This document discusses preventive measures in obstetrics and pediatrics. It covers antenatal, intranatal, and postnatal care including the importance of breastfeeding and monitoring infant growth and development. Key aspects include immunizing mothers and children, providing nutrition education, treating common issues like malnutrition and infection, and ensuring clean delivery practices. The overall goal is to promote maternal and child health through preventive healthcare.

1. Preventives in Obs
Pedia and Geriaterics
Dr. Ravi Jain
M.D.(Hom.)
Assistant Professor
Jayoti Vidyapeeth Women’ University Jaipur

2. Preventives in Obstetrics

3.  Mothers and children constitute a priority group.
 Women of the child-bearing age (15 to 44 years)
constitute 22.2 per cent, and children under 15 years of
age about 35.3 per cent of the total population. Together
they constitute nearly 57.5 per cent of the total
population.
 Most vulnerable or special-risk group.
 By improving the health of mothers and children, we
contribute to the health of the general population.

4.  Maternity cycle
 The stages :
 (i) Fertilization
 (ii) Antenatal or prenatal period
 (iii) lntranatal period
 (iv) Postnatal period
 (v) Inter-conceptional period.

5.  Growth phases :
 Prenatal period :
 (a) Ovum 0 to 14 days
 (b) Embryo 14 days to 9 weeks
 (c) Foetus 9th week to birth
 Premature infant from 28 to 37 weeks
 Birth, full term average 280 days.

6. MCH problems
 1. MALNUTRITION :
 Direct interventions : supplementary feeding
programmes, iron and folic acid tablets, fortification and
enrichment of foods, nutrition education, etc.
 Indirect interventions : control of communicable diseases
through immunization, improvement of environmental
sanitation, provision of clean drinking water, family
planning, food hygiene, education and primary health
care.

7.  2. INFECTION :
 Immunization programme, education of mothers in
medical measures, personal hygiene and appropriate
sanitation measures.
 3. UNCONTROLLED REPRODUCTION : family planning
services.

8. Maternal and child health
 Promotive
 Preventive
 Curative
 Rehabilitative health care for mothers and children.
 It includes :
 maternal health, child health, family planning, school
health, handicapped children, adolescence, and health
aspects.

9. Objectives of MCH
 Reduction of mortality and morbidity.
 Promotion of reproductive health
 Promotion of the physical and psychological development.
 Lifelong health

10. ANTENATAL CARE

11. Objectives of antenatal care
 To promote, protect and maintain the health of the
mother.
 To detect "high-risk" cases and give them special
attention.
 To foresee complications and prevent them.
 To remove anxiety and dread associated with delivery.
 To reduce maternal and infant mortality and morbidity.

12.  To teach the mother elements of child care, nutrition,
personal hygiene, and environmental sanitation.
 To sensitize the mother to the need for family planning,
including advice to cases seeking medical termination of
pregnancy; and
 To attend to the under-fives accompanying the mother.

13. Achievements of Antenatal care
 1. Antenatal visits : once a month during the first 7
months; twice a month, during the next month; and
thereafter, once a week. (General & systemic)
 2. Prenatal advice : diet, hygiene, radiation, warning
signs, child care
 3. Specific health protection : anemia, nutritional
deficiency, toxaemia, tetanus, Rh grouping, etc
 4. Mental preparation : removing her fears about
confinement
 5. Family planning : Educational and motivational efforts
 6. Paediatric component : paediatrician

14. INTRANATAL CARE

15.  Clean hands
 Clean surface for delivery
 Clean cord care
 Clean blade
 Clean tie for the cord

16. Aims of good intranatal care
 Thorough asepsis
 Delivery with minimum injury to the infant and mother
 Deal with complications
 Care of the baby (delivery resuscitation, Care of the cord,
care of the eyes, etc.)

17. Domiciliary care
 Confinement in their own homes.
 Advantages :
 Familiar surroundings
 Cross infection are fewer
 Mother is able to keep an eye upon her children.
 Disadvantages :
 Less medical and nursing supervision
 Less rest
 Diet may be neglected

18.  Danger signals :
 Sluggish pains or no pains after rupture of membranes
 Good pains but no progress.
 Prolapse of the cord or hand
 Slow irregular or excessively fast foetal heart
 Excessive 'show' or bleeding during labour
 Collapse during labour
 Placenta not separated within half an hour after delivery
 Post-partum haemorrhage
 Temperature of 38 deg C or over during labour.

19.  Institutional care :
 For all 'high-risk“ cases, and where home conditions are
unsuitable.
 Rooming in : Keeping the baby's crib by the side of the
mother's bed.

20. POSTNATAL CARE

21.  Care of the mother
 Care of children

22. Care of the mother
 Prevention of Complications :
 Puerperal sepsis
 Thrombophlebitis
 Secondary haemorrhage
 Others : UTI, Mastitis etc

23.  Restoration of mother to optimum health :
 Three divisions :
 Physical : Postnatal examinations, Anaemia, Nutrition,
Postnatal exercises.
 Psychological :Fear and insecurity
 Social : wholesome family atmosphere.

24.  Breast-feeding
 Family planning
 Basic health education : hygiene, feeding for mother and
infant, pregnancy spacing, importance of health check-up,
birth registration.

25. Care of Children

26.  Infancy (upto 1 year of age)
 Neonatal period (first 28 days of life)
 Post neonatal period (28th day to 1 year)
 Pre-school age (1-4 years)
 School age (5-14 years)

27. Neonatal Care
 Establishment and maintenance of cardiorespiratory
functions.
 Maintenance of body temperature.
 Avoidance of infection.
 Establishment of satisfactory feeding regimen.
 Early detection and treatment of congenital and acquired
disorders.

28. Immediate care
 Clearing The Airway : airways should be cleared of mucus
and other secretions.
 Apgar Score : Heart rate, Respiratory effort, Muscle tone,
reflex response, color.
 Care of Cord :cord should be cut and tied when it has
stopped pulsating.
 Care of the Eyes : lid margins should be cleaned with
sterile wet swabs, one for each eye from inner to outer
side.

29.  Care of the Skin : first bath is given with soap and warm
water to remove vernix, meconium and blood clots in few
hours.
 Maintenance of Body Temperature : child is quickly dried
with a clean cloth and wrapped in warm cloth and given to
the mother for skin-to-skin contact.
 Breast feeding : initiated within an hour of birth.
Bonding.

30. Measuring the Baby
 Birth-weight
 Length (height)
 Head circumference : occipito-frontal diameter

31. Neonatal Screening
 Neonatal Screening : causing mental retardation and
tendency to seizures if the child.
 Neonatal hypothyroidism : mental retardation
 Coombs' test : routinely on infants of all Rh-negative
mothers.
 Sickle cell or other haemoglobinopathies : thalassaemia,
G6PD.
 Congenital dislocation of hip

32. At-risk infants
 Birth weight less than 2.5 kg
 Twins
 Birth order 5 and more
 Artificial feeding
 Failure to gain weight during three successive months
 Children with PEM, diarrhoea
 Working mother/one parent.

33. Baby Friendly Hospitals Initiative
(BFHI)
 To improve infant and young child nutrition have
focused on promoting breast feeding :
 Written breast-feeding policy
 Train all health care staff
 Inform all pregnant women about the benefits and
management of breastfeeding
 Help mothers initiate breast-feeding within one half-hour
of birth
 Show mother, how to breast-feed and maintain lactation.

34. BFHI
 Give newborn infants no food or drink other than breast
milk.
 Practice rooming-in.
 Encourage breast-feeding on demand.
 Give no artificial teats or pacifiers.
 Establishment of breast-feeding support groups.

35. Breast-feeding
 Under normal conditions, Indian mothers secrete 450 to
600 ml of milk daily with 1.1 gm protein per 100 ml. The
energy value of human milk is 70 kcals per 100 ml.
 Advantages of breast-feeding
 It is safe, clean, hygienic, cheap and available to the
infant at correct temperature
 It fully meets the nutritional requirements of the infant in
the first few months of life.
 It contains antimicrobial factors such as macrophages,
lymphocytes, secretory IgA, etc which provide
considerable protection against diarrhoeal diseases and
respiratory infections in the first months of life.

36.  It is easily digested and utilized by both the normal and
premature babies.
 It promotes bonding between the mother and infant.
 Sucking helps in the development of jaws and teeth.
 It protects babies from the tendency to obesity.
 It prevents malnutrition and reduces infant mortality.
 It helps parents to space their children.
 Special fatty acids lead to increased intelligence quotients
and better visual acuity.

37. Growth and Development

38.  Growth : Increase in physical size
 Development : Increase in skills and function and also in
intellectual, emotional and social aspects.

39.  Growth and development are considered together because
the child grows and develops as a whole.
 Growth and development include :
 Physical
 Intellectual
 Emotional
 Social aspects.

40. Determinants of Growth and Development
 Genetic Inheritance
 Nutrition
 Age : maximum during foetal life, during the first year of
life and then again at puberty.
 Sex : female more mature than males
 Physical Surroundings : Sunshine, good housing, lighting
and ventilation.
 Psychological Factors :Love, tender care and proper
child-parent relationship.

41.  Infections and Parasitosis : infections of the mother
during pregnancy (e.g., rubella, syphilis) affect the
intrauterine growth. Infections after birth (e.g.,
diarrhoea, measles) slow down growth. Intestinal parasites
(e.g., roundworms) by consuming considerable quantities
of nutrients hamper growth and development.
 Economic factors
 Other factors : birth order of the child, birth spacing,
birth weight, education of the parents, etc.

42. Surveillance of Growth and
Development
 Physical Growth
 Behavioural Development

43. Physical Growth
 Weight-for-age : repeated measurement at intervals,
monthly from birth to 1 year, every two months during the
second year and every 3 months thereafter upto 5 years of
age.
 Height (length) for age : Low height for age, also known
as nutritional stunting or dwarfing.
 Weight-for-height
 Head and chest circumference : At birth the head
circumference is about 34 cm. It is about 2 cm more than
the chest circumference. By 6 to 9 months, the two
measurements become equal, after which the chest
circumference overtakes the head circumference.
 Mid arm circumference

44. Behavioural Development
 Motor development
 Personal-social development
 Adaptive development
 Language development

46. Milestone Development
 6-8 Weeks
 Looks at mother and smiles
 3 months
 Holds head erect
 4-5 months
 Listening
 Begins to reach out for objects
 Recognize mother

47.  6-8 months
 Sits without support
 Experiments with noises
 Transfers objects hand to hand
 Suspicious of strangers
 9-10 Months
 Crawling
 Increases range of sounds.
 Releases objects

48.  10-11 Months
 Stands with support
 First words
 12-14 Months
 Walks wide base
 Builds things

49.  18-21 Months
 Walks narrow base and begins to run
 Joining words
 Begins to explore
 24 Months
 Runs
 Short sentences

54. Growth chart
Road-to-health chart

55.  Designed by David Morley, and modified by WHO.
 Visible display of Child’s physical growth and
development and used for growth monitoring.
 Milestones of development.

56. Uses of growth chart
 Growth monitoring
 Diagnostic tool : high-risk children.
 Planning and policy making
 Educational tool
 Tool for action : type of intervention needed.
 Evaluation : effectiveness of corrective measures
 Tool for teaching : importance of adequate feeding; the
deleterious effects of diarrhoea.

57.  GOI Growth chart
 4 Reference curves.
 Top Curve 80% of median
 Lower 70%
 60%
 50 %

58.  Above upper most curve : Well fed healthy
 Between lines 1 and 3 are undernourished and require
supplementary feeding at home.
 Below line 3 and above 4 are severely malnourished and
need to consult the doctor.
 Below Line 4 will have to be hospitalized for treatment.

59. CARE OF THE PRE-SCHOOL CHILD

60.  Children between 1-4 years of age are called pre-school
age children or toddlers.
 Significance of Pre school child care :
 1. Large numbers : 9. 7 per cent of the general
population. Human resources of the future.
 2. Mortality : 2.3 per cent of all deaths. high mortality is
due to infection and malnutrition.
 3. Morbidity : data on morbidity of pre-school children
are scarce. Usually victims of PEM accompanied by
retarded growth and development.

61.  Other nutritional deficiency such as anaemia,
xerophthalmia, etc.
 Common diseases includes diarrhoea, diphtheria, tetanus,
whooping cough, measles and other eruptive fevers, skin
and eye infections, and intestinal parasitic infestations.
 Growth and development : first 5 or 6 years of life is well
known for the growth and development of a child. may
result in severe limitations.
 Accessibility : toddler is hard to reach, Special inputs
e.g., day care centres, play group etc are required to
reach the toddler and to bring him into the orbit of health
care.

62.  Prevention of health problems of adult life in childhood:
dental diseases, streptococcal infection, obesity,
hypertension, cardiovascular diseases, and certain mental
disorders.

63. Child Health Problems
 Low birth weight : maternal factors
 Malnutrition : PEM, Vit A, anemia, iodine
 Infections and parasitosis : Diarrhoea, respiratory
infections, measles, polio, etc
 Accidents and poisoning : burns, trauma, road traffic
accidents.
 Behavioural problems : battered baby syndrome.

64. Indicators Of MCH Care

65.  Health status is assessed through measurements of
mortality, morbidity and, growth and development.
 Morbidity data are scarce and poorly standardized.
 Commonly used mortality indicators are :
 Maternal mortality ratio
 Mortality in infancy and childhood

66.  Mortality in infancy and childhood
 a. Perinatal mortality rate
 b. Neonatal mortality rate
 c. Post-neonatal mortality rate
 d. Infant mortality rate
 e. 1-4 year mortality rate
 f. Under-5 mortality rate
 g. Child survival rate.

67. Maternal Mortality Ratio
 The death of a woman while pregnant or within 42 days of
termination of pregnancy, irrespective of the duration and
site of pregnancy, from any cause related to or aggravated
by the pregnancy or its management but not from
accidental or incidental causes.
 It is divided by Total no. of live births in the same area
and year and multiplied by 1000.

68. Statistical measures
 Maternal mortality ratio : Number of maternal deaths during a given
time period per 100,000 live births during the same time-period.
 Maternal mortality rate : Number of maternal deaths in a given
period per 100,000 women of reproductive age during the same time-
period.
 Adult lifetime risk of maternal death : The probability of dying from
a maternal cause during a woman's reproductive lifespan.
 The proportion of maternal deaths of women of reproductive age
(PM) : The number of maternal deaths in a given time period divided
by the total deaths, among women aged 15-49 years.

69. Approaches for measuring maternal
mortality
 Civil registration systems
 Household survey
 Sisterhood methods
 Reproductive-age mortality studies : causes of all deaths
of women of reproductive age in a defined
area/population.
 Verbal autopsy:interview with family or community
members.
 Census

70. Causes
 Haemorrhage (38 per cent),
 Sepsis (11 per cent),
 Hypertension (5 per cent),
 Obstructed labour (5 per cent),
 Abortion (8 per cent) and
 Other conditions (34 per cent).
 Anaemia ( 19 per cent) is not only the leading cause of
death but also an aggravating factor in haemorrhage,
sepsis and toxaemia

71. Social correlates
 Women's age : The optimal child-bearing years is between
the ages of 20 and 30 years.
 The further away from this age range, the greater the
risks of a woman dying from pregnancy and childbirth.
 Birth interval : Short birth intervals are associated with
an increased risk of maternal mortality.
 Parity: High parity contributes to high maternal
mortality.

72. Other factors
 Economic circumstances,
 Cultural practices
 Beliefs,
 Nutritional status,
 Environmental conditions
 Violence against women.

73. Preventive and social measures
 Early registration of pregnancy.
 At least four antenatal check-ups.
 Dietary supplementation, including correction of anaemia.
 Prevention of infection and haemorrhage during
puerperium.
 Prevention of complications, e.g., eclampsia,
malpresentations, ruptured uterus.
 Treatment of medical conditions, e.g., hypertension,
diabetes, tuberculosis, etc.

74.  Anti-malaria and tetanus prophylaxis.
 Clean delivery practice.
 Trained local dais and female health workers.
 Institutional deliveries for women with bad obstetric
history and risk factors.
 Promotion of family planning - control number of children
and spacing of births.
 Identification of every maternal death, and searching for
its cause
 Safe abortion services.

75. Mortality in Infancy
And Childhood

76.  Infant mortality rate (IMR) is defined as "the ratio of
infant deaths registered in a given year to the total
number of live births registered in the same year; usually
expressed as a rate per 1000 live births.“
 Perinatal mortality rate 28 weeks of gestation – 7 days
 Neonatal mortality rate – birth – 28 days (early 0-7, late 7-
28 days)
 Post-neonatal mortality rate : 28 days – 1 year
 Infant mortality rate : Birth – 1 year

77. FOETAL DEATH
 Foetal death is death prior to the complete expulsion or
extraction from its mother of a product of conception,
irrespective of the duration of pregnancy.
 The death is indicated by the fact that after such
separation the foetus does not breathe or show any other
evidence of life.

78.  Stillbirth Rate : Death of foetus weighing 1000 g
equivalent to 28 weeks of gestation or more occurring
during one year in every 1000 total births (live births plus
stillbirths).
 Perinatal Mortality Rate : includes both late foetal deaths
(stillbirths) and early neonatal deaths.
 Causes & Prevention : Already discussed earlier :
antenatal, intranatal, postnatal, danger sign,
complications, other factors.

79. Neonatal Mortality Rate
 Deaths occurring during the neonatal period, commencing
at birth and ending 28 completed days after birth.
 Neonatal mortality rate is the number of neonatal deaths
in a given year per 1000 live births in that year.
 Causes : Intrapartum complications, preterm
complications, respiratory infections, diarrhoea,
congenital anomalies, pneumonia, sepsis, tetanus etc.

80. Post-neonatal Mortality Rate
 Deaths occurring from 28 days of life to under one year
are called post-neonatal deaths.
 The post-neonatal death rate is the ratio of post-neonatal
deaths in a given year to the total number of live births in
the same year, usually expressed as a rate per 1000.
 Causes : Diarrhoea and respiratory infections. Malnutrition
is an additional factor, reinforcing the adverse effects of
the infections.

81. Infant Mortality Rate
 Infant mortality rate (IMR) is defined as the ratio of infant
deaths registered in a given year to the total number of
live births registered in the same year; usually expressed
as a rate per 1000 live births.

83. Factors affecting Infant mortality
 Biological
 Economic
 Social factors.

84. Biological Factors
 Birth weight :low birth weight under 2.5 kg and high birth
weight over 4 kg are at special risk.
 Age of the mother : below the age of 19 years or
relatively older over 30 years.
 Birth order : the fate of the 5th
and later children is
always worse than the fate of the 3rd
child.
 Birth spacing : Repeated pregnancies exert a great
influence on infant mortality. They cause malnutrition and
anaemia in mother, again predispose to low birth weight,
which results in higher infant death.

85.  Multiple births : Infants born in multiple births face a
greater risk of death.
 Family size : Studies show the infant mortality increases
with family size.
 High fertility : High fertility and high infant mortality go
together.

86. Economic Factors
 Infant mortality rates are highest in the slums and lowest
in the richer residential localities.

87. Cultural And Social Factors
 Breast-feeding : Early weaning and bottle-fed infants
living under poor hygienic conditions are more prone to
die than the breast-fed infants living under similar
conditions.
 Religion and caste : age-old habits, customs, traditions
affecting cleanliness, eating, clothing, child care.
 Early marriages : The baby of teen-age mother has the
highest risk for neonatal and post-neonatal mortality.
 Sex of the child : female infants receive far less attention
than males. Neonatal death rate is higher for males than
for female infants post-neonatal death rate is higher for

88.  Quality of mothering : children could reasonably survive
if they had an efficient mother.
 Maternal education : maternal education plays a major
role in the decline of infant and child mortality.
 Quality of health care : deliveries attended by untrained
persons or relatives.
 Broken families
 Illegitimacy

89.  Brutal habits and customs : depriving the baby of the
first milk or colostrum, frequent purgation, branding the
skin, application of cowdung to the cut end of umbilical
cord, faulty feeding practices and early weaning.
 Bad environmental sanitation : Lack of safe water
supply, poor housing conditions, bad drainage,
overcrowding, and insect breeding, all increase the risk of
infant mortality.

90. Preventive and social measures
 Prenatal nutrition
 Prevention of infection
 Breast-feeding
 Growth monitoring
 Family planning
 Sanitation
 Provision of primary health care
 Socio-economic development
 Education

91. Decline in infant mortality has bee attributed
to :
 Improved obstetric and perinatal care.
 Improvement in the quality of life, that is, economic and
social progress.
 Better control of communicable diseases, e.g.
immunization and oral rehydration.
 Advances in chemotherapy, antibiotics and insecticides
 Better nutrition, e.g., emphasis on breast feeding.
 Family planning, e.g., birth spacing.

92. SCHOOL HEALTH SERVICE

93.  School health service is an economical and powerful
means of raising community health, and more important,
in future generations.
 The Bhore Committee (1946) reported that School Health
Services were practically non-existent in India, and where
they existed, they were in an under-developed state.
 In 1960, the Government of India constituted a School
Health Committee to assess the standards of health and
nutrition of school children and suggest ways and means
to improve them.

94. Health problems of school child
 Malnutrition
 Infectious diseases
 Intestinal parasites
 Diseases of skin, Eye and Ear
 Dental caries

95. Objectives Of School Health Service
 The promotion of positive health
 The prevention of diseases
 Early diagnosis, treatment and follow-up of defects.
 Awakening health consciousness in children
 The provision of healthful environment.

96. Aspects of School Health Service
 Health appraisal of school children and school personnel
 Remedial measures and follow-up
 Prevention of communicable diseases
 Healthful school environment
 Nutritional services
 First-aid and emergency care

97.  Mental health
 Dental health
 Eye health
 Health education
 Education of handicapped children
 Proper maintenance and use of school health records.

98.  Health appraisal : It should cover not only the students
but also the teachers and other school personnel. It
consists of periodic medical examinations and observation
of children by the class teacher.
 It includes daily morning inspection.
 Remedial measures and follow-up : Medical examinations
do not end in themselves; they are followed by
appropriate treatment and follow-up.Number of
specialists are employed in the School Health Service.

99.  Prevention of communicable diseases : A well planned
immunization programme against the common
communicable diseases. A record of all immunizations is
maintained as part of the school health records.
 Healthful school environment : A healthful school
environment is necessary for the best emotional, social
and personal health. A minimum standards for sanitation
of the school and its environment.

100.  Nutritional services : The School Health Committee
(1961) recommended that school children should be
assured of at least one nourishing meal. Schools should
have some arrangement for providing mid-day meals.
 Specific nutrients are necessary for the prevention of
some nutrient disorders like Dental caries, endemic
goitre, nightblindness, protein malnutrition, anaemias,
etc.
 First-aid and emergency care : Teacher Training
Programmes or In-service Training programmes.

101.  Mental health : Juvenile delinquency, maladjustment and
drug addiction are becoming problems among school
children. Vocational counsellors and psychologists for
guiding the children into careers for which they are
suited.
 Dental health : A school health programme should have
provision for dental examination, at least once a year.
 Eye health services : early detection of refractive errors,
treatment of squint and amblyopia, and detection and
treatment of eye infections such as trachoma.

102.  Health education : education about personal hygiene,
environmental health, reproductive life.
 Education of handicapped children : to assist the
handicapped child to reach his maximum potential, to
lead as normal a life and to become independent and self-
supporting member of society.
 School health records : A cumulative health record of
each student should be maintained.

103. Handicapped Children

104.  An impairment is defined as any loss or abnormality of
psychological, physiological, or anatomical structure or
function.
 Disability is defined as any restriction or lack (resulting
from an impairment) of ability to perform an activity in a
manner or within the range considered normal for a
human being.
 Handicap is defined as reduction in a person's capacity to
fulfil a social role as a consequence of an impairment,
inadequate training for the role, or other circumstances.

105. Classification
 Physically handicapped
 Mentally handicapped
 Socially handicapped

106.  Physically handicapped children : who are blind, deaf
and mute; those with hare-lip, cleft palate, and the
crippled.
 Mentally handicapped children : term used for mental
retardation.
 Mild mental retardation IQ 50-70
 Moderate mental retardation IQ 35-49
 Severe mental retardation IQ 20-34
 Profound mental retardation IQ under 20

107.  Socially handicapped children : a child whose
opportunities for a healthy personality development and a
full unfolding of potentialities are hampered by certain
elements in his social environment.
 Juvenile Delinquency: Juvenile means a boy who has not
attained the age of 16 years and a girl who has not
attained the age of 18 years.
 It embraces all deviations from normal youthful behaviour
and includes the incorrigible, ungovernable, habitually
disobedient and those who desert their homes and mix
with immoral people, those with behaviour problems and
indulge in antisocial practices.

108.  Battered baby syndrome : "a clinical condition in young
children, usually under 3 years of age who have received
non-accidental wholly inexcusable violence or injury, on
one or more occasions.
 Girl child and gender bias

109. PREVENTIVE MEDICINE AND
GERIATRICS

110.  Objective :
 Protection
 Promotion
 Extention
 Getting old is a normal, inevitable biological phenomenon.
 Study of changes which are incident to old age is called
gerontology.

111.  Chronological age : is the number of years a person has
been alive
 Biological age : how old a person seems.

112. Health problems of the aged
 Problems Due To The Ageing Process
 Problems Associated With Long-term Illness
 Psychological Problems

113.  Problems Due To The Ageing Process
 Senile cataract
 Glaucoma,
 Nerve deafness,
 Osteoporosis affecting mobility,
 Emphysema,
 Failure of special senses,
 Changes in mental outlook.

114.  Problems Associated With Long-term Illness
 Degenerative diseases of heart and blood vessels.
 Cancer
 Accidents
 Diabetes
 Diseases of locomotor system
 Respiratory diseases
 Genitourinary system

115.  Psychological Problems :
 Mental changes : Impaired memory, rigid outlook
 Sexual adjustment : physical and emotional disturbances
may occur. Irritability, jealousy and despondency are very
frequent.
 Emotional disorders : bitterness, inner withdrawal,
depression, weariness of life, and even suicide.

116. Management
 Diet and nutrition
 Exercise
 Weight
 Smoking
 Alcohol
 Social activities

117. HelpAge India
 Largest voluntary organization working for the cause and
care of the disadvantaged older people.
 Supports the following programmes :
 Free cataract operations
 Mobile medicare units
 Income generation and micro-credit
 Old-age homes and day-care centres
 Adopt-a-Gran (grand parent)
 Disaster mitigation.