Dr Gaggandeep Singh Alg is currently a Consultant (AUC) Physician and Geriatrician working at the Royal Berkshire Hospital, UK. He is active in charity work supporting the most vulnerable in society and has an interest in equality and diversity. Twitter Handle @DrGSAlg
How often do we hear about the rapidly growing population of older people? Yes, we hear about it almost every day. But who are these older patients? Where are they originally from? What is their cultural and religious background? No one seems to be talking about that!
In the last 8 years while doing charity work in my free time I have noticed a growth in the older population from black, Asian and minority ethnic (BAME) groups. Older people from BAME backgrounds suffer from the same illnesses our other patients suffer from. However, in my experience they do not always know when and how to seek help. They have cultural, religious and language barriers which may prevent them from accessing health care services. Through the charity work I have seen many over 65 year olds living with signs and symptoms of various diseases, who have not been able to access the services we have built and provide!
A case study from the British Sikh Doctors Organisation (a charity working to support vulnerable people in society to understand and better manage their health): A 84 year old, Punjabi speaking man attended one of their charity events. He was walking with a stick, had a shuffling gait and stooped posture. He had an obvious right arm tremor, hypophonia and hypomimia. 6 years ago he had been diagnosed with an essential tremor. He complained of regular falls and changes in his swallow. This gentleman obviously had parkinsonism and had been deteriorating over the last 6 years. He did not want to see his GP or come in to hospital as he could only speak Punjabi and did not believe there were any services available which could help him. He was supported by the charity and is now under the care of a Consultant Geriatrician with a special interest in Movement Disorders. He is falling less and some of his symptoms are better controlled. The organisation were successful because they broke down the issue with language barrier and they gained the trust of the patient, as the charity team had prior knowledge of his possible religious and cultural beliefs which may have also played a part in him not getting help earlier.
So, my message is ‘it’s time for change’! We must look at the populations we serve and review how we deliver and improve the access to our services. For all those working in community and interface services we are in a great position to meet with charity groups, support groups and religious centres/places of worship, to start the process of looking at some of their concerns and to try and break down any potential barriers. These groups are sources of information and support for us, and can help us develop our services.
Let’s talk! If you are working in an area where you have acknowledged this issue and started dealing with it, we should start sharing some ideas. Let’s make Geriatric medicine even greater!