Challenges faced by elderly to meet their health and social requirement and how best we may offer them quality of care

1. Quality Of Care In Elderly- Meeting The Challenges
Dr. Anil Sharma, PhD(N)
Manikaka Topawala
Institute of Nursing-
CHARUSAT,
Accredited Grade “A” with
NAAC

2. Flow to presentation
To illustrate importance for elderly care that why
elderly deserve much centric care
To identify elderly care challenges, and
To practice quality care of elderly

3. Importance For Elderly Care
Physical Ailments & Multiple
Illness:
• Decreased muscle mass
• Diminished energy
• Decreased strength and
function
• Reduced basal metabolic
rate
• Decreased hormones
secretions
• Reduced visual acuity,
• Alteration in functions of all
senses
• Reduced immunity
• Altered functions of renal,
Cardiac, Hepatic
Poor Mental Health:
• Depression
• Substance abuse
• Acute confusional state
(Delirium)
• Dementia (Alzheimer’s disease)
• Grief
• Isolation
• Suicide
Psychosocial issues:
• Adjustment with retirement
• Loss of income & cost of health care
• Loss of skills and competencies
• Diminished quantity and quality of
relationship
• Dependence on governmental and
social system

4. Importance For Elderly Care
• Every second elderly suffering from at least one chronic disease
• Stay in hospitals needed longer period of time
• Body resistance is lowered and they are easily susceptible to infections
• Daily living activities also deteriorate due to immobility, los of poor eye
sight and hearing
• At risk for falls
• Abusing of elderly are also some of important reason for centric care

5. Challenges Toward Elderly Care
• Lack of health promotional strategies/attitude
• Lack of geriatric care knowledge
• Appropriate geriatric health care facility
• Management of disease
• Accessibility and affordability of health care
• Extension of alternative system of medicine
• Home based care
• Implementation issues of government support system
• Lack of any formal social security
• Fiscal security

6. Quality Care Of Elderly: Meeting Challenges
Health Promotion Measures:
• Physical activity (to reduce occurrence of NCD)
• Mental and psychosocial well-being
• Healthy nutrition
• Prevention of fall
• Stopping of smoking (more risk for stroke, cataract, lung
disorder, heart attack)
• Chronic disease management
• Empowerment (the elderly could contribute immensely to
the growth of the community )
• Holistic wellbeing (Concentrate on person’s wellbeing not
just physical health)
• Health promotion at Primary Health Care level

7. Cont….
Geriatric care knowledge and Geriatric health care facility:
It has to address two-fold problems:
1. Basic health promotion to retard the rate of physiological aging
2. Medical management of diseases and disorders
• Must know about drug interaction
• Geriatric pharmacotherapy has to incorporate in medical and
nursing curriculum
• Special training has to impart to medical and nursing staff
regarding geriatric health care especially at primary health care
level
• Health care facility has to create by need of the elderly
population.
• Since 71% of the elderly reside in rural areas, it is mandatory
that geriatric health care services be made a part of the primary
health care services

8. Accessibility And Affordability of Health Care
Accessibility
• Pathological progression of
disease
• Mobility
• Dependency
• family nuclearisation
• Employment
• Economy
• population-wide inequities
(gender, caste, religion, state etc.
• Social/economic status
• Social support
• Stigma & isolation and
• Ecological factors (sanitation,
crime and safety)
Affordability
• Enhancing social security
by insurance schemes,
pension schemes,
Microfinance
• Financial security: as higher
tax exemption, exemption
in age, greater tax
exemption for very senior
citizen,
• Affordable health service,
heavily subsidized for BPL’s

9. Alternative System of Medicine
To improvise geriatric
educational programmes at
medical, nursing and other public
health institutes can be
elaborated by extending the
education to AYUSH (Ayurveda,
Yoga and Naturopathy, Unani,
Siddha and Homeopathy)
professionals who can refill the
deficit of medical
manpower and gaps in delivery of
healthcare to the elderly
AYUSH is notably
strong in terms of
promotion of health
and Longevity, as it has
rich potential to
promote health of the
elderly.

10. Home Based Care
• Provide proper personal hygiene
• Keeping elders active
• Close monitoring on their physical health (signs of weakness)
• Close observations of medications and Adverse effect
• Assist them in their activities daily living
• Respect the elderly person
• Encourage them to volunteer
• Visit them frequently
• Allow them to carry their personal belonging
• Find out some of mutual interest area to mingle with them
• Sit with them and listen their stories
• Dealing with resistance

11. Care for Psychosocial Aspect
• Inform about various security plans to make financial independent.
• Aware them about various government initiative such as
• Income security in old age
 Indira Gandhi National Old Age Pension Scheme
 Public Distribution System
 Microfinance
• Healthcare:
 Affordable health care
 Health insurance schemes
• Safety and Security
• Housing
• Productive Ageing (employment or post retirement
opportunities)
• Welfare

12. References:
• Rajeev, M. M. And Ajikumar, V. J.,”Elderly In India: A Quality Of Life Of Elderly
Persons In Institutional Settings” International Journal Of Development
Research,Vol. 5, Issue, 01, Pp. 2845-2851, January, 2015
• Hurlock B Elizabeth, 1992. Developmental Psychology: A life Span Approach
(5th Edition) New Delhi TATA McGRAW-HILL Publishing Company LTD
• Eisdorfer, Carl, David A. Kessler, and Abby N. Spector, 1989. eds. Caring for the
Elderly: Reshaping Health Policy.ISBN 978-0-8018-3810-1.
• National Policy for senior citizen, 2011, Government of India
• Senior Citizens Guide Revised Edition 2016, Complied And Published By
Policy Research And Development Department
• Linda Anne Silvestri. Comprehensive review for the Nclex-Rn, 2nd south asia
edition, Elsevier;2017.
• Elderly in India 2016, released by ministry of statistic and programme
implementation, government of India.
• National Policy for Senior Citizens, March 2011
• Leena Myrtle, Geriatric nursing, 2nd edition, Jaypee; 2014

13. Thank You