GERIATRIC HEALTH Dr Navya N Assistant Professor Department of Community Medicine Yenepoya Medical College
Specific Learning Objectives • To enumerate the health problems of the elderly • To understand the measures to prevent geriatric health problems • To enumerate facilities provided by government of India for Elderly
DEFINITION • Study: physical+ psychological changes: elderly : Gerontology • Care of aged: Clinical Gerontology/ Geriatarics
DEMOGRAPHY OF AGED • World population: current >6.7688 billion(2009) • Projected >8 billion (by 2025) • India has 16.94% of total population(2009) • Population of elderly(>65 yrs) in the world: early 20th century-approx 12 million. • In 2009-approx 80million. • Population of elderly(>65yrs) in India: approx 8% of total population.
Health Problems of the aged • Ageing process • Long-term illnesses • Psychological problems
PROBLEMS DUE TO AGEING PROCESS • Ageing merely stands for growing old, senescence- deterioration in the vitality or the lowering of the biological efficiency that accompanies ageing. • Senile cataract • Glaucoma • Nerve deafness • Osteoporosis • Emphysema • Failure of special senses • Changes in mental outlook
PROBLEMS ASSOCIATED WITH LONG TERM ILLNESS • Degenerative diseases of heart and Blood vessels • Cancer • Accidents • Diabetes • Diseases of locomotor system • Respiratory illnesses • Genitourinary illnesses
PROBLEMS ASSOCIATED WITH LONG TERM ILLNESS 1. Degenerative diseases of heart and Blood vessels- After the age of 40, Inner walls of arteries break down lipoid material is deposited. Time replaced by calcium narrowing of blood vessels or atherosclerosis This leads to diminished biood supply, thrombus formation, rupture of blood vessels and high blood pressure. • No single factor- atherosclerosis- Diet, heredity, overweight, nervous and emotional strain have all been implicated.
PROBLEMS ASSOCIATED WITH LONG TERM ILLNESS 2. Cancer : past middle life, Cancer prostrate – common – after 65 3. Accidents : bones become fragile- decalcification- break easily. more common in the home than outside. Fracture neck of femur- very common geriatric problem. 4. Diabetes : faulty carbohydrate metabolism- >50yrs 5. Diseases of locomotor system : fibrositis, myositis, neuritis, gout, rheumatoid arthritis, osteoarthritis, spondylitis of spine 6. Respiratory Illness : Chronic bronchitis, asthma, emphysema 7. Genitourinary System : Enlargement of prostrate, dysuria, nocturia, frequent and urgency of micturition
PYSCHOLOGICAL PROBLEMS • Mental changes • Sexual adjustment • Emotional disorders
PSYCHOLOGICAL PROBLEMS • Mental changes : Impaired memory, rigidity of outlook and dislike of change Reduced income- fall in the living standards 2. Sexual Adjustment : Between 40 and 50- cessation of reproduction by women Diminution- sexual activity- men. Physical and emotional disturbances- Irritability, jealousy 3. Emotional Disorders: social maladjustment Failure to adapt- bitterness, inner withdrawal, depression, weariness of life, and even suicide
Lifestyle and Healthy ageing • Diet and nutrition • Exercise • Weight • Smoking • Alcohol • Social activities
Preventive Health Care in Elderly • The role of prevention in geriatrics is to delay the onset of age-related decompensatory problems of body functions. • It includes- • Primary prevention. • Secondary prevention. • Tertiary prevention.
Preventive Health Care in Elderly • Primary prevention • Health habits • Inadequate nutrition • Addiction to smoking & alcohol • Lack of exercise • Inadequate sleep 2. Predisposing factor for coronary heart disease • Modifiable- smoking, obesity, HT, DM, hyperlipidemia, hypercholesterolemia, etc. • Non-modifiable- age, sex, genetic factors, etc.
Preventive Health Care in Elderly- Primary Prevention 3. Immunization- • Influenza • Pneumococcal • Tetanus. 4. Osteoporosis prevention- • Calcium and vit-d supplementation. • Hip protector devices.
Preventive Health Care in Elderly- Primary Prevention 5. Injury prevention- Burns accidents and falls should be prevented by • Removal of obstacles • Keep the floor dry • Bright lighting • Flat shoes • Railing/holding bars in bathrooms • Low level switches • Easy and safe access to water.
Preventive Health Care in Elderly- Secondary Prevention • Screening- early detection of modifiable risk factors and their adequate management. • Hyper/hypotension, diabetes mellitus • Dental problems • Drug adverse effects • Cancers • Infections • Nutritional deficiency states • Eyes /ears • Early detection and treatment- important step in secondary prevention of disease and disability.
Preventive Health Care in Elderly- Tertiary Prevention • It deals with rehabilitation and caregiver support. • Rehabilitation- problem solving process focused on- patients functional abilities. • Rehabilitation team includes; • Physician, • Physiotherapist, • Occupational therapist, • Speech and language therapist, • Psychiatrist, • Dietitian, • Nurse and a social worker.
Programmes And Services • National Policy on Older Persons (NPOP): • Launched in 1999 Objective: To empower and improve quality of life: elderly Areas of intervention: • Financial security • Health care • Nutrition • Protection
National Programme for Health Care of Elderly (NPHCE) Launched in 2010 • Community based primary health care approach • Dedicated services at PHC/CHC level • Dedicated facilities at District Hospital with 10 bedded wards • Strengthening of 8 Regional Medical Institutes to provide dedicated tertiary level medical facilities for the Elderly • Information, Education & Communication (IEC) • Continuous monitoring and independent evaluation of the Programme • Research in Geriatrics and implementation of NPHCE.
Indira Gandhi National Old Age Pension scheme Salient Features: • Above 60 years • Financial benefits for those belonging to 60-79 is decided at Rs 200/- per beneficiary per month • Assistance of Rs 500/- per beneficiary per month for those who are aged 80 years or above • The beneficiary has to be a BPL card holder
OASIS (Old Age Social Income Security) • Ministry of Social Justice and Empowerment • To understand the issues related to social security for the elderly
Action Taken • Global strategy and action plan on ageing and health was adopted in May 2016 by the World Health Assembly. • Five strategic objectives: To achieve Healthy Ageing for all. • Call for countries to commit to action • Develop age-friendly environments. • Align health systems to the needs of older people • Development of sustainable and equitable systems of long-term care. • Improved data and research
Help Age India • Largest voluntary organization • Free cataract surgeries • Mobile medical care unit • Old-age homes • Adopt-a-gran • Disaster mitigation