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Tag: Care

  • GPs Urged to Embed Lifestyle Medicine into Primary Care

    GPs Urged to Embed Lifestyle Medicine into Primary Care

    LIVERPOOL – “Healthy doctors make healthy patients”, stated a GP during a workshop at the Royal College of General Practitioners (RCGP) annual meeting. The session aimed to encourage GPs to embed lifestyle medicine into primary care through collaborative action.

    Dr Callum Leesefrom Aberfeldy Medical Practice, Aberfeldy, who is also a lecturer at the University of Dundee for the Scottish Clinical Research Excellence Development Scheme (SCREDS), discussed the benefits of lifestyle medicine services in addressing lifestyle-related diseases, reducing their contribution towards the prevalence of chronic conditions, and helping prevent premature mortality. 

    Leese is leading a project to make Aberfeldy the healthiest town in Scotland by promoting physical activities, such as the 2 km, 5 km, and 7 km Santa Stride walking group in November, and a recent food festival to encourage healthy cooking and eating. “There’s loads of things that can be done to try and inspire change,” he said. “The research is fairly unequivocal in that healthy doctors make healthy patients,” Leese asserted. “The most important thing we can do is target our doctors and our nurses and make them advocates for what we want to see with our patients.”

    Speaking to Medscape News UK, he emphasised that, “if the doctors are moving, they’re much more likely to promote it, and if they’re eating well, they’re much more likely to be able to be evangelistic.” 

    Physical Activity Advice Shows High Return

    About one-third of the population in the UK are physically inactive, which costs the economy £7.2 billion, with £1 billion attributed directly to the NHS, he informed the workshop. 

    As an honorary support fellow in physical activity and lifestyle medicine at the RCGP, Leese specialises in integrating physical activity into primary care settings. “We know it’s cost effective. If we compare it to smoking cessation advice, we know that we need to give advice to one person about 50 times for one person to stop smoking in primary care. But for physical activity, you need to give advice to 12 people for one person to increase their physical activity levels to meet the guidance, he noted.

    Leese stressed the importance of short but effective discussions between GPs and patients. He gave examples of online resources to recommend to patients, such as Moving Medicine, which aims to help healthcare professionals integrate physical activity into routine clinical conversations, or the RCGP toolkit (the Physical Activity Hub). “It really takes one minute of asking if the patient has ever considered being more active, and briefly explaining that being more active might have really significant outcomes for their condition,” he said. 

    In primary care, most patients who need to be more physically activity are directed towards 12-week exercise referral schemes, and sometimes we use social prescribing, for example, inviting patients to walk in groups, Leese explained. “However, despite the best intentions, about 78% of GPs aren’t doing it [advising on physical activity] regularly,” he noted. He cited four main challenges: lack of time, knowledge, resources, and financial support.

    Geographical Variation in Social Prescribing

    Social prescribing, which links patients with non-medical community support, also varies widely across the UK. “Social prescribing is a real example of that because it’s really well established in some places and not in others,” Leese remarked. He noted that inner-city and rural areas often have different needs. Contrary to some expectations, city dwellers are sometimes more active than those living in rural areas because despite having lots of green space for physical activity, “they tend to park the car outside the front door and park again right outside their place of work, whereas in London, for example, you can persuade people to get off a stop early on the Tube or a stop early in the bus.”

    MAN v FAT 5-aside Football

    Leese also emphasised the importance of innovation in implementing lifestyle medicine, pointing out that non-medical personnel, social prescribers, and health coaches can alleviate time pressures on GPs. 

    Citing an example of a physical activity-related intervention, he described a UK-wide organisation developed for men in the 40s to 50s age group, called MAN v FAT which involves a novel weight-related way of playing 5-a-side football. Players have a weigh-in before each game and teams are rewarded with points on the pitch for every pound lost as a team since their last match.

    However, Leese acknowledged the need to tailor physical activity advice to different age groups. For example, “in an 80-year-old, physical activity might improve their balance and they’re less likely to fall and break something.” 

    Lifestyle Clinics

    Leese cited the PCN Lifestyle Clinics, originating from the Leamington Primary Care Network (PCN), as an example of successful lifestyle medicine integration to help address the needs of people living with chronic conditions. “We don’t want to prescribe a model, but we can draw on a programme run by the Leamington Spa PCN, that involves four group sessions of six to 10 people focused on lifestyle,” he said. 

    The weekly group-based sessions are run by a GP, a health and wellbeing coach, a dietitian, and a psychiatrist. Together, they cover four aspects of lifestyle and health comprising individual challenges, how community influences behaviour and vice versa, food and nutrition, and physical activity for health and wellbeing. 

    “We try to debunk some of those myths around nutrition compared with diet, and physical activity compared with exercise. So, for example, the idea that exercise is usually considered to be using an elliptical cross trainer whereas physical activity, which might be just dancing in your kitchen while you’re making dinner, is something that can be done more easily,” explained Leese.

    Physical activities include running and swimming in collaboration with a leisure centre. “It’s an amazing programme,” he remarked. 

    Outcomes from 142 patients who attended the Lifestyle Clinic at a North Leamington GP practice over 14 months showed that 53% gained confidence in making lifestyle changes, 60% noticed a positive impact on their physical health, and 77% reported positive impacts on their mental health.

    GP Embraces Lifestyle Medicine

    Rachel Burnett, a GP from Park Medical Practice in Derby, a delegate who attended the session, commented on the central idea of incorporating lifestyle medicine into primary care practice. She told Medscape News UK that, “I think it could prevent a lot of ill health and therefore a lot of health inequalities just by embedding lifestyle medicine into our work. To hear about the Leamington Spa project and how it’s been a success was really inspiring.”

    Referring to her own practice, Burnett said: “My patients are familiar with the way I go on and on about lifestyle measures, but I believe the way forward is with group sessions because we need to give the same advice to a large number of patients, for example, with pre-diabetes. This could save time and resource, and I think patients who are more likely to make the changes will actually attend the sessions so we’re not wasting our breath.” 

    Contributors to this article declared no conflicts of interest. 

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  • Residential Care Options For Your Elderly Loved One

    Residential Care Options For Your Elderly Loved One

    As our loved ones get older, we’ll often encounter decisions that need to be made about their welfare. Often that culminates in whether they’re able to stay living in their home or they need further care, whether it be moving in with family or transferring to residential care options.

    In the case of the latter, it can often be the best option, with professional care being available in many cases 24 hours a day, seven days a week. There are lots of options out there for residential care these days, all offering something slightly different to suit an individual person.

    So, if you have loved ones who are starting to age, or health conditions are becoming more difficult to manage without professional help, here are the residential care options available to you…

    Residential Care Options For Your Elderly Loved One

    Care Homes

    Care homes are the most common option for elderly loved ones who can no longer live independently. They provide assistance from staff 24 hours a day, including help with things like washing, dressing, eating and getting around.

    There are different types of care home, with the following most common:

    • Residential care home: A residential care home focuses primarily on providing personal care. These are ideal for those who need help with day-to-day tasks, and are simply feeling the effects of older age and minor health issues.
    • Nursing homes: Nursing homes provide more specialised care to suit medical needs and employ registered nurses. These are more for people who have medical conditions and disabilities that require frequent or continuous care.

    Across both types of care home, residents will typically have their own room, which can be customised to their needs, with communal living spaces to interact and engage with other residents. You’ll find the likes of lounges, gardens and dining areas, which are great for socialising and making friends with other residents.

    Extra Care Housing

    Residential Care Options For Your Elderly Loved One

    Known also as assisted living, extra care homes are for those that still want to maintain a level of independence, but still also require a level of support. This typically combines independent living with on-site care services for when needed.

    These are often self-contained flats or bungalows on a larger complex, and they differ from residential care homes as residents are more in control of their day-to-day. They can prepare their own meals, manage their own days and even leave the site as and when they please. Ultimately, everything is in their hands but there is still help if required.

    Support for medication and health reasons is available, as well as other forms of personal care, household chores and the like. There are also regular social activities and communal areas so people can still feel a sense of community.

    It’s often a good option for elderly people who wish to downsize but still value their privacy and autonomy, while also getting help when they need it.

    Dementia Care Homes

    Dementia care homes are specialised residential care facilities designed to meet the needs of individuals living with dementia or other memory-related conditions. Caring for someone with dementia requires specialised skills, and dementia care homes have staff trained to manage the unique behavioural and psychological symptoms associated with the condition.

    These homes often have additional safety measures in place to prevent wandering, confusion, and agitation, which are common challenges for individuals with dementia.

    In dementia care homes, the environment is often structured to promote familiarity and minimise confusion, with consistent routines and calming spaces. Additionally, sensory and cognitive activities are regularly organised to help stimulate memory and reduce anxiety.

    If your loved one is experiencing signs of dementia like significant memory loss, confusion, or difficulty managing daily activities due to dementia, a dementia-specific care home may be the best option to ensure they receive the specialised attention and support they need.

    Residential Care Options For Your Elderly Loved One

    Respite Care

    Respite care offers temporary residential care for elderly individuals, providing family caregivers with a break from their caregiving duties. This option is ideal for elderly people who are usually cared for at home but need temporary support due to a carer’s absence or their own need for additional care following an illness or hospital stay.

    Respite care can be provided in a care home or a dedicated respite facility and is available for varying durations, from a few days to several weeks. This gives both the elderly person and their family a chance to recharge, knowing that their loved one is being looked after in a safe and supportive environment.

    Retirement Villages

    For those who are relatively independent but want the reassurance of living within a community that offers care services, retirement villages can be an attractive option. These developments consist of self-contained properties, such as apartments or houses, within a communal setting.

    Residents can enjoy a high degree of independence while also having access to on-site services such as healthcare, housekeeping, and organised social activities.

    Retirement villages often come with additional amenities such as swimming pools, gyms, restaurants, and shops, providing a comfortable and engaging environment for older adults. This option is particularly suited for individuals who do not yet need extensive care but want the peace of mind of having help close by if their needs change in the future.

    Salon Privé

    Salon Privé Magazine is the quintessence of luxury lifestyle journalism, renowned for its sophisticated portrayal of the opulent world since its inception in 2008. As a vanguard of high-end living, the magazine serves as an exclusive portal into the realms of haute couture, fine arts, and the aristocratic lifestyle. With over a decade of expertise, Salon Privé has established itself as the definitive source for those who seek the allure of luxury and elegance.

    The magazine’s content is crafted by a cadre of experienced journalists, each bringing a wealth of knowledge from the luxury sector. This collective expertise is reflected in the magazine’s diverse coverage, which spans the latest in fashion trends, intimate glimpses into royal lives, and the coveted secrets of the affluent lifestyle. Salon Privé’s commitment to quality is evident in its thoughtful collaborations with industry titans and cultural connoisseurs, ensuring that its narratives are as authoritative as they are enchanting.

    With accolades that include being voted the number one luxury lifestyle magazine in the UK, Salon Privé continues to be at the forefront of luxury journalism, offering its discerning readership a guide to the finest experiences the world has to offer. Whether it’s the grandeur of global fashion weeks, the splendor of exclusive soirées, or the pursuit of wellness and beauty, Salon Privé Magazine remains the emblem of luxury for the elite and the aspirants alike.






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  • 5 Natural Ingredient Swaps To Replace Your Go-To Skin Care Products

    5 Natural Ingredient Swaps To Replace Your Go-To Skin Care Products

    Skin care starts from within. Sure, we love our desired moisturisers and serums, but the real glow comes from what we eat and feed our bodies. Whether it’s the water we drink, the foods we eat, or even the natural remedies we apply, nourishing skin doesn’t always mean using chemical-based products. Sometimes, natural ingredients are just as powerful as the popular acids and ingredients found in skin care. From brightening to hydration, your kitchen and pantry might just be hiding the secret to having smooth and supple skin. Intrigued? Well, you should be! Read on to know which ingredients you can switch to have naturally glowing skin.

    Also Read: Tomatoes For Skin Care: Here’s How You Can Use Tomatoes For Soft And Supple Skin

    Latest and Breaking News on NDTV

    Photo Credit: iStock

    Here Are 5 Natural Alternatives To Popular Skin Care Ingredients:

    Nutritionist Sakshi Lalwani shared five natural alternatives to use for your skincare instead of popular ingredients.

    1. Ditch Hyaluronic Acid For Aloe Vera 

    Hyaluronic acid helps keep your skin soft and smooth. It also helps your skin retain moisture and make it plumpy. The expert suggests you use aloe vera gel instead of Hyaluronic acid-based skin care products, for it is a natural hydrator that soothes and moisturises skin. All you have to do is take a fresh aloe vera leaf and cut it from between. Then apply the aloe vera gel on your face and wash it after 10-15 minutes with warm water. 

    2. Bid Adieu To Retinol For Carrot

    Retinol is popular for its ability to boost collagen production and promote skin renewal. But the expert recommends carrots – which are known as natural retinol – can be extremely beneficial for your skin. This is because, on consumption, carrots’ beta carotene converts to vitamin A which helps keep skin healthy and heal wounds quickly. Just juice one carrot and drink it empty stomach in the morning for skin cell renewal and a youthful glow.

    3. Replace Niacinamide With Green Tea Extract

    Niacinamide is known to improve skin elasticity and reduce inflammation. The expert shares that instead of niacinamide, you should use green tea extract. This is because green tea extract contains natural niacin to improve skin elasticity. Plus, if you have any sort of irritation on your skin, green tea extract can help soothe the skin and keep it smooth and supple. 

    Latest and Breaking News on NDTV

    Photo Credit: iStock

    4. Kick Out Glycolic Acid For Lemon Juice

    Glycolic acid is an effective exfoliant that brightens skin by removing dead cells. The expert asks you to replace glycolic acid and use and incorporate lemon juice in your daily diet. This is because lemon juice’s citric acid gently exfoliates and brightens your complexion. Just juice the lemons and dilute them with water. Drink this concoction every day to have smooth and supple skin.

    5. Instead Of Salicylic Acid, Choose Willow Bark Extract

    Salicylic acid is a hit amongst people with acne-prone skin and is used to unclog pores and reduce breakouts. The expert suggests ditching salicylic acid for willow bark extract. This is because willow bark contains salicin – a natural compound that helps unclog the pores and reduce breakouts.

    Watch the full video below:

    Also Read: 7 Easy Diet Tips You Should Follow For Healthy Skin In Summer

    Will you try these natural swaps at home? Let us know in the comments below!



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  • Agony of taking care of a parent who doesn’t know you

    Agony of taking care of a parent who doesn’t know you

    In Kenya, the weight of caregiving falls heavily on the shoulders of children when parents grow old or become terminally ill. Nursing homes remain a rare and culturally unpopular option, leaving adult children to manage the physical, emotional, and financial toll of caring for ageing or ailing parents.

    The burden becomes even heavier when these parents suffer from debilitating conditions like dementia or Alzheimer’s, a disease that destroys memory. For many caregivers, it is a silent struggle to take care of a loved one who does not know who you are. It is an act of love that reshapes their lives, often at a great personal cost.

    Elizabeth Mutunga understands this burden all too well. At just 17, her father began showing early signs of dementia, thrusting her into the role of primary caregiver. As the eldest of three, she put her dreams on hold to support her family, becoming the breadwinner while ensuring her younger siblings could finish their education.

    “My dad started getting sick in 1992, but it wasn’t until 2007 that we got the official diagnosis; Alzheimer’s disease,” Elizabeth recalls. “Before that, we didn’t know what was happening. He was a policeman, always dressing sharply, but suddenly, he started wearing pyjamas over his clothes. We didn’t have a clue,” the 49-year-old says.

    The lack of understanding about dementia made the early years incredibly difficult. With little medical information at the time, the family was left to search for answers on their own.

    “The doctor who gave us the diagnosis just told us to go and Google the disease,” Elizabeth remembers. “I had just finished high school and was toying with becoming an air hostess, but those dreams had to wait. My father needed me.” Despite the challenges, Elizabeth found solace in reaching out to others and having a support group.

    Her father passed away in 2007.

    It was this experience that prompted Elizabeth to found the Alzheimer’s and Dementia Organisation Kenya (ADOK), a support group that guides families affected by dementia.

    “Our main focus at ADOK is to support the caregivers. We help them understand what Alzheimer’s is and how to cope with it,” she explains. The stigma surrounding dementia, particularly in rural areas, adds to the burden. Many people still believe that dementia is caused by witchcraft, especially in regions with limited access to information. Elizabeth and her team at ADOK regularly visit villages to debunk these myths.

    Elizabeth Mutunga CEO and Founder of Alzheimer’s and Dementia Organisation Kenya during an interview at St. Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    “There’s so much stigma around the disease. People don’t realise it’s a medical condition, not just part of ageing or something caused by witchcraft,” she shares. The support group meets once every month.

    Writing became Elizabeth’s emotional outlet, helping her process the mental anguish she endured while caring for her father. “I would write about the pain I was going through, the questions I had, and the frustrations we faced,” she says.

    For Elizabeth, one of the most heartbreaking aspects of her father’s illness was his inability to recognise her. “Of all his children, I was the one he couldn’t remember,” she says.

    Wedding day

    “On my wedding day, when it was time to walk me down the aisle, I told him, ‘Okay, Dad, let’s go.’ But he just looked at me and said, ‘Don’t call me your father.’

    It was my wedding day, and I didn’t know whether to cry or laugh,” she recalls. After taking care of the family, Elizabeth went back to school and pursued a Bachelor’s degree in psychology, and she now has two Master’s degrees including a Master’s in dementia.

    Real sacrifice

    Julisa Rowe is also taking care of her mother, who has Alzheimer’s. When her parents moved back to Kenya, there was a lot of settling in to be done.

    “My parents were the founders of Daystar University, and they were called back, so they sold everything they had in the US and moved back to Kenya. This was in 2014, and they were settling down, building a house, and trying to adjust to the new life, we just assumed that maybe mom was having a hard time adopting. One thing that researching Alzheimer’s will tell you is that sometimes the symptoms can mimic many other causes, like anxiety and stress,” she says.

    Julisa Rowe an actress and Culture and Communication Specialist during an interview at St. Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    This disease smuggles itself in under the cover of other conditions. It was not until 2016 that they got a diagnosis and were informed that her mother has Alzheimer’s.

    Ms Rowe was spared the financial burden as her father had purchased a long-term care insurance policy in the US that helped cover the costs when her mother became frail and was diagnosed with the disease.

    “We were lucky that my father had planned for this, but even then, caring for my mother was a huge challenge,” Julisa recalls.

    “Medical care was mostly out of pocket, and we had to help her with everything; showering, dressing, and feeding.”

    Sitting in silence

    Visits were emotionally draining for the 58-year-old. “When you visit your mother, and she can’t communicate, it’s difficult. What do you say? How do you have a conversation when she’s not able to respond? It’s like sitting in silence, staring at the wall.”

    Though the experience was overwhelming, Julisa never saw caregiving as a sacrifice. “Yes, you give up certain things, but that’s just part of caring for your parents. I think the real sacrifice for me was my work. It took a back seat while I dealt with my mother’s illness and all the family responsibilities,” says Julisa, who is an actress and holds a doctorate in ethnodramatology, an academic discipline that studies world theatrical traditions.

    When her mother passed away a year ago, Julisa turned to acting for therapy, using her roles to express her emotions. She has also collaborated with Mugambi Nthiga to create a play, “In Other Words”, aimed at raising awareness about Alzheimer’s disease.

    “The arts can be a powerful way to bring these difficult issues into public conversation. Our play is a tribute to our parents, who have faced this disease with so much strength.”

    The play is set to premiere this month.

    Remember every face, name

    Apart from an unending love for theatre and arts, the other thing that Julisa and Mugambi Nthiga have in common is their parent’s struggle with dementia. In 2019, Mugambi’s father was diagnosed with dementia. Since then, Mugambi’s family has had to adapt to the rapidly changing needs of their father as his condition worsens. “Watching my father change so drastically has been one of the hardest things I’ve ever experienced,” Mugambi says.

    “He’s still physically present, but the man I knew, the one who could remember every face and name, has faded.”

    Mugambi Nthiga, a film and theatre storyteller during an interview at St Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    Caring for a parent with dementia is not just about memory loss; it affects cognitive function and personality. Mugambi talks about how relationships are built on shared memories, and without them, it becomes difficult to connect.

    “You realise just how much your interactions with people are rooted in memory. Without that, it’s like you’re meeting them all over again, every day,” he says.

    The financial burden of caregiving has also been significant. Mugambi’s father now requires a full-time caregiver, which costs the family between Sh25,000 and Sh50,000 per month, not including the cost of medication and therapy.

    “We’ve been fortunate that my father has a pension and medical insurance from his time working as a policeman. He is now retired. However, it is still incredibly expensive as we have to pay the caregiver,” the 44-year-old says.

    Besides the financial and emotional burden, finding the right caregiver for a dementia patient is also not easy either.

    “There are many people trained in basic caregiving, but understanding dementia requires more specialised knowledge, and that’s hard to come by,” Mr Nthiga says, noting, “However, old people’s care is growing at a very rapid rate. I fear that sometimes it might be growing at a rate that it’s becoming commoditised without being overseen. There still needs to be a function that oversees this field so that the quality of care for unwell people, particularly older people who are very vulnerable, is kept high. And people don’t come in as opportunists and decide that they’re going to provide care without any oversight,” he says.

    Despite the challenges, Mugambi finds solace in gardening and support groups. “You have to find your way to cope. For me, it’s being part of a support group and spending time in the garden. It helps me clear my mind.”

    Healthy lessons

    Damaris Ndichu’s mother, who had dementia, passed away four years ago, leaving her with valuable lessons on the importance of self-care. After an eight-year journey of caring for her mother through dementia, she realised the need to take care of her own well-being as well.

    Damaris Ndichu during an interview at St. Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    “I learned that I needed to care for myself too. It’s okay to take a break, walk away for a few minutes, and focus on your own health.”

    Now, the 52-year-old takes long walks and meditates to maintain her physical and mental health.

    “I don’t let myself get stressed by life’s challenges anymore. I learned the hard way that I need to prioritise my well-being. It’s not selfish; it’s necessary.”

    Elizabeth is also trying to maintain an active lifestyle to help prevent dementia. “I do crossword puzzles every day, and I make time for my friends. Sitting down for a face-to-face conversation is much more fulfilling than just talking on WhatsApp. I’ve also learned the favourite songs of the patients I visit, and I sing for them,” she says.

    Taboo of nursing homes

    For many families, the question of whether to place an ageing parent in a nursing home is a difficult one. As Elizabeth points out, it depends on the circumstances. She says, “A lot of young people are leaving the country for work abroad, so they may opt to leave their parents in nursing homes,” she explains.

    “But for those who are still in the country, it’s often best to keep parents in a familiar environment. Moving them to a new place can be traumatic, especially for someone with dementia. A drastic change like that can cause them to deteriorate even faster.”

    Dr Tasneem Yamani a Home health care specialist (geriatrics) during the interview at her home in Nairobi on September 11, 2024.

    Photo credit: Lucy Wanjiru | Nation

    Dr Tasneem Yamani, a geriatric general practitioner, explains that while the traditional approach is to care for parents at home, nursing homes can provide a supportive environment for ageing individuals.

    “Taking a parent to a nursing home is not about abandonment but about providing the right social and physical environment. Nursing homes are not a place to go and put the responsibility of care to the nurses. It’s more about creating a conducive environment for older people to thrive in. Just in the same way that you take a child to kindergarten first, not to primary school, because they will thrive in kindergarten as that is age-appropriate. Older persons also need a social environment that is conducive to ageing. That can be found around like-minded individuals where they are in the same category of activities, levels, and able to get a social life within peers,” she explains.

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  • Agony of taking care of a parent who doesn’t know you

    Agony of taking care of a parent who doesn’t know you

    In Kenya, the weight of caregiving falls heavily on the shoulders of children when parents grow old or become terminally ill. Nursing homes remain a rare and culturally unpopular option, leaving adult children to manage the physical, emotional, and financial toll of caring for ageing or ailing parents.

    The burden becomes even heavier when these parents suffer from debilitating conditions like dementia or Alzheimer’s, a disease that destroys memory. For many caregivers, it is a silent struggle to take care of a loved one who does not know who you are. It is an act of love that reshapes their lives, often at a great personal cost.

    Elizabeth Mutunga understands this burden all too well. At just 17, her father began showing early signs of dementia, thrusting her into the role of primary caregiver. As the eldest of three, she put her dreams on hold to support her family, becoming the breadwinner while ensuring her younger siblings could finish their education.

    “My dad started getting sick in 1992, but it wasn’t until 2007 that we got the official diagnosis; Alzheimer’s disease,” Elizabeth recalls. “Before that, we didn’t know what was happening. He was a policeman, always dressing sharply, but suddenly, he started wearing pyjamas over his clothes. We didn’t have a clue,” the 49-year-old says.

    The lack of understanding about dementia made the early years incredibly difficult. With little medical information at the time, the family was left to search for answers on their own.

    “The doctor who gave us the diagnosis just told us to go and Google the disease,” Elizabeth remembers. “I had just finished high school and was toying with becoming an air hostess, but those dreams had to wait. My father needed me.” Despite the challenges, Elizabeth found solace in reaching out to others and having a support group.

    Her father passed away in 2007.

    It was this experience that prompted Elizabeth to found the Alzheimer’s and Dementia Organisation Kenya (ADOK), a support group that guides families affected by dementia.

    “Our main focus at ADOK is to support the caregivers. We help them understand what Alzheimer’s is and how to cope with it,” she explains. The stigma surrounding dementia, particularly in rural areas, adds to the burden. Many people still believe that dementia is caused by witchcraft, especially in regions with limited access to information. Elizabeth and her team at ADOK regularly visit villages to debunk these myths.

    Elizabeth Mutunga CEO and Founder of Alzheimer’s and Dementia Organisation Kenya during an interview at St. Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    “There’s so much stigma around the disease. People don’t realise it’s a medical condition, not just part of ageing or something caused by witchcraft,” she shares. The support group meets once every month.

    Writing became Elizabeth’s emotional outlet, helping her process the mental anguish she endured while caring for her father. “I would write about the pain I was going through, the questions I had, and the frustrations we faced,” she says.

    For Elizabeth, one of the most heartbreaking aspects of her father’s illness was his inability to recognise her. “Of all his children, I was the one he couldn’t remember,” she says.

    Wedding day

    “On my wedding day, when it was time to walk me down the aisle, I told him, ‘Okay, Dad, let’s go.’ But he just looked at me and said, ‘Don’t call me your father.’

    It was my wedding day, and I didn’t know whether to cry or laugh,” she recalls. After taking care of the family, Elizabeth went back to school and pursued a Bachelor’s degree in psychology, and she now has two Master’s degrees including a Master’s in dementia.

    Real sacrifice

    Julisa Rowe is also taking care of her mother, who has Alzheimer’s. When her parents moved back to Kenya, there was a lot of settling in to be done.

    “My parents were the founders of Daystar University, and they were called back, so they sold everything they had in the US and moved back to Kenya. This was in 2014, and they were settling down, building a house, and trying to adjust to the new life, we just assumed that maybe mom was having a hard time adopting. One thing that researching Alzheimer’s will tell you is that sometimes the symptoms can mimic many other causes, like anxiety and stress,” she says.

    Julisa Rowe an actress and Culture and Communication Specialist during an interview at St. Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    This disease smuggles itself in under the cover of other conditions. It was not until 2016 that they got a diagnosis and were informed that her mother has Alzheimer’s.

    Ms Rowe was spared the financial burden as her father had purchased a long-term care insurance policy in the US that helped cover the costs when her mother became frail and was diagnosed with the disease.

    “We were lucky that my father had planned for this, but even then, caring for my mother was a huge challenge,” Julisa recalls.

    “Medical care was mostly out of pocket, and we had to help her with everything; showering, dressing, and feeding.”

    Sitting in silence

    Visits were emotionally draining for the 58-year-old. “When you visit your mother, and she can’t communicate, it’s difficult. What do you say? How do you have a conversation when she’s not able to respond? It’s like sitting in silence, staring at the wall.”

    Though the experience was overwhelming, Julisa never saw caregiving as a sacrifice. “Yes, you give up certain things, but that’s just part of caring for your parents. I think the real sacrifice for me was my work. It took a back seat while I dealt with my mother’s illness and all the family responsibilities,” says Julisa, who is an actress and holds a doctorate in ethnodramatology, an academic discipline that studies world theatrical traditions.

    When her mother passed away a year ago, Julisa turned to acting for therapy, using her roles to express her emotions. She has also collaborated with Mugambi Nthiga to create a play, “In Other Words”, aimed at raising awareness about Alzheimer’s disease.

    “The arts can be a powerful way to bring these difficult issues into public conversation. Our play is a tribute to our parents, who have faced this disease with so much strength.”

    The play is set to premiere this month.

    Remember every face, name

    Apart from an unending love for theatre and arts, the other thing that Julisa and Mugambi Nthiga have in common is their parent’s struggle with dementia. In 2019, Mugambi’s father was diagnosed with dementia. Since then, Mugambi’s family has had to adapt to the rapidly changing needs of their father as his condition worsens. “Watching my father change so drastically has been one of the hardest things I’ve ever experienced,” Mugambi says.

    “He’s still physically present, but the man I knew, the one who could remember every face and name, has faded.”

    Mugambi Nthiga, a film and theatre storyteller during an interview at St Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    Caring for a parent with dementia is not just about memory loss; it affects cognitive function and personality. Mugambi talks about how relationships are built on shared memories, and without them, it becomes difficult to connect.

    “You realise just how much your interactions with people are rooted in memory. Without that, it’s like you’re meeting them all over again, every day,” he says.

    The financial burden of caregiving has also been significant. Mugambi’s father now requires a full-time caregiver, which costs the family between Sh25,000 and Sh50,000 per month, not including the cost of medication and therapy.

    “We’ve been fortunate that my father has a pension and medical insurance from his time working as a policeman. He is now retired. However, it is still incredibly expensive as we have to pay the caregiver,” the 44-year-old says.

    Besides the financial and emotional burden, finding the right caregiver for a dementia patient is also not easy either.

    “There are many people trained in basic caregiving, but understanding dementia requires more specialised knowledge, and that’s hard to come by,” Mr Nthiga says, noting, “However, old people’s care is growing at a very rapid rate. I fear that sometimes it might be growing at a rate that it’s becoming commoditised without being overseen. There still needs to be a function that oversees this field so that the quality of care for unwell people, particularly older people who are very vulnerable, is kept high. And people don’t come in as opportunists and decide that they’re going to provide care without any oversight,” he says.

    Despite the challenges, Mugambi finds solace in gardening and support groups. “You have to find your way to cope. For me, it’s being part of a support group and spending time in the garden. It helps me clear my mind.”

    Healthy lessons

    Damaris Ndichu’s mother, who had dementia, passed away four years ago, leaving her with valuable lessons on the importance of self-care. After an eight-year journey of caring for her mother through dementia, she realised the need to take care of her own well-being as well.

    Damaris Ndichu during an interview at St. Andrews along Nyerere Road, Nairobi on September 14, 2024.

    Photo credit: Wilfred Nyangaresi | Nation

    “I learned that I needed to care for myself too. It’s okay to take a break, walk away for a few minutes, and focus on your own health.”

    Now, the 52-year-old takes long walks and meditates to maintain her physical and mental health.

    “I don’t let myself get stressed by life’s challenges anymore. I learned the hard way that I need to prioritise my well-being. It’s not selfish; it’s necessary.”

    Elizabeth is also trying to maintain an active lifestyle to help prevent dementia. “I do crossword puzzles every day, and I make time for my friends. Sitting down for a face-to-face conversation is much more fulfilling than just talking on WhatsApp. I’ve also learned the favourite songs of the patients I visit, and I sing for them,” she says.

    Taboo of nursing homes

    For many families, the question of whether to place an ageing parent in a nursing home is a difficult one. As Elizabeth points out, it depends on the circumstances. She says, “A lot of young people are leaving the country for work abroad, so they may opt to leave their parents in nursing homes,” she explains.

    “But for those who are still in the country, it’s often best to keep parents in a familiar environment. Moving them to a new place can be traumatic, especially for someone with dementia. A drastic change like that can cause them to deteriorate even faster.”

    Dr Tasneem Yamani a Home health care specialist (geriatrics) during the interview at her home in Nairobi on September 11, 2024.

    Photo credit: Lucy Wanjiru | Nation

    Dr Tasneem Yamani, a geriatric general practitioner, explains that while the traditional approach is to care for parents at home, nursing homes can provide a supportive environment for ageing individuals.

    “Taking a parent to a nursing home is not about abandonment but about providing the right social and physical environment. Nursing homes are not a place to go and put the responsibility of care to the nurses. It’s more about creating a conducive environment for older people to thrive in. Just in the same way that you take a child to kindergarten first, not to primary school, because they will thrive in kindergarten as that is age-appropriate. Older persons also need a social environment that is conducive to ageing. That can be found around like-minded individuals where they are in the same category of activities, levels, and able to get a social life within peers,” she explains.

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  • Social media is filled with skin care routines for girls. Here’s what dermatologists recommend

    Social media is filled with skin care routines for girls. Here’s what dermatologists recommend

    Girls are bombarded on social media with advice from influencers touting elaborate skin care routines with high-priced serums, mists and creams. But what is the right skin care routine for preteens?

    Simple is best, dermatologists say. Before puberty hits, most kids only need three things: a gentle cleanser, a moisturizer and sunscreen.

    “That’s it. Full stop. You don’t need anything else,” says Dr. Sheilagh Maguiness, a Minneapolis-based dermatologist.

    She and other dermatologists around the U.S. have seen growing numbers of teen and preteen girls using anti-aging skin care products. In some cases, the adult-strength products have damaged young girls’ skin. And the obsession with achieving the looks they see online has raised concern about the impact on their mental health.

    Many of the popular products from Drunk Elephant, Glow Recipe and others — which can cost $70 or more — contain active ingredients like retinols and hydroxy acids intended for mature skin that can irritate young faces and damage the skin barrier. Experts say they are unnecessary and a waste of money for children.

    “I hear all day, every day from all my patients who have children in their teens, and younger, that they are so fixated on all of these skin care products and TikTok trends and they’ve gone overboard,” says Dr. Dendy Engelman, a dermatologist in Manhattan.

    Here’s what dermatologists say about what’s safe for young skin and how families can navigate the fast-growing trend.

    Teens and preteens don’t need anti-aging products. Even the Personal Care Products Council, the trade association for cosmetics companies, says: “Anti-aging products are generally unnecessary for younger skin.”

    For tweens, dermatologists recommend brands of cleansers and moisturizers like Cetaphil, CeraVe and La Roche-Posay that are commonly available in drug stores.

    As puberty kicks in, teenagers might need to address skin issues brought on by hormonal changes like acne, excess oil, dark spots, blackheads and more. If an issue seems serious, it’s best to consult a dermatologist.

    When introducing a new product, especially if it contains a harsh ingredient, go slowly.

    “If they really want to use a product and see what all the fuss is about say, ‘How about we do a skin test before you rub it all over your face,’” says Maguiness, a professor of pediatric dermatology at the University of Minnesota. Dab a bit on the inner arm for a few days, and if there is no reaction, then maybe it’s OK to try on the face.

    Signs of an allergic reaction can range from redness, itchiness, flaking of skin, burning or stinging to patches of tiny bumps.

    “Those are all signs to stop using a product,” says Dr. Carli Whittington, a dermatologist at the University of Indiana School of Medicine. Continuing use of products that cause irritation can lead to more severe skin damage.

    Often, kids don’t realize that trendy products they are using contain harmful ingredients.

    Dr. Brooke Jeffy in Scottsdale, Arizona, had an 11-year-old patient with a severe rash around her eyes. The child had been using a retinol eye cream that caused irritation and itchiness. The reaction worsened as she continued using it and scratched at her skin.

    “She was using an eye cream for a condition she didn’t have and has now created this dramatic problem that is going to take months to resolve,” said Jeffy, one of many dermatologists now on TikTok and Instagram trying to debunk harmful social media trends with posts on “Do’s and Don’ts” for tween skin care.

    Engelman suggests setting a timer for skin care, like some parents do to remind kids to brush teeth for two minutes. Children should not need more than five or 10 minutes for skin care, she says.

    “When you have a 13-step skincare routine that takes 45 minutes a night, that is too much,” she says.

    Maguiness urges parents to talk with their skin care-obsessed kids about viral trends they’re following and why.

    “Treat it as a time to educate and ask questions: ‘What are you seeing on social media? Do you think the celebrity is being paid by the company? Do you think they are trying to sell you something? Do you think this is actually good for your skin?’” she says.

    Ask your adolescent what skin issue they are trying to address — acne, dark spots, et cetera — and try to build a basic routine around it, she says. Let them know the more things they put on their skin, the more they can be irritated.

    The focus on skin care does have one benefit, dermatologists say.

    “The one good thing that comes of this is wearing sunscreen to protect your skin. They are fully on board with that,” says Engelman. Many influencers and the kids who follow them apply sunscreen as the final step of their routine, unlike many of her adult patients. “These children who are skin care obsessed have brought in that important step. So that is a silver lining of this trend.”

    ___

    The Associated Press’ education coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

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  • Patients will suffer with bankrupt health care firm’s closure of Massachusetts hospitals, staff say

    Patients will suffer with bankrupt health care firm’s closure of Massachusetts hospitals, staff say

    AYER, Mass. — When Christina Hernon was 5, her throat swelled shut from an infection and her mother rushed her to a local Massachusetts hospital in the dead of night. She couldn’t breathe, suffered a seizure and was near death when a doctor saved her by inserting a tube down her throat.

    Hernon is now an emergency physician at one of two hospitals in the state that are due to close on Saturday. She and others among the 1,250 affected staff at Nashoba Valley Medical Center in Ayer and Carney Hospital in Boston believe that patients like she was will suffer and could even die as a result of the closures because they won’t have time to make it to other hospitals farther away.

    “I would consider it guaranteed that there will be some negative outcomes,” Hernon said. “To add on an additional 20, 25 minutes, or over, of travel time is potentially the difference between life and death.”

    Staff are furious because they say that behind the failure of the Dallas-based company that owns the hospitals, Steward Health Care, lies a story of alleged corporate greed involving one of their own.

    Former Massachusetts heart surgeon Ralph de la Torre, who founded Steward and remains its chief executive, extracted more than $100 million from the company before it filed for bankruptcy in May, according to lawsuits and bankruptcy filings. The company had earlier cashed in by selling all its hospitals for $1.2 billion and then leasing them back from the new owners. The company described it as an “asset-light” model designed to prioritize patient care.

    But a lawsuit filed by Aya Healthcare in Texas claims that during the COVID-19 pandemic, Steward elected to rain cash on its equity holders instead of paying bills and keeping critical hospitals operating at peak levels. Aya claims Steward owes it $45 million after not paying for hospital nurses it provided.

    The lawsuit claims de la Torre used ill-gotten gains to fund a lavish lifestyle, including buying two luxury yachts worth more than $65 million. In recent weeks, as Hernon and other staff fought to keep their hospitals open, de la Torre and his family were on vacation at the Paris Olympics, watching the equestrian dressage events at the Palace at Versailles.

    A spokesperson for de la Torre said that under the terms of the bankruptcy, he doesn’t have the authority to make decisions on which hospitals are sold or closed. He was “regrettably on a family vacation that was planned and paid for last year” when the decision to close the two Massachusetts hospitals was announced in late July, the spokesperson added.

    “Of course this feels like a betrayal,” Hernon said. “I think it would feel pretty close to the same kind of a betrayal if he weren’t a physician. But the fact that he is, it’s just hard to understand how that came to be. Where the goals changed from protecting and caring for patients, and ensuring their health and wellness, to taking actions that are so destructive.”

    At Nashoba Valley where Hernon works, signs urging action to keep the hospital open dot the parking lot, and pink hearts and writing on the emergency room window say “Save NVMC. Save lives!”

    The carnage left behind by Steward’s failure is widespread. After starting in Boston 14 years ago with funding from a private equity firm, Cerberus Capital Management, Steward expanded to operate 31 hospitals in eight states, employing about 30,000 people and serving more than 2 million patients each year. Cerberus cashed out in 2020, walking away with a profit of about $800 million.

    Steward even dabbled internationally, including the small Mediterranean Sea nation of Malta. Steward claimed it achieved rapid success there after running three hospitals for the Maltese government. But the arrangement ended last year, and authorities in Malta have accused Steward of fraud and collusion. Steward said its business in the archipelago was “conducted professionally and to support our provision of services to the people of Malta.”

    Steward’s Chapter 11 bankruptcy filing in Texas details how the company ended up with $9.2 billion in debt and liabilities. De la Torre has previously argued his company purchased many struggling hospitals that may not have otherwise survived.

    But staff don’t buy it.

    “With him getting away scot-free, being in France, doing whatever he needs to do, having his yachts, his planes, and not having to answer?” asked Michael Santos, who works security at the Nashoba Valley hospital. “What would happen if it was me or you?”

    Santos has needed to rush his own daughter, who has severe asthma, to the hospital in the past and said it remains pivotal to the community.

    “This closure, it’s going to result in deaths,” Santos said.

    About 50 miles (80 kilometers) southeast in one of Boston’s most diverse neighborhoods sit the imposing Carney Hospital buildings. Emergency room nurse Mary Ann Rockett said she considers staff and patients to be like a family.

    “We have patients here that when they walk in the door, we know their allergies, their meds, we know their medical history,” she said. “And in some instances, I can tell you what they’re here for before they’ve filled out that spot in the questionnaire.”

    Rockett said she also believes the closures will result in negative outcomes, including deaths.

    “It’s hard,” she said. “It’s heartbreaking.”

    Neither Steward nor a patient-care ombudsman appointed for the bankruptcy process responded to questions about whether deaths or other negative outcomes were expected as a result of the two hospital closures.

    This month, Massachusetts Gov. Maura Healey announced deals to sell four Steward hospitals to new owners and for the state to seize a fifth by using eminent domain before transferring ownership.

    Healey said no buyers put in qualifying bids for the Carney or Nashoba Valley hospitals and the state couldn’t be expected to run them, so they would need to close. She said the state had contributed $30 million to keep them open through the end of August.

    “I’m pleased to say we’re closing the book on Steward once and for all in Massachusetts,” Healey said at a news conference announcing the deals. “Good riddance and goodbye.”

    A spokesperson for the state’s Department of Health said it had been working with other hospitals and health centers in affected regions to preserve access to essential medical services, help patients transition their care and connect staff with new employment opportunities. The department had also been in discussions with fire chiefs near the Nashoba Valley hospital to develop plans to maintain a strong emergency response system there, the spokesperson said.

    Steward’s bankruptcy is now being investigated by the U.S. Senate Committee on Health, Education, Labor and Pensions, and de la Torre has been issued a subpoena to testify on Sept. 12.

    Saturday will mark the second closure of a Steward hospital that Rockett has endured. She worked at the nearby Quincy Medical Center when Steward shut down that 124-year-old hospital, citing operating losses. She said many of the neediest patients, the ones that fall through the cracks, also moved from Quincy to Carney, and she doesn’t know where they will go next.

    “There is no place in health care for profit,” Rockett said. “We should be here for the patients.”

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