Active Ageing by The Malta Independent

active ageing and elderly care

HOME IS WHERE THE CARE IS

Choosing a care home

The Malta Independent on Sunday 10 February 2019

ROBOTS OUR HELP IN YEARS TO COME

SIGHT AND SAND Health tips for eyes and ears

FEBRUARY 2019

active ageing

HOME is where the CARE is

People usually choose care homes, for themselves or a member of their family, because they requiring more attention than sheltered housing provides

ven if you have a certain home in mind, or an excellent recommendation to consider, it’s a good idea to visit plenty of different homes before deciding on your final choice. This way you will be able to make discoveries and comparisons which could throw up points that may not have seemed so important to begin with.

On your first visit you should feel you are given all the time you need to look around, and are meeting someone who is not only best qualified, but also very happy to answer any questions. Listen carefully to how those questions are answered. Are they actually being addressed, or are you getting sales patter designed to change the subject? And are you are being steered through only certain areas of the building and facilities? And, do you feel references to the

scarcity of places in care homes are being made to rush you into a decision before you are ready? Are you able to get straightforward estimates of the charges and exactly what they include, and all terms and conditions, as soon as you request them? These are important questions and the answers you receive should make a big impression on how you view each home and facility. If you leave your first visit unsatisfied, rather than just

HEALTHY and HAPPY LIVING at CASA ANTONIA

voking the feel of luxury accommodation complete with surrounding gardens, Casa Antonia Residential and Nursing Home is a distinguished yet affordable retirement home. Nestled in a quiet cul-de-sac in Balzan overlooking San Anton Gardens, the home offers an ideal and central location, where privacy and tranquillity are felt the minute one walks in. “At Casa Antonia, we give importance not only to improving the length of life but most importantly to providing safe and good quality living. This includes the physical, mental, emotional and spiritual well-being of each resident”, said Matron Antonia Attard. She overlooks the care of the 150 residents and various departments at Casa Antonia. “Every resident for us is an individual, a unique person, no matter their condition, physical or otherwise. Our staff is encouraged to be close to each resident for as much time as possible. We establish bonds and build relationships and get to know each other. Like this, we consider every resident as our father or mother and, for this reason, we seek to provide them with the best care and love”, explained Ms Attard. With the support of all the staff, the nursing team, carers, caterers, gardener, handyman, and administrative personnel, residents are guaranteed to spend their golden years in a nice environment, with the dignity they deserve. Relatives of residents at Casa Antonia can have the peace of mind that personalised care is given 24/7 by nurses and care assistants. Both groups work

Ms Antonia Attard reviewing a medical report with staff member Jelena Cvetkovi seamlessly together to provide the best service while respecting individual privacy. Apart from being a retirement home, Casa Antonia offers respite accommodation that generally requires a more specialised treatment. Residents benefit from a full programme

of activities that keep them active throughout the week, from crafts, board games, keep-fit classes to cinema nights and weekly outings to various places of interest across Malta and Gozo. “Whether it’s Valentine’s Day, Easter, Mother’s or Father’s Day, Carnival, the World Day for the Elderly, birthdays,

and/or the much-loved summer parties and barbeques in the garden, every month there is always a reason for a celebration or two, on top of weekly activities. On quite a few occasions each year, relatives of residents are invited to join the party, as usually happens when a family celebrates a particular event”, added Ms Attard.

active ageing

FEBRUARY 2019

Residents’ demeanor

undecided look elsewhere. First impressions are very powerful. But, if you like a place, make several further visits at different times of day to get a real feel of the space and the lives of the people for whom it is home. Here are a few questions to ask yourself as you look around.

General surroundings and ambience Are they instantly welcoming, with signs such as notice boards, floor plans and fire exits designed to look as 'uninstitutional' as possible? Common areas should be clean, but not reeking of artificial floral cleaning fluids, and comfortable; no one wants to relax or entertain visitors in a glorified corridor or village hall clone. Function ability should never be at the expense of style and comfort and neither need be the victims of budget concerns. Homely touches and a relaxing

ambience are the result of care and attention to all the right details, and that cannot be bought. The building must be secure, with arrangements made for the safety of residents and their possessions, without the place feeling like Fort Knox. Family and friends should be able to visit freely, within reason.

Food and drink Are the meals all made on the premises, do they look healthy and appetising? They should be served at reasonable times of the day, in pleasant surroundings; with a good choice and alternatives for those with allergies and food intolerances. A drink of water should always be available, or at least the means of getting one. What is the policy on visitors bringing food or drink for residents?

Watch how involved the residents seem to be. Do they feel secure and valued and confident that their views are taken into consideration, and that there is always someone they can talk to? Is there plenty for them to do? Do residents who are capable always have easy access to a phone, and the opportunity to come or go as they please? After all, no one should ever have to feel like a prisoner. Does the home have any links with local companies, schools, or clubs and societies who organise outings and activities? What facilities does it have for entertainment and socialising, on whatever scale a resident needs, or chooses?

Staff You will be putting a lot of trust in the home's staff, so how carefully does the home's management check the qualifications, prior conduct

and references of new employees? Do the staff seem over stretched or too busy to complete their tasks thoroughly and without undue stress? They should be always have time for a word with residents and visitors, and maintain a friendly, unhurried atmosphere. for everyone's benefit. How much interaction is there between staff and residents? Do all members of staff knock on a resident's door before entering, treat each one as an individual, talking to them in a normal tone, and call them by their name instead of the overused and slightly patronising dearie? Do they take your concerns seriously, deliver and follow up on messages and generally keep an open chain of communication? Are there sufficient liaisons between the home's staff and the resident’s family doctor or dentist, and who is responsible for seeing that regular

Newspaper stories and bad reports might sometimes be exaggerated, but when warning signs are ignored there is sure to be a bad result. Watch out for: •A high turnover, of staff, especially among the administrators, or an excessive number of employees who are hardly capable of communicating correctly in the residents' language. • Poor ventilation, rooms that too cold or warm • Excessive noise from gadgets, staff shouting etc. • Peeling paintwork, faded fake flowers, neglected outdoor areas, general signs that maintenance is not given enough attention. • Outdated fire safety equipment, inadequate lighting and call systems that are difficult to

appointments are made for health tests?

And staff backup By the same token, caring for the elderly can be physically and emotionally taxing, so does the staff have enough support and opportunity to express their concerns or suggestions? What percentage of the staff is fully qualified and are they regularly offered up to date training and specialisation courses, for example in dementia care, diabetes management and social and psychological care? These may seem like an awful lot of questions, but this is not a search that can be skimped or hurried. Nothing is more important than finding the right care home for yourself or your loved one. But if you are prepared to look beyond the brochure and the furniture polish, and judge the ‘palace’ by the people, you will surely find that special somewhere.

reach or go unanswered. • Inadequate bathroom facilities. •Irregular laundry arrangements • Lifts that fail to operate •Unchecked access for visitors and tradespersons • Cramped rooms, lack of privacy and too little space for residents’ possessions •Establishments that cannot show, quickly and confidently, how they have remedied any prior evidence of functional or staff problems which had, or could have, an adverse effect on residents' safety and comfort. •Managements who gloss over enquiries about rates, and/or charge for an exorbitant number of extras that really should to be standard in any establishment worth having the word care in its business ethos.

FEBRUARY 2019

active ageing

ROBOTS, what will we do without them? The insidious arrival of robots as the go to answer for everything from managing our smart homes to ‘taking our jobs’ is a subject of ongoing fascination and a certain amount of concern.

re they moving in too fast? Who will really be their controllers? What will their actual tasks be? And, can they be relied upon to stick to them

alone? These are perfectly reasonable questions for anyone from a generation who grew up with robots that appeared mostly as science fiction villains, or loveable toys with magic powers. Because, it now seems that these characters, previously the stars of comic books, or government defence plans and publications, are now being designed as assistants and companions to this very section of society. Children would probably think it great fun to have a tame and biddable robot. Older adults, having already experienced the foibles of machines, and the proliferation of means for artificial intelligence to follow every step

we take and every decision we make, may be a lot less enthusiastic. But let's take a look at why Robot-aid seems such a good idea. Populations in many countries worldwide are ageing. There is a worry that there will not be enough younger people to look after those who are unable to care for themselves in the not too distant future. The cost of care homes and the staff to run them, plus carers to visit anyone who needs help in their own home, could well rise to a level that those requiring their services are unable to afford. Robots and robotic technology would improve the lives of elderly people who need assistance with everyday tasks from eating and drinking to bathing, moving from a bed to a wheelchair and operating household gadgets. It remains to be seen just how much demand there will ultimately be for an automatic feeding robot, or an electric bathtub

robot, which will automatically wash and rinse our nearest and dearest relatives, as if they were bags of laundry. But it’s perfectly obvious that for people with impaired movement, as well those simply limited by age, all practical help is welcome. Carers are often under physical strain when completing their assignments and, with the best will in the world, human staff are limited by working hours, health issues, the necessary travelling from one client to another and, in the case of family members, their own immediate family; who all being different ages will be making their demands on chief carers. There are already robots which are capable of being everything from a butler to a security guard, without accompanying sulks or unexplained no-shows. Robot, EI-E can respond to many of the same commands and give the same help at home as a guide dog can – minus of course the companionship and devotion that is unique between dog and owner in such circumstances. RIBA, the Robot for Interactive Body Assistance can pick up and carry humans from A to B as instructed, recognise faces and voices and respond to spoken demands. And he has a teddy bear face; which adds a whole new meaning to the term second childhood and may or may not have been a good marketing choice. But who knows, in future we may be able to choose the face of our robot and finally get to live with our favourite celebrity after all. Such robots may sound like something we all might dream of owning one day, but we should think of them from the point of view of someone who is room or house bound. Their only human contact from day to day, or week to week or even longer, may be their health visitor or the meals on wheels deliv-

erer. Residential care doesn't guarantee human company either. Residents in busy, crowded, poorly staffed accommodation can be equally deprived of social exchanges when staff are too busy to spend time with them, or don't have the language skills for even a quick chat here and there. Today's older generations grew up in their local communities. If they even had a phone at home it was too expensive to spend hours chatting on. Friends met face to face, in real time, not on Facebook; following each other through their lives, desperate to outshine or at least keep up. Events and experiences were shared together, and the important ones cine-filmed or photographed, making memories to frame or file in precious albums and be pored over every now and again, mostly to the delight of grandchildren and old family friends. Can a memory stick really be a good substitute for that? What should never be allowed is that robot care and AI tools are used to lessen the burden of care for the rest of society in any way that affects a person's comfort, dignity, security or means of communication. Could drones delivering meals be able to notice if someone is unwell or lonely. Is a robotic pet any substitute for the look in a real ani-

mal's eyes when it's enjoying a pat and a cuddle from someone missing having a pet around the place? Can an automated game partner really replace the companionship of group activities? Robots can and should be welcome where they will save time, by doing routine tasks to free staff, who will then be better able to interact and apply more holistic measures to help their clients. They are welcome for tasks that require extra strength and long hours doing the same job. Some people are already grateful that their robot reminds them when to take their medication, or when its help with household chores means they are able to stay in their own homes or feel less of a burden on relatives and friends. Researchers are now looking into whether robots should be able to understand and show emotion, provide social support, converse and make eye contact. That is all well and good. But, until someone is able to build a being that can empathise share jokes or memories with a person who is feeling the effects of the passing years, or exchange opinions and information with someone who misses the buzz of working life, a robot cannot the whole answer; except for complete misanthropes.

active ageing

FEBRUARY 2019

SOUND and VISION, keeping them SHARP Ageing can affect all of the senses, but usually changes in hearing and vision are most noticeable

he ears, the hearing organs, are also involved in helping us maintain balance. Sound vibrations crossing the eardrum to the inner ear give us hearing. In the inner ear the vibrations are changed into nerve signals which are carried to the brain by the auditory nerve. Also in the inner ear are fluid and small hairs which stimulate the auditory nerve, helping the brain to maintain balance. In some people, aging causes changes to structures inside the ear, and their functions decline. This loss is called presbycusis, and both ears can be affected, especially in the case of high-frequency sounds, and the ability to tell the difference between certain sounds. Distinguishing conversation from background noise can become a problem. Another widespread problem for ageing ears is tinnitus, which is persistent noise or ringing in the ear. If you detect a decline in hearing get it seen to, immediately. It could be simply down to a build up wax, which is easily removable. Tinnitus, which can also be caused by wax, is more likely the result of long-time exposure to loud noise; machinery, loud speakers at music concerts or in cars, and even headphones streaming music with the volume too high, are responsible here. Regulations are in place to protect workers from this hazard, though sadly some compa-

nies or the workers themselves ignore them, while loud music is still in the hands of those who either think "it will never happen to them", or are too busy making a fortune from ticket sales and staging events. But, there are things that can mitigate most conditions and the aid of certain treatments, hearing aids and some lifestyle changes can slow the inevitable changes and even lead to some improvements or recovery. The eye is incredibly complex and, again, age can have a negative effect on the structures that allow them to function. The most noticeable and common change is being less able to focus on objects close to. Put simply people become long-sighted. But this can be corrected by using reading glasses, or bifocals. The cornea becomes less sensitive so minor eye injuries and conditions may go unnoticed. Lenses can become less flexible and grow cloudy and cataracts appear. The pupils can shrink to one third of the size they are in 20-year-olds and sometimes don’t adjust immediately to sudden bright lights or darkness. Elderly drivers need to be very aware of these problems with glare from shiny surfaces and sunlight or the way light changes during the day. Perceptions of colour can alter too; especially the difference in greens and blues, and reds and yellows. They may also become aware of changes in their peripheral vision. This is the area which we see out of the corner of our eye and which we are aware of when we are looking straight ahead or directly at something. Drivers who do not see people or vehicles in close proximity are a danger to themselves and other road users. The good news is that, caught early, these changes and symptoms, including dry eyes, tiny black floaters, macular degeneration, glaucoma, and diseases aggravated by diabetes and high blood pressure, can be managed in such a way that progression can be halted, or at least delayed, and sudden lifestyle changes can

often be avoided. However, since many of these conditions can become serious before symptoms are obvious enough to warrant investigation, it is wise to have regular annual or bi-annual appointments booked with an ophthalmologist. Nothing should be too much bother when it comes to caring for our eyes and keeping them healthy. We all know how precious sight is.

Tips for healthy eyes Here are some easy ways to ensure eye health.

atch what you eat, it’s obvious really, but healthy food helps the whole body, eyes included. Choose whole grains and cereals and avoid the sugars found in refined white flours, which may increase your risk of age-related eye diseases, Carrots have a reputation for helping us see in the dark but that’s just down to their vitamin content. In fact, most vegetables from bell peppers to spinach and kale are beneficial too. Include plenty of protein from non-meat sources such as nuts, pulses and eggs. Tuna, salmon and other fish rich in omega-3 fats are a must, as are nonmeat protein sources, pulses, eggs and nuts. If you are fond of meat, turkey has masses of zinc and Bvitamin niacin, which can help prevent cataracts. And don’t leave out fruit as an aid to healthy eyes. Oranges and citrus fruits and juices, especially kiwi fruit, and blueberries which may help to reduce the risk of cataracts, glaucoma, heart disease, cancer, and other conditions Stop smoking it causes so many health problems, some of which are every bit as harmful to the eyes as damage caused by smoke exposure. Exercise and enough sleep are equally important. Exercise stimulates blood circulation, which improves oxygen levels to the eyes and helps in the removal of toxins. Rest and enough sleep are also helpfull. For any length of time using screens, Place a computer screen within 50 to 60 centimetres of your eyes, with the top of your computer screen

slightly below eye level. And try to avoid holding phone and tablet screens too close to your eyes. There are special lenses that lessen the effects of the glare, but if your eyes become tired or irritated, stop for a while and use eye drops prescribed to lubricate the eyes. It is also a good idea to rest your eyes, by gazing into the distance at nothing, and blinking once in a while when doing any activities that could strain the eyes, such as reading, sewing, doing detailed crafts. Always wear protective glasses for DIY jobs, and special lenses for screen use or night driving if necessary. And for the best protection from harmful ultraviolet (UV) light use sunglasses which have both UVA and UVB protection. And even a hat with a wide brim will prevent most of the UV radiation that gets in from the side of your sunglasses.

FEBRUARY 2019

active ageing

When you get to MY AGE... Louis Gatt is already wondering how time has flown so fast

hey say you can tell a lot about a nation by the way they treat their old people. For instance, in the Far East the elderly are revered and very well treated into their dotage and beyond. Whereas, in our neck of the woods I sometimes get the feeling that once you hit 60 plus you should really do the decent thing and pop off as soon as possible, so as not to be a burden on the state. It is still the custom in China and Japan for anyone of retirement age to be looked after by their family, right through until death. And it used to be like that here in Malta. Our Nanna and Nannu were part of the family unit, never a burden. Well. all that has changed in new millennial Malta. the above family arrangement is very much the exception rather than the rule. Plus ca change. These days we live in a fast-food, throwaway society, where geriatric relatives exist on the level of ageing pets. It is the norm, rather than the exception, to bung granny, once she shows signs of going a little gaga, into one of the ever burgeoning crop of privately owned and run local retirement homes. And who is to say that

euthanasia for oldies won’t be a vote winner in a general election sooner rather than later? Fortunately it isn’t an option yet – not a legal option anyway – and, since graduating to the geriatricy myself (that’s anyone who is 60plus, in case you were wondering) I have a vested interest in what happens to we ancients in our, socalled, declining years. And I have come to the conclusion that in the case of care for the aged… Malta is nowhere near as caring and forward looking as Japan or China. Now I don’t want to turn this piece into one long moan about the inadequacies of our social security system. I am well aware of the strains placed upon our society by an ever-growing ageing population. Advances in medical care means that we are, on average living three to five years longer than our parents and grandparents and this all adds up. But if the Japs and the Chinese can make their oldies feel wanted and comfortable, why can’t we? Take the state old-age pension: It is generally acknowledged that here in Malta this is woefully inadequate. Pensioners who are obliged to live solely on their government annuity are, to a large extent, living in nothing less than

grinding poverty. There is an obvious solution, raise the level of contributions on everyone in work. Of course when I was myself in full-time employment I grumbled about having a chunk taken out of my salary cheque every month, but I did see the necessity of this and, to be honest, I – and every other salaried worker – could afford it… just. I really do feel that a decent lifestyle at the end of life is as important, if not more so, as it is during working age. In many countries in northern Europe the over 60s are granted several concessions that help to ease their financial burden. Free public transport is seen as a right, rather than a gift from the government. Adequate subsidised housing helps the economy as well as the elderly, by keeping retired persons in their own homes, as opposed to housing them, at the taxpayers‘ expense, in staterun (St Vincent De Paule) accomodation. We wrinklies do enjoy a few concessions here, things like free foot passage on the Gozo ferry and cheaper tickets at some cinema and theatre performances, but nothing like the ones that old people enjoy up elsewhere. We superannuated ones all have our own serious concerns. Mine, like many

others, is parking. I live in a house in a village square which always had a yellow squared space guaranteed outside it, later endorsed by the local council, back in 1993. But sometime later this was replaced by a white bay which was all too soon spotted by residents from streets away, who having converted their garages into playrooms or home gyms had nowhere to park their two family cars. Now, there are so many vehicles looking to park in our environs that I have to be extremely lucky to park anywhere near my home. Were I 20 years younger this would not be a problem but anno domini has inflicted on me a degree of immobility that makes walking even quite short distances both painful and tiring. Unless I am able to park in our pjazza, I have a long walk back from the nearest available parking area. So leaving the house for pleasure or necessity can be a grim business taxis being able to more or less name their price for a journey of a few kilometres. I am by no means the only one in this predicament but the signs of any local councillor showing the slightest interest in some obvious ways to remedy the situation, for all the genuine residents, and still leave spaces for in comers is not forthcoming. How do they have the cheek to canvas for votes when the aging population of their districts is relegated to coffee mornings, coach trips and an annual Easter and Christmas shindig, while their practical, quality-of-life suggestions raise no response other than an acknowledgement, if that? Sadly, this is the situation that prevails today, with little chance of things changing in the foreseeable future. Perhaps it really is time to get rid of local councils and centralise decisions that have such profound effects on the lives of older people. Now, one last observation on old age –a sort of optimistic one – I’d like to leave you with. Some time back an elderly woman was seen being relieved of her shopping bags and graciously assisted across a busy, wide road. Reaching the kerb, her helper explained she had to give her friend a hand as she was very old, 77in fact. That she herself was in her mid nineties simply had not occurred to her.

active ageing

FEBRUARY 2019

The added cost of TRAVELLING At a time when people start thinking of summer holidays, the fact that insurance cover for older travellers is so high becomes a real concern.

nsurance providers see older travellers as being a higher risk. They have a basic premium for the 18-64 age group, and rack up the charges for those of 65 or more. Some companies even refuse cover to people in older age brackets, limiting their choice and often their opportunity to travel overseas. Those who agree to issue a policy may charge almost as much as the trip itself. There is always extra cover for medical conditions such as high blood pressure or diabetes. Travellers who intend to take part in dangerous pursuits or sports, can all have appropriate adjustments made to their poli-

cies. But someone’s age, no matter how risk free their holiday will be and how good their general health is, appears to be a good enough reason to bump up the cost of their travel insurance payments. But it is not all bad news. Providing your travel company or tour organiser does not make it compulsory that you use their 'in house' insurance cover, which often happens even if you are already covered by another policy, there are still ways to cover your medical insurance bills and still travel further than Comino. It is well worth searching for providers that cater for all ages. There are specialists who offer cover that is tailor made to cover an individual traveller's

health and other circumstances, which will show that he or she is unlikely to be a high risk traveller. Aside from your general health, you holiday destination, including whether it has a reciprocal health agreements with Malta, and the duration of your trip will influence the cost of your insurance. You should also check if your pre-paid or package holiday includes travel insurance as part of the package' and whether you should simply top that up to allow for any 'senior' health complications that may arise during the holiday. This could greatly reduce the cost of cover. And if you have insurance with a bank product or other similar service, check where they stand on travel insurance.

Serial travellers will need to allow for more than one trip a year and for trips of various lengths. Very few regular insurers provide older holidaymakers with multi-trip policies; that is those that cover more than one holiday. But there are specialist insurers that do and it is well worth hunting them down. They can offer a simpler option, where jetsetters only need to book cover once, instead of taking out a new policy before every trip. It is important to check what limits there are, for example on the maximum length of your combined trips, before you pay. There are providers who have no upper age limits and trips can last as long as 120 days. Remember to

ask about couples discounts, if you're buying insurance with a partner. And take the policy out from the time you book your holiday. You won't want to be paying up for cancellations if a member of the family falls ill, preventing you from travelling. Finally, comparisons and small print are vital. By all means, shop around for the best deal but never be tempted to take any sales talk at face value, ask for, and be satisfied with, any information you need and never skip those tiny print paragraphs and asterisk at the bottom of each page. It is no exaggeration to say that failure to do so could result in at least half the policy being totally invalid, for the slightest reason.

Elderly residents at CAREMALTA HOME served by Management

his year’s first big event at CareMalta was a very special one described as ‘CareMalta here to serve’. This event was organised as a role change day with a difference where all the top management took on the role of chefs and hosts serving the elderly residents at Zejtun Home, one of the nine homes operated by CareMalta. The management team started off the day bright and early in preparation for a lavish lunch with the supervision of CaterEssence’s expertise. The management team was assigned different roles to prepare the food, set up the tables as well as plating the food and ultimately serving the residents. A life size frame with a fancy background was set up in the reception area where all the residents got a photo of themselves. The photos were then printed and given to the residents as a token of this occasion. January hosted another event at CareMalta named ‘Tea with the CEO’ where a number of I Care influencers meet up with CareMalta’s CEO Natalie Briffa Farrugia on a monthly basis to share their I Care experience so far. I Care, CareMalta’s service excellence programme was launched last year in cele-

bration of CareMalta’s 25th Anniversary. The programme focuses on three pillars, Compassion, Engagement and Professionalism where everyone speaks a common language, the language of care.

February will be featuring a very special event for Valentine’s Day where all couples residing in CareMalta homes will be treated to a romantic lunch at Mellieha home to celebrate love altogether.

CareMalta currently operates 9 homes for the elderly across Malta. For more information kindly get in touch by calling on 22584200 or sending an email to info@caremalta.com.