In this regard, it is worth mentioning the construction of several facilities, including the first unit for the evaluation of physical performance of older adults in Cuba – and one of the few existing in Latin America and the Caribbean -opened on October 1, 2019, taking into consideration the concept of healthy aging, promoted by the World Health Organization.

“This unit makes it possible to evaluate functional capacity based on variables such as walking speed and muscle strength, among other essential aspects. It also supports the diagnosis and rehabilitation of elderly persons with reduced functional capacity and promotes the development of research in key areas of aging and the training of competent human resources,” explained Dr. Lilian Rodriguez Rivera, director of the Center for Research on Longevity, Aging and Health.

In previous statements, Dr. Iván Tápanes López, specialist in Geriatrics and Gerontology, and head of the Center’s physical performance unit, reported that the facility has high-tech equipment which allows for better diagnoses and assistance, research and comprehensive assessment from the physical point of view, evaluating the performance of activities like walking and others requiring physical effort and strength.

Similarly, on November 21, last year, the Alzheimer’s and Cognitive Disorders Center opened in the municipality of Habana Vieja, also the only one of its kind in Cuba, specializing in early diagnosis and treatment of Alzheimer’s, support for caregivers, family members and professionals involved in the care of older adults who suffer from this health problem, and research that contributes to improving the care and management of these patients, as well as working with institutions associated with the BioCubaFarma state entrrpise group, according to Dr. Rodriguez.

On the day of its inauguration, Dr. Niurka Casado Barralesuna said that a priority of the institution will be the preparation courses, to contribute to supporting the establishment of memory clinics at the municipal level, for the identification of the most complex cases, she explained.

With services including nursing, geriatrics, social assessment, neuropsychology and group therapy, the center is committed to comprehensive treatment and has computerized systems.

For its part, the Center for Longevity, Aging and Health is developing a training program for the specialty of Gerontology and Geriatrics; a new study plan for Master’s degrees in Public Health and Aging; and clinical nutrition and sarcopenia consultation (a term that describes the degenerative loss of skeletal muscle mass and reduction of muscle strength that occurs with aging) have begun as outpatient services.

Likewise, at the Center for Research on Longevity, Aging and Health, 15 protocols for hospital care were updated and others approved for chronic obstructive pulmonary disease, malnutrition, and related to the use of anesthesia in elderly patients at high surgical risk, with the goal of implementing these nationwide.

In relation to academia and the importance of lifelong learning, the new study plan for MSc in Public Health and Aging is in the design phase, as well as a professional development course in Gerontology and Geriatrics.

The National Program for the Care of the Elderly, with its three subsystems: community, hospital and institutional, is also in the process of being updated.

The committee and working group for the development of the specialty on the island was created at the Longevity, Aging and Health Center i, and the program for the development of the specialty of geriatrics for the period 2020-2025 is currently in the working phase.

Good health must be an essential component of society’s response to the aging population, added Dr. Rodríguez Rivera, who recalled a thought expressed by Comandante en jefe Fidel Castro Ruz, who said, “The most humane thing a society can do is to care for the elderly.”

ADRESSING DEMOGRAPHIC TRENDS

In addition to these centers, in response to demographic trends, Cuba has continued to prioritize care for the elderly.

With advances made this past year, a total of 53 services in this specialty are now available in Geriatrics, with 1,063 beds destined for these patients, 53 more than at the close of 2018, according to the Minister of Public Health, José Ángel Portal Miranda, in a review of 2019.

During this period, the number of beds in the 155 nursing homes increased, for a total of 12,419, as well as two new community centers for the elderly, for a total of 295.

More than 973,000 older adults joined grandparents’ circles during the year and 29 mental health departments were created, bringing the total to 178 nationwide.

IN CONTEXT

-In 2019, 675 patients were admitted by the Center for Research on Longevity, Aging and Health, a greater number than 2018.

-The occupation rate was 78%.

-The average stay was 7.9 days, 1 day less than in 2018.

-Some 7,579 medical consultations were provided, slightly less than the number reported in 2018.

-Some 401 surgical procedures were performed, higher than reported over the last five years and 123 more than in 2018.

-The clean surgical wound rate was positive, with no infections reported.

-The average preoperative stay was 1.7 days, less than in 2018.

-The introduction of minimally invasive surgery is advancing successfully.

(Granma)

“Studies on aging in the world reveal a very important risk factor in these age groups, and our country is not exempt from this scourge, associated with violence. We refer to abuse and its manifestations,” Minsú Sotomayor Álvarez, MSc. in Public Health and Aging, and researcher at the Cuba’s Center for Research on Longevity, Aging and Health (CITED), told Granma.

She considers abuse to be any action, intentional or not, that produces harm from the biological, psychological, social, financial, or material point of few, as well as negligent behavior, be it temporary or permanent. “It occurs within any relationship where there is an expectation of trust and the most usual forms in which it occurs are physical, psychological, economic abuse or negligence, or neglect.

It is a little recognized problem by health teams, even when it is presented daily in geriatric consultations. It must be identified for timely intervention, since there are comprehensive solutions,” the researcher explained.

Regarding this phenomenon in adults and older adults in Cuba, Sotomayor commented on a recent study she conducted on patients admitted to CITED hospital wards, which had as its theme the abuse of dependent elderly people.

The results, she stressed, identified as forms of abuse negligence, psychological abuse and, to a lesser extent, financial abuse. No other forms were found in the sample, she added, referring specifically to physical abuse. Although this doesn’t mean that physical abuse does not occur, the study revealed that it is not the most common form of abuse among Cuba’s population.

However, there is a lack of knowledge on the part of caregivers of dependent patients about abuse of the elderly, and also of support networks. “Women aged 80 and over were the most mistreated; and as the degree of dependence increased, the abuse increased: negligence and psychological abuse,” the study showed.

In addition, regardless of the degree of harmony or discord in family relationships, this phenomenon was present, and caregivers were found to carry heavy burdens, the specialist noted.

CHARACTERIZATION OF VIOLENCE

Among the manifestations of violence and abuse discovered, the researcher mentioned threats of punishment or of taking the individual to an institution against his or her will; ignoring or unjustifiably confining him or her to a bed or chair, social isolation, refusing to respond to their concerns, using the world “old” to refer to them in a derogatory way, infantilizing them, overprotecting or depersonalizing them.

Likewise, the older adults surveyed reported other elements such as not being offered a seat on the bus, or help crossing the street; being excluded, disregard for their tastes in television programs, the improper use of their pension, forcing them to sign documents without their consent, be it due to their being mentally incapacitated to do so, or deception.

Providing suboptimal care at home, weight loss, be it unintentional or due to health conditions, dehydration, lack of hygiene; poor vision or hearing without correction, the aggravation of chronic diseases due to the withdrawal of necessary medications without prior consultation, causing physical pain; careless, dirty clothing, inappropriate for the time of year; the lack or poor state of prostheses (walkers, glasses, hearing aids, dentures, etc.); the search for or permanent change of professionals and/or health care centers; and unusual injuries to different parts of the body, were among the other manifestations identified.

The burden of caregivers and unawareness on how to manage stress could be, in the opinion of the specialist, one of the main triggers of situations of violence.

“To achieve an appropriate dynamic with the dependent older adult, it is valid to take advantage, whenever possible, of their integration with the environment that surrounds them in the neighborhood, acquaintances, friends and visiting places that provide entertainment,” Sotomayor stressed.

Allowing older adults to participate in activities with the rest of the family, whenever appropriate, encouraging walks and other physical activities which help them relate to other people, is essential, she added.

“It must be remembered that many times the person is ill, and this sometimes does not allow an adequate understanding of the task. The important thing is to get them out of the house and not take them to dangerous places where there is a lot of noise or a large number of people. It is opportune to participate in groups of people who have patients with the same conditions, this will allow them to inform themselves, relax, and make joint decisions,” she advised.

Sotomayor also recommended that caregivers contact community social services to assess whether they can receive support.

The aim is to promote a different view of older people, recognizing them as part of the society we enjoy today. Recognizing and identifying cases of violence or abuse is the first step. Dignity, in the end, does not age.

A WARNING

According to the World Health Organization, older people who see themselves as a burden to others can end up thinking that their life has less value and, as a consequence, they are more prone to depression and social isolation. In a recent study, it was observed that the average life expectancy of the older people surveyed who had negative attitudes regarding aging was 7.5 years shorter than that of those who had positive attitudes.

(Granma)