My posting in Geriatric

So here is it, Im back again~ wish to write a short post about my current posting, which is an interesting one>> Geriatric posting. In layman term, elderly health. Before I start, I wish to share a video here which my Doctor shared to us yesterday in the lecture. Very meaningful lesson to everyone from this 3 minutes video

People said minor posting is actually a honeymoon phase during clinical years. Well personally I don feel "honeymoon" at all, as I had to wake up at 5.30am for 3 consecutive days to attend ward round in HKL until 7pm in the evening, totally exhausted. Luckily I finished my session in HKL and going to have my session in Hospital Serdang for next week. The nightmare ends? nope, there is another ahead during family medicine, which means I had to wake up at 5.30am again and repeat the same cycles in various health clinics.

Back to topic, is Geriatric fun? yes it is ( besides the torturing schedule). We spent time together with the elderly ( 65 years old and above), clerking them, monitoring their ability to handle daily activities and etc. Clerking an elderly is totally different from a young adult ( maybe worse for paed but I haven gone thru yet). Some of the elderly are having delirium ( confusion) or worse, dementia, which they could not obey to command and give irrelevant answer to questions. Hence, lots of patience is required to take care of them.

From geriatric, we can see how our community treat the elderly. FYI, the elderly proportion in Malaysia population is increasing drastically, which is 7.5% of total population in 2010. Some of the elderly have good care from the family, but most of them were neglected and isolated from the society. In the hospital, we can see how stress a family member as a caregiver to a sick elderly becoz they had to accept all the behaviours of him/her, and it is really heartbreaking to witness the love one to suffer especially from physical disability and cognitive impairment. I saw a lady once broke down into tears when she talked to us, as her mom had dementia and failed to recognise her.

Those people who still can receive care and attention from family members are the blissful one. In the video above, although the old man was living together with his daughter, but he received stigma from his daughter-in-law and isolated from the dinner because he had incontinence and created "troubles" to the couple. This is still consider as the better one, I had seen some cases which is worse than this, the family just abandoned the old man/woman in the hospital, and he/she had to be sent to nursing home after discharge as no one wish to take care of them.

Think about it people, this is a normal ageing process, everyone will get old someday, so why you treat ur parents like tis? The grandma I met in the hospital ( not my biological grandma, she passed away ages ago) had many children but non of them visited her during her admission. As a result, we, the "trouble maker" in the ward ( describe by some nurses LOL) were her best companion during the day. Not only her, but several of them in the wards. They grow old, they had problem in handling their daily life due to osteoarthritis, vision problem, tremor and fall easily. Falling is a big issues in geriatric, it is not easy to handle a hip fracture in elderly. Infection, immobility, bed sore, depression, is a cascade following the complication.

Look, life is actually a recycling process. when we are young and small, we cry to get attention so our parents can take care of our need. We cant control our bowel and urination, that is y we need pampers. Then we grow and start to learn how to walk, with multiple falls. Still, we need someone to feed us for food. Then our parents teach us how to dress ourselves slowly. Then we learn to recognise words and speak. Then we go to school, makes frens, know how to socialise, make up ourselves in our best look, earn money, get married with the love one. We had all of this from our parents.

When we are strong enough to be independent, our parents are ageing and start to depend on us. They start to have confusion, forgetful. Then slowly suffer from several disease, they don look good anymore. Then start to have clumsy and unsteady walk, and fall. Please aware that one fall to elderly maybe FATAL enough. When they had pain, they refused to walk. Then they start to have isolation from the community, depression, and all this lead to delirium or worse, dementia. When either of this come, they start to behave like a child. they cant feed themselves, cant button their clothes, cant bath themselves. Slowly, they cant have normal speech intonation, they cant control their bowel and urination, which we call as incontinence. They cant express their feeling in a correct way, they start to feel frustrated with all the bad temper. In the late stage, they can only cry and shout to get our attention, and bedridden.

Some of the people gives up in the process to take care of the elderly due to severe stress, and some of the care giver commit suicide. Well I cant guarantee that I wont do the same, but I will make sure my parents get my attention all the time and always in a healthy condition. At least, I wont dump my parents just like that. * In fact I think my parents will dump me when they retired =..=.  if you think your parents are annoying, who is the one annoying the parents when he/she are small? who is the one crying all the time in the night? No one but us. All of us go through the same process, did our parents complain about that? yes they do. But do they give up on us? Nope they never. and this is the reason y we can enjoy our life here now. They feed up and raise us up with patience and love.

 I believe that all of us like to ask our parents nonsense questions repeatedly when we were small, and the favorite question will be "Mom/Dad, how do I come to this world". Don laugh, I know you got the similar favorite answer like me: " I pick u up from the rubbish site". When they old, they start to be forgetful. yeah this is so irritating, me too at the same time. this is actually a normal process, our brain start to retire when we stop using it. For dementia patients, they can only remember things decades ago, and forget the recent event. Some of them, which I met one today, forget that the lady who sat in front of her is her own daughter. So please give more patience when they start to ask " who are you" repeatedly. this is really something heartbreaking.

From geriatric, we can know the importance of family relationship. A strong faith among the family members to take care of the elderly gives a big support to the recovery of the illness of the old people. Instead of one caregiver, everyone in the family should take turn to take care of the old one, so everyone can get enough rest and improve the relationship together. Communication with the doctors is very important to have a good plan for the old one in terms of healthy recovery. Treat your old one in the family sincerely.

 Luckily my grandpa still very healthy now and independent. I wont say he is physically fit becoz he was so reluctant to move around due to knee pain. Lazy grandpa!! XDD

Lastly, thanks to Dr Rizar, Dr Yau, Dr Alan and Prof Nathan for the teaching and guidance during this posting. Especially to Dr Alan as my group supervisor in this posting. We learn about nutrition, Barthel scoring, elderly care and a lot more during the posting. This is just a 3 weeks posting, but we learnt a lot of moral values than knowledge during this period of time. Geriatric is an interesting posting anyway and I really enjoy it. Next rotation~ Family Medicine.
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