Maithri Health Advice & Help for Elderly

Kidney Cancer in the elderly can be a real challenge for an oncologic urologist. With the dramatic aging population, kidney cancer will have a massive impact on the urology department. More and more urologists will face elderly patients with renal cell carcinoma. Having a proper assessment of kidney cancer treatment is essential. An aggressive therapeutic approach may be balanced by the benefit of the treatment care or cure and the life expectancy and willingness of the patient. Many different treatment options would be available to the patient including surgery options such as radical or partial nephrectomy or treatment therapies such as cryotherapy or radiofrequency. With the increasing age population and the number of elderlies with cancer including renal cell carcinoma, it continues to grow. A study on cancer found with patients who have confined kidney tumors from ages 75 or older do not live longer even the whole kidney was removed.

What is Kidney Cancer? 

Kidney cancer is also known as Renal cancer. It is cancer that involves the kidney. Smoking, old age, high blood pressure, and obesity can increase the risk in the development of kidney cancer. Renal cancer is where the kidney cells become cancerous and they grow out of control which then forms a tumor. Nearly every cancer of the kidney appears first in the tiny tubes lining of the kidney. This is called renal cell carcinoma. A lot of cancers of the kidney is found before spreading to other organs. If the cancer is caught early it will be more easily treatable.

Symptoms of kidney cancer 

Usually, symptoms do not appear early in kidney cancer stages but some people can experience them initially if the cancer may have spread. The symptoms that can occur include:

• Pain in the side
• Blood in the urine
• Night sweat and a fever
• Anemia
• Vision changes
• Changes in liver function
• Loss of appetite
• Weight loss
• A mass or a lump in the lower back or the side
• High blood pressure
• Fatigue
• Liver function changes
• Varicose veins in the testes
• An enlarged testicle

If you do experience any of these symptoms it is important to see a doctor.

It is unknown what causes kidney cancer but there are many different factors that can put you at risk of developing kidney cancer. Cancer of the kidney occurs in someone who is older than 40. Here are some of the factors:

• Obesity (your hormones can change if you are overweight putting you at risk
• Smoking if you are a smoker you are at risk of this cancer is a lot higher than those who don’t smoke
• Men, a man is twice likely to develop kidney cancer than women are
• Some medications for pain over a long period of time
• Advanced kidney diseases or are on dialysis long term
• Genetic conditions which is inheritance papillary renal cell carcinoma or von Hippel Lindau
• Kidney cancer history in the family
• High blood pressure
• Exposure to some chemicals which include organic solvents, asbestos, certain herbicides, and benzene.

Treatment options 

There are several options for treating cancer however it depends on several factors, these include:

• The stage and type of kidney cancer
• Overall health
• Previous treatment for cancer
• Personal preferences

Modern Kidney Cancer Treatments 

Once you have received a diagnosis and what stage your cancer may be at. The process for treatment is the next stage which your doctor will discuss and go through with you. You may need to be referred to see a specialist in regards to your treatment. This may include a surgeon, a urologist, and radiation or medical. With many different options for modern kidney cancer treatment surgery would be one of the main steps.

Surgery  

The Surgical procedure involves the removal of the kidney and the tissues around the surrounding areas. If the cancer has not spread to any other part of the body, the only treatment that may be needed is the removal of the tumor, part of the kidney removed, and possibly the nearby lymph nodes and tissue.

Types of surgery options 

There are many different surgery options to treat cancer these include the following:

• Laparoscopic surgery

This type of surgery is a minimally invasive traditional keyhole surgery. The surgeon will operate through the body via small incisions generally through the belly button or abdomen. Long flexible tubes called a laparoscope are used during the surgery. The surgeon will then operate by removing some of the kidney or the entire kidney depending on the stage of your cancer. This type of surgery has many advantages such as recovering quicker and less scarring after the procedure. Laparoscopic surgery requires specialised training.

• Partial Nephrectomy

Partial nephrectomy can be keyhole or operation in some circumstances. This surgery is the removal of a tumor from a kidney or just part of the kidney with surrounding tissue. It is only performed if the tumor is small in size less than 4cm.

• Radical Nephrectomy

Radical nephrectomy is the surgical procedure performed for the removal of a tumor, the whole kidney, and the surrounding tissue. It is a common surgery treatment for kidney cancer and can be done through tiny incisions using a laparoscope. If nearby surrounding lymph nodes and tissue is the same and are also affected by the cancer a radical nephrectomy is performed to treat it. Radical nephrectomy is necessary if treating a large tumor where there is not much healthy tissue remaining.

Non-surgery treatments

In some cases, surgery may not be needed depending on the diagnosis, the risks, and the overall health. The following procedures may be necessary and all that is needed:

• Cryoablation

Also known as cryosurgery or cryotherapy. This treatment freezes the cancer cells with a metal probe that is inserted through small incisions. It is placed into the cancer tissue.

• Radiofrequency ablation

This treatment option is with the use of a needle that is inserted into the tumor to help destroy the cancer with an electric current. The procedure is performed by a urologist or an interventional radiologist.

Psychotherapy can aid the elderly in many more ways than generally accepted. It can treat problems directly associated with older people like loneliness and isolation, insomnia, and the side effects of multiple pharmacological drugs, while at the same time providing major health benefits. Older people need to regenerate their minds as much as younger folk to stay energised and connected. The applicability of psychotherapy for the elderly as an approach to care as well as a treatment is broad and useful. A wealth of opportunity exists for psychological approaches to deal with the transitions and changing roles of old age in addition to specific mental health problems. In sharp contrast to this are inadequate training and services and a dismal lack of understanding of the psychological challenges that aging people face. What is abundantly clear is that the elderly have unique anxieties related to age, not least of all the anxiety of their approaching death.

Why is Psychotherapy is Particularly Needed in the Elderly?

There are many reasons why the elderly can benefit hugely from psychotherapeutic approaches. Older people find it difficult to come to terms with transitions such as retirement, increased vulnerability, poor health and potential institutionalisation, failing bodily functions, and the prospect of death. At this stage of life, their memories may become tinged with nostalgia as they think of happier times in the past when they felt cared for. It is not uncommon to see older people develop psychological problems as they struggle to come to terms with the loss of a loved one or the end of a lifelong career. Personal transformation through psychotherapy can help them enjoy fruitful and meaningful relationships again whether at home, in a care facility, or in the community.

Challenges of Aging 

Falls can have a devastating effect on the aged. The experience can cause a loss of confidence and can sometimes lead to hospitalisation. Falls are often a reflection of a significant change or shift in everyday life for the elderly. Our bodies form a boundary between external reality and the self and falls can reveal the physical fragility of the aging body. Care often focuses on the outward physical harm while the emotional needs stemming from falls are neglected. After a fall the idea of emotional containment should be considered to assist in the rehabilitation of an aging individual. Shifts in equilibrium caused by the perception of a failing body can cause emotional pain in the form of guilt, disgust, shame, and injury to the psyche that stems from the loss of pride and independence. There is a need to recognise the vulnerability of an elderly person who has suffered a boundary insult such as a fall before they become lost in the emotional pain.

Fear of dependence and loss can haunt anyone, but it certainly has more significance for the elderly. Loss of physical ability or mental function as well as fear of ending life with regrets or without resolution of important goals are all factors for improvement that can be addressed by psychological intervention. Psychotherapy can help the elderly to accept past failures and allow good experiences that are significant for that person to shine through to the present.

Dementia can cause behavioural problems in the aged that severely impacts the function of the interaction between a patient and caregivers. Both behavioural and psychodynamic approaches can help caregivers and family members to provide care that is more effective and certainly less stressful for the patient as well. In caring for patients with dementia the care should centre around the value of more meaningful relationships, supervision by skilled staff, and a therapeutic environment that explores the reactions of patients to caregivers in day-to-day situations.

Personality disorders in the elderly are increasingly becoming apparent in the elderly, particularly late-onset personality disorders and the relationship to depression and treatment-resistant anxiety. Careful exploration of the personal history of such individuals is valuable in uncovering hidden stories of untold childhood trauma, often including physical and sexual abuse. Needing to be cared for in old age can re-ignite old attachment issues from childhood and disturbing interpersonal relationships from the past. Older people have learned to be stoical in adversity. Consequently very few have had the opportunity to work through difficult issues from the past. They need the best efforts of professionals to make access to psychotherapy treatment a reality for older people.

Drugs are another reason why psychotherapy can be a powerful treatment for the elderly. Older people take a lot of prescribed drugs and the effects are multiplied by age. Many physicians routinely prescribe drugs like antidepressants, anti-anxiety medication, and potent anti-psychotic drugs as a treatment for undiagnosed mental problems and even for common symptoms like insomnia in older people. With the short consultation times in the doctor’s room, it is understandable that it is faster to prescribe pills than taking the time to find out the underlying causes such as family issues and finding behavioural means to help people get better.

Meanwhile hospital admissions from drug side effects and death from overdosing keeps on rising. Psychotherapy is the answer as it has no side effects and, in fact, can be used to great effect to get people off addictive drugs and sedative-hypnotics. It has been proven over and over again that just talking to someone with a sympathetic understanding of problems associated with age, intelligent advice, and social support can help heal emotional problems and provide major physical health benefits. And psychotherapy for the elderly can also save the medical profession a lot of time and money which seems like a good deal that shouldn’t be passed up.

With the growing number of elderly people who are living alone and independently, it is more important than ever before to be safe in a home. The most common accident can be having a fall. If you are someone who takes care of an elderly person there can be safety and health risks. Activities such as moving or lifting or even general hazards such as trips or falls, so it is essential to have the right health and safety training practices in place when having to deal with the elderly. Whether you are a home care worker or simply just look after an elderly person at home it is important to take lots of care and be up to date with health and safety training.

Health and safety training is a legal requirement for all employers. It is essential that is correct and all staff members have the correct training for those people who need support and care.

Types of Health & Safety Training 

Care of an older person is a compassionate and virtuous role, whether it’s a voluntary role or a career you are pursuing there are many options out there for health and safety training courses. If you are caring for the elderly it requires a certain amount of skills and knowledge. Training will provide the care worker with an extensive set of skills and expertise that will equip them with the patient’s daily needs. So, let’s take a look at some of the courses that are available for training in health and safety.

• • Basic First Aid 

 

First aid training courses will equip the learner with the practical skills, knowledge, and understanding that is required to provide appropriate first aid treatment in the workplace in compliance with the requirement of the safety, health, and welfare at work. Carers have huge responsibilities and keeping someone safe is paramount in the job. So, if an accident happens you need to be well prepared and be equipped with first aid training.

• • Cardiac First Response 

Cardiac first response course will equip the learner in cardiopulmonary resuscitation and the using of the automated external defibrillator. If someone has suddenly collapsed and their lives may be at risk the cardiac first responder will play a vital role in keeping them alive.

• • Patient Handling   

Patient handling course will provide learners with instruction and information on safe patient handling techniques. If these techniques are followed correctly this may help in the prevention of an injury to someone’s back. This course entails moving the patient on the side of the bed from sitting to standing, rolling the patient in bed, moving the patient around the bed using slide sheets, use of a hoist, moving the patient from the bed to a chair, and moving the patient from a bed to a trolley.

• • Basic Food Safety   

The basic food safety course will equip the learner with the basic food safety knowledge to enable them to work with food in a hygienic and safe manner. Once the course is completed all participants will be able to understand the importance of cleaning schedules and cleaning, define food hygiene, identify a pest infestation and how to deal with it, and much more.

What is expected in Residential care facilities?  

All health and safety regulation must be fully compliant with by workers in residential care facilities. So it is essential that employees have the appropriate training from the courses listed above to ensure the proper health and welfare of the elderly they are taking care of. National standards must be fully compliant with the countries regulations the health care professional is working in. After all, we are going to probably need this type of service when we are older, so taking care of our elderly to the very best is the least we can do to help.