Need of the hour: Integrated Approach Towards Community Wellness Formulated on international research and knowledge based on important principles and guidelines by WHO Active Ageing Policy and Towards Building an Age Friendly City.

1. Dr. Alakananda Banerjee
President
Dharma Foundation of India
Chairman Health committee All India Senior Citizen
Confederation

2. Projected to be 113 million, i.e. 8.9% of total
populations by the year 2016

3.  Arthritis
 Respiratory Care
 Cancer
 Cardiovascular
 Vision/Cataract
 Bladder and bowel dysfunction
 Neurological deficits

4.  Elder abuse
 Social Isolation
 Financial
 Lack opportunities for re employment
 Unawareness of rights of elders.

5. “Attainment of Universal Access to Equitable,
Affordable and Quality health care services,
accountable and responsive to elderly needs,
with effective inter-sectoral convergent action
to address the wider social determinants of
health”.

6.  Constitute government and private sector
having primary, secondary and tertiary
healthcare facilities.
 The various problems faced by the healthcare
industry are shortage of doctors, nurses and
infrastructures leading to unavailability of cost
effective and accessible care at the primary
level.

7. Missing
Health Systems in India
NGO/Trust/SCWO
Private
Hospital
Semi-Govt (Public)Hospital
Govt. Hospital
Curative care Preventive care
Suggested Preventive Program
Corporate
Companies/
government
sector
employees
Absence of
government
policies
Community Care
Centre(CCC)
Allied Health Professionals
Sugar
Obesity
Pain
Blood pressure
Dementia

8.  Preventive and early
detection
 Curative
 Follow up
 Rehabilitation/Chronic
Care

9. 06/18/15
Towards Building an Age Friendly
Community 9
Participation of older
persons in finding solutions
•Old age home
•Assisted living
•Age in place

10.  Formulated on international research and
knowledge based on important principles and
guidelines by WHO Active Ageing Policy and
Towards Building an Age Friendly City.

11. COMMUNITY CARE CENTRE (CCC)
SOCIAL, PHYSICAL AND MENTAL HEALTH OF OLDER PERSONS IN
URBAN AND SEMI URBAN INDIA
Voluntary Elders
-Coordinator of CCC
-Emergency Healthcare Duties
-Workshop scheduling
Ageing in
Place
Age Friendly Initiative of Dharma Foundation of India
(DFI)
Allied Health Professionals
• informing and encouraging people to stay
healthy and prevent illness(Prevention)
• Early Detecting health conditions
• Having the capacity to treat disease
(Curative)
•helping patients with rehabilitation
(Chronic/long term care)
Managed by
Education/Empowerment
-27 workshops on health and social
issues
- Distribution of booklets
Groups formation
-Selection of voluntary elder members as a
group leader/local supervisor
-10-15 elder in a group
Integration of community care and
hospital services through CCC
- Small space allocated by Senior
Citizen Organization (SCO)
-Neighborhood hospitals
Technology for active ageing
- mHealth
- Point of Care Testing

12. MODEL FOR
ELDERLY
IN INDIA

13.  Empower and create opportunities for
community dwelling older persons to
participate in their health and social issues.
 Develop health and social models.

14.  Address the fragmented health and long-term
care system in India to adopt care models
 Publish research/evidence based data to help
State Governments and Central government of
India to framework future policies for older
persons.

15.  To help the elders of the area to avail basic
health facility the local SCWO will run a CCC
in a small space allocated by SCWO.
 The center will be managed by active elder
members of SCWO. A trained (graduate or post
graduate physiotherapist) will work for 4 hours
in the CCC.

16.  There will be basic equipments for
physiotherapy pain relief modalities, and
mobility aids. Equipments to measure blood
pressure, blood glucose, and nebulizers will be
available in the clinic.
 The nutritionist will visit the community elders
twice a month to assess nutritional uptake and
guide diet taken by elders.

17. •80 elder women members , Target disease: joint
pain ,hypertension
Exercises
Home to home
Diet Counselling
Nutritional Assessment

18. 06/18/15
Towards Building an Age Friendly
Community 18

19. • Activity:
• Workshops for education/empowerment of elders
•
27 awareness programs/ workshops (once a week)
• These workshops are taken by healthcare providers,
sociologists, lawyers and lawmakers

20.  Activity: Distribution of
booklets
 Briefs of these lectures are
translated in local languages
and distributed as booklets to
the elderly who attend the
workshops

21.  Physiotherapy Staff
 The Physiotherapy Staff shall run physiotherapy
services in CCC from 10am to 1pm.
 The Physiotherapy Staff and SCO have the right to
complete confidentiality and will not share any
information of subject/patient of in any forum.
 The Physiotherapy Staff shall be responsible for
equipment /inventory and maintain ace of
equipments .Registers shall be maintained for the
same.

22.  The Physiotherapy Staff shall follow SOP for
equipment and treatment given
 The Physiotherapy Staff shall visit home of older
person as part of campaign and projects of SCO.
 The Physiotherapy Staff shall take
workshops/awareness programs/caregiver
education of older persons.
 The Physiotherapy Staff shall supervise older
persons needing long term care.

23. Voluntary Older Member
8 members of the SCWO shall take up services
pertaining to the following duties (posted for 3
months)
 2- Running of CCC 10am to 6 pm (4 hours daily)
 2- Emergency Healthcare Duties (member
should own and able to drive a car confidently)

24.  2-Hold Education Workshop pertaining to
social laws/advocacy, distribution of handouts
to all members regarding Rights of Elders,
available 10am to 6 pm on phone to take calls
and guide and answer queries.
 2 –Working Committee Members

25.  Around 10-15 elders can avail this service every
day.
 The Community Therapist shall also do one on
one home visits to screen health, social and
mental issues and supervise elders who need long
term care.

26. • Elder Groups:
• Small groups of 10-15 elder subjects shall be
made.
• Selection of voluntary elder members as a
group leader/local supervisor.
• Social interaction will be encouraged in smaller
groups where group leader conduct
exercises/recreational activities/discussions

27.  Nonmedical interventions can assist elders in
coping with and adapting to changes as one ages.
 Health and social services delivered within a
neighbourhood by local people in local
establishments, and community-based support and
voluntary groups can play an important role in
delivering support and care to older persons.
 The Self-Management and Community Wellness
Program will not conflict with existing programs or
treatment as it is designed to enhance regular
treatment and disease-specific education given by
clinicians/family physicians in healthcare

28. • Inputs of group meetings will be discussed
carefully documented and presented to the local
government representative.
• Encourage active participation of the elders in
voicing their opinion regarding community
problems
• It may form a cost effective way to introduce
prevention/early detection of co morbidities in
elders.

29.  Community Care Centers may work as small
hubs where information about elder rights,
government policies, social issues,
environment concerns may be shared with
elders.

30.  Interventions of group activities and self
managing co-morbities have improved
mobility and quality of life of elders in the
community
 There is more awareness about government
services and policies available to older persons.
 The Community Physiotherapist is a friendly
healthcare provider, approachable and
accessible.

31.  The Community Physiotherapist is a known
face in the neighbourhood. A small fee of Rs
30/-is paid by elders for consulting her/him
and the nutritionist.
 The older persons prefer the services as they
can walk to the clinic which is accessible to
those staying nearby.

32. Manpower Costs:
Physiotherapy payout per month: Rs 4000
Voluntary Older Person : Gift for Rs 500 (on
completion of 3 months)
Stationary: Rs 1000/month
Equipment and stationary costs:
Equipment and furniture: Rs 1,00000 (one time cost)
Booklets in Hindi and English;Rs50,000 (for 1000
booklets)

33.  Physiotherapy per session at CCC: Rs 50
 Physiotherapy Package for 10 sessions at CCC:
Rs 400
 Physiotherapy per home session: Rs 200
 Physiotherapy Package for 10 home sessions:
Rs 1800
 Booklets: Rs 20

34.  DFI has been involved in research
and development with following
international collaborators where
the model has been developed with
WHO-SEARO

 Our International Collaborators
 Dr Anirban Dutta-INRIA France
 Dr Subhasis Banerjee: NTU Singapore
 Dr Pradeep Ray: APuHC Sydney
Australia