OTGV #52 - Eldercare 2
Broadcast Date: 08/03/04
Care for aged relatives.
The state can only do so much.
What the state and society can offer only compliments what the family itself can provide.
Hi, welcome to On the Grapevine with me Chong Ching Liang as I take another look at the issues surrounding eldercare.
At a recent SingHealth-organised national health conference, Minister of State for Health Balaji Sadasivan highlighted the importance of proper disease management.
"The challenges we face are to better prevent chronic diseases, detect such diseases early, prevent complications arising from disease conditions and ensure that every Singaporean has the means to provide integrated, holistic and seamless care. While much of the components and tools are already in place in the clusters, much still remains to be done in terms of developing disease management as a cost-effective and efficient model of delivery of care for patients with multiple medical conditions."
And the elderly are most likely to be the ones with multiple medical conditions.
Yet some elderly Singaporeans are bed-ridden and their family members have given up on taking them to a doctor for proper disease management.
You can't blame the relatives because it's gotten too tough for them both financially and psychologically.
This isn't a problem yet but Singapore, in a decade or more, will see its population of elders double or even tripled.
Head of Geriatric Medicine at the Singapore General Hospital, Carol Goh is looking over her shoulder at the looming problems.
"And they are getting quite scary. We are facing a situation [where] we are not growing as fast as a population but the percentage of elderly is growing extremely fast. And that's the worrying thing because all these elderly will need someone to take care of them."
As the public healthcare system strives to catch up with the demographic curve, relatives must step up to help with the care of the elderly.
The first thing they must do is to get rid of certain myths such as the one that the hospital is the answer to all their prayers.
Head of SGH's orthopaedic surgery Tan Seang Beng.
"When a person comes to hospital, automatically the relatives assume everything will be taken care of because they are at the hospital. But they forget that while the hospitals have increased their advancement in delivery of healthcare but we have gone very much into specialisation. So you may go into oncology ward and so on. So you have very highly trained doctors, very highly trained nurses in that particular field of speciality. So when you say you bring your mother in and automatically all the needs will be taken care of, that may not actually be the case."
The family or the patient can help plug in the gaps in disease management.
Discharging from the hospital means the onus of managing a patient has been passed on to the step-down healthcare institutions, neighbourhood clinics or the family members.
SGH's Senior Consultant in orthopaedic surgery, Wong Meng Koon says the family must be the one in control of the information.
"Every patient that is discharged from the hospital has a discharge summary. There's pretty comprehensive information on investigations and the surgeries and findings. I think you really need to encourage the public how to take ownership of your own information. I don't think it applies to you and our generation but certainly when my grandma goes to see her doctor, she says 'yeah I have some sort of allergies' and she has no idea what that was. So take ownership of your own information."
Greater awareness of what's happening to their aged relatives will help families.
Family members can be the best assistants any doctors of elderly patients can have.
For example, they can observe the effects or side-effects of any medication and pass this information on to the doctors.
Also, don't rush to the hospital all the time as some of the chronic conditions don’t require specialists says Dr Tan Seang Beng.
"Many of these diabetes, high blood pressure, heart disease etc you don't really need to have super-specialists. So by centralising it and partnering with the geriatrician, be it training our doctors and nurses, the level of care and standards is now much better. You don't have to call a cardiologist every time the blood pressure goes up."
It is inconvenient for families to bring their aged relatives to hospitals for follow-ups and home-base care for elderly patients isn't yet available on a large scale in Singapore.
So the family members may have to turn to GPs at the neighbourhood clinics for help.
But Dr Wong points out a stumbling block to GP making house calls.
"But if you go into a very successful business, that guy may not even resuscitate a person that'd just had an accident outside. The fact is that he has other commitment to a whole group of people in his clinic. We really can't make the call whether he did the right or wrong thing. There will be GPs that are hungry for business and they just come down. And once you formed that relationship where you grow old together, he's not going to say no. "
Ultimately, while the families of elderly patients need to have some faith in the doctors, they shouldn't just take their words wholesale.
After all, the attending doctors or specialists observe their patients only in the little ten minute slots each visit.
They are dependent on their elderly patients' relatives for information.
Research, understand, observe and report.
You'll be surprise how much your little involvement can turn up.
This is Chong Ching Liang for Newsradio 938.
===============================
Related Links:
Newsradio 938 (now 938Live)
http://www.938live.sg/
Ministry of Health
http://www.moh.gov.sg/
Tan Tock Seng Hospital
www.ttsh.com.sg
Singapore General Hospital
www.sgh.com.sg
Care for aged relatives.
The state can only do so much.
What the state and society can offer only compliments what the family itself can provide.
Hi, welcome to On the Grapevine with me Chong Ching Liang as I take another look at the issues surrounding eldercare.
At a recent SingHealth-organised national health conference, Minister of State for Health Balaji Sadasivan highlighted the importance of proper disease management.
"The challenges we face are to better prevent chronic diseases, detect such diseases early, prevent complications arising from disease conditions and ensure that every Singaporean has the means to provide integrated, holistic and seamless care. While much of the components and tools are already in place in the clusters, much still remains to be done in terms of developing disease management as a cost-effective and efficient model of delivery of care for patients with multiple medical conditions."
And the elderly are most likely to be the ones with multiple medical conditions.
Yet some elderly Singaporeans are bed-ridden and their family members have given up on taking them to a doctor for proper disease management.
You can't blame the relatives because it's gotten too tough for them both financially and psychologically.
This isn't a problem yet but Singapore, in a decade or more, will see its population of elders double or even tripled.
Head of Geriatric Medicine at the Singapore General Hospital, Carol Goh is looking over her shoulder at the looming problems.
"And they are getting quite scary. We are facing a situation [where] we are not growing as fast as a population but the percentage of elderly is growing extremely fast. And that's the worrying thing because all these elderly will need someone to take care of them."
As the public healthcare system strives to catch up with the demographic curve, relatives must step up to help with the care of the elderly.
The first thing they must do is to get rid of certain myths such as the one that the hospital is the answer to all their prayers.
Head of SGH's orthopaedic surgery Tan Seang Beng.
"When a person comes to hospital, automatically the relatives assume everything will be taken care of because they are at the hospital. But they forget that while the hospitals have increased their advancement in delivery of healthcare but we have gone very much into specialisation. So you may go into oncology ward and so on. So you have very highly trained doctors, very highly trained nurses in that particular field of speciality. So when you say you bring your mother in and automatically all the needs will be taken care of, that may not actually be the case."
The family or the patient can help plug in the gaps in disease management.
Discharging from the hospital means the onus of managing a patient has been passed on to the step-down healthcare institutions, neighbourhood clinics or the family members.
SGH's Senior Consultant in orthopaedic surgery, Wong Meng Koon says the family must be the one in control of the information.
"Every patient that is discharged from the hospital has a discharge summary. There's pretty comprehensive information on investigations and the surgeries and findings. I think you really need to encourage the public how to take ownership of your own information. I don't think it applies to you and our generation but certainly when my grandma goes to see her doctor, she says 'yeah I have some sort of allergies' and she has no idea what that was. So take ownership of your own information."
Greater awareness of what's happening to their aged relatives will help families.
Family members can be the best assistants any doctors of elderly patients can have.
For example, they can observe the effects or side-effects of any medication and pass this information on to the doctors.
Also, don't rush to the hospital all the time as some of the chronic conditions don’t require specialists says Dr Tan Seang Beng.
"Many of these diabetes, high blood pressure, heart disease etc you don't really need to have super-specialists. So by centralising it and partnering with the geriatrician, be it training our doctors and nurses, the level of care and standards is now much better. You don't have to call a cardiologist every time the blood pressure goes up."
It is inconvenient for families to bring their aged relatives to hospitals for follow-ups and home-base care for elderly patients isn't yet available on a large scale in Singapore.
So the family members may have to turn to GPs at the neighbourhood clinics for help.
But Dr Wong points out a stumbling block to GP making house calls.
"But if you go into a very successful business, that guy may not even resuscitate a person that'd just had an accident outside. The fact is that he has other commitment to a whole group of people in his clinic. We really can't make the call whether he did the right or wrong thing. There will be GPs that are hungry for business and they just come down. And once you formed that relationship where you grow old together, he's not going to say no. "
Ultimately, while the families of elderly patients need to have some faith in the doctors, they shouldn't just take their words wholesale.
After all, the attending doctors or specialists observe their patients only in the little ten minute slots each visit.
They are dependent on their elderly patients' relatives for information.
Research, understand, observe and report.
You'll be surprise how much your little involvement can turn up.
This is Chong Ching Liang for Newsradio 938.
===============================
Related Links:
Newsradio 938 (now 938Live)
http://www.938live.sg/
Ministry of Health
http://www.moh.gov.sg/
Tan Tock Seng Hospital
www.ttsh.com.sg
Singapore General Hospital
www.sgh.com.sg
posted by CHONG Ching-liang | 12:23 PM
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