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Elderly Care –Scope for Integrated Approach Dr. Sairu Philip

Elderly Care –Scope for Integrated Approach Dr. Sairu Philip Additional Professor ,Dept of Community Medicine T.D.Medical College, Alappuzha. Meet them!!!!.

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Elderly Care –Scope for Integrated Approach Dr. Sairu Philip

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  1. Elderly Care –Scope for Integrated Approach Dr. Sairu Philip Additional Professor ,Dept of Community Medicine T.D.Medical College, Alappuzha

  2. Meet them!!!! • 93 year old Saraswathy living in the coastal belt of Alappuzha. The other members of this house are Gopalan 87 year old brother in law of Saraswathy and Sarada 71year old daughter of Saraswathy.Sarada, widowed does household chores in a nearby home and earn money to look after her dependents. She has arthritis, hypertension. The house has loads of used clothes(fecal stained) dumped at one corner waiting to be washed and emanating a bad odour. The kitchen has remains of food in utensils lying uncleaned for days.

  3. Meet them!! Aleyamma is a 80 year old living alone in a two storied house. She is economically independent. She has arthritis ,need help to go out. She manages on her own . She refuses to go and stay with her daughter staying 10 kilometres from their house.

  4. DEMOGRAPHIC TRANSITION • INDIA • 2001-76 million(8%) • 2011-137million(11%) KERALA Highest life expectancy(M=75yrs;F=78yrs) Highest senior citizen ratio in India.

  5. Physical Problems • Functional disabilities -vision, hearing, mobility • Diseases -Nutritional -Hypertension, Stroke, Diabetes, Heart Attack -Arthritis -Asthma. COPD -Fractures -Urinary incontinence -Infectious diseases-TB

  6. Other problems • Mental-depression -anxiety -cognitive impairment -dementia • Emotional -insecurity • Economic-instability • Social -isolation

  7. Background factors • Increase in life expectancy • Medical advances • Urbanisation/migration • Fall in fertility • Breakdown of family support system • Inflationary trends-escalating cost of care • Growth of individualism

  8. Contributing factors • Do not want to leave home/familiar surroundings • Nonavailability of attendent or support care giver • Unfriendly environment -long waiting queue -unfamiliarity with computer -lengthy procedures -cumbersome local transport facilities

  9. Goal-Holistic and Integrated Care • Changes in lifestyle &medical care to prevent or postpone or reverse age related morbidity • Maintain autonomy with due concern for self respect • Ensuring welfare of care giver • Promote active and visible policies and programmes mainstreaming ageing into individual’s lifelong development • Developing low cost community based strategies

  10. Vision for elderly care • Affordable • Accessible • Comprehensive • Continuity of services -Shift required from managing chronic disorders to promotion of healthy and active ageing and prevention of chronic disorders -Optimum mix of institutional and community based services-integrated with related sectors

  11. INTEGRATION across levels of prevention • PRIMARY PREVENTION Health Promotion • Educational intervention -Nutrition -Exercise -smoking cessation -Yoga • Mental health counselling -General positive outlook & active ageing -Combat special situation-retirement,relocation,widow hood, bereavement GERIATRIC CLUBS

  12. Primary Prevention • Health promotion -Education –Nutrition,Exercise ,Smoking cessation,Yoga. -Counselling services -forge positive general outlook &facilitate active ageing -combat specific situations –retirement,relocation,widowhood,bereavement RECREATIONAL GERIATRIC DAY CARE CENTRES

  13. Secondary prevention • Screening for general health-vision,hearing • Screening for specific diseases - BP, Blood sugar, lipids • Specialist camps- Physician, Physiotherapist, ENT, Opthalmologist,Psychiatry,Gynaecology -Ayurveda, Homeopathy • PHC regular geriatric clinics& referral services in a geriatric friendly environment (Cooperative societiesfor provision of medicines) ……….FOLLOW UP SERVICES!!!

  14. Tertiary Prevention • Community based Palliative Care- -Home care for the bedridden -End of life support -Care of care giver to prevent burn out. At CHC and Taluk level complementary facilities for palliative and restorative surgery

  15. Geriatric friendly Society • Bus/shop/buildings/toilets/staircases • Kiosk- internet friendly • Helpline ‘ VAYOMITHRAM’-KSSM • Pension schemes • Social security measures • concessions

  16. Integration…..&….mainstreaming • Family • Health system • Local self government • Social welfare • Transport • Education • Finance

  17. Mindset change Society .Caring for elderly from inevitable liability to an opportunity /blessing. Elderly .Unrealistic expectation from family leading to self pity & insecurity to realistic acceptance of ageing gracefully and with dignity

  18. THANK YOU

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