This study aimed to describe the health problems and socio-demographic characteristics of elderly patients attending the Out Patient Department of Base Hospital in Nawalapitiya, Sri Lanka. The most common presenting complaints were body aches and pains, fever, breathing difficulties, and abdominal pain. Chronic diseases prevalent among the elderly patients included hypertension, chronic respiratory diseases, and diabetes mellitus. The study recommends screening elders for chronic diseases, promoting elderly care at home, and providing healthcare services and health education to elders in both Sinhala and Tamil languages.

1. COMMON HEALTH PROBLEMS OF ELDERLY PATIENTS
ATTENDING
BASE HOSPITAL NAWALAPITIYA
BY
DR. W.A.D. JAYASINGHE
MBBS, MSc, MD (COMMUNTY MEDICINE)

2. ABSTRACT
The demographic changes affect the socio-economic development of a country. The changes of age distribution of population, in the past few decades show an increase in the proportion of elderly. This hospital based descriptive study was done, at the Out Patient Department, Base hospital Nawalapitiya, to determine the health problems and socio-demographic characteristics of elders. The study declared the usual complaints of some common diseases and the socio-economic, demographic and behavioural factors of elderly patients. The existing family support for elders at the residence, companion for treatment and the chronic diseases of elderly patients were described.
The study was conducted among elderly patients in the 60-89 year age group. The time preferred for treatments at O.P.D. by most elderly patients were between 8.00- 9.49 am. Common presenting complaints were body ache and pain, fever, difficulty in breathing and abdominal pain. They were diagnosed as abnormal clinical findings, arthropathies, viral fever and respiratory tract diseases. The significant chronic diseases were hypertension, chronic respiratory tract diseases and diabetes mellitus. The result suggests that it is important to screen elders for chronic diseases. The promotion of elderly care at home is necessary for elders who ‘stay alone’. The resources available with elders, for example, skills, knowledge, and properties can be used to promote healthy lives for them. Non-smoker and non-alcoholic are healthy than smoker and alcoholics.

3. 3
Page
CONTENT 1
LIST OF TABLE 3
CHAPTER 1- INTRODUCTION AND OBJECTIVES 4
1. Introduction 4
1.1 Main objective 5
1.2 Specific objectives 5
CHAPTER 2- LITERATURE REVIEW 7
2.1 Demographic changes in the world 7
2.2 Influence of ageing on the demography of Sri Lanka 8
2.3 Physiological and biological changes that take place
in the body as a result of ageing 8
2.4 Health problems among elders 9
2.5 Effect of modernization in Sri Lankan families 10
3 New emergences in the world due to increased elderly
population 10
3.6 Special programmes for elders in Sri Lanka 11
3.7 Successful ageing 12
CHAPTER 3- METHODOLOGY 13
3.1 Study design 13
3.2 Study area 13
3.3 study population 14
3.4 Exclusion criteria 14
3.5 Sample 14
3.6 Method of data collection 14
3.6.1 Pre-test 14
3.6.2 Questionnaire 15
3.6.3 Training of investigators 15

4. 4
3.6.4 Data collection 15
3.7 Data processing 16
3.8 Quality of data 16
CHAPTER 4- RESULT 17
CHAPTER 5- DISCUSSION 31
5 Socio-economic and demographic characteristics of elderly
patients 31
5.1 The family support available to the elderly patients 33
5.2 Presenting complaints and probable diagnoses 34
5.3 Chronic diseases among elderly patients coming for
treatment to the Out Patient Department 37
CHAPTER 6- CONCLUSION AND RECOMMENDATION 38
CHAPTER 7- LIMITATION OF THE STUDY 40
ACKNOWLEDGEMENT 41
REFERENCES 42
ABBREVIATIONS 45
ANNEXURE 46

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Page 1-4 removed
1.1 Main objective
To describe health problems, and socio-demographic characteristics of the elders attending the Out Patient Department of Base Hospital, Nawalapitiya.
1.2 Specific objectives
1.2.1 Among the elderly patients attending Out Patient Department, Base Hospital Nawalapitiya to find out the;
1. Socio-economic and demographic characteristics.
2. Presenting complaints and probable diagnoses.
3. Family support available to them.
4 Chronic disease/s they suffer from.
1.2.2 To make recommendation based on the above findings that could improve the quality of life of the elderly patients.

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CHAPTER 6
Conclusion and Recommendation
The time period of 8.00 am to 9.59 am was most popular among 60 years to 79 year aged elderly patients attending the O.P.D. This may be so in other hospitals too. Health promotive programmes for the elderly should be arranged during this session. A high proportion of O.P.D. elders over 80 years of age were treated during the 10.00 am to 12.00 noon period. The arrangement of a special counter or other facilities for treatment of elderly patients should be conducted at least from 8.00am to 12.00 noon.
Twenty percent of elderly sample were Tamil speaking, necessitating the provision of health education and instructions at the O.P.D. in Tamil medium too. Tamil literacy or translator facilities for medical officers and other staff are recommended in elderly health care services.
Although verbal communication is better, written instructions in Sinhala and Tamil also are preferable at the O.P.D. communications, due to 77.9 percent literacy rate of elderly patients. 6.2 percent resourceful Senior School Certificate (Grade 10) qualified elders found in the study could be used in health education programmes in the elderly community. Most of the elders have ability in doing a job, but only 12 percent of the elders were occupied. This could be due to lack of suitable jobs for elders. The arrangement of government and NGO based programmes for increasing the job availability for elders, would be helpful in reducing the elderly dependence.
Small proportion (4.1 percent) of the sample was living alone. They were more vulnerable to get health problems than others. Community workers should therefore, provide domiciliary care to this category of elders.
Priority should be given to elderly females and children in health education and promotion programmes for elders, as these groups are actively involved in the care of the elderly.
Checking of blood pressure of elderly patients with faintishness, vertigo, headache, body ache and chest pain is important to detect the hypertensive elderly.
The involvement of medically qualified people in the study could help in detecting the real health problems on examination even though patients do not complain. Asthma/ Chronic obstructive pulmonary diseases, viral fever and ulcers were higher among males than

7. 7
among females. That could be due to high exposure of males to risks than females. Hypertension and skin disorders increase along with advancing age.
The low prevalence of respiratory tract diseases and skin diseases among Sinhalese, may be due to healthy attitude and behaviour than other ethnicities. Gastritis was higher among Sinhalese compared to other groups. A scientific study should be arranged to determine the causative factors leading to this situation, as no explanation has been provided. Higher respiratory tract diseases and skin disorders of Tamil elders were detected which should be reduced by health promotion, to establish productive life. The prominent diseases of elderly Moors were the abnormal clinical findings and arthropathies.
Nine percent of elderly Moors suffered from hypertensive diseases, which was the highest among all three groups of ethnicities. Further study of immediate risk behaviours like dietary habits and low physical activities may be helpful in identifying the causative factors of hypertensive diseases. Current diagnoses were not significantly associated with past occupations. Arthropathies, viral fever and body injuries were higher among alcohol users than non-users.
Respiratory tract diseases and chronic obstructive pulmonary diseases among elderly smokers were markedly higher than non-smokers and the smoking and alcoholism should be prevented for health promotion of elders. A larger proportion (33.2 percent) of males than females (24.5 percent) of the sample had chronic diseases other than the current health problems. The respiratory tract diseases were common among males as chronic diseases. Hypertensive diseases were common among females. Screening and preventive programmes should be arranged to prevent and control such chronic diseases.