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Dr Pierre Guillet Chronicle: The five pillars of successful aging - Chap.1
Advancing the space of healthy life

We are, today, the parent of the person we will be tomorrow. Gerontology, which is the science of evolution of living beings in time, also serve to reflect on this future. This reflection allows to prepare, based on past history and the realities of the day, what we can become with age. It includes prevention, that is to say, how to organize themselves to avoid a bad aging. The area of healthy life, that is to say life without self need anyone to ensure the actions of everyday life is to progress.

What are the pillars of a successful aging? What should you be careful, how to fix problems before it's too late? The answer to these questions came to me after a thirty years experience in general medicine, the Association of Gerontology of the thirteenth arrondissement of Paris, in a study of the main reasons that cause one day, suddenly in this or that person an abrupt change of life and an entry in the dependency. Most of the time, said older people just ask for a partial relief, regardless of their overall living conditions. Now life is moving in a succession of periods of equilibrium and crises rather than dispersing aid throughout the aging is mainly the crisis we must focus our attention. Although analyzed, they can afford to find another balance health as good as before for the person and his entourage. While unforeseen or aggravated by clumsy aid, they are to create situations of loss of autonomy.

We call frail difficulty or inability to provide only the basic needs of life: drinking, eating, elimination, but also wash, dress, and beyond, maintaining the house, manage accounts, shopping and meet other people. All of these disabilities is addictive and there are fears of old age. It may, for various reasons linked to disease or inadequate living space, needing outside help once or several times a week: it is a small frail. If you need daily assistance for many tasks, it is an average loss of autonomy. Finally, the great loss of autonomy is defined by the need to be helped 24 to 24 hours on his home or be placed in institutions, often called médicalisée.Ce assistance to old age does that on extreme periods of life, where a dependency is already apparent. Although it softens, but does not change the duration.

The gerontological balance sheet aims to identify a set of elements that determine the proper age of an individual. Then, a "dialogue" between family members, medical responders and / or social and the individual itself, enabling the latter to understand where she is, what it can count. That gives him time to be accompanied to navigate his life. See, for example, that housing is inadequate does not necessarily mean that we accept his amendment without fear. As with other life changes, it will reflect a maturing.

It is architecture that gave me the idea of "Pillars". Controlling the strength of buildings such as palaces of Venice and the Bridges of Paris requires regular monitoring of the most important pillars. Similarly, we can not consider a "successful aging" without a permanent control of the "pillars" that support the most important daily life, namely resources, housing, health, social and emotional life. In humans, only the physical health, been more or less regular assessments. But health is not the only pillar of balance of good aging. It should be read in a broader context.

Successful aging requires a harmony between health, desire and pleasure of living and ways of living. It is a balance between risk and lifestyle choices, between an individual and his environment, and each of these terms is as important as others. We will see in future columns the importance of these five pillars.

Discussion Forum


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Comment by Coralie Matthews on March 11, 2013 at 6:14pm

I'm just wondering if this group is still active?  Been a while since anything new has been posted.  I have just started Cert III Aged Care, anyone else has done it or is doing it?

Comment by khelil omrane on November 27, 2012 at 2:30pm

Elderly: urologists break the "taboo" of sexuality in old age

"A misunderstanding" doctors on the subject

Sexuality - including sexuality and the elderly - was one of the dominant themes of the annual congress of the French Association of Urology (AFU), which took place from November 21 to 24 at the Palais des Congrès in Paris.

The report on "Sexual Medicine" presented Saturday, November 24, examines the state of medical knowledge on the subject to help urologists, specialists in the urinary tract, to deal with issues more numerous and precise their patients.

"People do not die of sexuality, but when it does not work you can be very poor and there is a growing demand on the part of men and women in this area," says urologist François Giuliano (Raymond Poincaré Hospital, Garches) , one of the report's authors.

"Disorders of desire and orgasm in women," side effects ("iatrogenic") drugs on sexuality, "surgery of female genital mutilation" or "sexuality of the elderly couple" are some of the topics that have been addressed in this report.

"Over the past decade, there has been considerable progress in understanding the mechanisms of sexual dysfunction in their treatment, and there is a waiting population growth," says Dr. Giuliano.

A majority of urologists, whose average age is 50 years, had no specific training in this field while in office and places a growing sex life.

Good example of this trend: the arrival of "expected" in 2013 in France, the first specific treatment against premature ejaculation. The Dapoxetine (brand name Priligy, laboratories Janssen / Furiex / Menarini) which acts on the hormone serotonin, would "multiply by three or four times for the ejaculate," according to Prof. Giuliano.

This product should be taken "on demand", as well as against male impotence pills like Viagra, is a "new" drug as far prescribed antidepressants, did effect after 15 days.

Another area of ​​growing importance for urologists: the "iatrogenic sexual drug", ie the side effects of the treatment on sexual life. "Numerous drugs may induce sexual problems such as erectile dysfunction caused by anti-hypertensives" says Dr. Giuliano.

"But there is a great ignorance about this although it is a major cause of non-adherence" by men, he says.

Urologists also need to know to answer the questions "less exceptional" couples aged 75 to 80 years who want to "have sex more satisfying."

According to figures released by Afu, nearly 90% of women over the age of 50 living couple now say sexually active against 77% in 1992 and 53% in 1970.

"The acceptance of the other aging is essential to continue to project themselves into a sexual relationship" says Dr. Giuliano to that specialist advice can be valuable in these cases.

Comment by khelil omrane on November 18, 2012 at 3:28pm

Overcoming isolation

Seeing in person, never leaving little or elderly person can retreat into isolation, which could have important consequences: sadness, depression, or disorientation.
In fact, isolation is often synonymous with long days and all alike, and that force can cause confusion at times of the day, and ultimately, any disorientation. It is therefore important to surround the elderly. However, family members often live far away and it is difficult to move as they wish.

So what to do? Several solutions are available to caregivers: seniors clubs rural * that allow the elderly to socialize, discuss, participate in workshops ... engage a lady companion who come several times a week, or search for a person placed in the same situation and a little company interested. Through the center of communal social action (the town hall) or Office for Seniors ** (OPA), it is possible to get in touch with voluntary organizations offering visits to patients, residents, seniors ...

Comment by khelil omrane on October 30, 2012 at 3:25pm

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Comment by khelil omrane on October 30, 2012 at 3:24pm
Photo : <iframe title="Stupeflix Video Player" class="SxPlayer" src="<a rel=nofollow href="; width="640" height="360" frameborder="0"></iframe>" width="403" height="403"/ _origwidth="403">
Comment by khelil omrane on October 26, 2012 at 4:00pm

health practice
"Health is a state of complete physical, mental and social, and not merely the absence of disease or infirmity."
Throughout life, our well-being (personal and subjective state) is based on this balance.

Aging Well, it is defined "five pillars" upon which it is important to exercise constant supervision because they support our everyday life resources, housing, health, social relations and intellectual activity.

Getting older is an opportunity and we can indeed be old and feel good. Many diseases are caused by our choices and behaviors, not aging.
Health, well being regardless of age, pass in the first place, for a healthy life "Prevention is better than cure," according to the dictionary.

Prevention to optimize its health in its three dimensions: physical, social and mental. This is the best way to delay the loss of autonomy.

1) To maintain good health, it is mainly to ensure:

- Eat well and maintain the pleasure of eating
- Perform regular physical activity
  Tests to measure his fitness after 60 years and adapt its activities.
- Keep the brain alert
- View doctor regularly
- Protect the 5 senses
- Sleep well "Passport to sleep"

Comment by khelil omrane on August 25, 2010 at 6:19pm

Two research projects selected in the first nursing PHRI Two of the twelve projects selected (out of 84 submitted) in the first Programme Hospitalier Research Nurse (PHRI) established by the Ministry of Health are projects submitted by teams of the CHU of Limoges. One is related to nutrition among the elderly, the other is the pain and music therapy. This decision confirms the work done daily by the Department of Clinical Research and innovation, the promotion committee paramedical research and innovation from the Commission on Nursing rehabilitation and medical technical and nursing staffs.

"Focus on the two research projects Limousin
"" PRAXALIM: Impact of the shape of plates on the preservation of praxis in the diet in elderly patients with severe dementia of the Alzheimer type or mixed institution "Unit protected life of Dr. Ehpad Chastaingt. Dementia gradually deprive the individual of his autonomy, his personality and identity. The patient with severe dementia, needs benchmarks. The use of objects of "talking" is significant to him, is to prioritize the universe as institutional, often impersonal, reminds him little. The institutional base can be destabilizing for the dementia patient. PRAXALIM is a study in routine care, quasi-experimental, multi-center, over 3 years. Its main objective is to compare the behavior of the person with dementia and their ability to feed herself as containing proposed. As a secondary objective, this independence could allow the resident to keep the fun in this activity.

"Pain and music therapy in the rehabilitation of dressing peripheral arterial disease stage IV" in Thoracic and Cardiovascular Surgery
The unit accommodates CTCV septic patients with arteritis obliterans of lower limbs. The disorder associated with chronic pain, acute pain in connection with the dressing changes that may delay healing and anxiety everyday. In France and the Anglo-Saxon studies show the value of music therapy in the management of acute or chronic. The context of painful rehabilitation dressings such peripheral arterial disease, associated with music therapy has not yet been explored. It is therefore a study biomedical experimental prospective clinical trial type of superiority, randomized, conducted in two parallel groups over 18 months. Its main objective is to assess the impact of music therapy on acute pain caused by the rebuilding of the dressing. Secondary objectives are to evaluate the reduction of acute pain taking opioids and anxiety score. Improving the effectiveness of wound care, reduce length of hospital stay and develop a protocol of best practices is the impact of expected results.

The research will question the paramedical professional practice, to try to understand, to find solutions to make health care more efficient service to patients. In this context, the Committee to promote research and innovation paramedical aims to assist nursing staffs in the emergence and shaping of their research project in health care.
Comment by khelil omrane on August 24, 2010 at 3:06pm
World Day of Alzheimer's disease Sept. 21: More than 100,000 Algerians involved

Posted: Aug 23 2010 2:21 AM PDT
Alzheimer's disease is the third leading cause of death worldwide after cardiovascular disease and cancer. It affects one in ten people aged over 65 years.

Some 24 million people worldwide suffer from Alzheimer's disease, including more than 4 million U.S..

As every year the World Day of Alzheimer's will be celebrated on September 21 next. This date will be the opportunity for different organizations participating in the organization of this day around the world to focus on the importance of obtaining a diagnosis as soon as possible and encourage doctors to to recognize earlier the signs of the disease for early treatment of the disease.
Many tracks are now followed to improve the diagnostic delay that often occurs many years after the start of disease development.
First described in 1906 by the German neuropathologist Lois Alzheimer (1864-1915), this degenerative disease is present in the form of behavioral problems, compounded by intellectual deterioration, which affects memory, thinking. She is not considered a mental illness is not contagious.
According to the latest WHO report, released in February 2009, about 1 billion people worldwide suffering from neurological disorders, including 24 million from Alzheimer and other dementias relatives that will only grow with the aging world population.
The condition of the brain that causes progressive and irreversible loss of mental functions, is ranked the third leading cause of death worldwide after cardiovascular disease and cancer. It affects one in ten people aged over 65 years. In Algeria's over 100,000 people with Alzheimer's disease.
WHO advocates the integration of today neurological care and management of the disease of Alzheimer's in the primary health care.
K. H.
Comment by khelil omrane on August 24, 2010 at 1:19am

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Fight against dementia: focus on diabetes and depression

And maintenance of intellectual activity

Reduce the incidence of diabetes and depression and enhance the intellectual capacity, two key elements to prevent dementia after age 65.

The elimination of diabetes and depression and improving mental capacity and the increased consumption of fruits and vegetables are measures that have the greatest impact on reducing the incidence of dementia ( number of new cases) in the years to come, say Karen Ritchie, INSERM Unit 888 Director "Pathologies of the nervous system in an article published in early August on, the website of the British Medical Journal.

These results suggest priorities for future interventions in public health.

Although the cause of dementia remains unknown, several modifiable risk factors have been identified, including cardiovascular risk factors (heart disease, stroke, hypertension, obesity, diabetes, high cholesterol), history of depression , diet, alcohol consumption and level of education.

With these data, a team of researchers based in France and Great Britain followed 1433 healthy people aged over 65 years, recruited between 1999 and 2001 and living in southern France (Montpellier Agglomeration) . Participants were tested in cognitive baseline, then 2, 4 and 7 years later. A reading test (Neale score) was also used as an indicator of intellectual ability in lifetime.

Medical history, height, weight, monthly income, educational level, alcohol and tobacco were also found. The individual genetic risk of dementia was measured.

The analysis of these data collected by the team of Karen Ritchie shows that the suppression of depression and diabetes and increased consumption of fruits and vegetables would lead to an overall reduction of 21% of new cases of dementia or moderate cognitive deficits, depression having the largest contribution (10%). However, regarding depression, the researchers emphasize that the causal relationship of depression-dementia remains uncertain.
The improvement of intellectual capacity would lead to a 18% reduction in the number of new cases among the general population over 7 years.

However, say the researchers, "eliminating the major known genetic risk factor in the general population - 4 allele of apolipoprotein E - not only would reduce by 7% the number of new cases. In light of these results, Karen Ritchie and colleagues suggest that public health programs should encourage intellectual activities for all ages, regardless of the abilities of each, the rapid processing of depressive symptoms and early detection of glucose intolerance and insulin resistance, early signs of developing diabetes.

"Although these results provide only a rough estimate of the impact on the incidence of dementia, they can set priorities in terms of public health in the area of prevention," conclude the authors.

updated 22/08/2010
Comment by khelil omrane on August 23, 2010 at 5:45pm
Life "encourages and invites us to ask 10 questions concerning patients' rights and end of life

The old law Leonetti, passed April 22, 2005 remains unclear. To know the essence of its content, the weekly "Life", with the support of the Federation of hospitals Assistance Fehap-person, the ethical space of the Assistance Publique-Hôpitaux de Paris and Hospital Federation of France-FHF-publishes a booklet that outlines the principles of the law.

The adults, facing the end of life, non-emergency, are affected by the law Leonetti. Here are the founding principles:
- Aggressive treatment is illegal,
- The patient has the right to refuse treatment,
- The physician must make every effort to relieve pain,
- Everyone can express their wishes to organize his last moments.

Thus, "The Life", encourages and invites us to ask 10 questions.
- How to be sure we will respect your wishes
- Why appoint someone you trust?
- How and why to write "advance directive"?
- Who decides what is or is not aggressive therapy?
- Sedation: when, how and why?
- What happens happens after the cessation of treatment regarded as unreasonable?
- And after the cessation of feeding or artificial respirator?
- What action have the patient or his family if the doctor refuses to listen?
- And if you are treated at home?

This, in 4 situations envisaged by the Act as the person:
- Is conscious but kept alive artificially;
- Is aware, in advanced or terminal phase of severe and incurable;
- Unconscious, in a chronic vegetative state;
- Unconscious, in advanced or terminal phase of severe and incurable.


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