Benin, UBTH, under the leadership of Chief Medical Director, Prof. Darlington Obaseki, is pioneering ways to provide better care for older adults, discover better therapies, and educate the next generation of medical professionals, caregivers and community members.
The hospital now operates a Geriatric Unit, under it’s Elder-Friendly Hospitals Initiative (ELDRHI) solely dedicated to the care of elderly Nigerians.
Geriatrics or geriatric medicine is a speciality that focuses on the health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults.
The unit is currently being strengthened to provide patient-centred, holistic care to older persons in a setting with a good ambience that encourages family participation. It manages various categories of patients with geriatrics syndromes who otherwise would have required care in other climes.
Obaseki describes the geriatric unit of the hospital as a unit very dear to his management and is therefore not sparing any effort in strengthening its manpower, equipment and other vital requirements needed for the provision of quality geriatrics services.
“We have provided wheel-chair accessible toilets, handrails and grab bars across the hospital to improve patients’ safety. The geriatrics ward is almost always over-subscribed and plans are in place to establish a purpose-built, one-stop centre to broaden the scope of services and patient coverage.”
He said beyond the geriatric ward, the hospital wants to scale-up innovations to ensure the hospital, in general, remains elderly-friendly.
Head of Unit, Prof. Obehi Akoria, a Geriatrician, is happy that the unit is well on its way to becoming Nigeria’s leading centre for geriatric care.
According to her, the goal of UBTH is to add years to the lives of the elderly but where this could not be achieved the hospital would like to add life to the years they have by improving their quality of life.
Thus the 20-bed unit, established in July 2013, with highly proficient multi-disciplinary professionals including a geriatrician, other specialist doctors, geriatric nurses, geriatric physiotherapists, geriatric occupational therapies, clinical pharmacists and medical social workers, amongst others, now offers specialized interdisciplinary healthcare to address ageing-related challenges of the elderly.
The unit, according to Prof. Akoria, applies a model that combines acute care for elders plus integrated rehabilitative care. For instance, she explained, physiotherapy enables them to maximize their physical functioning whereas occupational therapy enables them to optimise their individual independent living even if they may have an impairment.
“Some of them are visually impaired, some of them have impairment in their muscular-skeletal system because of arthritis and other kinds of diseases but what occupational therapist does for them is that even if you are blind, you can still be independent, feed yourself and dress yourself.
“The whole idea is when they recover, we are hoping that we are able to transition them and their family members back home into society, but they are able to live optimally.”
Prof. Akoria listed common problems presented by this aged population which include hypertension and it’s complications, heart failures, stroke, diabetes all complications of diabetes.
“But over and beyond that, we have what we call geriatric syndromes which other people are not trained to diagnose and which they will often miss. We talk about the three Ds; dementia, depression and delirium. Then the six “Is”: incontinence, immobility, intellectual impairment, iatrogenesis, infections instability with a tendency to fall.
“These are things that people usually don’t recognize or even when they see them they say they feel that their parents are getting old. But these are things, if you don’t identify and manage can kill patients very slowly and even some can kill very quickly.
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On how Covid-19 has impacted the centre, she said older persons have died more from covid-19 according to the Edo state data with 7.7 per cent of persons in the first wave here were older persons.
“In this ward, the first two cases were very scary, reason being that they were already with us being managed before the diagnoses were made and they were subsequently moved to the isolation centre but in the cause of the event, five of our own staff got infected but they all did very well and we didn’t have any casualty.”
Speaking to Vanguard, a 79-year-old Mr. Pascal Okodiye and a retiree from the University of Benin was delighted with the care he has been given so far.
“They have been taking care of me. They’ve been doing their job well. We thank God for that, may God bless all of them. I came here on the 12th of March. I can’t remember what brought me here. I was weak and couldn’t walk on my own.”
A relative later informed Vanguard that the septuagenarian was diagnosed with pneumonia. He responded so well and was about to be discharged from the unit.