The common sense advisor

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Dr Elena Mucci

Dr Elena Mucci, Consultant Physician and Geriatrician at the Conquest Hospital and the Spire, Hastings, gave up her time on April 17 to come and talk to the Hastings and Rother Forum of Patient Participation Groups (PPGs) about avoiding frailty in older age. Supported by Rother and Hastings Voluntary Action Group, Spire Healthcare, Hastings and Rother Clinical Commissioning Group and the seven surgeries that make up the PPG Forum, this was the first event jointly organised by the Forum for the patients of these seven practices.

Sedlescombe Village Hall, hired for this event, was absolutely packed with over 140 people, who came to hear Dr Mucci give a thoroughly entertaining and thought provoking lecture about avoiding frailty.  She was also very amusing, a blessed relief from the doom and gloom often surrounding this.

A full hall to listen to Dr Mucci

A real advocate for the social and economic value of older people, it was refreshing to be told that we were not a burden on society, as our media would have it, but a valuable resource instead. Celebrating older age, she pointed out that we contribute hours of our time to voluntary work, provide employment for others in the care sector and enable our children to work whilst we care for our grandchildren, a huge economic benefit. We have the most disposable income which helps the fitness and sports sectors, travel widely and even help the dating agency businesses! Our life experience and tacit knowledge contribute enormously.

Moving on to the main topic for her talk, she explained that frailty has a specific definition: ” the ability to cope when everyday or acute stressors are compounded …. a state of vulnerability.” It happens when the person’s ageing body, that has coped well, is subject to infection, little stroke events (TIAs) and falls, for example. This leads to an amalgamation of problems and reduces that person’s health and wellbeing. The reserves are running low.

Particular precipitating factors were then dealt with and she urged us all to accept that our bodies are ageing, for example, our kidney function atrophies by 40% by the time we are 80. To prevent ourselves falling, look at the environment around us, do not leave electric leads trailing across the floor, don’t try and put on your socks balancing on one leg, we all know the challenges! Do use a stick if it will help balance and safety, wear your glasses and hearing aids, better to be safe than deceased.

She dealt with issues of too much medication. Apparently. more than 5 medicines is called polypharmacy and is to be avoided, as the drugs interact and cause adverse reactions. She urged us to question why we are on some medications, not all of which may be necessary.

So, what are we to do to avoid becoming frail?  One way would be to make sure we get enough vitamin D from sunlight, oily fish and supplements, but sunlight is best. And don’t reach immediately you step out of the door for SPF 10 or 15, let the sun shine on the face and arms for a few minutes.

Prevent your muscles wasting, move about, go for a walk, do the housework! And prevent continence problems by talking to your doctor and not being embarrassed. The stigma attached to bowel and bladder is unfortunate and continence is not only an issue of old age, ask any new mum. Obesity, smoking came in for comment and the psychological problems of depression and dementia led us to ways of avoiding it.

Any ideas? We need to maintain our physical activity and stimulate our brains with new learning and new ideas, carry on working, and continue our social interaction, which will all help. It seems there are different sorts of things that lead to dementia, but sadly there is a large genetic component to the best known, Alzheimers. The importance of diagnosis, so affairs can be put in order and the best use made of remaining time, was emphasised.

Dr Mucci certainly didn’t “beat about the bush” her favourite English phase from this Russian born Consultant. Our life expectancy may average 79 years for men and 83 years for women, but we older people need to live it well and to the full. We need to keep control of our lives. Go and hear her talk if you can, full of common sense and joined up thinking, she will cheer you up no end!

Image Credits: Gillian Roder .

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