AN­GE­LO JE­DIDI­AH

Re­porter

an­ge­lo.je­didi­ah@guardian.co.tt

For many, it is of­ten a re­lief when their loved ones are dis­charged from the hos­pi­tal. But while the hos­pi­tal doors may close be­hind them, for many old­er pa­tients, the jour­ney to­wards pa­tient safe­ty has just be­gun.

When an el­der­ly pa­tient is dis­charged and re­turns home, it prompts a se­ries of new ques­tions that should be asked sur­round­ing med­ica­tion in­take, ap­pro­pri­ate di­et and ease of move­ment around the house. How­ev­er, there is an­oth­er ques­tion that should be asked: Have there been any changes that we’ve failed to no­tice?

For reg­is­tered nurse and A&A Se­nior Well­ness Haven and Med­ical Cen­tre co-di­rec­tor Abi­o­la Bap­tiste, pa­tient safe­ty must ex­tend well be­yond the walls of a hos­pi­tal. With World Pa­tient Safe­ty Day hav­ing been recog­nised on Sep­tem­ber 17, the con­ver­sa­tion takes on par­tic­u­lar im­por­tance for Trin­bag­o­ni­ans due to the coun­try’s age­ing pop­u­la­tion.

The World Health Or­gan­i­sa­tion re­ports that ap­prox­i­mate­ly 1.1 bil­lion peo­ple world­wide were aged 60 years and old­er in 2023, with this num­ber pro­ject­ed to reach 1.4 bil­lion by 2030. Lo­cal­ly, peo­ple aged 65 years and old­er rep­re­sent­ed ap­prox­i­mate­ly 12.4% of T&T’s pop­u­la­tion in 2024.

“When you think of pa­tient safe­ty, it’s any­thing that you can do to en­sure that your pa­tient is not harmed and to pre­vent pa­tients from be­ing harmed,” Bap­tiste told Guardian Me­dia.

Bap­tiste, who has spent more than 15 years in nurs­ing, be­lieves rel­a­tives need to be­come bet­ter ob­servers of the se­niors in their lives. She en­cour­ages fam­i­ly mem­bers to eval­u­ate and in­ves­ti­gate their home us­ing “the eyes of a de­tec­tive” rather than sim­ply through the eyes of a son or daugh­ter, in­clud­ing notic­ing changes that might seem mi­nor. These sub­tle shifts tell a sto­ry and present an un­der­ly­ing is­sue that can of­ten be reme­died.

Bap­tiste stress­es that this ob­ser­va­tion should not be lim­it­ed on­ly to se­niors who are al­ready vis­i­bly sick or deal­ing with a pre-ex­ist­ing med­ical prob­lem.

“For ex­am­ple, if mom is not eat­ing as she should, if dad is us­ing the fur­ni­ture to move around and prob­a­bly not us­ing his aids, or he is not tak­ing as many baths. If mum­my is sud­den­ly not cook­ing as much. Is there sud­den­ly a pile-up of dirty dish­es? Why?” Bap­tiste ex­plained.

“We can’t wait for a cri­sis to hap­pen to know when to in­ter­vene and on­ly then re­alise mum­my or dad­dy needs that sup­port.”

Bap­tiste says that a par­ent who sud­den­ly stops bathing reg­u­lar­ly may not be ex­pe­ri­enc­ing mem­o­ry loss, but rather a sim­ple fear of falling due to a lack of handrails. Sim­i­lar­ly, when a pre­vi­ous­ly ac­tive par­ent sud­den­ly wants to spend most of the day in bed, that too de­serves at­ten­tion.

The home it­self may al­so re­quire a clos­er in­spec­tion. While you may think your liv­ing space of­fers safe­ty, it can al­so present hid­den haz­ards for your loved ones. Things like clut­ter and the ab­sence of handrails in the bath­room or near the bed can cre­ate sig­nif­i­cant risks.

“I wouldn’t say that home mightn’t be the safest place. But is there any clut­ter? Are the things that they have with­in their range? They do have to stretch, right? The walk­ing aids, are they close by? If there is a need for handrails or bath chairs, do you have one?”

Med­ica­tion in­take mat­ters

When it comes to pa­tient safe­ty, med­ica­tion is an­oth­er area that needs spe­cial at­ten­tion, as it can be­come com­pli­cat­ed very quick­ly.

When an old­er per­son is dis­charged from the hos­pi­tal, they of­ten leave with pre­scrip­tions that dif­fer from what they were tak­ing pre­vi­ous­ly. Bap­tiste stress­es that rel­a­tives need to keep track of med­ica­tion lists as well as dosage in­struc­tions. Some pa­tients may mix up in­struc­tions or ne­glect their pre­scribed med­i­cine en­tire­ly due to a de­sire not to feel over­ly de­pen­dent.

“Med­ica­tion mis­use and med­ica­tion er­rors have claimed too many lives due to some pre­scrip­tions chang­ing so much at times, and per­sons mix­ing up in­struc­tions. Get a dis­penser with the dates, so that you set out which ones mum­my and dad­dy need to take,” she said.

“Ex­plain to them that ‘lis­ten, the doc­tor has changed it, he’s now giv­ing you this.’ Have that con­ver­sa­tion even if you might have to re­peat your­self, be­cause for­get­ful­ness is a part of old age. It may not be de­men­tia. We our­selves can be for­get­ful when you’re hus­tling through life. But again, have that con­ver­sa­tion with mum­my or dad­dy.”

Care­giv­ing op­tions

While the se­nior in your home is the pa­tient, there is an­oth­er per­son whose safe­ty must not be for­got­ten: the care­giv­er. Of­ten, fam­i­ly mem­bers may lack the med­ical ex­per­tise, time or phys­i­cal abil­i­ty to pro­vide ad­e­quate care. That is why, for some fam­i­lies, the hard­est con­ver­sa­tion in­volves ac­knowl­edg­ing the truth: an old­er rel­a­tive may need more care than you or your home can pro­vide.

This is where spe­cialised se­nior liv­ing cen­tres step in—of­fer­ing not on­ly geri­atric care, but al­so home-based nurs­ing, adult day care and respite care for fam­i­lies who are trav­el­ling and need short-term ac­com­mo­da­tion for their loved ones.

To­geth­er with her co-di­rec­tor, Ayan­na Fi­garo-Ram­sam­my, Bap­tiste op­er­ates A&A Se­nior Well­ness Haven and Med­ical Cen­tre, a nurse-led se­nior care fa­cil­i­ty. Bap­tiste not­ed that they es­tab­lished the cen­tre af­ter recog­nis­ing a strong need for pro­fes­sion­al, nurse-led care.

Bap­tiste be­lieves these dis­cus­sions should take place long be­fore a health cri­sis forces a de­ci­sion.

“I think it would be nice for us as a pop­u­la­tion to have these con­ver­sa­tions be­fore mum­my and dad­dy reach the cri­sis stage, or reach the for­get­ful stage, or reach the stage where they can’t cope no more on their own. I think we need to change around that mind­set. Be­cause if we change around that, then se­nior homes would not ap­pear as gloomy.”

Bap­tiste em­pha­sised that pa­tients and their fam­i­lies de­serve ac­cess to fa­cil­i­ties where loved ones feel val­ued rather than aban­doned, en­sur­ing they are treat­ed with dig­ni­ty even in chal­leng­ing sit­u­a­tions.

Be­yond serv­ing as a space for so­cial in­ter­ac­tion, care fa­cil­i­ties can of­fer dai­ly joy and laugh­ter, a med­i­cine in its own right.

“But be­yond car­ing about peo­ple, there is a cer­tain re­spect for dig­ni­ty, re­spect for in­de­pen­dence and re­spect for the per­son. The per­son is more than just a di­ag­no­sis.”