geriatics

1. PRESENTED BY:Miss Goba

2. 1. ENUMERTAE THE TYPES OF SERVICES
AVAILABLE FOR THE AGED.
2. STATE THE IMPORTANCE OF THE
SERVICES.
3. ASSESS THE USE OF THE SERVICES.

3. SERVICES FOR THE ELDERLY (AGED)
 OBJECTIVES OF THESE SERVICES
 To provide an easy access to promotional, preventive,
curative and rehabilitative services to the elderly
through community based primary health care.
 To identify health problems in the elderly and provide
appropriate interventions in the community with a
strong referral backup support
 To build capacity for care takers within the family.
 To provide referral services to the elderly patients
through district and regional hospitals and clinics.

4. NEED FOR DEDICATED HEALTH
CARE SERVICES FOR ELDERLY
 Decrease in physical ability or economic inadequacy.
 Increase vulnerability to diseases.
 Chronic, disabling and multiple health problems.
 Different approach and management.
 Degradation in family values.
 Rising population

5. MAJOR CONSTRAINTS FOR
GERIATRIC HEALTH CARE
 Lack of specialized and trained manpower.
 No dedicated health care infrastructure for the elderly.
 Geriatric not yet a popular specialty.

6. PACKAGE OF THE SERVICES
The range of services will include
 Health promotion
 Preventive services
 Diagnosis and management of geriatric medical problems
both in and out patients.
 Day care services
 Rehabilitative services
 Home based care services
 Districts will be linked to regional geriatric centers for
providing tertiary level care.
 Integration with existing PRIMARY HEALTH CARE
delivery system at district as more specialized health care
are needed for the elderly.

7. SERVICES AT THE PRIMARY
HEALTH CARE
 Weekly geriatric clinic by a trained health worker like
the CHNs.
 Conducting a routine health assessment (e.g.. Eye, BP,
Blood Sugar and record keeping).
 Provision of medicines and proper advice on chronic
ailments.
 Public awareness on promotional, preventive and
rehabilitative aspects of geriatric during health and
village sanitation or camp day.
 Referral services

8. ITEMS NEEDED AT THE PHC
 Nebulizer
 Glucometer
 Shoulder wheel
 Walker
 Cervical traction
 Exercise bicycle
 Lumber traction
 And so on

9. SERVICES AT SUB CENTER
 HEALTH EDUCATION RELATED TO HEALTHY
AGEING:
Domiciliary visits to home bound or bedridden elderly
persons
Arrange for suitable calipers and supportive advices.
Linkage with other supportive groups and day care
centers.

10. ITEMS NEEDED AT THE SC
 Walking sticks
 Calipers
 Shoulder wheel
 Pulley
 Walker
 And so on

11. SERVICES AT COMMUNITY HEALTH
CENTER
 First Referral Unit (FRU) for the elderly from PHC and
below.
 Geriatric clinic for the elderly persons twice a week.
 Rehabilitation unit for physiotherapy and counseling.
 Domiciliary visits by the rehabilitation worker for the
bedridden elderly and counseling of the family members
on their Home Based Care.
 Health promotion and prevention.
 Referral of difficult cases to District Hospital or higher
health institutions.

12. ITEMS NEEDED AT THE CHC
 Nebulizer
 Glucometer (BM machine)
 ECG machines
 Pulse Oximeter
 Defibrillator
 Multi channel monitor
 Shoulder wheel, walking, calipers
 Cervical traction (manual) and so on

13. SERVICES AT DISTRICT HOSPITAL
 Geriatric clinic for regular dedicated OPD services to
the elderly with lab facility and adequate medicines.
 Ten bedded geriatric ward with existing specialties.
 Provide services to referred by the CHCs or PHC etc
 Conducting health camps for the elderly within the
CHCs and PHCs.
 Referral services to the tertiary level Hospital.

14. ITEMS NEEDED AT THE DH
 Nebulizer
 Glucometer (BM machine)
 ECG machines
 Pulse Oximeter
 Defibrillator
 Multi channel monitor
 Shoulder wheel, walking, calipers
 Cervical traction (manual) and so on
 Ultra sound machine
 Pelvic traction
 Non invasive ventilator

15. SERVICES AT REGIONAL GERIATRIC
CENTER
 30 bedded geriatric ward for in patient care and
dedicated beds for the elderly patients in the various
specialties.
 Laboratory investigations required for the elderly with
special sample collection center in the OPD block
 Tertiary health care to the cases referred from other
health facilities like District Hospitals and below.

16. REASONS OR IMPORETANCE OF
THESE SERVICES
 To provide accessible, affordable and high quality long
term, comprehensive and dedicated care services to an
ageing population.
 Creating a new “architecture” for ageing.
 To build a framework to create an enabling
environment for “a society for all ages” .
 To promote the concept of Active and Healthy ageing.

17. ASSESSING THESE SERVICES TO
ACHIEVE OPTIMUM ELDERLY CARE
 Active advocacy at various levels of planning
 Need for reorganization of the facilities and approach.
 Efforts to be made to revive cultural values and
reinforce the traditional practice of interdependence
among generations
 Surveillance of the ongoing programmes and evaluate
for effectiveness.

18. PART TWO
ROLE OF THE NURSE IN GERIATRIC
CARE SERVICE DELIVERY
THE NURSE PERFOMS THE
FOLLOWING:
HEALER, CAREGIVER,
EDUCATOR, ADVOCATOR AND
INNOVATOR

19. HEALER
 Nursing plays a significant role in helping individuals stay
well overcome or cope with disease restore function and
purpose in life and mobilize internal and external
resources.
 In this healer role, gerontological nurse recognizes that
most human beings value health, are responsible and active
participants in their health maintenance and illness
management, and desires harmony and wholeness with
their environment.
 Holistic approach is essential viewed in context of their
biological, emotional, social, cultural and spiritual
elements.

20. CAREGIVER
 Conscientious application of nursing process to care of
elders. Inherit in this role is the active participation of
older adults and their significant others and
promotion of highest degree of self care in elderly.
 Providing care, efficiency and best interest that rob
them of their existing independence.

21. PERFORMANCE OBJ. 4:
 KNOW THE COMMUNITY BASED FACILITIES FOR
THE AGED:
 DISCUSS THE FACILITIES AVAILABLE FOR THE
AGED

22. OBJECTIVES OF THESE FACILITIES
 To provide residential care facilities for those who, for
personal, social, health and/or other reasons are
unable to live at home.
 establish residential care, accommodation standards
to monitor accommodation services in residential care
facilities.
 Establish Adult Day Care Centers where the elderly can
come on a roistered basic for forfellowship, recreation,
rehabilitation and occupational therapy within their
community.

23. OBJECTIVES OF THESE FACILITIES
 Develop a cader of trained personnel in geriatric care.
 Ensure that all institutions which will cater for the
elderly are equipped with warning devices, sprinklers,
smoke detectors, fir extinguishers and up to date
disaster and emergency management plans.
 Educate, train and update the skills of all care givers
including family members and community support
groups on quality of care issues.

24. OBJECTIVES
 Develop a charter of Personal Rights and
Responsibilities on Residential Care Facilities and
Services for older persons.

25. FACILITIES
 RECREATIONAL HALL
 Where they can meet to watch things, play games and
discuss with other freely.
 HEALTH INSTITUTION
 Health center where they can go for treatment or for
checkups.
 DORMITORIES OR HOSTELS:
 Ageing is that period in life when body function begins to
decline usually from 30 yrs.

26. FACILITIES
 ADULT DAY CARE
 Like day center. Many local authorities and volunteer
bodies provided day care center which elderly people
can visit during the day.
 ASSOCIATIONS
 Example religious, red cross, age grade associations.
they assist financially and morally in the care of the
aged.

27. FACILITIES
 GOOD NEIGHBOURHOOD SCHEME
 In the scheme individual agrees to call an elderly person living
close to himher to assist them in simple task eg shopping, light
house, house work, light the fire and simple cooking.
 PROVISION OF RAILS:
 To enable those who cannot walk to move little in their houses.
 WHEEL VENDOR:
 Provided cooked food for the elderly through the assistance of
associations NGO individuals eg FAO, WFP

28. ROLES OF COMMUNITY HEALTH
NURSES IN CARING THE AGED
 Elderly individuals require special care and support.
The Primary Health Care Team has the responsibility
for providing care for the elderly starting from the
community level to the Sub Health Center or Health
Wellness Center (SHCHWC) and PHC-HWC level.

29. ROLE OF CHNs
 At the community level: Home Based Care Givers will
identify elderly individuals in the community including mapping
of elderly population under HWC in the category of bedbound,
restricted and mobile elderly, undertake risk assessment of the
elderly, provide counseling and support to the elderly for various
health conditions, including basic nursing care, provide support
to the caregivers, identify and report medical conditions
suspected to be elderly abuse cases to the HWC, enable
formation of support groups for the elderly and caregivers,
identify and medical conditions and refer to the CHN for further
management and provide follow up care.

30. ROLE OF CHNs
 At the SHC-HWC level: CHN will carry out
comprehensive geriatric assessment of elderly
individuals, manage common geriatric ailments and/or
refer to appropriate higher centers, arrange for suitable
assistive devices from higher centers to the
elderly/disabled persons to make them ambulatory,
provide counseling and support to elderly and their
caregivers.

31. ROLE OF CHNs
 At the referral center level: Diagnosis and treatment
of complicated conditions, surgical care, rehabilitation
and counseling will be provided for the elderly by the
medical officer or specialists