There are many different healthcare professionals available to Caribbean people that we may not have known about 20 years ago. Sometimes older people are uncertain of how different therapies or treatments can really help them. Below is a list of some common healthcare professions and how they can work for you. Many times, using one of these other professionals (besides your regular doctor) and can save you money in the long run and improve your quality of life. Here's how:
Psychiatrists- Psychiatrists are doctors who have specialised in the treatment of mental illness. First, we go to medical school. This is why we can prescribe medications- we are trained firstly as doctors. Then we spend some time specialising and training in psychiatry. Some psychiatrists like myself decide to spend even more time training, so we sub-specialise in a certain kind of psychiatry, like addiction or geriatric psychiatry.
Speech & Language Pathologists- These professionals are very useful for stroke and dementia patients. They are trained in helping people with communication issues or swallowing problems.
Physical Therapists (also known as Physiotherapists) Physiotherapists are specially trained to help persons recover from muscle injuries and strengthen their body. They can assist with mobility and balance issues. They are useful for persons who have had a fall or who have had a stroke.
Occupational Therapists- Occupational Therapy is very important for persons who have fallen ill and can no longer go about their daily tasks the way they used to. This includes dementia patients, stroke patients, or people with mobility challenges like Parkinson’s disease. Occupational Therapists assist with increasing a person’s independence and confidence by helping them to adapt and learn how to do day to day tasks such as bathing, dressing and hobbies even though they are ill or injured.
Cognitive Stimulation Therapy- In the UK, this is the only other approved treatment for dementia patients, in addition to medication. This therapy is like ‘exercises for the brain’ that can take place within a group session. It can help persons with orientation, confidence and socialisation.
Psychologists – sometimes people become depressed or anxious after they have retired from a job they loved, or received a scary health diagnosis. Very often, family members who are looking after an older, ill person can become depressed as well! Psychology is a very healthy way of addressing these issues and uses talking therapy to help persons cope with difficulties. Psychologists are not doctors and cannot prescribe medications, but they often work with doctors and psychiatrists to help a person get through a difficult time.
Dieticians – A dietician is different from a nutritionist. They have had specialist training in what kind of nutrition persons need to maintain a healthy weight, or to manage illness like diabetes or high blood pressure. Sometimes eating is a huge problem in Dementia patients and family members become concerned that their loved one is not getting their nutritional needs. A Dietician is an expert in this area and can help.
Social workers – Social workers can be extremely helpful in situations where there are serious social issues that a family needs help with. Some social workers might assist with government financial aid, or refer a family to government counselling or legal aid. Many social workers in the public sector are stretched thin because there are not too many of them. So it may take some time before you receive assistance.
Neurologists- Both Geriatric Psychiatrists and Neurologists can treat Dementia. A Neurologist treats disorders affecting the brain, spinal cord and nerves. For example, they are the specialist you will go to if you have had a stroke or to get tested for dementia.
Your GP- A general practitioner is probably your family doctor and is a good first stop if you suspect anything is wrong. Your GP will then refer you to a specialist depending on the circumstances. Your GP should say why you are going to a specialist if you are referred so you can fully understand your situation.
Learn more about finding these resources on our 50+ Resources page.
If you are confused or uncomfortable, ask whoever you go to about their training and qualifications. Many of the professionals listed are available both publicly and privately, so you may have options once you do your research. When you choose to see a professional, try to listen and follow their instructions as closely as possible. Remember, they have likely trained for many years in their field. If you are still uncertain, you are free to ask questions or get a second opinion.
Yes, I'm talking about falls again. I have to! Falls can be extremely dangerous for older persons and can result in broken bones, head injury, shaken confidence and immobility. As I mentioned in the review on the Falls Prevention Programme, it is extremely important to do what we can to prevent falls in older persons. The most important change to make includes doing regular strength and balance exercises. In addition, below are 10 tips to help you take necessary action in preventing costly, potentially traumatic falls:
"Falls can be extremely dangerous for older persons and can result in broken bones, head injury, shaken confidence and immobility..."
1. Check your eyesight - your vision plays an important role in your sense of balance and movement. It is a good idea to check your eyes at least every 2 years. Remember that bifocal glasses can make objects appear closer than they really are and could cause you to trip or lose balance. Ask your Optician for advice. And if the cost is a problem, call your local social services division and ask if you qualify for any relevant grants or assistance.
2. Manage your medications - some medications can make you faint, unsteady or light-headed on your feet. These include tablets for high blood pressure, diabetes and insomnia. Talk to your doctor about it and ask if the dose can be reduced, or the medication changed.
3. Ensure good lighting around the house, especially on the stairs. If you need to get up in the middle of the night to use the bathroom, use a night light or switch on the light first before doing anything else.
4. Have handrails fitted in the bathroom or on the stairs to make it safer and easier to get in and out of the shower, or to climb the stairs. Remember it's better to be safe than sorry and handrails cost very little compared to the cost and pain of breaking your hip.
5. Keep your house clear - rearrange your furniture to help you move around or to prevent you from bumping into things. Keep the floor clear of anything that might make you trip, such as carpets, boxes, cords or anything else.
6. Remember pets can cause you to fall as well as they tend to scurry under your feet! Put a bell on their collar to alert you of their presence or use a brightly coloured collar so you will see them better (e.g. red).
7. Use a non-skid mat in the bathroom or if you already have a mat that you like, you can stick a rubber sheet underneath to prevent it from moving. Alternatively, if you are re-doing your bathroom, put in non-skid tiles. Wet tiles are notorious for making people fall!
8. Avoid standing on a chair to change light bulbs or to hang up curtains. Ask someone else to do this or if you have to, use a stepladder.
9. In the garden or yard watch out for uneven paths, sharp stones and slippery surfaces after it rains. Keep foot paths clear. Put in railings or a ramp as needed.
10. Use proper footwear and clothes - it is important to choose suitable shoes that fit you well. Buy shoes with a good grip, low heels and high sides. Inspect your shoes. Think about what problems you have with respect to walking. Let's take Diabetes for example. People with Diabetes over time can develop a loss of sensation in their feet. You might often wear sneakers which tend to be well-cushioned and are very comfortable, but tend to have thick soles. Therefore, because you cannot feel the floor this may make you more unsteady. Avoid rubber slippers as they invariably make people fall. Avoid flared pants or clothing that trails to the ground. Avoid walking in slippery socks or tights. You can buy special socks that have a grip underneath.
AND ABOVE ALL
Continue to exercise regularly to improve your strength and balance.
Caregivers are often concerned that their loved ones don't get enough sleep. If you have noticed a change in sleeping patterns of an older person, do not panic. As we get older, we tend to sleep less. We may get up during the night more frequently due to aches or because we need to use the washroom.
Some older persons find that instead of getting 8 or 10 hours of sleep each night, they are only getting 4 or 6 hours of sleep. This is a common change and is nothing to be alarmed about. Do not turn to sleeping tablets right away. They can be addictive, and many more people (in T&T for example) end up taking sleeping pills for several decades, which is not healthy.
"As we get older, we tend to sleep less."
Sleeping tablets should be your last resort, after consulting with a trusted doctor. Some more creative, healthier ideas to improve sleep quality for older persons are suggested below, as adapted from Philip T. Hagen, M.D. of the Mayo Clinic, USA:
Dr James Bratt, Lead Consultant at Age Caribbean and Geriatric Psychicatrist.