The document discusses the aging population trends globally and in India. It notes that populations are transitioning to lower birth and death rates, resulting in more older persons than ever before. In India specifically, 10% of those over 60 suffer from mobility issues and over 50% of those over 70 have at least one chronic condition. The National Programme for Health Care of the Elderly was launched in 2010 to address the growing health needs of the elderly through community-based primary care and establishing geriatric services at various levels of the healthcare system from the community to regional centers. The program aims to promote healthy aging, prevent and manage diseases, and rehabilitate the elderly.
The care of older adult is crucial in the present scenario. there are changes that occur in all aspects in the late years of life. the presentation explains the comprehensive changes and their effective management by health care personal.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
medical surgical nursing , nursing care of elderly patient with disease conditions and different care given to them,it contain introduction , definition, nursing care, patient teaching, diet management, research.
The care of older adult is crucial in the present scenario. there are changes that occur in all aspects in the late years of life. the presentation explains the comprehensive changes and their effective management by health care personal.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
medical surgical nursing , nursing care of elderly patient with disease conditions and different care given to them,it contain introduction , definition, nursing care, patient teaching, diet management, research.
Health promotion is the process of enabling people to increase control over & improve their health by developing their resources to maintain or enhance well being.
this presentation will contains problem of old age, how can they affect the life of geriatric peoples, prevention and control of geriatric problems, national program for better health of old peoples, initiations done by private trusts to improve their health
A man's life is normally divided into five main stages namely infancy, childhood, adolescence, adulthood and old age. In each of these stages an individual has to find himself in different situations and face different problems. The old age is not without problems. In old age physical strength deteriorates, mental stability diminishes; money power becomes bleak coupled with negligence from the younger generation.
Old age is a sensitive phase; elderly people need care and comfort to lead a healthy life without worries and anxiety. Lack of awareness regarding the changing behavioral patterns in elderly people at home leads to abuse of them by their children.
Health promotion is the process of enabling people to increase control over & improve their health by developing their resources to maintain or enhance well being.
this presentation will contains problem of old age, how can they affect the life of geriatric peoples, prevention and control of geriatric problems, national program for better health of old peoples, initiations done by private trusts to improve their health
A man's life is normally divided into five main stages namely infancy, childhood, adolescence, adulthood and old age. In each of these stages an individual has to find himself in different situations and face different problems. The old age is not without problems. In old age physical strength deteriorates, mental stability diminishes; money power becomes bleak coupled with negligence from the younger generation.
Old age is a sensitive phase; elderly people need care and comfort to lead a healthy life without worries and anxiety. Lack of awareness regarding the changing behavioral patterns in elderly people at home leads to abuse of them by their children.
SO GUYS ONCE AGAIN HERE I PRESENT U THE OWN MADE PRESENTATION ON THE TOPIC DEMENTIA I HOPE U LIKE THAT IT IS BEEN USEFUL U WHILE MAKING PSYCHIATRIC PRESENTATION
The care of older persons is unique. This is looking at the impact of COVID 19 on health care policy, planning and in relation to the attitude of older persons. The international day of older persons is celebrated every year, the presentation tries to review the impact of covid 19 , Healthcare policy and attitude of older person
At the end of this session, the student shall be able to
What is gerontology and it’s branches?
Describe the growing burden of geriatric age group.
Classify and Enumerate the Health problems of the aged.
What are the lifestyle factors which helps the aged?
Describe the health status of the aged in India.
Describe the Schemes & Policy for Older Person in India
Explain the Implication of the ageing population in India
How are these diseases prevented in the elderly?
Preventing Illness 2015 Commissioning a Sustainable Health System4 All of Us
Preventing Illness 2015 was held at The Wellcome Trust on Tuesday November 24th the conference looked at how we can create a preventative health system which focuses on reducing illness, improves sustainability, improves public health whilst joining health and social care together and reducing pressure on our NHS.
23 September 2010 - National End of Life Care Programme
This guide is principally for professionals working in health and social care and allied professions. Its main aim is to provide links to information sources, resources and good practice in end of life care (EoLC) for people with dementia, particularly for those who work with people with dementia who are not EoLC experts and EoLC experts who are not particularly knowledgeable about dementia.
While the document is not principally written for patients and carers, some of the information will be relevant to them.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
The goal of this webinar is to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.
Prof. Dr. Vladimir Trajkovski: HEALTH CARE SYSTEM FOR PEOPLE WITH INTELLECTUA...Vladimir Trajkovski
Prof. Dr. Vladimir Trajkovski presented this topic: HEALTH CARE SYSTEM FOR PEOPLE WITH INTELLECTUAL DISABILITIES IN MACEDONIA at Bristol conference, May 13, 2010
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. Over the past few years, the world’s population
has continued on its remarkable transition path
from a state of high birth and death rates to low
birth and death rates coupled with improvement
in health services & standard of living.
At the heart of this transition has been the
growth in the number and proportion of older
persons.
Such a rapid, large and ubiquitous growth has
never been seen in the history of civilization.
The current demographic revolution is predicted
to continue well into the coming centuries.
2
3. 60-69 70-79 80+
Old Old -
Older
Oldest-
Old
60-74 75- 84 85+
Young
Old
Middle
old
Old-Old
Source: National Policy on Older Person
1999 GOI
4. Changing world Scenario
The world will have more
people who live to see their
80s or 90s than ever before.
The past century has seen
remarkable improvements in
life expectancy.
Soon, the world will have
more older people than
children.
The world population is
rapidly ageing.
Low- and middle-income
countries will experience the
most rapid and dramatic
demographic change.
4
Source :WHO 2010
5. 1980 1990 2000 2010 2020
World 381.2 484.7 608.7 754.2 1011.6
Developed 173.3 203.6 234.6 232.4 308.2
Developing 207.9 281.8 374.1 491.8 703.4
Asia (excl. Japan) 160 218.2 290 377.7 539.9
China 78.6 101.2 131.7 167.9 238.9
India 44.6 60.2 81.4 107 149.7
United Nations,World Demographic Estimate and Projections
6. India is one of the few countries
in the world where sex ratio of
aged is in favour of males.
Population above 60 years-
10% suffer from impaired
physical mobility.
10% Hospitalized at given point
of time.
Age more than 70 years-
More than 50% suffer form 1 or
more chronic conditions like
CHD, Cancer and HT .
12/12/2015
6
7. Elderly persons lives in rural
area.
Women
Illiterate and dependent.
BPL
Were in vulnerable situation
and without sufficient food. 12/12/2015 7
75%
48%
66%
73%
66%
Source : Census
2001
10. PRONE FOR
INFECTIONS
PRONE FOR
INJURIES
PRONE FOR
PSYCHOLOGIC
AL PROBLEMS
PRONE FOR
DEGENERATI
VE
DISORDERS
INCREASED
RISK FOR
DISEASE
INCREASED
RISK OF
DISABILITY
INCRASED RISK
OF DEATH
10
14. 14
Decrease in physical ability / Economic inadequacy
Increase vulnerability to diseases
Chronic, disabling and multiple Health problems
Different approach and management
Degradation in family values
Rising Population
16. 16
National Policy On Older Persons (NPOP) -1999
Recommendations by working group of planning
commission -2006 for national programme
Maintenance and Welfare of Parents and Senior
Citizens Act – 2007
Announcement of National programme for Health
Care of Elderly during Budget speech (2008-09)
Approval of “National programme for Health Care
of Elderly” by Ministry of Finance - June 2010
17. Components
Support for financial security
Health Care
Shelter
Welfare and other needs of older persons
Protection against abuse and exploitation
Opportunities for development of the potential of
older persons
Improving quality of life
17
18. Geriatric ward for elderly at all DH
Treatment facilities for chronic, terminal and
degenerative diseases
Providing Improved medical facilities at CHCs
/ PHCs / Mobile Clinics
Inclusion of geriatric care in the syllabus of
medical courses including courses for nurses
Reservation of beds for elderly in public
hospitals
Training of Geriatric Care Givers
Research institutes for chronic elderly
diseases such as Dementia & Alzheimer 18
19. Article (20) : The State Government shall ensure
The Government hospital or Govt. funded
hospitals shall provide beds for senior citizens
as far as possible.
Separate queues be arranged for senior
citizens.
Facility for treatment of chronic, terminal and
degenerative diseases is expanded for senior
citizens
Research activities for chronic elderly diseases
and ageing is expanded
Earmarked facilities for geriatric patients in
every district hospital.
19
20. “The other major intervention will be for the elderly. A
National Programme for the Elderly with a Plan outlay of
Rs. 400 crore will be started in 2008-09. Among other
measures, we will establish, during the XIth Plan Period
two institutes of aging eight Regional Centres and a
Department of Geriatric Medical Care in one of the Medical
Colleges/Tertiary level Hospitals in each State.”
20
22. Constitutional and legal provisions.
Maintenance and welfare of parents and
senior and welfare of parents and senior
citizens Bill 2007
Ministry of Social Justice & Empowerment
22
23. National policy on older persons policy on
older persons
January, 1999. areas of intervention --
◦ Financial security, healthcare and nutrition, shelter,
education, welfare, protection of life and property
etc. for the wellbeing of older persons in the
country.
National Council for Older Persons
◦ Constituted by the Ministry of Social Justice and
Empowerment to operationalise the National Policy
on Older Persons
23
24. The Vision:
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;
Convergence of NRHM, AYUSH & all other dept.
24
25. Objectives
To provide an easy access to promotional,
preventive, curative and rehabilitative services to
the elderly through community based primary
health care approach
To identify health problems in the elderly and
provide appropriate health interventions in the
community with a strong referral backup support.
To build capacity of the medical and paramedical
professionals as well as the care-takers within the
family for providing health care to the elderly.
To provide referral services to the elderly patients
through district hospitals, regional medical
institutions
25
26. Core
Strategies
COMMUNITY
LEVEL -
domiciliary visits
by trained health
care workers.
PHC/CHC level -
equipment,
training,
additional human
resources (CHC),
IEC,
DISTRICT HOSPITAL
–
10 bedded wards,
additional human
resources,
8 RMC - PG
courses in Geriatric
Medicine, and
training
IEC using mass
media, folk media
and other
communication
26
Strategies for NPHCE 2010
27. Promotion of
public private
partnerships in
Geriatric Health
Care.
Mainstreaming
AYUSH and
convergence with
programmes of
Ministry of Social
Justice and
Empowerment in the
field of geriatrics.
Reorienting
medical education
to support
geriatric issues.
27
28. Regional Geriatric Centres (RGC) in 8
Regional Medical Institutions
Post-graduates in Geriatric Medicine (16)
from the 8 regional medical institutions;
Video Conferencing Units in the 8 Regional
Medical Institutions to be utilized for
capacity building and mentoring;
28
29. District Geriatric Units
Geriatric Clinics/Rehabilitation units
Sub-centres
Training of Human Resources
29
30. Package of Services at different levels
(SC/PHC/CHC/RGC)
30
31. The range of services will include
Health promotion
Preventive services
Diagnosis and management of geriatric medical
problems (out and in-patient)
Day care services
Rehabilitative services
Home based care
Districts will be linked to Regional Geriatric Centers for
providing tertiary level care.
Integration with existing primary health care delivery system
and vertical at district and above as more specialized health
care are needed for the elderly.
31
32. Weekly geriatric clinic by a trained Medical Officer
Conducting a routine health assessment (eye, BP,
blood sugar & record keeping).
Provision of medicines and proper advice on chronic
ailments
Public awareness on promotional, preventive and
rehabilitative aspects of geriatrics during health and
village sanitation day/camps.
Referral services.
32
34. Health Education related to healthy ageing
◦ Domiciliary visits to home bound / bedridden elderly persons .
◦ Arrange for suitable calipers and supportive devices.
◦ Linkage with other support groups and day care centers.
34
35. First Referral Unit (FRU) for the Elderly from
PHCs and below.
Geriatric Clinic for the elderly persons twice a
week.
Rehabilitation Unit for physiotherapy and
counselling
Domiciliary visits by the rehabilitation worker
for bed ridden elderly and counselling of the
family members on their home-based care.
Health promotion and Prevention
Referral of difficult cases to District
Hospital/higher health 35
36. Geriatric Clinic for regular dedicated OPD services to
the Elderly with Lab facility & adequate medicine.
Ten-bedded Geriatric Ward with existing specialties
Provide services to referred by the CHCs/PHCs etc.
Conducting camps for in PHCs/CHCs and other sites.
Referral services to tertiary level hospitals
36
37. 30-bedded Geriatric Ward for in-patient
care and dedicated beds for the elderly
patients in the various specialties.
Laboratory investigation required for
elderly with a special sample collection
centre in the OPD block.
Tertiary health care to the cases referred
from medical colleges, district hospitals
and below.
37
38. At Sub Centre level:
Health Education related to healthy ageing,
environmental modifications, nutritional
requirements, life styles and behavioural
changes.
Special attention to home bound / bedridden
elderly persons and provide training to the
family health care providers in looking after
the disabled elderly persons.
Arrange suitable callipers and supportive
devices from the PHC.
Linkage with other support groups and day
care centres etc. operational in the area.
38
Activities under NPHCE at various levels
39. Following items will be made available at the Sub-
centre level:
Walking Sticks
Calipers
Infrared Lamp
Shoulder Wheel
Pulley
Walker (ordinary)
No additional contractual staff.
39
Activities at SC level
40. At PHC level:
The weekly geriatric clinic
by trained medical officer.
Coordination with CHC, district hospital, sub centers, other
National Health Programmes/ Departments for medicines,
ambulances
Training of manpower & Separate registration counter for
elderly.
Public awareness during health and village
sanitation day/camps.
Provision of medicine to the elderly for their
medical ailments.
40
41. Following items will be made available at the PHC:
Nebulizer
Glucometer
Shoulder Wheel
Walker (ordinary)
Cervical traction (manual)
Exercise Bicycle
Lumber Traction
Gait Training Apparatus
Infrared Lamp etc.
41
42. At RH/CHC level:
◦ First level medical referral centre for medical care and
rehabilitation services
◦ Twice weekly health clinics for the elderly persons
◦ Rehabilitation unit
◦ Domiciliary visits for care of disabled persons by Multi
rehabilitation worker
◦ Referral Services to DH
◦ Training of staff
42
43. Following items will be
made available at
the CHC:
Nebulizer
Glucometer
ECG Machine
Pulse Oximeter
Defibrillator
Multi - Channel
Monitor
Shortwave
Diathermy
Cervical traction
(intermittent)
Walking for gait
training equipment
Walking Sticks /
Calipers
Shoulder Wheel
Pulley
Walker (ordinary)
Cervical traction
(manual).
43
44. At District Hospital level
Regular Geriatric OPD with Specialty Care for
Elderly.
Geriatric Ward (10-bedded) for in-patient care to
the Elderly.
Training to the Medical officers and paramedical
staff of CHC’s and PHC’s
Camps for Geriatric Services in PHCs/CHCs and
other sites
Referral services for severe cases to tertiary level
hospitals/ Regional Geriatric Centers
44
45. Following items will be made available at the District
Hospital:
Nebulizer
Glucometer
ECG Machine
Defibrillator
Multi-channel Monitor
Non invasive Ventilator
Shortwave Diathermy
Ultrasound Therapy
Cervical traction (intermittent)
Pelvic traction (intermittent)
Tran electric Nerve stimulator (TENS)
Adjustable Walker.
45
46. Sr
No Regional Institutes States Linked
1 All India Institute of Medical Sciences,
New Delhi
Delhi, Haryana, Uttarakhand,
Punjab Himachal Pradesh, M.P.
2 Institute of Medical Sciences, Banaras
Hindu University, Uttar Pradesh
Uttar Pradesh, Bihar, Jharkhand,
West Bengal
3 Grant Medical College & JJ Hospital,
Mumbai, Maharashtra,
Maharashtra, Goa, Northern
Districts of
Karnataka,Chattisgarh
4 Sher-e-Kashmir Institute of Medical
Sciences, Srinagar, Jammu & Kashmir
Jammu & Kashmir
5 Govt. Medical College,
Tiruvananthapuram, Kerala,
Kerala, Southern Districts of
Karnataka & Tamil Nadu
6 Guwahati Medical College, Guwahati,
Assam
Assam & NE States
7 Madras Medical College, Chennai, TN. Tamil Nadu, Andhra Pradesh,
Orissa 46
47. Provide tertiary level services for
complicated/serious Geriatric Cases.
Post graduate courses in Geriatric Medicine.
Training to the trainers of identified District hospitals
and Medical Colleges.
Developing evidence based treatment protocols for
Geriatric diseases prevalent in the country.
Developing/and updating Training modules &
guidelines and IEC materials.
Research on specific elderly diseases.
47
At Regional Geriatric Centers level
48. State will monitor release of
funds and expenditure incurred
under various components of the
programme in the State.
Submit monthly statement of
expenditure in the prescribed
format to the State Health
Society.
48
49. 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.
49
HOW TO ACHIEVE OPTIMUM
ELDERLY CARE?
53. 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.
Holoistic approach is essential viewed in context
of their biological, emotional, social, cultural and
spiritual elements.
54. 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.
55. Formal and informal opportunities to share
knowledge, skills related to care of older
adults.
Educating others including normal aging,
pathophysiology, geriatric pharmacology and
resources.
Essential to this role is effective
communication involving listening,
interacting, clarifying, coaching, validating
and evaluating.
56. Advocacy including aiding older
adults in asserting their rights and
obtaining required services,
facilitating a community or other
group’s effort to affect change
and achieve benefits for older
adults.
57. Assumes an inquisitive style, making
conscious decisions and efforts to
experiment for an end result to improved
gerontological practices.
58. STANDARD I. Assessment: The gerontological
nurse collects patient health data.
STANDARD II. Diagnosis: The gerontological
nurse analyzes the assessment data in
determining diagnoses.
STANDAR III. Outcome identification: The
gerontological nurse identifies expected
outcomes individualize to the older adult.
STANDARD IV. Planning: develops a plan of cares
that prescribes interventions to attain outcomes.
STANDARD V. Implementations: implements the
interventions identified in the plan of care.
STANDARD VI. Evaluation: evaluates the older
adults progress towards attainment of expected
outcomes.
59. STANDARD I. Quality of Care: The gerontological systemically
evaluates the quality of care and effectiveness of nursing practice.
STANDARD II. Performance Appraisal: The gerontological nurse
evaluates his/her own nursing practice in relation to professional
practice standards and relevant statutes and regulations.
STANDAR III. Education: The gerontological nurse acquires and
maintains current knowledge in nursing practice.
STANDARD IV. Collegiality: contributes to professional
development of peers, colleagues and others.
STANDARD V. Ethics: decisions and actions on behalf of older
adults are determined in an ethical manner.
STANDARD VI. Collaboration: collaborates with older adult, the
older adults caregiver, and all member of interdisciplinary team to
provide comprehensive care.
60. STANDARD VII. Research: interprets applies
and evaluates research findings to
improved gerontological nursing practice.
STANDARD VIII. Resource Utilization:
considers the factors related to safety,
effectiveness and cost in planning and
delivering patient care.
61. Aging is a natural process common to all living
organisms.
Various factors influence the aging process.
Unique data and knowledge are used in applying
the nursing process to the older populations.
The elderly share similar self-care and human
needs with all other human beings.
Gerontological nursing strives to help older
adults achieve optimum levels of physical,
psychological, social and spiritual and spiritual
health so that the can achieve wholeness.
62. Heredity
Nutrition
Health status
Life experiences
Environment
Activity
Stress produce unique
64. Text book of “preventive and social medicine”
k. park ,21st edition, m/s banarsidas
bhanot publisher.page no-812to 814.
“Community health nursing”, ‘principal
& practices’,k. k.gulani, published by, neelam
kumar,page no-34-36
“Community health nursing”, BT
basavanthappa, jayapee brothers medical
publisher- page no-19-20.
65. Community health nursing, “concept and
practice”, barbara walton spradly, lippincott
4th edition, page no-70to76.
“Nursing care in the community”,joan m.
cookfair,second edition,page no-671 to 678
“Community health nursing”,stenhope,
Lancaster trends, page no-172-171