As we prepare for the New Year tomorrow and get caught up in the celebratory mood, many of us with elders in our families, often forget to anticipate the risks they face, especially, during the festive period. Consequently, we expose them to numerous dangers outside their homes on the roads, and worse, inside their homes where they expect to feel safe.
To find out what these dangers are, and how we could make environments outside and inside the home safe for all elders this festive season, the Sunday Observer spoke to a specialist in the field, Consultant Physician Geriatrics Unit, Kalubowila Teaching Hospital, Dr DILHAR SAMARAWEERA .
Excerpts …
Q. Most Lankan households are now in the midst of last minute preparations to usher in the New Year tomorrow. However, the chances are their celebratory mood could end up with tragic outcomes both outside and inside their homes. If excessive holiday spirits drove them to partying till late night and driving under the influence of liquor, senior citizens, especially, could be vulnerable to road accidents and even injuries from lighted fireworks thrown into their cars by youthful merrymakers. Your comments?
 Dr Dilhar Samaraweera |
A. We are experiencing a rapidly ageing population, and nearly 12.5% of our population is over 60 years according to data of the Department of Census and Statistics. Of that, 7.6% is 60-69 years old and 1.3% 80 plus. The vulnerability to injuries increases with the age of the individual. The reduction of senses, including problems with reduced vision, decreased hearing and instability leading to falls and injuries can result in fatal outcomes, especially, during this festive season. During merry making we forget there is an elderly population who are at risk of injuries. The elderly with sensory deficits who are not swift as the young are likely to encounter falls and burn injuries due to ignorant people who accidentally knock against them, and due to the careless use of fireworks. The festive season is also a period for travel locally and internationally and shopping in crowded places. Travelling and exposure to crowds exposes the elderly to infections such as, viral influenza, and consumption of food from outside boutiques lead to food borne illnesses which could place them at risk of hospitalization and even death.
Q. As a Consultant Geriatric Physician tell us how road accidents which spike at this time around impact on their health?
A. The elderly have brittle bones and reduced muscle mass. Thus even minor road traffic accidents can cause fractures of bone irrespective of them being passengers or pedestrians. Fracture of the hip and whiplash injuries to the spine and bleeding into the brain can cause permanent disabilities. Elderly pedestrians are especially at risk due to their decreased senses and slow reactivity. In recent years there have been many reported incidents of elderly deaths due to them being run over by speeding vehicles.
Q. Many elders tend to get neglected by their families and caregivers during the festive period, resulting in serious health risks. One category includes Alzheimer patients who may wander outside their homes and get lost. Or get lost inside their own homes ending up in kitchens with open fires that could harm them. This could happen to young children too, especially, toddlers.. Your comments?
A. One has to have presence of mind while enjoying the festivities, especially, when an elder with dementia is at home. The noise of the fireworks and the hustle and bustle due to celebrations could cause confusion in demented older persons and result in them wandering and getting lost and subject them to injuries due to falls and road traffic accidents. There have been instances where the elderly had forgotten to switch off the stove or the kettle, and the eruption of fires killing occupants of the house. Curtains and flammable material should be away from the stove. Fire alarms and vigilance regarding the whereabouts of occupants and activities of elders and toddlers could prevent many such home hazards.
Q. In your experience what are the most common home injuries in elders at this time around?
A: The most common home injuries in elders during this time are falls. Falls have resulted in fatal and nonfatal injuries. Injuries in road traffic accidents due to erratic driving and the ignorance of drivers are the next common cause for injuries. Regarding children, burns sustained from fireworks are a common injury during the festive season.
Q. What should you do when an elder is injured at home?
A. When an elder is injured at home the most important actions are to take the victim to a safer place, away from the source of injury, give appropriate first aid, if needed seek medical assistance, find out the reason for the injury and take action to prevent such injuries in the future.
Q. Recent data from the Accident Service reveals that slips and falls among elders have spiralled, especially, during festive seasons. Considering their advanced age, tell us what sort of injuries are likely to occur from such accidents?
A . Injuries due to falls are commonly fracture of hip and wrist, others are vertebral fractures causing spinal injuries, shoulder and elbow dislocations, contusions, abrasions and head injuries. These injuries are due to decreased vision and instability, osteoporosis and decreased muscle mass and strength. Hospitalization and rapid response with hip surgery, relocation of displaced joints, assessment, monitoring and surgery for head injuries would enable the elderly to live longer with a better quality of life
Q. What about home remedies?
A. Home remedies are not recommended as the window of opportunity for correctional procedures preventing disability could be lost. Home remedies could help minor aches and sprains only.
Q. Accidental burns among the very young and adults from open cooking hearths, kerosene stoves, oil lamps and candles are also frequently reported during a festive period. How are these burns treated? What are their adverse health impacts?
A. Burns are treated according to their extent and depth, minor burns with an extent less than 3 inches could be attended by cooling it, by holding under running water until pain ceases, or by applying a wet compress. If blisters are formed do not break them, apply a moisturising lotion and antibiotic cream, if necessary with a doctor’s advice. Cover the burn area with sterile gauze bandage. In large burns remove the person from the danger area make sure the person is no longer in contact with the source of burn, and do not immerse in water as it can cause hypothermia,
Cover with a clean cloth, elevate the area of burn, look whether the person is breathing, shout for help and take the person to the hospital immediately.
Q. Accidental electrocution from festive illuminations with faulty wiring and sub quality multi plug sockets are now an emerging danger to children and adults. What is the first thing that one should do if a person suffers from an electric shock at home?
A. The first thing is to switch off the Main Switch and cut off the electric supply. Never touch the patient while the person is still in contact with the electric supply.
Q. What happens to a victim of electrocution? How soon should he be rushed to hospital?
A. Electrocution can cause cardiac arrhythmia, loss of consciousness, seizures, burns. If burns are present, cover with a clean cloth. If the victim has breathing difficulties, suffers from confusion, loss of consciousness or from burn injuries or severe pains, rush to hospital immediately.
Q Eating too much rich food and allergic reactions to certain foods are also common at this time. Your comments?
A. Food can cause infections, food poisoning and blood sugar rise in patients with Diabetes mellitus. Especially, cakes with many mixed ingredients and fried food items including various meats cooked in large quantities with reused oil can result in food allergies during this period.
Q. More food poisoning cases are also reported during a festive season due to housewives cooking their meals in bulk to save time, and not de-frosting the food, especially, meats, properly. What are the symptoms of food poisoning?
A. Symptoms of food poisoning are nausea, vomiting, diarrhoea which can be watery or bloody, abdominal cramps and fever which usually occurs within hours of consuming the contaminated food. However, symptoms may occur a few days later or a week later. They can be mistaken for indigestion or heartburn, and one should seek medical advice if unable to drink due to persistent vomiting, bloody vomit or diarrhoea, fever, severe abdominal pain/cramps and reduced urine output or weakness.
Q. Health impacts on elders who consume such food?
A. Elders are already having decreased adaptability due to reduction of physiological reserve and resilience and are vulnerable to reduced sodium levels in blood, dehydration leading to renal failure, and critical illness.
Q. Any special message on how we can collectively minimise injuries in elders to allow them to lead their twilight years comfortably?
A. When celebrating the New Year, we should first take control of ourselves. Avoid risky behaviour which could cause injuries to others. Spare a thought for the not so quick and agile elders who have decreased resilience and could easily injure themselves due to the ignorance of the merry makers. Adopt simple measures to avoid home injuries. Remove obstacles in their way. Ensure dry floors so they won’t slip and fall. Avoid driving under the influence of alcohol and don’t exceed speed as though you own the roads. If you can do this, it will prevent fatal injuries and loss of lives of elderly pedestrians with reduced senses and instability.