QUESTIONS AND ANSWERS

Frequently asked questions regarding the research topics and findings.

Q1. Can a doctor cure major illness in the elderly?

A1. The elderly present with multiple problems, often unrelated to their major illness, which reduce the probability of total cure. One must therefore be cautious about predicting the degree of cure from such illnesses.

Q2. Should an elderly patient accept an 80% cure and endure the rest in order to avoid suffering from over treatment?  

A2. Yes, as long as this allows for minimal erosion of the quality of life.

Q3. Can a doctor who has very little practical knowledge of other disciplines be an effective leader or co- ordinator of multi- disciplinary hospital teams?

A3. The leader must act as advocate for the welfare of the elderly, and should someone with wide training and experience able to evaluate the input of other disciplines. In the present system this usually falls to the doctor, who may need to expand his knowledge regarding the skills of other disciplines.

Q4. Is it advisable to transport the frail elderly to various departments in the hospital for therapy whilst they are recovering from a major illness?

A4. No. When recovering from a major illness the elderly are liable to become frail, tire easily and respond badly to stress and strain. Transporting to various rehabilitation units in the hospital is often counter- productive and should be carefully assessed. It would be logical to treat such a person in their own ward unless it can be demonstrated that a rehab unit can offer a positive benifit.

Q5. Do the elderly respond better when rehabilitation is carried out in a known environment and amongst staff members of their own ward?

A5. Yes. The response of the elderly to rehabilitation improves remarkably when this is carried out in their own known environment  amongst the people with whom they are well acquainted. Confidence with the ‘activities of daily living’ is the aim and the demonstrable result of effective rehabilitation.

Q6. The re-admission rate of the elderly to hospital is often as high as 30-35% before being reviewed at the out- patient clinic. How can be this be reduced?

A6. Where the emphasis on hospital treatment is not matched with the practice of ‘activities of daily living’ the elderly find it hard to cope on returning home, and seek re-admission to the hospital. The elderly patient's ability to perform the ‘activities of daily living’ is the corner stone of minimising re-admissions.

Q7. What is the land mark of old age?

A7. Dependence on others for basic activities of daily living makes a person old and vulnerable to stress and strain. They become indecisive about their essential needs, feel insecure, when left alone or in a room with inadequate lighting, and yet prefer to be alone rather than associate with others.

Q8. Why is middle age an oppertunity to maximise the benefits of life?

A8. This is a time of maturity, of being experienced in life skills and having time to use for yourself. Middle age is the opportunity to plan, to make changes and become a fitter person, pushing back the boundary of old age and subsequently, death.

Q9. What is the sequence of events in slipping from middle to old age?

A9. Losing confidence in oneself is the turning point. A person who is house-bound gradually becomes bed room then bed- bound. A multiplicity of problems follow including confusion, incontinence, pressure sores and contractures of limbs.

Q10. How does maintaining the quality of life push back progress into old age?

A10. Feel good factors, or the quality of life factors, provide confidence and contentment and thereby enrich life, allowing you the opportunity to get more out of life, delaying the gloom of old age.

Q11. What is the role of a Preventive Geriatric Clinic?

A11. Awareness of illness and physical limitations can help to defer infirmities. A good case history, thorough physical examination and problem oriented documentation are needed to uncover an illness complex. The objectives of the clinic are achievable without an elaborate supporting service. It is cost effective and can maintain the quality of a person’s life for a longer period.