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Doc Talk: Don't let yourself get frail with age

Set the foundation for a healthier, happier old age by taking charge of your health now

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Richard Hui on 12 Aug 2019

The Straits Times

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As a 67-year old who lives on her own and has always been independent, Madam Z experienced great frustration when she started tripping and falling repeatedly.

 

She had overcome a minor stroke many years ago and survived a hip fracture after a recent traffic accident. But now, she was losing her balance just walking to the market.

 

She was understandably in low spirits and did not realise that frailty had set in.

 

Frailty is a state of declining health and functioning, when symptoms such as weakness, slowing movements, falls and slower recovery from illness occur.

 

It is commonly associated with ageing and often creeps up on us. If left unchecked, it can lead to permanent disability and a poor quality of life.

 

Recent studies show that about 6 per cent of Singapore residents are frail. The prevalence rises to about 10 per cent among patients with multiple illnesses.

 

As Singapore ages and chronic illnesses become more common, frailty and disability are expected to increase.

 

Yet, as a growing number of active elderly can attest to, frailty and disability are not inevitable.

 

Regular exercise, especially if this includes resistance training, and avoiding unnecessary medications have been proven to reverse or slow down frailty.

 

Having a healthy diet, adequate rest, an active mind and strong social support are other key deterrents.

 

Preventing and controlling chronic diseases such as diabetes, hyperlipidaemia (high cholesterol), and heart disease are also vital in reducing one's risks of developing frailty. Even when frailty occurs, it can potentially be reversed, if it is detected early.

 

HELP FROM THE COMMUNITY

 

Madam Z's case was flagged by Mei Lin, a case manager from the Agency for Integrated Care (AIC), who had visited her and the other elderly residents in the HDB block.

 

She noticed that Madam Z had not been taking her cholesterol medications regularly.

 

She had also been missing her polyclinic appointments due to her low spirits and worries about her finances.

 

Mei Lin then linked Madam Z up with a community nurse from the National University Health System's Community Network for Seniors (CNS), who assessed her functioning at home before she headed to her regular polyclinic.

 

This way, the polyclinic team, made up of the family physician, care manager and medical social worker, was able to thoroughly assess her for frailty in a single visit.

 

Following the polyclinic team's assessment, Madam Z was referred to St Luke's Hospital Day Rehabilitation Centre to start on a special exercise regimen to improve her balance and strength.

 

Eye surgeons managed her cataracts, while the polyclinic psychologist and her church friends provided her with psychological and social support to help lift her spirits.

 

A dedicated team of polyclinic doctors and an experienced nurse managed her medications and cholesterol and coordinated her medical care.

 

Through the Community Health Assistance Scheme and Medifund, Madam Z also managed to receive financial help.

 

At the centre of this is Mei Lin, who helps her navigate the many health and care services that she needs. Mei Lin even accompanies her on her appointments and has become her advocate and confidante.

 

As Madam Z's case illustrates, much can be done to help the elderly combat frailty and preserve their independence.

 

Agencies such as AIC, Silver Generation Office and CNS provide programmes and services to encourage healthy living among the elderly population.

 

Financial packages such as the Pioneer and Merdeka Generation ones make healthcare more affordable and the raised retirement age encourages financial independence.

 

Many exercise amenities, courses and leisure activities promote physical, mental and social resilience. Groups of general practitioners are also working with public health institutions to provide better, more affordable primary healthcare.

 

And there are initiatives by social service agencies as well as community efforts targeted at helping the elderly to eat and live better.

 

For example, Share A Pot prepares and shares hearty broths to encourage social bonding and good nutrition.

 

Gym Tonic runs a low-cost exercise programme specially tailored to seniors, and the Healthy Ageing Promotion Programme for You (Happy) combines physical and mental activities in a fun exercise routine led by volunteers.

 

Ultimately, the fight for a healthier, happier old age starts now with each of us.

 

It is better to take charge of your health than to wait for other organisations, authorities and healthcare providers to assist you with your health.

 

Build up your physical, mental, emotional and social reserves by adopting a healthy lifestyle at a younger age.

 

If you have a chronic disease, seek a trusted healthcare provider who can provide good care and advice over the long run, and even detect frailty before it progresses.

 

• Dr Richard Hui is a family physician and the head of Choa Chu Kang Polyclinic.

 

Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.

 

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