Nigeria: Prioritising Special Care for the Aged

15 April 2021

Rebecca Ejifoma reports on the recent extensive reforms, upgrade of equipment, and technological innovation at University of Benin Teaching Hospital, with premium placed on special care for the aged.

From 2017 to 2021, the University of Benin Teaching Hospital (UBTH) has driven extensive reforms, and upgrading of its facilities with world class equipment, technological innovation, ancillary services, and revamped its entire modus operandi.

Among the many transformations as seen during a two-day media tour of its facility is the newly refurbished Geriatric ward, a 20-bed unit that caters to 20 elderly patients with varying chronic illnesses.

Today, the elderly friendly ward - although set up in 2012 - comprises persons aged 60 and above, who have hypertension and its complications, vision impairment, geriatric syndrome, stroke, dementia, and depression among others.

Launched by the Minister of Health, Dr. Osagie Ehanire on March 9 last year, it was specially to address structural, infrastructural and process gaps in hospitals, with a view to improving older persons' experiences in accessing quality healthcare.

One of such older patients is 65 years old Angelina Osobase, a stroke patient. Her daughter, Mrs. Mercy Ozegin, who sat on a guest chair beside her bed, had brought her in for treatment.

Osobase was among the 14 elderly patients at the Geriatric ward, which has five bays, with four beds in each. The ward has 22 nurses, 10 healthcare assistants and medical social workers, one geriatrician, a medical officer, a registrar in internal medicine, three physiotherapists, one occupational therapists and her assistant, nutritionists, and two pharmacists, registrars from internal medicine, and two house officers part time.

The 20 bed-ward is tagged ELDFRHI (Elder Friendly Hospital Initiative). This initiative powered the installation of grab bars from the wards to the doorways through to the corridors for support and prevention of falls, non-slip floor tiles, lightning, and wheelchair-accessible toilets.

To train multidisciplinary healthcare workforce on the principled of person-centred, holistic, and ageing friendly care, UBTH had the international training of trainers in geriatrics in UBTH from March 9 to 23 last year. It was facilitated by leading experts.

With these innovations in place, Ozegin told newsmen how she brought her mum to the facility three weeks ago after she developed stroke. "We have been here for three weeks. She had a stroke that affected part of her brain."

Unlike the initial stage, Ozegin is pleased to see the impressive improvement in the health of her mum. "Yes, there is improvement; she is getting better," nodding her head in confidence.

Now, this is thanks to UBTH's four year strategic plan, which vows to rev up its services to beat best international practice with a core value for life, care, respect for people, and strive for excellence, and inward medical tourism.

And while Ozegin has heard of the treatment, she has also had a feel of it. "When we came here, she could neither lift her hand nor open her eyes, but now her hand is moving and she can communicate with her eyes as well."

Ozegin, taking a deep sudden sigh, mused: "The experience here has been great!" she exclaimed, gesturing "When I came, I was thinking that UBTH could not give me services like LUTH in Lagos, but I found out that they are better."

In her description, she rated the medical personnel as passionate, remarkable, and never cutting corners. "They take my mother like she is their mother. When she excretes, they take care of her, even the feeding".

Surprisingly, Ozegin continued, the hospital supplies us the medicine. "I don't go out to buy anything; I simply go to the pharmacist inside the clinic to confirm my bill and pay once the nurses supply the medicine," she added.

Although she gave the facility thumbs up, like Oliver Twist, Ozegin asked for more. "They are good, but they should put more effort. The environment is clean but we need more to compare with hospitals outside the country," she chuckled.

And just a walk from that bay, where Ozegin's mum is lay a retired staff of the University of Benin (UNIBEN) Pascal Okodiye, a 79-year-old man.

When asked of the treatment, Okodiye chorused the words of Ozegin. "They have been taking care of me", he said almost in whispers, as he lay still in bed. "They have been doing their job well".

Although the retiree could not recount how or what landed him at UBTH, he reminisced how weak he was, and could not walk on his own. "Oh I was told I came here 12 days ago." he quickly admitted.

One of his relatives, name withheld, opened up. "We thought it was malaria at first. So when we came here, they now diagnosed pneumonia. But ever since, he has been responding.

"Now, he can come down from bed on his own, he can brush his teeth, get up on his own, eat, drink water and take his drugs."

With the hospital certifying Okodiye fit and ready for discharge, his relative announced with a gleam, "They said he has fully recovered; and we can now go home. So today we will be leaving."

In her reaction, the ward Geriatrician, Dr Obehi Akoria, credited UBTH for sponsoring her training and the unit was set up upon her return.

"The initial crop of staff were 19 nurses - physiotherapists, occupational therapists, medical workers, dieticians, pharmacists," adding that they were all trained intensively for six weeks before they started.

"So what we do here", she said, "is provide person's centered holistic care. It goes beyond the focus of diagnosis to think about and provide care for the total human being".

With physiotherapy and occupational physiotherapy in place, Akoria noted that enables them to maximise their physical functioning whereas occupational therapists enable them to optimise their individual independent living even if they may have impairment.

"For example, some of them are visually impaired, some have impairment in their muscular skeletal system because of arthritis and other kinds of diseases. What occupational therapist does for them is that even if you are blind, you can still be independent, feed yourself and dress yourself," the geriatrician emphasised.

"The idea is when the elderly recover, the ward hopes to transition them and their family members back home into society to perform optimally.

While defining what the ward is about, the CMD UBTH, Prof. Darlington Obaseki, conceded, "We have to understand that it's not a geriatric ward issue alone, so across the hospital, there are things we should put in place hospital wise to prioritise care of the elderly."

Beyond the geriatric ward, Obaseki revealed their plans to scale up all that has happened here across the whole hospital. "When we noticed that all these things would require a lot of resources, we requested ministry of health should champion it."

According to the CMD, if up to 50 per cent of consumers of health care are above age 60, "the resources we are giving to them is just about five to 10 per cent of total budget. We should have a reliable programme, policies and training to provide the required man resource anywhere and everywhere in the country."

For the expert, there is huge training gaps and a lot of assumptions, "But we are making progress", he chipped in with excitement.

"One thing I see across the country, even among the post graduate trainees is that people are beginning to see the need for us to focus more on learning more about how to do more for older persons," says Obaseki with delight.

Proudly, UBTH announced that a large proportion of patients who access care in UBTH are older persons. Thus its priority remains adding years to the lives of the elderly, if not, add life to the years they have and improve the quality of life they have left, thereby, making their lives worth living.

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