The holiday season is a good time to spot signs of decline in our loved ones. Too often, older adults blame it on normal aging, when it’s possible to take preventative measures for certain health problems. The AGES Foundation is launching a free online training course to help people guide the assessment of their elderly relatives.
The training program entitled “Sentinels in Social Geriatrics” is divided into three main parts. The first is to identify signs of deteriorating health; the second is to plan actions to prevent accelerated aging; and the third is to prepare effectively for an appointment with a healthcare professional.
“Unfortunately, even today in society, people often say, ‘Oh, it’s normal, he’s getting old,’ and then they let it go until the deterioration is so severe that there’s not much that can be done. The idea is really to make people realize that they shouldn’t panic, but they need to take care of it because it’s not just normal aging,” explains Dr. Stéphane Lemire, an internist-geriatrician and founder and president of the AGES Foundation, in an interview.
“The idea is to empower people to take better care of themselves, to identify problematic situations and connect them to a support system, which we call social geriatrics,” he continued, explaining. “It’s a support system that helps people navigate the complexities of the healthcare system when necessary, but sometimes, avoid going into the healthcare system for things that can be resolved without going there.”
Dr. Lemire gives a few examples of things you can spot when you arrive at a Christmas or New Year’s party. For instance, if the driveway isn’t cleared of snow at all, or if the person has completely messed up their recipes—for example, if the turkey isn’t cooked properly or the sugar has been mixed with the salt in the meat pie. “These are signs you can look for,” he points out.
“Sometimes, in conversations, there are people who, due to aging, hesitate to talk about their hearing problems, their deafness,” he adds. “And then, in conversations, they seem all confused and their answers are irrelevant. Whereas sometimes, simply by going to see an audiologist, the situation can be resolved.”
Sharing a concern without being confrontational
Sharing concerns about signs of deterioration with a loved one can be a delicate matter. “When people take the ‘Sentinels’ training, they are given tips on how to interact effectively, but ultimately, it’s important to avoid being confrontational and, above all, to express any concerns you may have, for example, about memory, appetite, or a fall,” says Dr. Lemire.
He mentions that people tend to downplay it, justifying it by saying that it’s normal to eat less with age or to be less active. “But we need to change this way of thinking,” he says.
According to Dr. Lemire, this denial stems from a fear of ending up in a seniors’ residence, particularly a long-term care facility (CHSLD). “What people are most afraid of is being placed there, being forced to see the social worker at the CLSC. […] What we want is to show people that there are plenty of very simple solutions they can implement on a daily basis. Just in terms of minimal physical activity like walking, in terms of nutrition by eating more protein, etc.”
During the training, participants are asked to follow the acronym SENIORS AD-PLUS, where each letter corresponds to a checklist for assessing older adults. In 2011, the Ministry of Health and Social Services implemented the Adapted Approach for Older Adults (AAPA) in hospital settings. This approach included, among other things, the SENIORS signs: A for autonomy, I for skin integrity, N for nutrition and hydration, E for elimination, E for cognitive status, and S for sleep.
The training adopts this adapted approach. “It was a deliberate choice because […] when people arrive in the health network, they don’t have the right vocabulary. So, we wanted to equip people with the right vocabulary to be able to structure their observations at the health level, as we do in the hospital with the ELDERLY,” explains Dr. Lemire.
The AD-PLUS component was added because, he says, other elements come into play in a community setting. For example, attention can be paid to self-care capacity, home safety, and the interaction between the senior and their caregivers. It is also important for seniors to have a social life to combat isolation.
The “Sentinels in Social Geriatrics” training course is available free of charge on the website agirpourmieuxvieillir.com.
—The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.
–This report by La Presse Canadienne was translated by CityNews
