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Community

Geriatrics.
Old age is an incurable
disease

Geriatricsorgeriatric medicine is
a sub-specialty ofinternal medicine
andfamily medicinethat focuses on
health care ofelderly people.
It aims to promotehealthby
preventingand treatingdiseases
anddisabilitiesinolder adults

Community Geriatrics.
Caring for older patients means not
only understanding their diseases
and knowing who the support people
are in their lives, but also creating a
plan of care that includes their social,
financial and personal goals.

There is no set age at which patients


may be under the care of
ageriatric physician, a physician
who specializes in the care of elderly
people.
This decision is determined by the
individual patient's needs, and the
availability of a specialist.

WORLDS
DEMOGRAPHICS

Today worldwide there are


600 million persons aged 60
and above.
The elderly population will
get double by 2025, and will
reach virtually 2 billion by
2025.
The
percent
age
of
population >65 years will be

Cont.
By 2025 countries with highest % of
people with >65 are expected to be:-Japan(28%)
-Italy(27.1%)
-Germany(24.6%)

However as India and China have


largest population so in 2002,
greater no. of people>80 years lived
in China followed by US and Indiia.

INDIAN DEMOGRAPHICS

In India elderly population is


over 82 million.

Indian elderly population is


expected to reach the
mark of
177 million, almost double by
the year 2025.

A nation gets labeled as aging


when the 60+ age group in its
population crosses 7%.
India has earned such

Average old age population of India,


1961-2050
population
350

300

population in million

250

200

population

150

100

50

0
1961

1991

2001

2050

General problems in
Economic
old
age
problems

Sociological
changes
Spiritual
changes

System wise
changes

1.Cardiovascular changes:
.Elevated blood pressure
.Venous stasis
.Exertion and fatigue
.Reduced cardiac efficiency
.Thickening of blood vessels
.Arrhythmias and murmur
.Dilated abdominal aorta
.Decreased physical activity

2. Respiratory

Decreased physical ability


system
Increased potential for infections
Decreased gas exchange
Aspiration
Decreased elasticity of alveolar
sacs
Skeletal changes of chest
Decreased cough strength
Dysphagia
Common diseases are Asthma,
bronchitis and emphysema

3. Gastrointestinal
system
Difficulty in chewing
Dry mouth
Difficulty in digesting starches
and fatty foods
Decreased appetite
Feeling of fullness
Malnutrition
Heart burn after meals
constipation

NEUROLOGICAL SYSTEM
Reduced speed
in nerve
conduction
Increase
confusion
Loss of
environment
clues
Reduced
cerebral
circulation
Slow to respond

Accidents
Bones become fragile
Accidents are more common in home
than outside
Fracture neck of femur is very
common .

Cancer
The leading cause of death of death
after 40 years of age .

Percentage of elderly reporting


various ailments
Reported
percentage

Ailment
Visual impairment

88.0

Joints, muscles disorder

40.0

Neurological complaints

18.7

Cardiovascular disease

17.4

Respiratory disorder

16.1

Skin conditions

13.3

Psychiatric problems

9.0

Hearing loss

8.2

Report of commission on
health in India 1997

Various Levels of
healthcare

Primordial prevention
Pre geriatric care
Primary prevention
Health education
Exercise
Immunization- influenza, and tetanus

Secondary prevention
Screening for hypertension, diabetes
periodontal disease dental caries
sensory impairment medication side effects
colon-rectal cancer breast cancer, cervical
cancer and prostatic cancer nutritionallyinduced anaemia's depression, stress urinary
incontinence podiatric problems fall risk
Annual medical check-up
Early detection ( Universal approach,
Selective approach)
Treatment

Tertiary prevention
Rehabilitation - physical deficits cognitive
deficits functional deficits
Caretaker support -Introduction of support
necessary to prevent loss of autonomy .
Counselling and Welfare activities ( Sanjay
Niradhar Yojana, Vridhashrama )
Improving quality of life
Cultural programme
Old age club
Home help
Old age home

How government help old age


people
Government announced a National Policy on
older persons in January 1999.
This policy identifies principal areas of
intervention as security, healthcare, nutrition,
welfare and protection of life and property.
A national council for older persons (NCOP)
was constituted to operationalise this policy .
234oldage home,398 daycare centers and 40
mobile medical units are operational under
this policy.

Under National Social Assistance


Programme, old age pension is being
provided to more than 4 million aged
people.
Old Age Social and Income Security (OASIS)
was launched to examine policy questions,
connected with Old age income security.
Health care is provided to the older people
under Bhavishya Arogya Mediclaim and
Rural Group Life insurance Schemes .

Help Age India is the largest


voluntary organization working for
the cause and care of the older
people.
Help Age India supports various
programmes to make life easier for
older people like
1. Free cataract operations
2.Mobile medical units
3.Old age homes and care centers.
4.Adopt a gran (grand parent).
5. Income generation and micro

NATIONAL PROGRAMME FOR THE HEALTH


CARE
OF THE ELDERLY
(NPHCE)

NPHCE is an articulation of the International


and
national commitments of the Government as
envisaged
under the UN Convention on the Rights of
Persons with
NPHCE
would
operate
through
NCD
Disabilities (UNCRPD), National Policy on
cellsPersons
under the programme
Older
constituted
at State
District of India
(NPOP) adopted
by theand
Government
inlevels
1999.

National NCD cell


State
NCD
teri.lev
el

Regional Geriatric
Centres
Geriatric Ward (30 beds)

District
NCD

District Hospital
Daily Geriatric Clinic
Geriatric Ward (10
beds)

CHC/PHC
Geriatric Clinic on fixed
days

Sub Centre
Home-based
Care

You do not heal old age.


you protect it; you
promote it; you extent
it. -Sir James Sterling Ross

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