Health Essentials
Is abuse of the elderly real?
The elderly are at risk of various forms of abuse
“This week, we are charting a path that we do not often do. An area that people too often gloss over but it is one that is becoming increasingly troubling. Guess who delivered this apt, informative, and thought-provoking piece?
The one and only Dr. Yaw Berko aka Yaw B who is my akonta, friend and colleague. Do not just enjoy reading but also let us all take the necessary steps to protect our priceless men and women in their golden years.”
As a child, I used to live in a compound house at Adabraka. My understanding at the time was that the complex was built by an old lady who had turned over the management of the buildings to her son who collected rent!
Looking back, I believe the old lady had dementia and sometimes soiled herself! This action was met with emotional and physical abuse at the hands of the son! I feel so bad I could not do anything about it, but I was a child at that time.
With the advent of this unfortunate pandemic and its resultant shutdown of the economy and social distancing, depression and other psychiatric illnesses have increased in incidence!
In fact, emotional and physical abuses have been rampant in this pandemic! I can imagine that our elders are not exempt from abuse in this perilous time!
I would like to bring to the fore what elder abuse is and how to prevent or report it when you witness one.
To grasp how the elderly can easily be abused, it is imperative to consider some of the physiological changes that occur as we all age. Our skin loses thickness and elasticity which makes it more prone to bruising!
The elderly lose muscle mass and have generalised reduction in hormone production and activity.
This results in easy bruising, poor bone formation, and increased risk for falls leading to trauma and fractures! The loss of neurons and brain mass causes dementia. Urinary and fecal incontinence can lead to offensive smell and pressure ulcers.
What exactly is elder abuse? Up-to-date, an electronic clinical resource tool for physicians and patients that provides information on adult primary care and internal medicine defines it as any action taken by a person who has an ongoing relationship with an older person that harms the older person and is done with the intent to harm.
Abuse could be physical, emotional, financial, and even sexual abuse.
Physical abuse causes physical pain or injury to the older adult. Emotional abuse entails verbal assaults, threats of abuse, harassment, and intimidation.
Financial abuse leads to misuse or withholding of an older adult’s resources by another. Sexual abuse involves forcing the older person to remove clothing or do any sex act or downright rape!
Statistics are hard to come by in Ghana but in America, it is believed that approximately one in 10 elders experience some form of abuse! I suspect the incidence in Ghana is about the same or higher but will not be known because it is a taboo to talk about such.
The elderly who are at risk of the various forms of abuse are women, those older than 80 years, older people with dementia, and those with less social connections and have trouble paying bills!
Unfortunately, abusers are both women and men and in most cases are family members! Two-thirds of perpetrators are adult children (as I witnessed as a child) or even spouses! In some instances, the abuser may be someone who cares for older people, maybe a house help hired by family members to take care of their loved ones.
It is very easy to suspect abuse in the elderly. Things to look for are cuts and bruises. Pain, soreness, and bleeding in the anal or genital area are some indicators.
Pressure ulcer on the buttocks that develop when a person sits in one position for too long must arouse your antennae for elder abuse!
Elders with a strong smell of urine or faeces suggest poor hygiene and lack of proper care. Emotional abuse sometimes leads to withdrawal from normal activities, unusual depression, and frequent arguments between the caregiver and the older adult.
The effects of elder abuse are daunting. Abuse in the elderly population causes a 300 per cent higher risk of death as compared to those who have not been mistreated.
So how does one prevent elder abuse? The most important thing to do is to keep in touch with him or her. You can also ask the elderly direct questions if you suspect abuse or neglect!
I always suggest paying unexpected visits to their homes if they are under the supervision of a caregiver!
Some countries have adult protective services that seek the interest of the elderly population! If none of that exists in Ghana, I strongly urge the Social Welfare Department to set up one and educate the general population about the existence of elder abuse and how it can be reported.
So just as the Bible says in Exodus 20:12, “honour your father and mother so that you may live long in the land the Lord your God is giving you.” This is the time to take care of our elders who nourished us from the womb to who we are today.
Good luck!
Source:
Dr. Yaw Berko
(yawberko2001@gmail.com)
References
● Ref National Council on Aging NCOA
● National institute on aging
● Uptodate
By Dr. Kojo Cobba Essel
Health Essentials
Glaucoma – a call to have your eyes checked
As we raise awareness of Glaucoma this week (it should continue all year), the importance of community education to prevent vision loss, regular eye care and early detection of this silent disease is key. The theme “SEE THE FUTURE CLEARLY” puts the whole process into perspective.
What will you do if after years of enjoying the beauty of the world through your eyes, you wake up one day and realize your eyes are failing or have failed you? It could be a major life-changing event. You may even run the risk of causing accidents. Imagine what one goes through during the DUM phase of DUMSOR.
Now imagine life perpetually in DUM. All this could be prevented if you make time to care for your eyes: check your eye pressure and have your sight checked as well.
Glaucoma is a group of eye conditions that damage the optic nerve (nerve of the eye) leading to loss of vision. It is most often but not always associated with an increase in eye pressure.
In Ghana, glaucoma is a leading cause of blindness second only to cataract. Ghana appears to have many challenges with “vision” (note the pun) as we have been identified as the country with the second (some data quote third) highest prevalence rate of glaucoma.
Glaucoma is sometimes referred to as the “silent thief of sight” because it can damage your vision so gradually that you may not notice any loss of vision until the disease is at an advanced stage. The most common type of glaucoma, primary open-angle glaucoma has no noticeable signs or symptoms except gradual vision loss. As always, the key is to be diagnosed early and managed since this can prevent or minimize damage to the optic nerve. Early diagnosis is only possible if we have regular check-ups. I checked my eye-pressures six months ago, what about you?
Isolating the risk factors
1. Age – Anyone can get glaucoma, but it most often occurs in those above forty years.
2. Ethnicity – Africans and African Americans are at an increased risk compared to Caucasians. In high-risk groups it may be necessary to have your eyes checked even in your 20s.
3. Family History/ Genetics – You are at an increased risk if a member of your family has glaucoma.
4. Medical Conditions – Diabetics and people with hypothyroidism are also prone
5. Nearsighted/shortsighted – For this group of people, objects in the distance appear fuzzy without corrective lenses.
6. Prolonged Steroid use – especially if used as eye drops, increases our risk for glaucoma.
7. Other Eye conditions – Severe eye injury, some of which may even cause the eye lens to dislocate. Retinal detachment, eye tumours and some eye infections may also predispose us. Some eye surgeries may occasionally trigger glaucoma.
Recognising the warning signs
It is important to drum home the point that just as in high blood pressure, there may be no warning signs. As stated above, the commonest form of glaucoma will hardly warn you. In some forms of glaucoma, however, we may experience the following:
1. Gradual loss of peripheral (side) vision leading to tunnel vision where one is able to see only objects directly in front of him/her
2. Redness of the eye
3. Blurred vision
4. Halos around lights
5. Severe eye pain is sometimes associated with nausea and vomiting
6. Sudden onset of poor vision especially in low light
Overview of tests available
1. Measuring eye pressure. This is a simple painless procedure. It is often the first line for screening for people with glaucoma.
2. Visual Field Test – your doctor will use this test to determine whether glaucoma has affected your peripheral vision
3. Several other tests are available and include testing for optic nerve damage and measuring corneal thickness.
Treatment options
There is NO CURE for glaucoma, but it can be successfully managed. Our options include eye drops, oral medication or surgery, which reduce pressure in the eye to a level that is unlikely to cause further optic nerve damage.
You may not be able to prevent glaucoma, but you can avoid its complications if diagnosed and its management started early. Talk to your healthcare professional and have eye examinations when necessary.
This is the only way to ensure that you can “…see clearly now the rain is gone. I can see all obstacles in my way” and you will enjoy this great vision for years to come.
Glaucoma is “a silent thief of sight.” This is another reminder that NOT ALL SILENCE IS GOLDEN! Get checked.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh. com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “The next big thing in Healthcare in Ghana is the Medics Clinic. Visit https://medicsgroupgh.com/ for more information.”
References:
1. 37 Military Hospital Eye Department infomercials
2. Mosby’s ACE the BOARDS
3. www.mayoclinic.com
By Dr. Kojo Cobba Essel
Health Essentials
Making the most of your visit to the doctor
Very often we leave the doctor’s office only to remember that we left out a major complaint. Some patients immediately rush back to the consulting room totally oblivious of the privacy that the next patient is entitled to. They expect that as they walk in, the doctor should ignore the seated or positioned patient and attend to them. That is totally outrageous. Others go home and continue to live with the condition hoping to be healed miraculously.
Most of us will be extremely lucky to spend fifteen (15) minutes with our doctor and this time is often much shorter in countries/communities where the doctor-patient ratio is so low that at best it can be described as criminal.
We are still in the first quarter of 2025, and I highly recommend that you see a doctor not only when you are unwell but as a means to assess your state of wellbeing and take the needed precautions.
To make the most out of our time with the doctor we need to PREPARE. If your condition is an emergency, then you do not have the benefit of time to prepare.
A must do!
Kindly ensure your personal hygiene is excellent.
- Take a good bath and brush your teeth
- Wear clean clothes that also make undressing easy, especially if you need to expose some areas for inspection/examination.
This may sound ridiculous, but the opposite does happen in real life.
Remember that doctors are human and when you are unkempt you may not get adequate contact with your doctor.
Research on the symptoms
If you have access to the internet or a book worth its salt you may read about your symptoms or wait to read after your doctor tells you your diagnosis.
Remember that if you need to research on the internet, it is essential that you use a reputable site.
In tune with your complaints
- Write down your complaints/symptoms if you think you may forget
- If you have had a similar problem and have the results of any investigations e.g. Laboratory tests, x-rays, CT scans etc kindly carry them along
- Let your doctor know if you react to any drugs
- Be truthful about any medications you have taken for the condition, if you do not remember the names make sure you go with the containers
- If you have any other medical conditions (and medication) make the doctor aware
- Remember to make a note of the following
- When did the symptoms/complaint begin?
- How long have you had these symptoms?
- Is it getting worse?
- Does anything make the condition worse?
- What makes you feel better?
- Is anything related to their onset?
- How often does it occur?
- How long does it last e.g. in pain conditions as well as rash, allergies etc
- Does anyone else in your family have them?
- How do they affect your daily life?
- Is it related to work or home?
You may need to modify these slightly when you have skin lesions, swellings etc. This list is by no means exhaustive, and you may not need to find answers to all of them before getting help, but they will definitely help you ace the visit to your doctor.
If your doctor books you for surgery, do not leave his presence without finding out the following:
- Will you go home on the same day of the surgery?
- Will you need assistance to go home or can you drive unsupervised for instance
- What form of anaesthesia will you be given?
Then, if your visit is for a medical examination, do remember that also being aware of disease conditions in your family will help your doctor select the appropriate tests and make the whole experience and time useful.
See you in the consulting room soon.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh.com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “The next big thing in Healthcare in Ghana is the Medics Clinic. Visit https://medicsgroupgh.com/ for more information.”
References:
By Dr. Kojo Cobba Essel
