Tag Archives: Martina Lesperance

Ukraine: How War Affects the Elderly and Health Systems

Since the war between pro-Russian separatists and government forces in Eastern Ukraine began, living conditions have changed for the worse. A war always affects the weakest and most vulnerable population. In Ukraine, more than a million people have been displaced from their homes; 60% of those are elderly. In some cities and villages, most people stayed because they were too old, disabled, or just did not want to leave their homes. They had to find shelter in their basement or hide out in bomber shelters for months during gunfire.

Living conditions have been appalling and the winter especially caused havoc. The cold and stress worsened the health conditions of all Ukrainians, particularly the elderly, many of whom already suffer from chronic illnesses and cannot defend themselves like the younger population. Last November, the government cut off services to all rebel-held areas. As a result, the elderly have not received their pensions in months and are dependent on food donations for daily meals. People are in danger of starvation in many villages and most elderly have lived without electricity and water for the last few months. Water may be available at wells, however, those may be difficult to reach and the quality of the water cannot be guaranteed. Besides the lack of food, there is also limited access to basic health care and medical supplies for elderly. Health workers have left the hospitals, medical facilities are damaged, and shelves in drug stores are empty. Many elderly die from treatable chronic conditions such as hypertension or heart problems due to poor living conditions, lack of treatment and medicine. No one knows how many have died by now since no one keeps track of the deaths related to malnutrition or medical shortages.

Thankfully, non-governmental organizations have come to Ukraine to help. Médecins sans Frontières (MSF)/Doctors without Borders is an organization that has provided medical services for people in Eastern Ukraine. People can call and be seen by a nurse or doctor at home. MSF also provides mobile clinics where up to sixty people per day can be seen at any advertised location. Dr. Polyakov, a MSF doctor in Donetsk, Ukraine, tells the New York Times that so often he has to turn away patients because he does not have the right medications in stock or the prices for the ones available have risen substantially and can no longer be afforded by his patient. Around 90% of his patient population is elderly. The doctor’s work is challenging as Ukraine puts limits on the kind and amount of supplies that they can bring into the country and eventually use. In addition, United Nations workers need special documents to travel through the war-torn area, which limits the delivery of aid and causes the crisis to worsen.

During war time, the most vulnerable population is the one suffering the most. The elderly need special care and often do not have the coping mechanisms to deal with stress and anxiety. In Ukraine, the elderly are dependent on aid from non-governmental organization such as Doctors without Borders. We can now hope that the crisis will end soon and the elderly will receive the basic health care they need to survive.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

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Europe: How to Tackle the Lack of Support and Accessibility for the Influenza Vaccine

Every year, millions of people become infected with the influenza virus. In the U.S., it is recommended that anyone over the age of six months be vaccinated against influenza (flu). The World Health Organization (WHO) has come up with “six priority groups” that are strongly encouraged to get vaccinated. These groups include pregnant women, health care workers, small children (ages six months to two years), people with chronic medical conditions, and the elderly.

Photo Credit: Pixabay

According to WHO Europe, “90 percent of deaths related to seasonal influenza occur among those 65 and older.” Elderly who are infected with the influenza virus experience more severe symptoms, have a longer recovery time, and are hospitalized more often and longer. Compared to the U.S., there is an overall lack of support for the influenza vaccine in Europe. This is a result of missing data on the effectiveness and feasibility of the vaccine as well as lack of money.

In 2013, the flu vaccine was only 62 percent effective. For the elderly and frail, the vaccine is even less effective. The main reason for the ineffectiveness is that the influenza vaccine only responds to certain circulating viral strains. Also, the responsiveness of the vaccine depends on “the seroconversion in the individual” after vaccination. Anytime a vaccine (antigen) enters the blood, antibodies are created by the immune system to fight off the disease that a person is immunized for. A reduced seroconversion can lead to a reduced effectiveness of the vaccine.

Although the flu vaccine is less effective in the elderly, it is still recommended that older adults get vaccinated because “some protection is better than none,” and immunization can lead to decreased recovery time and severity of illness. In addition, hospital admissions and the death rate related to influenza are reduced, which lessen the burden of a health care system in any country. Therefore by 2014-2015, 94 percent of countries in the WHO European Region recommend that at least 75 percent of the elderly population should get vaccinated. However, only the Netherlands were able to reach this goal.

How can we increase the uptake levels of the influenza vaccine? Dr. Caroline Brown, Programme Manager for Influenza at WHO/Europe, highlights that we need to “estimate the burden of influenza, assess the costs and benefits of influenza vaccination programs,” and still maintain and improve the vaccination programs we have. Making a vaccine easy to access and afford is key as well. In Europe, vaccines can only be given by doctors and vaccine programs do not always exist, which causes a lack of accessibility to vaccines. Some countries offer free vaccines while other countries require residents to pay for them. It is important to improve the public’s perception of the influence of vaccines, which will happen once there is more data about the effectiveness of vaccines. Researchers are also eager to find a more effective vaccine; a vaccine that could possibly be effective for a longer period of time and be given in higher doses as a recent study shows. This could increase the protection for influenza especially among the elderly.

If the vaccine is not as effective among the elderly, we need to take another approach. In order to protect the elderly in nursing homes, let us reduce outbreaks and mortality rates as well as advising all health care workers to get vaccinated, which ultimately leads to herd immunity.

Martina Lesperance is a Health Educator and Screening Technician at Catapult Health.

Health Benefits of Pet Ownership for Seniors

As most pet owners already know, our pets are best friends and considered part of our families. Especially in nursing homes where the elderly suffer from depression, loneliness, and lack of social contacts, pets can be very therapeutic, improve the quality of life, and alleviate emotional and physical problems. Research has shown that stroking and even talking to a pet lowers one’s blood pressure and heart rate which can lead to an increase in life expectancy. When a person is stroking a pet, a chemical reaction takes places and a high level of mood enhancing hormones, such as serotonin, prolactin and oxyctocin is produced, while less stress hormones are released.

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In the US, pet therapies, also called animal-assisted therapies, are very common and popular in nursing homes. Owning a pet might not be for everyone because of the many responsibilities that come with a pet ownership. Pet therapy allows the elderly to spend time with a pet, usually a dog, and feel closeness. In addition, the elderly have something to look forward to and feel that they have a purpose in life again. While pets in nursing homes can ameliorate the psychological state of mind, they also contribute to an improved physical health of the elderly such as reduced need for medication and improved vital signs. The elderly who take their dog for a walk prove to have improved mobility, more social interactions, and enjoy their daily exercise routine. It has been researched that older pet owners walk significantly farther when they walk with a dog, which can contribute to the fact that pet owners require fewer doctor visits.

The European Union understands the importance of pet ownership for the elderly. As part of the Europe 2020 Initiatives, a new campaign was launched to promote the benefits of pets for the elderly. The motto is called “Animals are good for us, be good to them. We care.” IFAH Europe, the International Federation for Animal Health Europe, started a Facebook page where anyone can get information on how to care for pets. The elderly are also asked to post personal videos about how they enjoy their lives with a pet. This campaign promotes the benefits of pets for the elderly and may raise awareness of the elderly’s emotional needs.

In Romania, pet therapies are just as common, but dogs used for pet therapy have a different story to tell; they are street dogs. Bucharest, the capital of Romania, has more than tens of thousands of street dogs. The dogs have always been seen as a plague and had a bad reputation due to a few fatal incidents with city residents. After a 4 year-old boy was killed by a street dog in 2013, a law was published stating that street dogs will be euthanized unless they have a home. As a response to the law and a vision to save the dogs and give back to the community, the organization Vier Pfoten started a project and trains street dogs to be used for pet therapy in nursing homes. What a great idea to save street dogs in Bucharest as well as give comfort and companionship to elderly!

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

The Need for Improved Health and Social Reforms for Britain’s Aging Population

Photo Credit: Garry Knight

In today’s society, social and health care reforms for the elderly are more important than ever due to increasing aging populations worldwide. In Britain, these reforms have not greatly supported elderly care and need some major improvements. The current situation is shameful as more elderly should receive the care they need. Funding for health and social care services have been decreasing since 2005. In 2005-2006, a total of 1.231 million people aged 65 and older received some form of social care while in 2012-2013, a total of 896,000 received assistance. This shows a decrease of 335,000 elderly who did not receive the necessary care and services, although the overall number of elderly has been increasing in the last years. These services, such as Meals on Wheels or visits to daycare centers, had been terminated but are important to the elderly since it allowed them to live at home independently and have daily social interactions.

Oftentimes, the elderly do not have the support of their families and rely on these social services. As we get older, illnesses and disabilities can prevent us from getting out and becoming socially active. Life-changing events such as retirement and death of a family member or friend can also increase the risk of loneliness and isolation. In fact, 46% of people aged 80 and older reported that they often feel lonely. In addition, 10% of the population mentioned that television is their main form of company. This is sad and shocking at the same time. Are we all too busy to visit our parents or grandparents? “Each and every lonely person has someone who could visit them and offer companionship,” states states British Health Secretary Mr. Hunt to the Daily Express.

What can we do to involve the elderly in our lives and communities? Britain has started to recruit volunteers since they are important to nursing homes and older adults living at home. Volunteers provide much needed companionship and connections to communities. For example, Prime Minister David Cameron activated 30,000 teenagers to help people with dementia. In addition, these teens will teach the elderly modern technology so they can use Skype to talk with their families via internet.

Britain can also learn from health care or social systems in other European countries. A study showed that the elderly in Britain are poorer and lonelier than in similar European Countries. In addition, “they are more likely to suffer ageism in health care and in their daily lives than in either Germany, Sweden or the Netherlands.”

A role model for elderly care is the Asian culture that is well known for the respect and good treatment of the elderly. If an older person cannot live at home anymore, he or she will be taken in by family members. Nursing homes are usually the last option family members will consider as there is a strong social interaction and relationship among all generations. Britain as well as other countries can learn from this and strengthen the social relationships between generations.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas. 

 

An Invisible Epidemic: Substance Abuse Among Baby Boomers in Europe

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Substance abuse among the elderly is a real problem. In Europe, it was reported that the number of people over the age of 65 with a problem of drug abuse will double between 2001 and 2020. These substances include legal medication, tobacco, alcohol, illegal drugs, prescription drugs, as well as over-the counter medicine. One of the reasons why there is an increase of substance abuse among today’s elderly, also called Baby Boomers, is because they have a more tolerant attitude towards drugs, which in the 1960’s, were acceptable for recreational use. Other reasons are mostly related to emotional and psychosocial issues that result from dealing with difficult life changes or situations. These life situations may be caused by a death of a friend or family member, retirement, loneliness, depression, and even homelessness. The elderly use drugs to compensate for the loneliness and social isolation they may experience. However, being intoxicated definitely hinders them to take part in social events and gatherings, which could improve their mental state. It seems to be a cycle that a drug user may not get out of without help.

Most reports and research about substance abuse are focused on the younger generation although with an increase of aging population worldwide, drug abuse among the elderly has become more of a problem and is often referred to as a hidden or “invisible epidemic”. Why is this a public health issue we need to fix? Drug abuse not only affects the mental state of a person but can also lead to physical harm. Alcohol and illegal drug abuse are among the top ten risk factors for premature death and health problems. It is also reported that the mortality rate of older drug users is significantly higher compared to young drug users.

After a long-term drug abuse, one may experience memory loss, social isolation, weight loss, and pain. Older people who are drug users are intoxicated and more likely to suffer falls and serious injuries. Especially after a fall, their mental and physical health will decline rapidly. In most cases, substance abuse of older adults who live at home alone will go undetected because they are able to hide it from their family as well as their physician. Physicians are often not able to differentiate between the symptoms of substance use and symptoms of aging. This is why the elderly rarely get referred to a Substance Abuse Specialist so they can receive the help they need. It is important to raise awareness of substance abuse among the older generation. We need to educate physicians, nurses, as well as our family members on how to recognize symptoms or behaviors of substance abuse. In addition, treatments and interventions have to be tailored to the needs of older drug users.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas. 

Dementia Village: A Unique Place

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Dementia
can affect anybody and there is no cure for it. It is estimated that in 2050, more than 16 million Americans will have Alzheimer’s, which is the most common form of dementia. Dementia is a disease that affects the mental ability to perform everyday life activities. A person who has dementia progressively experiences a decline in memory loss which results in confusion and even fear. Imagine if you could not remember your own spouse, children, or even forget where you are at a certain time? People with dementia live in their own world and as the disease progresses, need help from care givers. Oftentimes, this care will be provided in a nursing home.

In Holland, a Dementia Village called “Hogewey”, has been created where every patient has dementia. The nursing home has specialized itself to provide care to dementia patients and offers amenities that the elderly need to feel at home and secured. All rooms face a courtyard in which patients can sit outside, enjoy the sun, and even go for a walk on a trail. Physical exercise is important for all ages and even for elderly with dementia. Exercise benefits the brain cells and oxygen flows to the brain. For the families, it is a relief to know that their loved ones are taken care of and can live in a world that is true to them.

Hogewey is certainly a unique place and its positive effects on patient care have already been studied by Germany, Switzerland and USA. In the USA, a dementia village is already in planning. It will be based in San Luis Obispo and called Maha Cielo Village. No one knows how much it will cost to build the village or how much the monthly rent will be for elderly. Just so you know, the construction of Hogewey cost $25 million, of which $22 million was funded by the Dutch government. Although it is a great project, not every patient with Dementia may be able to afford the monthly rent of $7000 at Hogewey or at any other Dementia Village. Government agencies, insurances, non-profit or private organizations may have to come on board and support patients needing financial assistance.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas. 

Italy: How Location Affects Mental Health

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Depression among the elderly is very common and can cause suicidal thoughts. People think that having depression is part of growing old and a disease that needs to be lived with. However, depression can be treated. There are many factors that can cause depression such as losing a lifelong partner and seeing their own children grow up. These life situations can result in many elderly people feeling useless and asking themselves: What else is there to live for? Is death the only thing to wait for?

In Italy, researchers have found out that a certain factor contributes to depression among the elderly more than gender, marital status, age, or lifestyle choices. This factor is that the elderly who live on the island of Sardinia are less depressed than Italian elderly from anywhere else in the country. Does it really make a difference where you live? Yes, it does. In the field of Public Health, we know that availability and infrastructure of health care services as well as social and recreational services are important for the peoples’ well-being. Elderly from Sardinia have health care services nearby to get treatment and preventive services they need. In addition, they are more physically active and more socially and culturally engaged, which increases their self-esteem and mental health.

What can Italy and other countries worldwide take away from this study? I believe that offering cultural, social, and recreational events for the elderly can improve their mental health. In addition, improving health care services in cities as well as in rural areas can not only prevent many mental and physical illnesses, but also give the elderly the treatments needed to live a longer independent life.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

Old and Homeless in Australia: It Can Happen to Anyone

In Australia, on any given night, 1 in 200 people are homeless.” One fifth of all people who are older than 55 years of age are homeless; many more live in unsecured housing.

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What is homelessness and what may cause someone to become homeless? A person is considered homeless when he or she does not have a conventional home and lives on the streets or in a park. Someone may be at risk of homelessness when living in unsecured housing. There are certain reasons that can cause homelessness which may include lack of social bonding and support from family or friends. What if you are in a crisis and cannot receive help from the closest people in your life—your family and friends? What would you do? You may think it can never happen to you but that may not be the case. Homelessness can happen to anybody. Young, old, women, and men.

Today, Australia and most other developed nations face more issues with divorces, family breakdown, and higher rent for affordable housing. Due to the growing aging population, homelessness will become a rising issue because of the lack of money to build affordable housing or lack of space for seniors in existing homeless shelters.

ABC Australia reports that Australian older women outnumber the men in homeless shelters. In fact, 9% of single women over the age of 45 are in crisis accommodation and that number will continue to rise. The woman being interviewed by ABC makes it clear that it can happen to anybody. She notes that “there is a fine line between having a roof over your head and having nothing.” Imagine if you, from one day to another, lost everything and couldn’t turn to anyone.

The report “Homelessness and older Australians: Scoping the Issues” reports that there are systems in place in Australia that give the homeless population access to certain services. However, the homeless believe that their complex needs are not addressed. In addition, they have difficulties to access those services and obtain the needed information because the service system in itself is too complex. There needs to be an increased collaboration and integration of existing service departments.

Australia must think of sustainable ideas and strategies to increase and invest in the affordable housing stock. The government, non-governmental organizations and service providers also need to step up and create strategies to reduce the bureaucracy and make easier access to the services the homeless population needs easier.

Martina Lesperance
is a Health Educator and Screening Technician in El Paso, Texas.

Sweden: A Role Model for Elderly Care

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As mentioned in previous blog entries, worldwide, countries are facing challenges due to aging. By 2050, the elderly will outnumber children under the age of 15, mostly in developing countries. So, reforms for more cost-effective health care systems for elderly’s long-term care are becoming more and more important. Sweden is known for its universal and comprehensive social and health care programs. Most care is funded by citizen’s taxes. In fact, Sweden allocates 3.6% of its GDP on long-term care and also provides the highest number of health care workers for the elderly over the age of 65. As a result, it is not surprising that in 2013, Sweden was ranked first for treatment of elderly in a United Nations (UN) supported global study, The Global AgeWatch Index (BBC).

Sweden is one of the nations that established reforms which focus on and encourage high quality long-term care for elderly in institutions as well as in home care. In Sweden, municipalities are responsible for elderly care and provide funding for in home assistance as well as manage the needs of accessible housing. 94% of the elderly over the age of 65 live at home and are given the opportunity to live an independent life, even if someone is in need of supported assistance. If an older person needs assistance from a health care worker, he or she can apply for this assistance. In addition, most regions offer ready-cooked meals which are even delivered to the elderly’s home.

Sweden’s approach of taking care of the elderly in their own home is unique and allows them to keep their independence. In addition, their families are at ease knowing that their loved ones are in good care. Is this a system that can be adopted by other countries? Who wouldn’t wish to live at home until the end of life? Don’t the elderly have a right to decide where they want to live? It is great to see that the Swedish local governments give them the option to either live at home or in accessible housing. The seniors contributed to their communities all their lives. They have worked, raised a family, and paid taxes, therefore securing care for their countrymen and women. They deserve to receive the same high quality of care. In addition to the care the elderly receive, health care workers are needed and appreciated. So it is a win-win situation for everybody: the elderly, their families, as well as all current and futures citizens of Sweden.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

 

Singapore: Prevention is Better Than Cure

As we all know, in today’s world, people have longer life expectancies. In fact, 75% of the world’s population is older than 60 years of age (WHO). We live longer but the fact is the fact is that we are not aging very well. Once we reach a certain age, chronic diseases occur and hinder us from living a healthy long life; two out of three global deaths are due to chronic diseases such as heart disease or stroke. Due to the aging population, these chronic diseases and necessary expensive treatments put a financial burden on nations’ healthcare systems. As Dr. Lim states in the video, “the healthcare system in Singapore has worked well the last few decades, but was not built for such an aging population and a population that struggles with chronic diseases.”

                                                                                          Photo Credit: Niall Kennedy

Singapore has responded to the trend and puts emphasis on preventative health strategies rather than on just treating or curing the diseases. In Singapore, many fitness parks with workout stations have been built, which not only help the elderly to get active and stay physically healthy, but also to meet and get to know one another. With the increasing aging population possibly living alone, the social aspect of these fitness parks is important and improves the mental state of the elderly.

Public Health professionals can only hope that such preventative initiatives towards healthy living situations for the elderly, or better yet all age groups, will be continued not only in Asia. If we can persuade the entire family to get involved in these types of physical activities, we will have healthier children, adults, and elderly and can lessen the financial burden on the healthcare system. Other community organizations may get involved by offering exercise classes and promoting fitness among seniors.

In addition, local governments need to be convinced that building fitness parks has a positive impact not only on the elderly, but all residents’ physical and mental health. Governments overall need to rethink and focus on disease prevention, and not only treatment and cure.

What else can WE do to improve the health of our community members?

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.