Transcultural Geriatrics: Caring for the

Lister Hospital, Stevenage, UK. Text addresses the care of elderly people of Indo-Asian origin. Examines medical, cultural, and social interactions of transcultural gerontology. Topics include religious history, immigration policy, diet, funerals abroad, alternative medicine, and more. For practitioners and social workers. British-oriented. Softcover.

Preface

viii

About the authors

x

Acknowledgements

xi

Transcultural geriatrics and the Indo-Asians: an international perspective

1

(6)

Ageing in the developed world

1

(1)

Ageing in the developing world

1

(1)

Definition of old age

2

(1)

Geriatrics and transcultural geriatrics

3

(1)

The future

4

(1)

Further reading

5

(2)

Historical perspective of immigration: the Indo-Asians abroad

7

(8)

Who are the `Indo-Asians'?

7

(1)

The prehistoric period

8

(1)

The Hindu Buddhist period

9

(1)

The Muslim period

9

(1)

The British Raj

9

(2)

British immigration policies

11

(1)

East African Asians

12

(1)

The future

12

(1)

Further reading

13

(2)

Ethnicity and ethnic elders: the sociocultural background

15

(16)

Indo-Asian ethnic groups in the UK

16

(1)

Geographical background

17

(1)

Social aspects of Indo-Asian life

18

(9)

Conclusion

27

(1)

Further reading

27

(4)

Indo-Asians: ethnicity and clinical practice

31

(8)

History

31

(1)

Examination

32

(1)

Perception of health problems

33

(1)

Investigations

34

(1)

Principles of managing elderly patients

35

(2)

Recommendations

37

(1)

Further reading

38

(1)

Diabetes mellitus and the Indo-Asians

39

(18)

Introduction

39

(1)

Diabetes and Indo-Asians

39

(1)

Epidemiology

39

(1)

Pathophysiology

40

(2)

The thrifty genotype and thrifty phenotype hypothesis

42

(2)

Complications

44

(1)

Attitude of Indo-Asians towards diabetes and barriers to change

45

(1)

Impact of religious beliefs on diabetic control

46

(3)

Management

49

(6)

Diabetes, driving and the DVLA

55

(1)

Further reading

55

(2)

Hypertension in Indo-Asians

57

(20)

Introduction

57

(1)

Hypertension in the elderly

57

(1)

Types of hypertension

58

(1)

Hypertension in Indo-Asians

59

(1)

What is normal blood pressure for Indo-Asians?

60

(2)

Diagnosis of hypertension

62

(1)

Complications

63

(1)

Benefits of treating hypertension in older people

64

(1)

Lifestyle changes

64

(2)

Drug therapy

66

(4)

Follow-up

70

(1)

Compliance

71

(1)

The very elderly

71

(1)

Cognitive impairment and hypertension

71

(1)

Recommendations

72

(1)

Further reading

72

(5)

Cardiovascular disease

77

(16)

Introduction

77

(1)

Prevalence

77

(1)

Indo-Asians and coronary heart disease

78

(1)

Atherosclerosis in Indo-Asians

78

(1)

Risk factors for coronary heart disease

78

(5)

Ageing and coronary heart disease

83

(1)

Anatomical differences in coronary arteries

83

(1)

Management of coronary heart disease

83

(3)

Prognosis

86

(1)

Heart failure in Indo-Asian patients

86

(1)

Peripheral vascular disease in Indo-Asians

86

(1)

Ischaemic heart disease, driving and the DVLA

87

(1)

Access to healthcare and coronary heart disease

87

(1)

Prevention of cardiovascular disease in Indo-Asians

87

(1)

Conclusion

88

(1)

Further reading

89

(4)

Stroke and the Indo-Asians

93

(14)

Introduction

93

(1)

Definition

93

(1)

Incidence and prevalence

93

(1)

Types and classification of stroke

94

(1)

Causes of ischaemic stroke

95

(1)

Causes of cerebral haemorrhage

96

(1)

Risk factors

97

(1)

Pathogenesis

98

(1)

Attitude towards rehabilitation

98

(1)

Management

99

(3)

Secondary prevention of stroke

102

(3)

Further reading

105

(2)

Travellers' illnesses in Indo-Asian elders

107

(12)

Who are the travellers?

107

(1)

What attracts them to the Indian subcontinent?

108

(1)

Getting medical treatment in the Indian subcontinent

108

(1)

Preparations for travel

108

(3)

Incubation periods

111

(2)

Descriptions of symptoms and illnesses

113

(4)

Respiratory tract infections

117

(1)

Assessment of travellers returning from the Indian subcontinent

117

(1)

Further reading

118

(1)

Psychiatric problems in Indo-Asians

119

(8)

Social and cultural influences

119

(1)

Indo-Asians and psychiatric illnesses

120

(2)

Depression

122

(1)

Suicide

123

(1)

Substance abuse

123

(1)

Cultural syndromes

124

(1)

Dementia

124

(1)

Migration and stress

125

(1)

The elderly exile

126

(1)

Conclusion

126

(1)

Further reading

126

(1)

Death and bereavement among Indo-Asians

127

(10)

Introduction

127

(1)

Procedures and practice at death

127

(7)

Funerals abroad

134

(1)

Patterns of mortality

134

(1)

Further reading

134

(3)

Alternative medicine and Indo-Asian elders

137

(4)

Introduction

137

(1)

Ayurvedic medicine

137

(1)

Tibb-i-Unnani

138

(1)

Homeopathy

138

(1)

Indo-Asian elders and alternative medicine

138

(1)

Conclusion

139

(2)

Commonly encountered medical problems

141

(6)

Renal disease

141

(1)

Haematological disorders

141

(2)

Osteomalacia

143

(1)

Hip fractures

143

(1)

Heavy metal poisoning

144

(1)

Acute abdomen

144

(1)

Less common pathologies

144

(1)

Further reading

145

(2)

The Indian subcontinent

147

(8)

People's Republic of Bangladesh

147

(1)

Republic of India

148

(2)

Islamic Republic of Pakistan

150

(1)

Sri Lanka

151

(4)

Useful organisations and contacts

155

(6)

Index

161

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Transcultural Geriatrics: Caring for the Elderly of Indo-Asian Origin

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Transcultural Geriatrics: Caring for the Elderly of Indo-Asian Origin

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Table of Contents

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