Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

Geriatric Home Care Tips

The most common geriatric orthopedic problems are osteoporosis, back pain and Osteoarthritis of the knee.

Osteoporosis is a degenerative disease which is characterized by progressive loss of bone mass throughout the body. Osteoporosis may strikes at any age but is more common among older people. If an elderly need a special care, then an elderly with osteoporosis need an “extra” special care and precautions. If you are caring for an elderly, especially if that person is female, there’s a high percentage that they have osteoporosis.

Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. Fractures occur typically in the hip, spine, and wrist. There are treatments that can slow its progression.

Caring for someone with osteoporosis is a difficult task. As a caregiver you must constantly be on your guard against anything that could contribute to a fracture in osteoporotic patients.

Here are some tips on how to take care of elderly with osteoporosis:

–         Facilitate doctor’s visitation. It is important to learn about the specifics of the elder’s condition. Take lots of notes and jot down your questions before heading to doctor for appointment. Ask about things such as medications, diet, physical activity and warning signs. Your doctor is also your first resource in dealing with any other medical conditions or questions that may arise as a result of living with osteoporosis.

–         Be attentive to elder’s medication. Encourage elderly patients with osteoporosis to stay on their medication, and not just those prescribed to treat the osteoporosis. Make sure that they are taking the correct medications, and also make sure that medications are taken as prescribed.

–         Watch out for side effects. Be wary of the side effects that caused by medications, not only the medication for osteoporosis but even to over-the-counter drugs, vitamins and supplements. They may pose risks. Side effects that impair vision or balance are particularly important to note since they can contribute to falls—a key concern with osteoporosis since bones break easily. Talk with the doctor about any drugs the elderly takes and stay on top of prescribed treatments.

–         Provide an elderly proof home. A home for an elderly with osteoporosis should be “fall-proof.” Statistics have shown that 30% of those who are above the age of 65 have experienced a fall before, and those beyond 80 years of age may have fallen once or more in a year. This is significant as an elderly who has fallen may suffer from injuries like fractures, bruises, contusions and other injuries.To prevent this clear any clutter from hallways, stairs or other walkways. Make sure living space is well lighted. Install handrails in bathrooms and textured mats in tubs and showers. Cover hard floors with rugs—with rubber mats beneath them if they are not already slip-proof.

Back pain affects people of all ages and older patients are more difficult to treat.  Whether it’s osteoporosis, arthritis, shrinking padding between backbones or just the normal changes that come with aging, addressing the problem before it becomes debilitating is very important.

Back pain in the elderly usually causes a decrease in function, much more so than in the younger population, so that they’re not able to perform basic tasks of daily living.  Their pain also tends to be more chronic.  Incorporating physical therapy occupational therapy, nursing and exercise physiology to ones routine can produce significant results for the aging population even before the onset of back pain.

General recommendations are to resume normal, or near normal, activity as soon as possible.Stretching or activities that place additional strain on the back are discouraged, however.

–         Sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees.

–         Avoid exercise in people with acute back pain. Exercise, however, may be useful for people with chronic back pain to help them return to normal activities and work.

–         Non-prescription medications may provide relief from pain and are available over-the-counter. It is an excellent medication for the short-term treatment of low back pain. Because of the risk of ulcers and gastrointestinal bleeding, talk with your doctor about using this medication for a long time.

–         Topical agents such as “deep heating rubs” have not been shown to be effective for most patients but if it helps the individual then it is OK to use it.

–         Some people seem to benefit from the use of ice or heat and generally if it very safe if it is applied correctly.

The knee is the largest joint in the body. The elderly require normal functionality to perform every-day activities. Over the course of a lifetime, natural lubricants dry-up and the joint wears away, increase the likelihood of osteoarthritis and knee pain.

The incidence of knee pain increases with age. Performing knee exercises along with glucosamine supplementation are excellent for preventing knee damage.

When learning to perform leg extensions, it is sensible to seek the guidance of a fitness instructor. Most instructors are readily available and will be only too happy to assist. Always warm up properly and choose a sensible training weight. The correct execution of leg extensions is fundamental to preventing knee pain.

–         Choose a manageable weight. Selecting a weight that is too heavy can only serve to cause further knee damage. It doesn’t take a large weight to build surrounding muscle and act as a joint treatment.

–         Sit down with the back directly against the support. This is essential so that no strain is placed on the lower back.

–         Ensure abdominal muscles are tensed, knees are bent and chest is upright.

–         Perform a slow pushing motion, stopping just before both legs are straightened and then steadily lower the weight to the starting position.

–         Repeat the process for 10-12 repetitions. There should be a minor burning feeling in the surrounding muscles caused by lactic acid build-up. This is perfectly normal for any muscle-related exercise.

Research suggests that glucosamine slows the progression of osteoarthritis. It works by lubricating joints and building cartilage. Taking 1500mg tablet of glucosamine can help as a joint treatment and protect the elderly from premature knee damage.

Knee problems are a reality for millions of seniors. As a knee treatment, few things work better than leg extensions and the supplement, glucosamine. Seek guidance from the family doctor before starting any exercise regime. If knee pain has become too extreme, it might be possible to get a knee replacement.

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