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Elderly Care, or simply Eldercare or Senior Citizen Care (also known in parts of the English speaking world as Aged Care), is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, and home care.

Elderly Care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity. It is an important distinction, in that the design of housing, services, activities, employee training and such should be truly customer-centric. The form of elderly care provided varies greatly among countries and is changing rapidly. Even within the same country, regional differences exist with respect to the care for the elderly. However, it has been observed that the global elderly consume the most health expenditures out of any other age group, an observation that shows worldwide elder care may be very similar. We must also account for an increasingly large proportion of global elderly, especially in developing nations.

Traditionally, Elderly Care has been the responsibility of family members and was provided within the extended family space. Increasingly in modern societies, elderly care is now being provided by the state or charitable institutions. The reasons for this change include decreasing family size, the greater life expectancy of elderly people, the geographical dispersion of families, and families comprising of working couples. Although these changes have affected European and North American countries first, they are now increasingly affecting Asian countries. In most western countries, Elderly Care Facilities are Residential Family Care Homes, freestanding Assisted living facilities, Nursing Homes, and Continuing Care Retirement Communities (CCRCs).

Some Issues in Geriatric Care

l Promoting independence in the elderly

Promoting independence in self-care can provide the elderly with the capability to maintain independence longer and can leave them with a sense of achievement when they complete a task unaided. Older adults who require assistance with activities of daily living are at a greater risk of losing their independence with self-care tasks as dependent personal behaviours are often met with reinforcement from caregivers. It is important for caregivers to ensure that measures are put into place to preserve and promote function rather than contribute to a decline in status in an older adult who has physical limitations. If the older adult is able to complete self-care activities on their own, or even if they need supervision, they should be encouraged in their efforts as maintaining independence can provide them with a sense of accomplishment and the ability to maintain independence longer.

l  Improving mobility in the elderly

Impaired mobility is a major health concern for older adults, affecting 50% of people over 85 and at least a quarter of those over 75. As adults lose the ability to walk, to climb stairs, and to rise from a chair, they become completely disabled. The problem cannot be ignored because people over 65 constitute the fastest growing segment of the population.

Therapy designed to improve mobility in elderly patients is usually built around diagnosing and treating specific impairments, such as reduced strength or poor balance. It is appropriate to compare older adults seeking to improve their mobility to athletes seeking to improve their split times. Someone attempting to improve an older adult’s mobility must decide what impairments to focus on, and in many cases, there is little scientific evidence to justify any of the options. Today, many caregivers choose to focus on leg strength and balance. New research suggests that limb velocity and core strength may also be important factors in mobility.

l  Legal issues about incapacity

Legal incapacity is an invasive and sometimes, difficult procedure. It requires that a person file a petition with the local courts, stating the elderly person lacks the capacity to carry out activities that include making medical decisions, voting, making gifts, seeking public benefits, marrying, managing property and financial affairs, choosing where to live and who to socialize with. Most states’ laws require that a minimum of two doctors or other health professionals provide reports as evidence. Only then can the individual’s legal rights be removed and legal supervision by a guardian or conservator be initiated. The legal guardian or conservator is the person to whom the court delegates the responsibility of acting on the incapacitated person’s behalf and must report regularly his or her activities to the court.

l  Ethical and medico-legal issues

Elderly persons sometimes cannot make decisions for themselves. Geriatricians must respect the patients’ privacy while seeing that they receive appropriate and necessary services. More than most specialties, they must consider whether the patient has the legal responsibility and competence to understand the facts and make decisions. They must support informed consent and resist the temptation to manipulate the patient by withholding information.

Elder abuse is the physical, financial, emotional, sexual, or other type of abuse of an older dependent. Adequate training, services, and support can reduce the likelihood of elder abuse, and proper attention can often identify it. For elderly people who are unable to care for themselves, geriatricians may recommend Legal Guardianship or Conservatorship to care for the person or the estate.

What is Geriatric Care Management?

Geriatric Care Management (also known as “elder care management”, “senior health care management” and
“professional care management”) is the process of planning and coordinating care of the elderly and others with physical and/or mental impairments to meet their long term care needs, improve their quality of life, and maintain their independence for as long as possible. It entails working with persons of old age and their families in managing, rendering and referring various types of health and social care services.

Geriatric Care Management integrates health care and psychological care with other needed services such as housing, home care services, nutritional services, assistance with activities of daily living, socialization programs, as well as financial and legal planning (for example, banking trusts).

Who are Geriatric Care Managers?

Geriatric Care Managers typically have prior training in nursing, social work, gerontology or other health service
areas. They are expected to have extensive knowledge about the costs, quality, and availability of services in their communities. In some countries and jurisdictions, they may obtain certification from various professional associations.

A typical team if care managers include geriatricians,  nurses, physiotherapists, social workers, health workers, occupational therapists, and care-givers.