Articles on care

Home Care for Elderly

Dr. Shreedhar Archik, Orthopedist
Dr. Gandhi fell at home and broke his hip bone. Dr. Gandhi is 87-year-old, who practiced till he was 78 years old. He had no diabetes or blood pressure. His only problem was dementia, from which he was suffering since last 5 years. He hardly remembers anything and stays all alone with his 80-year-old wife. Dr. Gandhi has two married daughters.Dr. Gandhi underwent a replacement surgery of his hip bone successfully and suffered no complications. However, our physiotherapist could hardly get anything out of him. He used to be violent at times or simply refuse to co-operate. He used to stay awake most nights in spite of sedatives, and then sleep the whole day. His diet suffered. He was on a urinary catheter and a diaper. He was put on an air mattress since he refused to turn in bed and we were worried that he would end up having bed sores.The time came to discharge him from the hospital as there was nothing to be done from the medical team. Physiotherapy was advised by the doctors so that he could get out of bed and get going, however, sadly, he refused to co-operate with the doctors, mainly due to his poor mental health. Both his daughters started panicking as we started discussing with them about his discharge. Though from a well-off family, the daily bill of a good hospital started pinching them. How would they take care of their father at home? How would their frail mother manage him? They had their own families to look after and could not spend the entire day with him.This is where the new home care startups came to our help. These new startups provide almost entire hospital facilities at home. We arranged a hospital type of bed and an air mattress on rent. We arranged two ward boys to take care of him in two 12 hours shift. We arranged a MBBS doctor to visit him once a week to check on his parameters. The cost of all this was almost 50 % of his daily hospital bill.We lack nursing home facilities for such elderly patients who need to be discharged from the hospital but are not fit enough to go home. In foreign countries, these facilities are available (though very expensive). The new startups in India have managed to fill this gap very well.We see patients like Dr. Gandhi who have their kids in the USA and no one local to take care of them. For such elderly couples, any such institution that takes care of them and yet lets them live a quality life, is a god-send facility.These startups vary from region to region and your treating doctors would be happy to share their numbers with you.

Care and Management of Geriatric Patients

Dr. Yogesh Rao, Dentist
Introduction- Aging is a natural process. Old age should be regarded as a normal, inevitable biological phenomenon. As a result of the advances made in medicine and public health measures in the last half of the 20th century, there is a substantial increase in the life span of man. Elders above 65 years (old age) have health problems as a result of aging process, which calls for special consideration.In India, with its population of over one billion people, people older than 60 years constitute 7.6% of the total population, which amounts to 76 million. Incidence of oral cancer, which is an old age disease, is highest in India.A LINK TO SYSTEMIC HEALTHThe exploding geriatric population, coupled with recent discoveries surrounding links between oral health and systemic health, make it increasingly important for the dental community to be prepared to treat geriatric patients in the dental office or where they live. Ongoing research suggests that periodontal bacteria entering the bloodstream may be linked to conditions such as respiratory disease, diabetes, heart disease, increased risk of stroke, and osteoporosis. Studies further suggest that periodontal bacteria can pose a threat to people whose health is already compromised by these conditions.3 In light of this growing body of research, comprehensive dental care becomes increasingly important to help improve our geriatric patients’ quality of life and outlook.ENCOURAGING SENIOR VISITS AND PREVENTIVE CAREA natural part of aging can be dramatically diminished pain perception, which can easily mask the need for professional dental care. Additionally, many individuals accept oral problems and tooth loss as inevitable results of aging, making dental visits unimportant to them. These patients may not understand that regular dental appointments become increasingly important as they age or that professional care can positively impact their quality of life and attitude. Given this, the entire dental team needs to encourage older patients to maintain daily oral hygiene as well as regular dental visits.With patients who wear complete or partial dentures it is just as important to stress proper care and maintenance procedures as it is to encourage follow-up appointments. One report showed that only 19% of denture wearers remember their dental professionals’ instructions regarding regular checkups. In particular, it is advisable to stress oral re-evaluations for denture patients when considering bisphosphonate therapy. By remembering to emphasize these details to your elderly patients and explain why it is important they follow your advice, you can help make check-ups routine and not just a painful emergency.  STRATEGIES FOR SUCCESSDental care for seniors has always posed unique challenges. It requires understanding and sensitivity to the medical, psychological, social, and financial status of elderly patients. When providing care to aging patients with physical and sensory limitations, the entire dental team needs to ensure that patients feel welcomed and comfortable. Be sure that written information such as health history forms, business cards, brochures, appointment cards, and postcards are available in large-printArrange furniture to accommodate wheelchairs and walkers, and to reduce or eliminate barriers. Be sure to offer supportive armchairs (that are not too deep or too low) in easy-to-access areas of the reception room. For wheelchair transfers, always position the seat of the dental chair at the same height as the patient’s wheelchair..BEFORE THE EXAMDental providers will find more success when they communicate clearly, respectfully, and reassuringly with elderly patients. Speak slowly and directly to the patient. Knowledge of the patient’s medical and dental history aids the practitioner in planning and providing safe, personalized, appropriate, and comfortable treatment. An accurate health history is more than a legal necessity..ENCOURAGING CAREGIVER INVOLVEMENTGeriatric patients may have difficulty performing routine oral hygiene procedures due to physical limitations and/or memory problems, making the instruction and coordination of home care particularly important. Because of the possibility of actively declining skills. Demonstrate the use of power brushes and interdental aids and, most importantly, have the caregiver don gloves and participate. Dental professionals need to make sure patient and caregiver completely understand the oral care they will be practicing at home.CONCLUSIONGeriatric healthcare is complex. The medical team’s goals include maximizing each person’s function, health, independence, and quality of life. Ideally, every geriatric team should include a dentist and/or dental hygienist to promote optimal quality of life through proper oral care. Poor dental health does not have to be an inevitable consequence for America’s aging population. By keeping abreast of the complex issues that impact geriatric dental care and offering treatment that takes into consideration the physical, mental, and social status of older adults, dental healthcare providers can enhance their older patients’ health, thus enabling them to enjoy healthier, longer lives with improved comfort, outlook, and quality of life.

9 Ways to Take Care of Your Eyes

Dr. Charu Tyagi, Ophthalmologist
There is a huge population of people in India who are suffering from severe Visual loss.While not all eye diseases can be prevented, there are simple steps that everyone can take to help their eyes remain healthy now and reduce their chances of vision loss in the future.1. WEAR SUNGLASSESUV blocking Sunglasses delay the development of cataracts, since direct sunlight hastens their formation. Sunglasses prevent retinal damage; they also protect the delicate eyelid skin to prevent both wrinkles and skin cancer around the eye, and both cancerous and non-cancerous growths on the eye. Check for 100 percent UV protection: Make sure your sunglasses block 100 percent of UV-A rays and UV-B rays.2. RIGHT FOODVitamin deficiency can impair retinal function. The belief that eating carrots improves vision has some truth, but a variety of vegetables, especially leafy green ones, should be an important part of your diet. Researchers have found people on diets with higher levels of vitamins C and E, zinc, lutein, zeaxanthin, omega-3 fatty acids DHA and EPA are less likely to develop early and advanced AMD.3. QUIT SMOKINGTobacco smoking is directly linked to many adverse health effects, including age related macular degeneration ( ARMD). Studies show that current smokers and ex-smokers are more likely to develop AMD than people who have never smoked. Smokers are also at increased risk for developing cataracts.4. BASELINE EYE EXAMINATIONAdults with no signs or risk factors for eye disease should get a baseline eye examination done at 40 — the time when early signs of disease and changes in vision may start to occur. Based on the results of the initial screening, an ophthalmologist will prescribe the necessary intervals for follow-up exams. Anyone with symptoms or a family history of eye disease, diabetes  or high blood pressure should see an ophthalmologist to determine how frequently your eyes should be examined.5. EYE PROTECTIONIt is important to wear proper eye protection to prevent eye injuries during sports such as hockey and cricket and home projects such as home repairs, gardening, and cleaning. For most repair projects and activities around the home, standard approved protective eye wear will be sufficient. Sports eye protection should meet the specific requirements of that sport; these requirements are usually established and certified by the sport's governing body .6. KNOW YOUR FAMILY HISTORYMany eye diseases cluster in families, so you should know your family's history of eye disease because you may be at increased risk, retinitis pigmentosa,high myopia with degeneration,.. Age-related eye diseases, including cataracts, diabetic retinopathy, glaucoma and age related macular degeneration ( ARMD)are expected to dramatically increase in coming decade.7. EYE STRAINBe aware of eye strain.If you have eye strain working on computers or doing close work, you can follow the 20-20-20 rule: Look up from your work every 20 minutes at an object 20 feet away for twenty seconds. If eye fatigue persists, it can be a sign of several different conditions, such as dry eye, presbyopia, or spectacles with lenses that are not properly centered. See an Eye Doctor. to determine why you are having eye fatigue and to receive proper treatment. 8. EARLY INTERVENTIONMost serious eye conditions, such as glaucoma and AMD, are more easily and successfully treated if diagnosed and treated early. Left untreated, these diseases can cause serious vision loss and blindness. Early intervention now will prevent vision loss later.9. KNOW YOUR DOCTORWhen you go to get your eyes checked, there are a variety of eye care providers you might see. Ophthalmologists, optometrists and opticians all play an important role in providing eye care services to consumers. However, each has a different level of training and expertise. Make sure you are seeing the right provider for your condition or treatment. Ophthalmologist are highly trained professionals who can help you,from prescribing glasses and contact lenses to complex and delicate eye surgery.

Skin and Hair Care for Holi for Everyone

Dr. Jolly Shah Kapadia, Dermatologist
Holi, the festival of colourful fun is approaching. Children are eagerly waiting to play with their pichkaris and have fun.Here are a few tips to take care of your skin and your children's skin and hair during Holi.Skin Care Before Holi:Avoid bleaching, waxing, threading, peeling, laser treatments at least 2 days prior to playing Holi.Stop using retinoid, benzoyl peroxide or hydroquinone based creams for at least 2 days prior to playing Holi.Start moisturizing your skin especially if dry, until the skin texture returns to normal.Skin Care before going to play Holi:Moisturize your skin head to toe properly before you go out to play. This will protect your skin and also help to remove the colour more easily. You can either use coconut oil, or a good moisturizing lotion.Sun protection: Apply a good sunscreen lotion liberally on face, neck, arms; all exposed parts. Lips: Use a lip balm with SPF.Nails: Trim your nails short and cover them with a nail paint and then apply a coat of oil.Clothing: Wear dark coloured-full sleeved cotton clothes. Synthetics would be sticky and denims would be heavy once you have a bucket full of water splashed on you. The more you cover your body, the higher are the chances of saving your skin from colour damage.Hydrate yourself by drinking plenty of water, thandai, fresh fruit juicesSkin Care After playing Holi:Avoid excessive hot water (since your skin is already exposed to the chemicals in colours and also heavy sun, don’t irritate it more).Avoid loofa or scrubs, or rubbing with a harsh towel. Do not rub or scrub the skin a lot to remove the colours. The friction of rubbing would aid in penetration of colours and irritate the skin more.Apply little oil on the skin and then gently try to remove the colour.The colours of Holi, water, sun and finally overzealous cleaning leaves your skin dry. After bathing, pat dry your skin to leave it slightly damp. Apply a thick body lotion to trap the water on the surface of skin, hydrate it and keep it soft and supple.  Repeat moisturizer each time your skin feels dry.Hair care for Holi:Avoid Steam and sauna a couple of days before.Avoid applying hair colour a couple of days before Holi.If possible, pamper your hair to a good oil massage for a couple of days to make them more soft and supple.Hair Care On the day of Holi:Oil your hair heavily hair before you go out to play Holi. Oil will coat the hair shafts and act as a barrier and prevent colours from coming in direct contact with hair shafts and will lessen the damage.Avoid using styling gels or creams.Tie up your hair if possible while playing Holi. Open hair will become more tangled and tend to break easily. Use a fancy bandana to prevent the hair from getting messy.Hair Care Post Holi:Wash your hair with plain lukewarm water so that most of the colour comes off. Use a mild shampoo. The colour might not go off in just one wash. Do not panic and desperately shampoo more.The hair might be already dry, so don’t wash it twice on the same day.Avoid combing wet hair, avoid hair dryers. Dry your hair with a soft cotton cloth,avoid excessive rubbing.Once the hair are dry, massage hair liberally with oil again especially for children.What if there is itching or redness while playing Holi ?Inspite of taking proper precautions, colours can still cause a reaction especially for those with sensitive skin.If your skin starts to burn or you feel itchy, then immediately stop playing, get out of the sun to a cooler place.Splash plenty of cold water,  pat dry with a soft cloth. Don’t try desperately to remove the colour. Rubbing will only irritate the skin more.Avoid further sun exposure.Apply ice packs or cold compresses.Do not apply soap or hot water and try to remove the colour if it doesn’t come off.Apply little coconut oil to pacify the skin.Apply chilled Calamine lotion or medicated aloe vera gel if there is severe burning.See a Dermatologist at the earliest.

Primary Eye Care in 7 Emergency Situations

Dr. Manoj Rai Mehta, Ophthalmologist
Many People learn Basic Life Saving skills to save lives and render primary care to the sufferers in emergency situations.  Similarly, there can be "sight saving situations" where timely action can restrict damage and give sufficient time safely to reach a higher centre for further management.1. Sputtering of hot cooking oil into the eyes while frying.Rinse eyes immediately in running cold water or simply dip your head in a bucket full of water to bring down the temperature as soon as possible.  Apply cool patch/ice pack around the lids.  Instil only lubricating drops (if available), gently patch the eyes with a sterile eye pad or clean handkerchief and take the patient to an eye surgeon. 2. Squirting of glue in the eyes.This is not an infrequent occurring with people trying to squeeze tubes that have a blocked nozzle. Immediate action should be to rinse eyes in running water.  Luke warm water around 40 degrees is somewhat more effective.  Put an ointment (lubricant or antibiotic) in the eye, gently cover the eye and take the patient to an eye surgeon.3. Chemical Injury to the eyes (domestic).Diluted Hydrochloric Acid, phenols, diluted caustic soda are some of the common corrosive chemicals found in homes for cleaning purposes.  They are acidic or alkaline in nature. Accidental exposure is not uncommon.  Immediate action is again washing off of the chemical to dilute its damaging effect.  Wash should continue for several minutes before a patient is taken to a medical facility.  lubricating drops, gels, ointments or antibiotic ointment may be applied for relief.Carry the bottle or the container in which the chemical was stored, with a label, in case the exact nature of chemical is not known, it will help the treating doctor in carrying out specific treatment.4. Foreign Body (FB) in the eye (domestic)Foreign bodies of different kinds fall into eyes under various circumstances such as- dusting, blowing dust with a vacuum cleaner, using a screwdriver on rusted components, hammering a nail, splicing cables, cutting wires, gardening or simply going for a ride.  Do not rub the eyes or put pressure as the FB can go deeper into the cornea.  Rinse in running water for a while, cover the eye with a suitable patch and take the patient to a facility.  One can use lubricating drops or antibiotic drops on the way.  No ointment, please.   5.  Soap solution, shampoo, chlorine in water or face creams in the eyesThis is a common issue especially with young children and all it requires is thorough rinsing followed by a lubricating eye drop and some cool compresses.  Creams can be very irritating as they adhere to the cornea and take a while to get washed off.  Chlorine in the swimming pools can also cause a lot of irritation especially on the days when tipping is done.  Preservative free lubricating drops, cold compresses provide relief.    6. Blunt trauma around the eyesAccidental injuries from window panes, friendly boxing or grappling amongst children are also a frequent occurrence.  Apply gentle pressure on the bones to prevent swelling around the eyes and apply a cold patch with pressure.  Take the opinion of a doctor in due course.  At times a blue haematoma may occur after a few days.  Please take an opinion as some blunt traumas around the eyes can lead to retinal oedema (Berlin's Oedema) that needs to be tackled timely to prevent a loss of visual acuity. 7. Penetrating InjuriesPenetrating injuries are seen with pencil tips, pen tips, compass used in geometry, knives, scissors, sewing needles, screwdrivers etc. Do not try to examine the eye forcefully, prise the lids, put pressure on the eye or even touch it. All these actions can result in disastrous outcomes!  Prevent the child from pressing or touching the eye by firmly holding in lap. Patch the eye gently with a clean handkerchief or a sterile pad and reach a facility at the earliest.You may keep a special first aid kit ready with disposable sterile eye pads, clean bandages, one-inch plaster tape, scissors, preservative free lubricating gel drops and gel tubes, antibiotic eye ointment, antibiotic eye drops etc.  A plastic bottle with a bent tube at the opening may be useful for gentle irrigation of the eyes with water.  It is equally important to reduce the risk of injuries at home by keeping potentially harmful chemicals out of reach of children and supervise them when they are using sharp instruments.  Safety always Saves.   

Eye Care During Holi Festival!

Vasan Eye Care Hospital
Holi matches the riot of colors of spring in full bloom and traditionally was played by making colors from the flowers blooming at that time and even herbs etc. The fragrant natural colours also had therapeutic value and were beneficial for our skin and health. But over the years, natural colours have been replaced by synthetic ones to the extent that most Holi colours sold in the market are oxidized metals or industrial dyes (like those for dyeing our clothing). All these are toxic and can result in anything from skin allergies to cancer, eye irritation to blindness... and much more. When washed, they enter our water and soil, and cause even more pollution. Regrettably, most of the Holi colours sold these days contain many harmful chemicals. In fact most are dyes meant for industrial uses like dyeing textiles and are not meant to be applied on humans. These colours include heavy metals, acids, alkalis and powdered glass. The black paste has lead oxide, green contains copper sulphate, red is mercury sulphite etc. All these are toxic and can result in anything from skin allergies to cancer, eye irritation to blindness... and much more. Even the base in which these chemical are mixed are highly toxic. Several powder or dry colours use a base of asbestos talc, chalk powder or silica. Asbestos is a known human carcinogen which gets built up in the body tissue, even micro quantities can result in cancer. Silica may dry as well as chap the skin. The shine in the colours is due to addition of powdered glass or mica. Many water colours have an alkaline base capable of causing severe injuries. If it enters the eyes, it can pose a great danger to the vision. Colours in the form of pastes have toxic compounds mixed in a base of engine oil or other inferior quality oil, capable of causing skin allergy, temporary blindness. Why your eyes are at risk during Holi: The eyes can get injured easily during Holi because of their placement in the body and also because of the use of harmful chemicals in colours these days. Some safety tips: - Use clear glasses or if in the sun, sunglasses to protect your eyes from coloured water and powder. - Wear a hat or cap to protect your hair and eyes. - Apply a thick layer of cold cream on your face especially around the eyes so that the colour doesn't stick and it can be easily washed... While washing off the colour, keep your eyes tightly closed and use warm water. - If you are travelling, keep the car windows tightly shut. If travelling by bus, do not use the window seat. It makes sense to avoid travelling on the day of playing colours. Contact lenses and Holi Contact lenses do, in a way provide protection however due to its Hygroscopic properties (takes up water) it will absorb and concentrate solution to the eye. Thus while aniline dyes used alone will cause irritation, used on the surface of a contact lens enhances its exposure and thus its side effects and lead to a total loss of epithelium from the eye and even inflammation of the brown iris of the eye leading to severe pain and long lasting eye problems. It is imperative that the contact lens used when the dye entered the eye, should be discarded immediately. It is virtually impossible to clean the dye off. For Holi if you do wish to wear lenses best to use the disposable daily wear lens and discard. Your contact lens specialist will be able to provide you lenses which you may use and discard. It is important to caution your friends when they play Holi that you do not want any powder, or paste or even liquid in the eye. In case it goes inadvertently, wash the eyes out immediately with copious water which will dilute the side effects of the irritant. If redness persists or if the vision seems to be affected it is vital to see your eye doctor immediately.

Take Care of Yourself During Transitional Times

Dr. Abhay Talwalkar, Homeopath
Turning 40 is a milestone and often a time of transition. Your children may be growing up or you may be caring for your parents or considering a career change. One change that is inevitable in the women's life  at this stage is menopause.The average age of menopause for Indian women is 51, with most women reaching this milestone somewhere between ages 45 and 55. A women is considered to attain menopause if she does not have a period for 12 consecutive months. Many women experience a number of changes before getting there and this is called as the premenopausal stage. As you are getting there you will observe a change in every part of your body , in your looks, in your heart, in your bones. This whole change is due to the change of oestrogen levels in your body. Lets look at some of the changes you will experience:Your periods will become  heavier or lighter, shorter or longer than you're used toYou may have one or more missed menstrual period followed by a regular periodYou may feel flashes of heat (Hot flashes)You may tend to be more irritableYour sexual drive may decreaseAnd, you may have a problem sleepingWhile these are just the outward  manifestations  your body is going  through a massive change internally. Your metabolism continues to slow during this  period, your weight gradually shifts from your hips and thighs to your abdomen, shoulders and chest.Yearly screeningIt is recommended that you  see your doctor once in a year after 40 and get your self screened for the followingA pelvic examinationA mamogramBlood sugar levelsBone density testA thyroid function testA clinical breast examinationA Pap smear Must do things after 40 Start a regular regular aerobic exercise and  strength training program, to maintain a healthy weight and a well toned body.Eat a lot of fruits and green vegetables and cut down on sugar, junk food, alcohol & smoking.Find ways to relax, pursue your hobby, like dance, music, painting, yoga etc.Talk to your health care professional as and when needed.   

Taking Care of Our Elderly Patients

Dr. Kamal Kiswani, Dentist
Although the importance of oral health is as good as general health, the complications associated with the former are more severe and different with advances in age. We all are provided with only one set of permanent teeth and hence it becomes vital to maintain them throughout our life. But unfortunately, due to ill practices and unhealthy lifestyle habits, a substantial percentage of us fail to maintain oral hygiene and thereby, lose natural teeth. Moreover, it should be borne in the mind that poor oral hygiene can pave way for heart problems, pneumonia, diabetes and other life threatening illness. Some of the common oral problems and their treatment methodologies and preventive techniques to achieve good dental care for senior citizens are listed below:Good oral habits: The first step towards keeping gums and teeth healthy is by brushing twice a day with good fluoridated toothpaste and flossing at least once in a day. Remember, fluorides are good choice for fighting against cavity and offers assistance in maintaining good oral hygiene. Regular dental check-ups: It is utmost necessary for every senior citizen to visit dentist for routine check-up and professional cleaning, as additional issues pop up in senior years. It is a known fact that general health conditions and medications have a toll on oral health and the only possible way to address these issues is through regular visits to a professional dentist.Sensitivity: Sensitivity is another crucial issue that always nags when one age. As the gum line recedes, teeth that are not protected by the enamel surface become prone to sensitivity to both hot or cold food and beverages. Although it is quite possible to address this complication through anti-sensitive toothpaste, it would be a wise decision to approach a dentist, as sensitivity may be a symptom of a complicated problem such as cavity or any other defect in tooth.Dry mouth: The probability of dry mouth condition is very high for senior citizens and the reason being the side effect of medications. Presence of good amount of pH controlled saliva is very essential to retard the growth of bacteria in mouth. As dry mouth is the end result of absence or limited production of saliva, it needs immediate attention.Gum diseases: Gum diseases or periodontal diseases are one of the major oral complications faced by the people once they reach their advanced ages. Fortunately, the onset of gum diseases can altogether be avoided through good oral hygiene. There are numerous factors that contribute towards the occurrence of periodontal complications: Poor diet habitsBad oral hygieneSmoking Side effects of medicationsMedical conditions such as diabetes and heart problemsIt should be borne in the mind that if proper treatments are availed at the initial stages of the gum diseases, the chances of reversing the effects are quite good. Clean dentures: Many senior citizens wear full or partial dentures in order to achieve functional requirement. But the problem arises when these dentures are not cleaned properly. It is very essential to follow these practices to achieve good oral care for the senior citizens with dentures:Dentures should be properly cleaned only with the prescribed cleaners and never with ordinary tooth paste or any other household cleaners.To maintain the healthiness of dental lining, it is highly beneficial to remove dentures atleast for four hours a day or as prescribed by your dentists.Good food habitsGood diet plays a huge role in maintaining a flawless dental care. Fresh fruits, vegetables, leafy greens, whole grains, low fat dairy products are good choices to maintain good oral care. In general, it is better to avoid processed foods that are loaded with sugar, which has the potential to contribute towards cavity formation.