Reaching out to the vulnerable community

Posted by on Aug 3, 2017 in Blog | 0 comments

Reaching out to the vulnerable community

Elderly persons have specific needs which make them more vulnerable than others. Their limited mobility, poor vision and multiple chronic illnesses can make access to support difficult. The population of the elderly in Kenya is increasing and estimated that their number will be 2.2million. This is due to declining fertility and increased life expectancy.

Globally, there has been increased recognition of the elderly and their needs including palliative care. In order to increase awareness and sensitization of palliative care among the elderly, Dr. Katherine Pettus, Advocacy Officer atInternational Association for Hospice and Palliative Care (IAHPC) wrote on the European Association for Palliative care blog, that the global, regional and national palliative care community now has the opportunity to make our case on UN member states need to protect older persons’ rights to palliative care. This is because Eighth UnitedNations Open Ended Working Group on Ageing(OEWGA) has selected long term and Palliative care as one of the two questions to be discussed during its 2018 session (OEWGA).

Advocacy is a fundamental element in order to sustain palliative care services for the elderly. In Kenya different organizations in the counties have started helping the elderly by provision of essential items that are important in order for them to live a comfortable life. One of the organizations that have supported the elderly persons is Mama Ibado, a charitable foundation based in Isiolo County.

The foundation is currently supporting over 400 persons. This entails; steady monthly food rations, shelter, and clothing. It also conducts awareness creation to the community on the needs and rights of the elderly. They recently conducted their annual medical camp at Al-Falah Islamic Center for the elderly. Over 600 aged persons benefitted from professional medical consultations and appropriate treatment. Kenya Hospices and Palliative Care Association (KEHPCA) team also participated in the medical camp since the association recognizes the need for palliative care targeting the elderly to improve their quality of life.

“Majority of the patients I have served today have unmet palliative care needs especially pain, symptom control and malnutrition”, remarked one of the healthcare workers.

The elderly are prone to many diseases due to their decelerating immunity. Therefore they mostly end up diagnosed with malnutrition, diabetes, cancer, heart and respiratory diseases, influenza and pneumonia, depression, arthritis, athralgia among many other diseases. For that reason it is important to factor and blend them in the Palliative Care services.

Many of them elderly said that they live with untreated chronic pain, insufficient food and poverty and that they are ignored by the society, their family members and the government.

‘It is really sad, we are alone, suffering. I have pain in my joints and back and cannot tend to my shamba (garden) to grow my vegetables. This camp is a life saver for me and I wish this would be on a frequent basis to meet our needs’, said one of the elders.

Palliative care is fundamental to health and human dignity and is a basic human right. Palliative

care for older persons is centered around the provision of symptom management and pain relief for chronic and life-limiting illnesses, taking into account the distinct needs and capacities related to aging. Care may be provided through inpatient facilities, community-based centers, or at home, and often requires collaboration between multiprofessional health workers across different settings. Effective palliative care for older persons involves both patient and family needs and integrates physical, psychosocial, legal, and spiritual support. The right of older people to decide about individual treatment preferences and where they receive care must be protected at all times.

Open Society Foundations paper on Palliative Care and Human Rights of Older Persons states that older persons are more commonly affected by multiple medical problems of varying severity, with intensified effects that may be much greater than any individual disease and typically lead to greater need for care. They are also at greater risk of adverse drug reactions and their illness may be superimposed on physical or mental impairment, economic hardship, and social isolation. Patient surveys consistently find that pain is a predominant symptom in approximately one third of older patients, yet older persons tend to underreport pain, and the high prevalence of sensory and mental impairment often makes their communication more difficult. They may also be reluctant to report pain because they expect that symptoms are a “natural” part of aging and do not believe their pain can be alleviated.

The UN Independent Expert on older persons’ notes that “Older persons have different patterns of disease presentation than younger adults, they respond to treatments and therapies in different ways, and they frequently have complex social needs that are related to their chronic medical conditions. Particular attention needs to be given to palliative care. In certain countries, this is not officially recognized as a medical specialty and the medicine used in such care is limited, for several reasons, including restrictive drug regulations, failure to implement a properly functioning supply and distribution system, and inadequate health-care system capacity.”

Clearly there is a great need to give more attention to the palliative care needs of older persons.

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