Commentary: You don’t have to age and grow frail alone. Nurses have your back

SINGAPORE: A few years back, my married woman and I noticed my 83-yr one-time father needed more time with several daily activities.

He walked slower. Putting on a shirt and pants seemed a more than laborious chore than before.

However, he remained determined to "report for piece of work" at his hawker stall, where he runs his own business organisation selling coffee and drinks for half a mean solar day.

Recently, he told me he wants to retire presently. My father enjoys working and does non rest except during Chinese New year, so this is a big step.

He has finally decided to listen to his torso. Age is catching up.

Though it is a relief that my dad is coming to terms with this new reality, I worry that he may become frail if he does not maintain some level of physical action.

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HELPING Fragile SENIORS A HEALTHCARE PRIORITY

My father is 1 of the many elderly among us experiencing life-altering changes. One in four Singaporeans will exist 65 and in a higher place in 2030.

Studies show that every bit seniors age, they may eat less, lose muscle, and go more decumbent to illness. When they fall ill, they tin can take longer to recover.

Frailty is characterised by ageing-related weight loss, reduced muscle strength and a slower walking stride.

An elderly adult female wearing a protective confront mask pushes a cart in Singapore on May 8, 2020. (Photograph: AFP/Roslan Rahman)

Clinicians increasingly believe that frailty can exist a key cistron leading to longer hospital stays or poor recovery.

It's in the infirmary where tackling frailty can make a huge divergence in a senior's quality of life but healthcare workers are often more focused on managing their admitting diagnosis, and not the syndromes unremarkably associated with frailty.

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NURSES ARE STEPPING Upwards

What gives me hope after more than ii decades equally a nurse, is how vast an improvement my peers and I take seen in the upskilling in the profession, spanning administration, enquiry, education and even informatics.

We believe nurses can play a leading role in addressing the needs of the silver tsunami, in addressing ii mutual health bug: Frailty and caring for chronic wounds.

These are cardinal challenges for Tan Tock Seng Infirmary (TTSH), which sees a big majority of patients who are above 65.

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For such reasons, TTSH along with Changi General Infirmary were the beginning hospitals to subscribe to NICHE – Nurses Improving Care for Healthsystem Elders, a nurse training programme that tackles ageing-related conditions such every bit dumb cognition, incontinence or gait instability.

More than 500 nurses accept undergone this calendar week-long training with subsequent on-the-job cess.

Under this programme, nurses take upward master roles to manage the care of hospitalised seniors. They are trained to look out for common problems associated with skincare, mobility, nutrition, hydration, continence and delirium that may delay recovery.

Medical staff look to cross the street to the National Centre for Infectious Diseases building at Tan Tock Seng Hospital in Singapore on Jan 31, 2020. (Photo: AFP/Roslan Rahman)

During a defined written report flow involving more than four,200 seniors at TTSH from August 2022 to Oct 2017, nearly half were provided nurse-led interventions such as early cess to look out for conditions such as frailty, fall risk or cognitive harm, nutrition screening and counselling for patients and families were done.

In daily care, nurses encouraged the elderly to motility about, assisting patients with sitting out of bed and ensuring regular bathroom breaks to encourage independence especially later on belch. These actions have shown to reduce episodes of delirium, bed sores, as well every bit the use of diapers and restrainers amidst elderly patients who were provided specialised geriatric intendance.

Nurses likewise play a key role in helping reduce infirmary access rates among seniors. In the United Kingdom, nurses assess elderly patients for signs of frailty, nutrition deficiencies, or problems arising from dementia or delirium at the emergency department, so they may be directed to customs services if hospitalisation is assessed to exist a less optimal solution.

In other advanced countries, nurses in dwelling intendance services have stepped upward to manage frailty and the common geriatric syndromes.

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In Singapore, nurses are well-positioned to practise the aforementioned, peculiarly community nurses, who visit discharged patients at home to proceed them from being readmitted into the infirmary.

These nurses are equipped with a myriad of skills taught past physicians, physiotherapists and occupational therapists to care holistically for patients with non-complex conditions such as arthritis, hypertension and moderate diabetes.

Meanwhile, a home care nurse can exist the single contact point to provide care and advice to a frail elderly with malnutrition who may exist experiencing side effects from the multiple medications he or she has been taking.

Such a ane-terminate point of care would improve affordability and assist coordinate intendance needs. Regular health reviews tin besides build trust between seniors and their healthcare provider.

NURSES CAN Train VOLUNTEERS

Yet relying on nurses alone for elderberry care is not sustainable in the long run, as developed countries grow greyer.

A community nurse helps her patient use an eyedrop applicator, Sep 2019. (Photograph: Christy Yip and Say Xiangyu)

We know this and have therefore worked with our larger community to enlist the help of ordinary citizens. At TTSH, nosotros have more than 500 active volunteers across 33 volunteer programmes, who contribute and back up our clinical teams in various ways.

In one programme, volunteers first receive online training led by nurses to understand what delirium looks like and guided in engaging with and caring for patients. Volunteers play puzzles, memory games, and even bear reminiscence therapy with patients; activities which take been proven to prevent delirium episodes.

Some other programme trains volunteers to help patients in simple rehabilitation exercises to enhance their recovery.

Anyone who is willing can learn these skills. Volunteers who contribute to patient care could help free upward nurses for more urgent, college-order tasks.

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NURSES Tin Assist Support CAREGIVERS

Ane other group deserving of more than attention are family caregivers of patients with chronic illnesses, whom nurses are also equipped to help.

We oftentimes hear stories of how caregivers, who may be seniors themselves, experience fire-out.

A nursing research team at TTSH recently developed an assessment tool to decide how a caregiver is coping. They are now looking at how to design support services and validate training programmes for caregivers.

In due time, nurses may have yet an additional role to identify and aid distressed caregivers. We do this knowing that with adept caregiver grooming, we can besides avoid mismanagement of chronic wounds, and assist caregivers care for such seniors living with them.

An elderly woman in a wheelchair, pushed past her caregiver. (Photo: Gaya Chandramohan)

Technology and telehealth have made wound care more attainable to caregivers. The Home Nursing Foundation has used a wound imaging app that can digitally tape the appearance and size of the wound. Nurses can then determine an advisable treatment program.

Colleagues tell me bed sores and diabetic wounds are mutual among the elderly. Unsurprisingly, many patients and their caregivers may easily dismiss a pare tear on a bed-bound elderly or a pocket-sized cut on the foot of a diabetic.

This tin be unsafe. Though such wounds may look harmless initially, they can deteriorate fairly rapidly and become septic if inadequately managed.

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LIGHTING THE Way FOR NEW NORMS IN NURSING

The impact of the silvery tsunami on healthcare cannot exist underestimated.

With nurses forming 30 per cent to twoscore per cent of the healthcare workforce, we know nosotros can play a significant role in anile care if we pool our expertise, skillsets and compassion to help caregivers, volunteers and members of order build basic knowledge in managing mutual health bug surrounding ageing.

Together we can help our seniors age well in their homes and communities, and strengthen the textile of social club to be more elderly-friendly.

Offshoot Associate Professor Yong Keng Kwang is a veteran nurse at Tan Tock Seng Infirmary. He has been Master Nurse at TTSH since 2022 will accept on the portfolio Group Main Nurse at the National Healthcare Group (NHG) from Oct 1.

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Source: https://cnalifestyle.channelnewsasia.com/commentary/commentary-you-dont-have-age-and-grow-frail-alone-nurses-have-your-back-295506

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