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Your Health - 24 March 2020
Your Health - 24 March 2020
YOUR HEALTH
Attending
to crucial
ageing needs
MANY people do not know much
about geriatrics, says Dr Lam Ngee
Wei, consultant physician and
geriatrician at Subang Jaya Medical
Centre. “The public and even a few
people in the medical industry
think that geriatricians are general
practitioners (GPs) who treat
elderly people, as opposed to
geriatrics being a legitimate sub-
specialisation,” he says.
These misconceptions affect the
way patients seek treatment, as
they do not think a visit to a
geriatrician is necessary. Dr Lam
explains that geriatricians are
trained with advanced knowledge
in the healthcare of the elderly.
Geriatricians analyse the physical,
physiological, social and emotional Dr Lam Ngee Wei.
challenges of the elderly patient
and determine if these issues are intervention. If patients go to the
caused by the natural ageing hospital early, geriatricians can
process, multiple medical anticipate, target and treat the
conditions and cultural or social condition so patients can stay
influence. healthy and independent for
Dr Lam illustrates the longer. It may be too late if you
differences between a geriatrician wait for something to happen If an elderly loved one is reluctant to see a geriatrician, Dr Lam suggests eliciting the help of someone trusted by the
and a GP, saying, “GPs will treat an before going to the hospital.” patient to encourage him to do so.
illness and discharge you when For patients who may be
you are well. Geriatricians will considering a first visit to a
look into why the illness occurs geriatrician, Dr Lam advises that The care you deserve in your later years
and if there are any underlying the patients bring along all the
causes to the illness. For example, medication they may be on, as well The study of geriatrics infections and diseases and social support and caregiver
geriatricians will not just give a as past health reports and their requires a prior background in proneness to falling to anticipate availability. Hence, the
patient with pneumonia main carers or guardians. internal medicine. Geriatricians and prescribe preventative geriatrician will assess the
antibiotics. Geriatricians will check He assures that there is no need operate by the rule of 5Ms to methods to help elderly patients situation and provide
if the patient has had problems for any additional preparation to assess and ensure the well-being maintain their independence. personalised plans for the care
swallowing or bad dental hygiene an appointment. “Geriatricians will of elderly patients l Medication – Some elderly and treatment of the patient.
as these factors could be causing carry out a comprehensive l Mind – It is common for the people have multiple ailments l (What) Matters most –
the pneumonia, and we will geriatric assessment on your elderly to experience dementia, and consume various types of Geriatricians provide a holistic
provide vaccinations after medical illness, medication, daily depression or delirium. medications a day. Geriatricians line of care by taking the
treatment to prevent its activity, social support, mood and Geriatricians are trained to evaluate the reactions the patient’s concerns and life
reoccurrence.” more. They can draw conclusions diagnose and differentiate these medication have with each other situation into account when
He emphasises that the elderly and help you come up with a conditions and formulate the and optimise the drug prescribing a care plan. While a
do not recover as easily as younger healthy ageing plan for you. appropriate treatment and combinations to reduce or general physician may discharge
people do, and thus require a more Geriatricians work very closely in a intervention. manage unwanted side effects. you after treatment,
cautious approach during team with professionals of other l Mobility – Geriatricians will l Multi-complexity – Every geriatricians will follow up on
treatment. specialties and allied health staff to assess the mobility of the patient patient has his or her own set of your condition and care plan to
coordinate and provide the care such as body functionality, worries such as multiple medical prevent and detect potential
Not just a simple cold you need accordingly.”
At the end of the day, for older
balance, frailty, vulnerability to conditions, financial ability, health issues.
Q: What role did probiotics modulation properties. Preparation in Colorectal Cancer Q: Are all probiotics in the
play in this study? In addition, these probiotic Patients: A Randomized Controlled market the same? Why is
A: Many cancer patients who strains promote the return of Trial published in World Journal of clinical evidence important in
undergo chemotherapy and normal gut function in post- Surgery. choosing which probiotics to The gut represents
surgery have had adverse effects
that reduce their respective quality
surgical CRC and ICU patients,
therefore they can absorb nutrient Q: The study describes
consume?
A: Not all probiotics are the
almost 80% of the
of life. The goal for medical better for a faster recovery and probiotics as “immunobiotics”. same. There are so many immune system. An
professionals is not only to treat
patients, but also improve their
shorter hospitalisation duration,
according to a 2016 study titled
Please explain this new term.
A: In this study, the
probiotics in the market but not
many of them have been clinically
imbalance of the gut
quality of life after treatment. This Microbial cell preparation in enteral Lactobacillus and Bifidobacterium tested with randomised controlled microbiota can trigger
study emphasised how certain
probiotic strains can significantly
feeding in critically ill patients: A
randomized, double-blind, placebo-
probiotic strains showed an
immuno-biotic effect by positively
clinical trials.
A randomised controlled
an inflammatory
reduce the levels of pro- controlled clinical trial published in influencing the immune status of clinical trial is a type of scientific response through
inflammatory cytokines, which are
high in CRC patients, through the
Journal of Critical Care and another
2016 study titled Pre-surgical
CRC patients by lowering pro-
inflammatory cytokine levels by at
clinical trial that aims to reduce
certain sources of bias when
the production of
probiotic strains’ immuno- Administration of Microbial Cell least 60%. testing the effectiveness of the harmful proteins called
new treatment. Randomised
controlled trials are the most
pro-inflammatory
reliable method available for cytokines, which
testing new treatments.
The function and efficacy of
can slowly lead to
probiotic products would not be the development of
known if studies have not been colorectal cancer.
conducted on it. Not all probiotic
strains can be used in
immunocompromised people such
as CRC patients. Other probiotic Malaysians in conjunction with
strains may not have given the CRC awareness month?
same results as what was seen in A: In Malaysia, colon cancer is
this study. It is very important for the most common type of cancer
consumers to know the efficacy for men and second most common
and safety of different probiotic for women. The good news is that
strains before they make a choice. colon cancer can be screened and
prevented. I hope that CRC
Q: How safe is the awareness month will serve as a
use of probiotics in reminder for all Malaysians to take
immunocompromised patients? care of their gut health.
A: The safety of every probiotic Colon cancer screening has been
strain needs to be justified proven to reduce the prevalence of
through clinical study. The the disease and, hence, lower the
probiotics used in this study were fatality rate. If you want a better
considered safe as they did not quality of life, make certain
worsen patients’ diarrhoea and lifestyle changes and practise a
there was no infection, antibiotic healthy diet. Most importantly,
usage or patient hospitalisation access to healthcare and
during the period of the study. undergoing screenings at
Preserving our gut health is important to ward off diseases, because, as Hippocrates once said, “All disease stipulated ages are the best ways to
begins in the gut.” Q: Do you have advice for prevent colon cancer.
THE STAR, TUESDAY 24 MARCH 2020 3
4 THE STAR, TUESDAY 24 MARCH 2020
THE STAR, TUESDAY 24 MARCH 2020 Your Health 5
Natural way to
factors can negatively affect the remarkable herb have shown that fat stored around the internal
collagen and elastic fibres in the it contains high levels of organs such as the heart and liver,
body, causing the skin to sag and polymethoxyflavonoids (PMFs). and the greater the amount of
form unsightly wrinkles and dark PMFs play a major role in visceral fat, the higher our risk of
boost immunity
spots. activating SIRT1, an effective contracting type 2 diabetes and
It is common to turn to factor that protects cellular heart disease.
skincare products and DNA from further This herb can be difficult to
over-the-counter damage, according to a procure, so an alternative is a
remedies such as 2014 article titled black ginger supplement. Look for
medication and Potent SIRT1 one that has been standardised to AMID the pandemic, a growing honey, measured by a standard
steroid Enzyme-stimulating contain more than 15% of all five concern is in strengthening bacterial-killing scale.
creams to and Anti-glycation types of PMFs, such as the immunity to fight off disease. In Opceden Jarrah Honey is
prevent the Activities of patented Sirtmax black ginger addition to medical treatment, laboratory-tested and certified for
extract. Bonus points if it also certain natural products can help its TA score, which is usually 20+,
contains green tea, which is well boost your immunity. but can be as high as 35+.
known for its high antioxidant Western Australian Jarrah With a TA value this high,
levels. Honey is high in antimicrobial Opceden Jarrah Honey
activity, and therefore can be used demonstrates therapeutic
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healthy skin and overall well-being. antibacterial property of the Healthcare at 03-6156 2836/2936.
6 Your Health THE STAR, TUESDAY 24 MARCH 2020
Reconnecting
the link between
generations
ACCORDING to University Malaya’s Social
Wellbeing Research Centre, Malaysia will
soon become an ageing nation as the
number of people above the age of 60 is Intergenerational care works
expected to reach 3.5 million in 2020, and
6.3 million by 2040. As such, the demand
by incorporating pre-schools
for retirement homes or villages will likely or day care with retirement
increase in the coming years.
Nevertheless, retirement homes have
homes. The idea arose Establishing intergenerational contact is said to yield positive results in how well children
perceive and respond to the elderly.
always carried a stigma associated to because of the increase of
loneliness, abandonment, loss of
independence, and pitiful or patronising for
the elderly who are living shown to increase the amount of smiling
and conversation among older adults.
Much more to learn
the elderly, making such homes the last alone as more children This is a particularly positive progress as Despite the advantages of
choice for many senior citizens. These are living away from their a 2012 study by the University of California intergenerational care, Malaysia has not
stigmas are inflated even in Asian San Francisco reported 43% of seniors feel been able to hop on the bandwagon in
cultures such as Malaysia that places high grandparents. lonely, and identifying as a person feeling supporting the experiences of our elderly in
focus on filial piety, where the younger lonely comes with a 59% higher risk of retirement homes. This is because there are
generation is expected to care for the declining health and a 45% higher risk of still many issues and challenges the
elderly. alone as more children are living away death. Malaysian retirement home system has to
from their grandparents. The combination The Atlantic article adds that studies have iron out before it is able to implement new
Co-helping one another of these two groups of people will provide
the relationship needs generally gained
also suggested children who have early
contact with older people are less likely to
changes.
A 2014 study by Universiti Sains Islam
However, living in a retirement home through intergenerational families who live view them as incompetent and less likely to Malaysia, Challenges in managing elderly care
does not always have to carry such stigma. together. exhibit ageism, which is the prejudice or centres in Malaysia, cites financial,
Several countries such as Japan, the US and According to a 2017 article by American discrimination on the grounds of a person’s infrastructure, professionalism, collaboration
the Netherlands have been testing out in magazine The Atlantic, titled The Preschool age. and support, living arrangements, different
small scale the concept of intergenerational inside a Nursing Home, numerous studies These intergenerational interactions also socio-cultural backgrounds and emotional
care since the 1970s. have linked social interaction with enhance children’s social and personal and psychological needs of the elderly
Intergenerational care works by decreased loneliness, delayed mental development, making them prone to be people to be challenges that still need to be
incorporating pre-schools or day care with decline, lower blood pressure, and reduced more comfortable around those with dealt with in the country’s retirement homes.
retirement homes. The idea arose because risk of disease and death in elders. disabilities and impairments of all kinds
of the increase of the elderly who are living Socialising across generations has also been than their peers who lack such experiences. > SEE NEXT PAGE
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THE STAR, TUESDAY 24 MARCH 2020 Your Health 7
Friendly
bacteria and
the amazing gut
HOW much do you know about your combination of Lactobacillus acidophilus
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The balance of good and bad bacteria in consumed, able to withstand the gastric
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the critical factors determining not only your Lactobacillus and Bifidobacterium are the
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Our environment greatly influences this probiotic products, of which a few strains
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and an unhealthy lifestyle can disrupt it. beneficial. The bacteria must be alive or
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experience digestive health problems, such salt to have a better survival rate, in order to
as bloating, intestinal pain, constipation and perform their beneficial functions after they
diarrhoea. have been consumed.
On the other hand, a healthy, balanced Probiotics that contain highly stable
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health. For instance, a 1994 study titled stabilisation processes during packaging and
Lactobacilli in the treatment of dyspepsia due transportation will protect the bacteria
to dysmicrobia of various causes published in against light, heat, humidity and moisture
Vnitrni Lekarstvi suggests that the breakdown.
Establishing
intergeneratonal
contact is said to
yield positive
results in how well
children perceive
and respond to
the elderly.
Building self-confidence
> FROM PREVIOUS PAGE a nursing home combined with a childcare
center? A hopeful model for the future of
However, this does not mean we should aging, on the TED website is hopeful for the
give up hope that our country’s elderly can success of this concept.
one day experience a well-rounded and He says, “The idea is to use community
well-socialised environment. Our design to re-create natural opportunities for
neighbours Singapore are trying out this cross-generational support — to move from
model with the St Joseph’s Home for the programme to proximity, from concept to
Aged and Hospice, which also includes an reality. The conscious effort is all the more
infant and childcare centre, and a common striking in an Asian society where
space provided for the two generations to interaction and care between young and
interact with each other. old, especially in families, occurred
Hence, it is not impossible for Malaysia to naturally for much of its history. But in our
see this concept reaching our shores as fast-paced, highly mobile, globally-oriented
awareness on the advantages of 21st-century world, there’s a need to find
intergenerational care expands throughout new ways to cultivate these time-honoured
the globe. Marc Freedman’s article, What’s values.”
8 Your Health THE STAR, TUESDAY 24 MARCH 2020