Challenges in the elderly patients for undergoing medical tests

Dr Th Dhabali Singh *

It is important to take extra care when an older person requires a medical test. What seems like a simple procedure for an average adult can be significantly challenging to an elderly person.

There are enough pointers towards this:

o The elderly are more likely to have hearing, vision and other cognitive impairments. A lab test usually requires certain instructions prior to the testing but because of the physical limitations, understanding or following instructions may be difficult.

o Older people are likely to have problems with mobility and balance because of which collection of some types of samples may be physically harder and even dangerous.

o Because the skin is thinner, the subcutaneous tissue is weak, and the veins are more fragile and prone to tearing when punctured, even a blood test can be more difficult for the elderly.

o For a person with dementia, the sample collection need to be scrutinised carefully. It can be extremely traumatic and may provoke undesirable reactions from the patient.

TRANSPORTATION CONCERNS

Transportation problems are common for the elderly, who may not drive or may need someone to take them to the testing facility. It makes sense to let someone accompany the person to the testing centre to eliminate the stress and difficulties. Let the person be dropped off at the entrance of the centre and ask for assistance like wheelchairs from the laboratory people. One may also enquire beforehand about the busy times and about the best time for the sample collection.

If the person who needs the test does not drive or faces difficulty for arranging someone to accompany him or her to the healthcare centre, one may enquire about the onsite or home services provided by the lab.

SAFETY CONCERNS

Falls are common and serious in people over the age of 65, and washrooms can be particularly hazardous. The laboratory personnel should pay proper attention when an elderly person is asked to collect urine or stool sample, particularly if the person has mobility or vision problems.

The laboratory personnel may encourage the use of grab bars or other supports near the toilet area to prevent from falling.

HELP DURING TESTING

An elderly person may need assistance when having a medical test. A person with arthritis, joint stiffness, or other mobility problem may find it difficult to obtain a urine or stool sample without help. Persons with dementia may not be able to follow instructions for obtaining a “clean catch” urine sample. A person with poor vision or limited mobility of the hands may find it difficult to obtain sample in containers specified for the purpose.

Assistance is also needed during radiological investigations. The nature of the testing being such, these investigations require the patients to be physically inside the scanning rooms. Whether, it’s the positioning of the patient during procedures like X-Ray or CT Scans or the administration of contrast material during certain scans, optimum care should be taken so that everything happens smoothly without being stressful.

WAYS TO MAKE SAMPLE COLLECTION PROCEDURE GO SMOOTHLY

There are specific ways in which the sample collection from the elderly could be smooth and less stressful. It is the responsibility for both the patient and the laboratory to ensure that everything happens smoothly.

An older person may have trouble hearing verbal directions or even reading written instructions about the things needed prior to the testing. The lab may provide written instructions for preparations needed. When giving oral instructions, the laboratory person should take one step at a time and ensure that everything has been understood properly. There are instructions to be followed prior to certain imaging tests. These need to be properly communicated to so that the preparation is optimal.

Helping a person obtain a urine or stool sample can be a stressful event to both the patient and the one who’s helping. The person needing help may be embarrassed. Hence, it is desirable to provide as much privacy as is safely possible to increase everyone’s comfort level. Compassion is needed in such situations and to ensure that the patient receives competent care.

With an increasing life expectancy everywhere, the number of patients suffering from geriatric diseases rises and consequently more and more people need daily assistance. A good prevention system like regular health check-ups allow early detection of diseases and to find optimal care.

However, even a good preventive health care and regular physical exercise cannot stop the ageing process that goes hand in hand with the decrease of the physical as well as mental capacities.

Age-friendly infrastructure and amenities in a healthcare centre are equally important too.