The document discusses social geriatrics and problems faced by the aged. It defines key terms and outlines problems faced by the aged including medical, psychiatric, and social issues. It discusses the global response to problems of the aged including frameworks to promote healthy aging. It also provides strategies to address social problems of the aged such as financial insecurity, elder abuse, loneliness, and loss of social roles.
HEALTH PROMOTION IN OLDER ADULT, POPULATION AGEING - CHALLENGES DETERMINANTS OF ACTIVE AGEING HEALTH STATUS OF ELDERS PREVENTIVE GERIATRICS POLICIES AND PROGRAMMES FOR ELDERLY PEOPLE ADVANCING HEALTH AND WELLBEING Of OLD AGE
This document discusses geriatric health needs and gaps in India. It begins by defining the elderly population and noting that India will experience a significant increase in those aged 60+ in coming decades. It then examines the socioeconomic profile of elderly Indians, finding most live in rural areas, are illiterate women, and lack financial security.
The document outlines several health issues facing the elderly, including social isolation, financial dependence, lack of support systems, and high rates of medical conditions like cardiovascular disease and arthritis. It notes gaps in the healthcare system like few geriatric specialists and services. The document concludes by discussing government initiatives and the need for dedicated healthcare programs to address the growing needs of India's expanding elderly population.
This document discusses nutrition during old age. It notes that ageing brings physiological, psychological and immunological changes that influence nutritional status. Some key changes that occur with ageing include reduced taste, smell and gastric function as well as changes in organ functions. The document outlines nutritional requirements for older adults including reduced needs for energy, carbohydrates and proteins but continued needs for vitamins, minerals, water and fibre. Specific nutritional concerns for older adults like osteoporosis, neurological issues, anaemia and immunity are also covered.
This document discusses important considerations for counseling older adult clients. It covers topics like ageism, physical and mental health concerns, family dynamics, abuse/neglect, substance abuse, depression, suicide risks, and sexuality. Counselors are advised to make older clients feel comfortable, understand family roles in dementia cases, address sensitive topics like sex carefully, and be aware of biases against the elderly.
The document discusses several topics related to gerontology and aging:
1. It defines gerontology as the scientific study of aging and lists some myths and misconceptions about older adults.
2. It discusses trends in population aging globally and factors studied in demography related to aging populations.
3. It covers several topics in geriatrics including living options, legal/financial issues, and physiology/pathology of aging.
This document discusses common chronic diseases of old age and strategies for health promotion. It begins by outlining the physiological changes that normally occur with aging and how aging differs between individuals. Common chronic diseases that increase with age like arthritis, hypertension, heart disease, and diabetes are then examined in terms of prevalence, symptoms, risk factors, and impact. The final section emphasizes the importance of lifestyle behaviors for health promotion, including regular exercise, a healthy diet, not smoking, medical screenings, and seeing a doctor regularly to help prevent and manage chronic diseases of aging. Local and online resources for seniors are also provided.
medico social problems of elderly in indiaNaveen Phuyal
This document provides an overview of medico-social problems faced by the elderly population and national programmes in India to address these issues. It discusses key facts about population aging globally and in India. Some of the main challenges faced by elderly Indians include lack of financial security, health issues like chronic diseases, malnutrition, and lack of access to affordable healthcare. Studies have also found issues of social isolation, abuse, neglect and crime against the elderly. The document highlights the heterogeneity among elderly groups and need to address their varying needs. It also notes that population aging will impact society and presents both challenges and opportunities.
HEALTH PROMOTION IN OLDER ADULT, POPULATION AGEING - CHALLENGES DETERMINANTS OF ACTIVE AGEING HEALTH STATUS OF ELDERS PREVENTIVE GERIATRICS POLICIES AND PROGRAMMES FOR ELDERLY PEOPLE ADVANCING HEALTH AND WELLBEING Of OLD AGE
This document discusses geriatric health needs and gaps in India. It begins by defining the elderly population and noting that India will experience a significant increase in those aged 60+ in coming decades. It then examines the socioeconomic profile of elderly Indians, finding most live in rural areas, are illiterate women, and lack financial security.
The document outlines several health issues facing the elderly, including social isolation, financial dependence, lack of support systems, and high rates of medical conditions like cardiovascular disease and arthritis. It notes gaps in the healthcare system like few geriatric specialists and services. The document concludes by discussing government initiatives and the need for dedicated healthcare programs to address the growing needs of India's expanding elderly population.
This document discusses nutrition during old age. It notes that ageing brings physiological, psychological and immunological changes that influence nutritional status. Some key changes that occur with ageing include reduced taste, smell and gastric function as well as changes in organ functions. The document outlines nutritional requirements for older adults including reduced needs for energy, carbohydrates and proteins but continued needs for vitamins, minerals, water and fibre. Specific nutritional concerns for older adults like osteoporosis, neurological issues, anaemia and immunity are also covered.
This document discusses important considerations for counseling older adult clients. It covers topics like ageism, physical and mental health concerns, family dynamics, abuse/neglect, substance abuse, depression, suicide risks, and sexuality. Counselors are advised to make older clients feel comfortable, understand family roles in dementia cases, address sensitive topics like sex carefully, and be aware of biases against the elderly.
The document discusses several topics related to gerontology and aging:
1. It defines gerontology as the scientific study of aging and lists some myths and misconceptions about older adults.
2. It discusses trends in population aging globally and factors studied in demography related to aging populations.
3. It covers several topics in geriatrics including living options, legal/financial issues, and physiology/pathology of aging.
This document discusses common chronic diseases of old age and strategies for health promotion. It begins by outlining the physiological changes that normally occur with aging and how aging differs between individuals. Common chronic diseases that increase with age like arthritis, hypertension, heart disease, and diabetes are then examined in terms of prevalence, symptoms, risk factors, and impact. The final section emphasizes the importance of lifestyle behaviors for health promotion, including regular exercise, a healthy diet, not smoking, medical screenings, and seeing a doctor regularly to help prevent and manage chronic diseases of aging. Local and online resources for seniors are also provided.
medico social problems of elderly in indiaNaveen Phuyal
This document provides an overview of medico-social problems faced by the elderly population and national programmes in India to address these issues. It discusses key facts about population aging globally and in India. Some of the main challenges faced by elderly Indians include lack of financial security, health issues like chronic diseases, malnutrition, and lack of access to affordable healthcare. Studies have also found issues of social isolation, abuse, neglect and crime against the elderly. The document highlights the heterogeneity among elderly groups and need to address their varying needs. It also notes that population aging will impact society and presents both challenges and opportunities.
On the occasion of World Elder-Abuse day -15th June.........
Sharing an article previously published in "Yoga Prasad" Shree Ambika Yoga Kutir, Thane, India Oct.-Dec.2015,
the magazine has Global circulation.
The article focuses on some old-age issues, sometimes overlapped with neurological conditions that are not so openly discussed in many cultures and contribute to family, social, emotional disturbances ultimately affecting human systems on the National and the Global level....
Most of the problems could be addressed if we all wish to do so......
This document discusses social issues and factors in old age. It covers topics like aging concepts, ageism, loneliness, social isolation, retirement, and marriage/widowhood. Regarding loneliness, it describes three types (situational, developmental, internal), risk factors, impacts on health, and potential interventions. Social isolation is also discussed in depth, including its prevalence, attributes, and negative health consequences. Interventions for social isolation focus on convening regular social groups. The relationship between retirement and mental health is complex, with involuntary retirement increasing mental health risks. Marriage provides benefits in old age, but many older women live alone due to higher male mortality rates.
The document discusses aging, disability, and development. It notes that disability is an umbrella term covering impairments, activity limitations, and participation restrictions due to problems with body function/structure, task execution difficulties, and life situation involvement problems respectively. Disability is a complex phenomenon influenced by both individual and societal factors. Common causes of disability and loss of livelihood among older adults include hearing loss, vision problems, and mental disorders. Fewer than 25% of those affected by conditions like Alzheimer's and depression have access to adequate treatment. The document calls for a focus on chronic but treatable conditions and wider access to low-cost interventions to help older adults live productively.
A midlife crisis is a normal transition experienced between ages 40-60 where people take stock of their lives and may make changes. It can involve feelings like unhappiness, boredom, or confusion about identity and life choices. Men may experience issues like decreased sex drive, sleep problems, or changes in appearance. For women, it can involve doubts about value or career, lost confidence, or questioning choices. Both men and women commonly deal with changes in sexuality including issues like erectile dysfunction or reduced libido during this phase. Menopause is also a natural life change where hormone level changes can cause symptoms for several years before and after the last period.
This document discusses issues in nutrition for frail elderly individuals. It provides an overview of physiological changes associated with aging that affect nutritional status. Key points include increased risk of malnutrition and undernutrition due to changes in body composition, digestion, and sensory perception. The document reviews tools for screening and assessing nutritional status. It also discusses nutritional interventions for common geriatric problems like weight loss, sarcopenia, and pressure ulcers. Optimal nutrition is important for successful aging and quality of life.
This document discusses psychological well-being in elderly people. It defines subjective well-being as having three aspects: life satisfaction, positive and negative affect, and a sense of purpose. Subjective well-being is determined by both internal psychological factors like cognitive function and external factors like income, environment, and health. Cross-cultural studies show that life satisfaction decreases with age in some regions but follows a U-shape pattern in others. Maintaining psychological well-being is important for health in older adults.
This is the updated slideshow for the 2011 NFMBR presentation of Geriatrics. We apologize sincerely for the error in the manual, you can both view the slideshow online or download it to your computer and view with PowerPoint.
The document discusses sexuality and sexual health in older adults. It notes that sexuality is an important part of human life at all ages. However, providers often have misconceptions about sexuality in older adults and do not adequately address their sexual health needs. The document outlines several barriers to sexual health for older adults, including physical and psychological changes, health issues, and societal attitudes. It provides guidance for healthcare providers on properly assessing and managing the sexual health needs of their older adult patients.
Common Geriatric Syndromes - July 2022 Dr. A.E.A. Jaiyesimi.pdfAdamu Mohammad
This document discusses geriatric syndromes and the increasing burden of diseases affecting the elderly population in Nigeria. It notes that life expectancy has improved worldwide, leading to an aging population. In Nigeria, reliable data is lacking but estimates suggest around 3.1% of the population is aged 65 and over, a proportion that is increasing. Common geriatric conditions discussed include stroke, Parkinson's disease, dementia, cancers, cardiovascular diseases, diabetes, arthritis, and renal diseases. The document emphasizes that geriatric syndromes can impact quality of life and notes some key problems to assess in elderly patients like falls, memory issues, incontinence, pain, mobility and more. Early detection of these conditions is important for treatment and rehabilitation.
How can we improve the quality of life of an aging person? How can a geriatric physician and a geriatric counselor can work as a team. Who else are the other professionals to be included in the geriatric care team? What are the problems faced by the elderly? These are some of the questions we are trying to find an answer for. Caring for elder persons is getting more and more importance as the number of old people are increasing these days. Relatives alone can't meet the challenges of caring for the old. You need professional who can understand and render proper help in this regard. So geriatric counseling is getting more and more acceptance. Alzheimer's Syndrome, senile dementia, rheumatic pains, feeling of alienation etc are some of the problems counselor have to cope up with.
Healthy aging is a multidimensional process influenced by genetics, lifestyle, environment and healthcare factors. It involves maintaining physical and cognitive function to allow well-being in older age. Key aspects of healthy aging include regular health assessments, nutrition, exercise, managing chronic conditions, mental health, vaccination, sleep, and injury prevention. Geriatric assessments evaluate multiple health domains. Nutrition, exercise, stress management and preventing smoking and excessive drinking promote healthy aging. Public health policies also play a role by supporting factors like financial security, housing, mobility and social connections in older adults.
Elderly care involves caring for those aged 60 and over. As populations age, the percentage of those over 65 is increasing which has led to the emergence of geriatrics as a field. Older adults often require care due to declining health and abilities. Care can be provided in homes, old age homes, or day care centers and includes medical, social, and financial support. Governments have implemented policies to support the elderly including welfare programs and national policies focusing on areas like health, shelter, education, and family support.
The document discusses senior citizens in India, defining them as those aged 60 and above. It outlines the contributions senior citizens make to communities and families through skills, knowledge, and assistance. While elders were once seen as wise, some are now excluded and neglected. The government has enacted policies and schemes to protect seniors' rights and provide financial, health, and other support. Concessions are offered for transportation, healthcare, pensions, and other services to assist senior citizens.
The UK population is aging rapidly, with the number of people over pension age projected to rise significantly in coming decades. This aging population will place greater pressure on public services like healthcare and the state pension system. It may also impact economic growth by reducing the proportion of working age people. However, an older population also presents opportunities for businesses if they adapt to changing spending patterns and demand. Policymakers will need to consider reforms to ensure public services and the welfare system remain financially sustainable in light of these demographic challenges.
Nutrition in older age. Adequate nutrition, especially in older age, aids in the maintenance of health and in decreasing the onset of chronic diseases, contributes to vitality in everyday activity, to energy and mood and helps in maintaining functional independence.
ARGEC - Assessment of Geriatric Depression kwatkins13
This document provides an overview of assessing geriatric depression. It discusses prevalence rates and risk factors for depression in older adults. Common assessment instruments are highlighted, including the Geriatric Depression Scale, Beck Depression Inventory, Hamilton Depression Rating Scale, Center for Epidemiologic Studies Depression Scale, and PHQ-9. Cultural considerations in assessing minority older adult populations are presented. Differential diagnosis between depression, dementia, and delirium is contrasted. Case studies and videos are provided to demonstrate assessment and diagnosis of depression in older adults.
Psychological and social factors affecting aging womanRavi Soni
The document discusses various social and psychological factors affecting aging women. It begins by defining aging and noting that aging is different for women than men due to hormonal changes, diseases, and changes in bodily appearance. It then discusses maintaining stability and accepting changes as a key psychological factor. Social factors include role changes, marriage and widowhood, retirement, and involvement in extended families and groups. The document outlines developmental milestones in old age such as integrating one's life, developing wisdom, conducting life reviews, retirement, grandparenthood, and facing mortality. It concludes by noting benefits of growing old such as a happier outlook and wisdom.
Government Policy, Schemes, Law for Senior Citizens in India Sailesh Mishra
The document discusses government policies and schemes in India for senior citizens. It provides key population figures showing India's aging population is increasing significantly. Currently around 100 million Indians are elderly, and by 2050 nearly 20% of the population will be over age 60. It also notes issues faced by elderly Indians such as poverty, illiteracy, lack of employment, health problems, and abuse. The document outlines international frameworks for aging issues, as well as provisions in the Indian Constitution. It summarizes India's National Policy on Older Persons from 1999 and its key objectives of ensuring welfare and an equitable society for elderly citizens.
The cardiovascular system undergoes several changes with age. As people get older, their heart rate slows, cardiac output decreases, and blood vessels become stiffer. This makes the elderly more vulnerable to cardiovascular diseases like hypertension, heart failure, and stroke. Common symptoms include chest pain, shortness of breath, and fatigue. Treatment involves medications, surgery, and lifestyle modifications to manage risks and conditions.
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
On the occasion of World Elder-Abuse day -15th June.........
Sharing an article previously published in "Yoga Prasad" Shree Ambika Yoga Kutir, Thane, India Oct.-Dec.2015,
the magazine has Global circulation.
The article focuses on some old-age issues, sometimes overlapped with neurological conditions that are not so openly discussed in many cultures and contribute to family, social, emotional disturbances ultimately affecting human systems on the National and the Global level....
Most of the problems could be addressed if we all wish to do so......
This document discusses social issues and factors in old age. It covers topics like aging concepts, ageism, loneliness, social isolation, retirement, and marriage/widowhood. Regarding loneliness, it describes three types (situational, developmental, internal), risk factors, impacts on health, and potential interventions. Social isolation is also discussed in depth, including its prevalence, attributes, and negative health consequences. Interventions for social isolation focus on convening regular social groups. The relationship between retirement and mental health is complex, with involuntary retirement increasing mental health risks. Marriage provides benefits in old age, but many older women live alone due to higher male mortality rates.
The document discusses aging, disability, and development. It notes that disability is an umbrella term covering impairments, activity limitations, and participation restrictions due to problems with body function/structure, task execution difficulties, and life situation involvement problems respectively. Disability is a complex phenomenon influenced by both individual and societal factors. Common causes of disability and loss of livelihood among older adults include hearing loss, vision problems, and mental disorders. Fewer than 25% of those affected by conditions like Alzheimer's and depression have access to adequate treatment. The document calls for a focus on chronic but treatable conditions and wider access to low-cost interventions to help older adults live productively.
A midlife crisis is a normal transition experienced between ages 40-60 where people take stock of their lives and may make changes. It can involve feelings like unhappiness, boredom, or confusion about identity and life choices. Men may experience issues like decreased sex drive, sleep problems, or changes in appearance. For women, it can involve doubts about value or career, lost confidence, or questioning choices. Both men and women commonly deal with changes in sexuality including issues like erectile dysfunction or reduced libido during this phase. Menopause is also a natural life change where hormone level changes can cause symptoms for several years before and after the last period.
This document discusses issues in nutrition for frail elderly individuals. It provides an overview of physiological changes associated with aging that affect nutritional status. Key points include increased risk of malnutrition and undernutrition due to changes in body composition, digestion, and sensory perception. The document reviews tools for screening and assessing nutritional status. It also discusses nutritional interventions for common geriatric problems like weight loss, sarcopenia, and pressure ulcers. Optimal nutrition is important for successful aging and quality of life.
This document discusses psychological well-being in elderly people. It defines subjective well-being as having three aspects: life satisfaction, positive and negative affect, and a sense of purpose. Subjective well-being is determined by both internal psychological factors like cognitive function and external factors like income, environment, and health. Cross-cultural studies show that life satisfaction decreases with age in some regions but follows a U-shape pattern in others. Maintaining psychological well-being is important for health in older adults.
This is the updated slideshow for the 2011 NFMBR presentation of Geriatrics. We apologize sincerely for the error in the manual, you can both view the slideshow online or download it to your computer and view with PowerPoint.
The document discusses sexuality and sexual health in older adults. It notes that sexuality is an important part of human life at all ages. However, providers often have misconceptions about sexuality in older adults and do not adequately address their sexual health needs. The document outlines several barriers to sexual health for older adults, including physical and psychological changes, health issues, and societal attitudes. It provides guidance for healthcare providers on properly assessing and managing the sexual health needs of their older adult patients.
Common Geriatric Syndromes - July 2022 Dr. A.E.A. Jaiyesimi.pdfAdamu Mohammad
This document discusses geriatric syndromes and the increasing burden of diseases affecting the elderly population in Nigeria. It notes that life expectancy has improved worldwide, leading to an aging population. In Nigeria, reliable data is lacking but estimates suggest around 3.1% of the population is aged 65 and over, a proportion that is increasing. Common geriatric conditions discussed include stroke, Parkinson's disease, dementia, cancers, cardiovascular diseases, diabetes, arthritis, and renal diseases. The document emphasizes that geriatric syndromes can impact quality of life and notes some key problems to assess in elderly patients like falls, memory issues, incontinence, pain, mobility and more. Early detection of these conditions is important for treatment and rehabilitation.
How can we improve the quality of life of an aging person? How can a geriatric physician and a geriatric counselor can work as a team. Who else are the other professionals to be included in the geriatric care team? What are the problems faced by the elderly? These are some of the questions we are trying to find an answer for. Caring for elder persons is getting more and more importance as the number of old people are increasing these days. Relatives alone can't meet the challenges of caring for the old. You need professional who can understand and render proper help in this regard. So geriatric counseling is getting more and more acceptance. Alzheimer's Syndrome, senile dementia, rheumatic pains, feeling of alienation etc are some of the problems counselor have to cope up with.
Healthy aging is a multidimensional process influenced by genetics, lifestyle, environment and healthcare factors. It involves maintaining physical and cognitive function to allow well-being in older age. Key aspects of healthy aging include regular health assessments, nutrition, exercise, managing chronic conditions, mental health, vaccination, sleep, and injury prevention. Geriatric assessments evaluate multiple health domains. Nutrition, exercise, stress management and preventing smoking and excessive drinking promote healthy aging. Public health policies also play a role by supporting factors like financial security, housing, mobility and social connections in older adults.
Elderly care involves caring for those aged 60 and over. As populations age, the percentage of those over 65 is increasing which has led to the emergence of geriatrics as a field. Older adults often require care due to declining health and abilities. Care can be provided in homes, old age homes, or day care centers and includes medical, social, and financial support. Governments have implemented policies to support the elderly including welfare programs and national policies focusing on areas like health, shelter, education, and family support.
The document discusses senior citizens in India, defining them as those aged 60 and above. It outlines the contributions senior citizens make to communities and families through skills, knowledge, and assistance. While elders were once seen as wise, some are now excluded and neglected. The government has enacted policies and schemes to protect seniors' rights and provide financial, health, and other support. Concessions are offered for transportation, healthcare, pensions, and other services to assist senior citizens.
The UK population is aging rapidly, with the number of people over pension age projected to rise significantly in coming decades. This aging population will place greater pressure on public services like healthcare and the state pension system. It may also impact economic growth by reducing the proportion of working age people. However, an older population also presents opportunities for businesses if they adapt to changing spending patterns and demand. Policymakers will need to consider reforms to ensure public services and the welfare system remain financially sustainable in light of these demographic challenges.
Nutrition in older age. Adequate nutrition, especially in older age, aids in the maintenance of health and in decreasing the onset of chronic diseases, contributes to vitality in everyday activity, to energy and mood and helps in maintaining functional independence.
ARGEC - Assessment of Geriatric Depression kwatkins13
This document provides an overview of assessing geriatric depression. It discusses prevalence rates and risk factors for depression in older adults. Common assessment instruments are highlighted, including the Geriatric Depression Scale, Beck Depression Inventory, Hamilton Depression Rating Scale, Center for Epidemiologic Studies Depression Scale, and PHQ-9. Cultural considerations in assessing minority older adult populations are presented. Differential diagnosis between depression, dementia, and delirium is contrasted. Case studies and videos are provided to demonstrate assessment and diagnosis of depression in older adults.
Psychological and social factors affecting aging womanRavi Soni
The document discusses various social and psychological factors affecting aging women. It begins by defining aging and noting that aging is different for women than men due to hormonal changes, diseases, and changes in bodily appearance. It then discusses maintaining stability and accepting changes as a key psychological factor. Social factors include role changes, marriage and widowhood, retirement, and involvement in extended families and groups. The document outlines developmental milestones in old age such as integrating one's life, developing wisdom, conducting life reviews, retirement, grandparenthood, and facing mortality. It concludes by noting benefits of growing old such as a happier outlook and wisdom.
Government Policy, Schemes, Law for Senior Citizens in India Sailesh Mishra
The document discusses government policies and schemes in India for senior citizens. It provides key population figures showing India's aging population is increasing significantly. Currently around 100 million Indians are elderly, and by 2050 nearly 20% of the population will be over age 60. It also notes issues faced by elderly Indians such as poverty, illiteracy, lack of employment, health problems, and abuse. The document outlines international frameworks for aging issues, as well as provisions in the Indian Constitution. It summarizes India's National Policy on Older Persons from 1999 and its key objectives of ensuring welfare and an equitable society for elderly citizens.
The cardiovascular system undergoes several changes with age. As people get older, their heart rate slows, cardiac output decreases, and blood vessels become stiffer. This makes the elderly more vulnerable to cardiovascular diseases like hypertension, heart failure, and stroke. Common symptoms include chest pain, shortness of breath, and fatigue. Treatment involves medications, surgery, and lifestyle modifications to manage risks and conditions.
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?
Social determinants, ethnicity and healthJoyce Browne
This document discusses social determinants of health and ethnicity, with a focus on definitions, measurements, and implications for health research. It provides an overview of key concepts related to social determinants of health like inequalities, inequities, and frameworks for understanding their impact. The document also explores challenges in measuring and analyzing ethnicity and social factors, as well as recommendations from reports on improving health equity.
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.
Public health optometry combines principles of public health and optometry. It aims to provide eye care, promote eye health, and train community eye care workers by reaching out to communities. An optometrist applies these principles to address barriers preventing access to services. Public health optometry programs provide access to eye care while educating communities on conditions like cataract, refractive errors, and diabetic eye diseases. Outreach visits are planned to meet local needs, through screening and identifying issues and providing treatments like spectacles.
This document provides an overview of geriatric health in India. It begins with definitions of key terms like gerontology, geriatrics, and active aging. It then discusses the growing elderly population globally and in India. The main health problems faced by elderly Indians are described, including physical, psychological, social, and economic issues. Preventive measures for geriatric health are outlined at the primary, secondary and tertiary levels. Several government policies and programs to support elderly health and welfare are summarized, such as the National Program for Healthcare of the Elderly and schemes providing pensions and healthcare access. Community resources for older adults in Raipur are also briefly mentioned.
Geriatrics focuses on healthcare for elderly patients. It aims to promote health by preventing and treating diseases and disabilities in older adults. Caring for older patients requires understanding their diseases, support systems, and personal goals to create an appropriate care plan. There is no set age threshold for geriatric care; it depends on individual patient needs and specialist availability. Globally and in India, the elderly population is growing rapidly and will nearly double by 2025. Common health issues among the elderly include cardiovascular, respiratory, gastrointestinal, neurological, and accidental problems. The Indian government provides various social and healthcare programs to support the elderly population.
The document defines children, persons with special needs, impairment, disability, and handicap according to various sources. It discusses the global prevalence of disabilities, common types of special needs, and causes of disabilities. In Malaysia, an estimated 2.6% of the population has a disability. The Ministry of Health, Ministry of Women, Family and Community Development, and NGOs provide services for children and persons with special needs, including assessments, treatment, rehabilitation, education support, and welfare assistance.
This document discusses issues related to geriatric care and aging populations. It begins with an introduction to aging and key facts about the global aging situation. Population aging is increasing rapidly around the world, with the number of older persons expected to double by 2050. The document then discusses what aging and geriatrics are, as well as global and national initiatives to address aging populations, including the Madrid International Plan of Action on Aging. It outlines TARAQUI Association's role in aging issues and proposes ways forward, such as enhancing public-private partnerships and establishing an age-friendly society.
Prof. Ron Baecker
The Technologies for Aging Gracefully lab (TAGlab)
Department of Computer Science, University of Toronto
HCII Invited Course
Los Angeles, 4 August 2015
Optometrists play an important role in public health through patient care, observing broader health issues in their communities, educating patients and at-risk groups, specializing in relevant health areas, and identifying issues like high blood pressure, obesity, and smoking that can impact eye health. They are well-positioned to address public health problems across diverse populations and help prevent disease through education and referrals to other providers.
1. The document outlines the ground rules and objectives for a Community Health Nursing class, including starting each day with prayer and Quran recitation, maintaining respect and focus in class, and the roles of the community health nurse.
2. Key concepts that will be covered include defining community, community health, and the community health nurse role. The historical background of public health nursing will also be discussed.
3. Students will learn about health, wellness, illness, disease, and the roles of the community health nurse in different settings like educator, counselor, and advocate.
Geriatric health in public health prospective naveen shyam
The document summarizes information about geriatric health and policies related to senior citizens in India. It discusses:
1) The definition and scope of geriatrics according to WHO. It also discusses the size of the geriatric population globally and in India.
2) Key policies and programs introduced by the Indian government to address the health and welfare of senior citizens, such as the National Policy on Older Persons, Maintenance and Welfare of Parents Act, National Program for Healthcare of the Elderly, and pension schemes.
3) It also outlines the role of NGOs like HelpAge India in providing services and care for senior citizens.
A webinar on ' Concept of Impairment, Disability, and Handicap' organised by Department of Education,
Manonmaniam Sundaranar University,
Tirunelveli.
Invited Resource Person
Dr. R. P. Deepa,
Assistant Professor,
NVKSD College of Education,
Attoor.
Between 2015 and 2050, the proportion of the world's population over 60 will nearly double from 12% to 22%. By 2050, 80% of older people will live in low- and middle-income countries. As people age, they are more likely to experience multiple health conditions at once. Maintaining healthy behaviors throughout life contributes to reducing disease risk and improving mental and physical capacity in older ages.
Legal & ethical issues provisions and programmes for elderlypradeepmk8
This document discusses several ethical issues related to research involving elderly subjects. It notes that elderly subjects may be more vulnerable due to physiological and psychological factors. Key issues include obtaining proper informed consent, assessing subjects' ability to make decisions, and evaluating risks and benefits of research for this population. The document calls for more interdisciplinary research on ethical guidelines to properly address these challenges and protect elderly participants.
This document discusses safeguarding, wellbeing, and inter-professional practices related to supporting children and young people. It outlines key aspects of the Teachers' Standards, the Every Child Matters framework, and agencies involved in safeguarding. It also addresses original and continued focuses of inter-professional work, sharing concerns, measuring happiness and wellbeing, bullying resources, mental health statistics, and strategies to promote wellbeing and safeguarding in the classroom.
4 dow-ifa presentation on health promotion and older peopleifa2012_2
1) The document discusses health promotion strategies for older adults, including education, physical activity programs, volunteering, and age-friendly cities.
2) Evidence shows multi-factorial programs that incorporate social, educational, physical activity, and participation components can provide the most benefits to healthy aging.
3) The Active Aging Framework provides guidance for understanding health in older adults and for developing broad-based health promotion programs.
Similar to Social Geriatrics: Problems of the Aged and Identification of Predisposing Factors (20)
This document summarizes a presentation on stress, anxiety, and depression. It discusses what stress is, how the body responds to stress, and common stress disorders. It also examines anxiety as a future-oriented response to threats and lists different anxiety disorders. Finally, it defines depression as a mood disorder and outlines its major symptoms and management strategies, which include seeking medical help, maintaining social support systems, and avoiding alcohol or drugs.
This document discusses nutritional surveillance. It begins with an introduction defining nutritional surveillance as the regular collection and analysis of nutrition data. It then outlines the purpose of nutritional surveillance, which includes monitoring nutrition situations, informing policies, and tracking program progress. The document also provides a brief history of nutritional surveillance and describes the process involving data collection, analysis, dissemination and decision making. It further discusses challenges and provides guidance on establishing nutritional surveillance systems.
Management of sewage and waste water disposalOsahon Otaigbe
The document discusses various methods of excreta and sewage disposal. It begins with definitions of terms like sewage and sullage. It then describes different types of latrines for excreta disposal in unsewered areas like pit latrines, ventilated improved pit latrines, borehole latrines, and pour-flush latrines. It also discusses trench latrines and composting toilets. The document emphasizes the importance of proper sanitation and sewage management for public health.
PRINCIPLES OF PUBLIC HEALTH NUTRITION PROGRAMME.pdfOsahon Otaigbe
This document outlines the principles of public health nutrition programs. It discusses several key points:
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Social Geriatrics: Problems of the Aged and Identification of Predisposing Factors
1. SOCIAL GERIATRICS:
Problems of the Aged and
Identification of
Predisposing Factors
DR. OSAHON OTAIGBE
Department of Community Medicine
Irrua Specialist Teaching Hospital
13th January 2020
2. Outline
• Definition of terms
• Introduction
• Problems of the aged
• Global response
• Healthy ageing
• Case study
• The ICOPE package of tools
• Awareness days
• Individual response
• Breaking limits
• References
2
3. Definition of terms…1
•Geriatrics –The branch of medicine
specializing in the health and illnesses of
older age and their appropriate care and
services
•Gerontology –The study of the social,
psychological and biological aspects of
ageing
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Social geriatrics - Dr. Osahon Otaigbe 3
4. •Healthy ageing –The process of developing
and maintaining the functional ability that
enables well-being in older age
•Functional ability –The health-related
attributes that enable people to be and to
do what they have reason to value
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Social geriatrics - Dr. Osahon Otaigbe 4
Definition of terms…2
5. •Intrinsic capacity –The composite of all
the physical and mental capacities of an
individual
•Ageism –The stereotyping and
discrimination against individuals or
groups on the basis of their age
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Social geriatrics - Dr. Osahon Otaigbe 5
Definition of terms…3
6. •Long-term care –The activities undertaken
by others to ensure that people with or at
risk of a significant ongoing loss of intrinsic
capacity can maintain a level of functional
ability consistent with their basic rights,
fundamental freedoms and human dignity.
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Social geriatrics - Dr. Osahon Otaigbe 6
Definition of terms…4
7. Introduction…1
•People worldwide are living longer. Most
people today can expect to live into their
sixties and beyond.
•By 2050, the world’s population aged 60
years and older is expected to total 2 billion,
up from 900 million in 2015. (WHO, 2015)
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Social geriatrics - Dr. Osahon Otaigbe 7
8. •With longer life comes opportunities as
well as problems.
•This presentation will highlight the
problems of the aged, the predisposing
factors and how these problems can be
managed.
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Social geriatrics - Dr. Osahon Otaigbe 8
Introduction…2
9. Who is an older person?
•No general agreement
•Chronological age/biological age vs sociocultural
markers
•WHO: ≥ 65 years
•UN: ≥ 60 years
•Developed countries vs less developed countries
•Eligibility for retirement pensions
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 9
10. Demography –The Global Picture
•Between 2015 and 2050, the proportion of the
world’s population over 60 years will nearly
double from 12% to 22%. (UN, 2017)
•By 2020, the number of people aged 60 years and
older will outnumber children younger than 5
years. (WHO, 2015)
•By 2050, one in every five persons will be 60
years of age or older (WHO, 2015)
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Social geriatrics - Dr. Osahon Otaigbe 10
11. Demography –The Nigerian Picture
•According to the 2006 census, there are
6,987,047 older persons ≥ 60 years (4.98% of
total population).
•This is projected to rise to 6% in 2025 and 9.9% in
2050, representing a doubling within 45 years.
•The 2018 NDHS estimates that 3.9% are in the 65
and above dependency age group. (NPC and ICF,
2019)
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 11
12. Different classifications exist
•Health problems
➢Medical problems
➢Psychiatric/psychological problems
•Social problems
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Social geriatrics - Dr. Osahon Otaigbe 12
Problems of the aged
13. •Biologically, ageing is associated with the
gradual accumulation of a wide variety of
molecular and cellular damage
•Over time, this damage leads to
➢a gradual decrease in physiological reserves,
➢an increased risk of many diseases, and
➢a general decline in the capacity of the individual
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Social geriatrics - Dr. Osahon Otaigbe 13
Health problems
14. • Senile cataract (from denaturation of lens protein)
• Arcus senilis – corneal clouding
• Presbyopia – loss of accommodation
• Ptosis
• Glaucoma
• Blindness
• Presbycusis – degeneration of cochlear hair cells
• Nerve deafness
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Social geriatrics - Dr. Osahon Otaigbe 14
Eye/Ear
15. •Loss of teeth
•Gum diseases
•Poorly fitted dentures
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Social geriatrics - Dr. Osahon Otaigbe 15
Dental
17. •Impaired cognition and behavior
•Alzheimer’s disease and other dementias
•Parkinson’s disease
•Bradykinesia
•Impaired thermoregulation
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Social geriatrics - Dr. Osahon Otaigbe 17
Central nervous system
19. •Reduced cough reflex and ciliary action
giving rise to RTIs
•Reduced lung elasticity giving rise to
COPD and asthma
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Social geriatrics - Dr. Osahon Otaigbe 19
Respiratory system
26. Social problems…2
•Insecurity
•Loss of status
•Loss of friends
•Prejudice, stereotyping and
discrimination
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 26
27. Elder abuse…1
•Elder abuse is a single or repeated act, or
lack of appropriate action, occurring
within any relationship where there is an
expectation of trust, which causes harm
or distress to an older person. (WHO,
2018)
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 27
28. •It can be:
➢Physical abuse
➢Psychological/emotional abuse
➢Financial abuse
➢Sexual abuse
➢Neglect
•Each type may be intentional or unintentional; it can
occur at home or in institutions
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 28
Elder abuse…2
29. Risk factors…1
Victim risk factors
•Poor physical and mental health
•Gender: female
•Age: increased risk in those > 74 years
•Significant disability
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 29
30. Victim risk factors contd.
•Social isolation
•Low socioeconomic status
•Financial dependence
•Living alone with abuser
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 30
Risk factors…2
31. Risk factors…3
Abuser risk factors
•Mental disorders
•Substance abuse
•Dependence on the abused
•Living alone with victim
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 31
32. Family/Societal risk factors
•Long history of poor family relationships
•Ageist stereotypes
•Cultural norms
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 32
Risk factors…4
33. Institutional risk factors
•Poorly trained staff
•Poorly motivated staff
•Low standards for health care
•Deficient physical environment
•Policies operating in the interest of the
institution rather than the residents
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 33
Risk factors…5
35. Global response to problems of the
aged…1
•International legal and policy frameworks
➢International human rights law (UN, 1966)
➢The Madrid international plan of action
on ageing (UN, 2002)
➢Active ageing concept (WHO, 2002)
➢Healthy ageing concept (WHO, 2016)
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 35
36. •The new global focus for health care in
older age is on healthy ageing
•Healthy ageing aims to optimize people’s
intrinsic capacity and functional ability as
they age.
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 36
Global response to problems of the
aged…2
37. Fig 1: A public health framework for healthy ageing: opportunities for
public health action across the life course 37
38. Healthy ageing
•Health systems should be designed to
encourage healthy ageing.
➢Adapting interventions to individuals and
their levels of capacity
➢Implement older-person-centred and
integrated care
➢Align health systems
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 38
39. Age-friendly health systems…1
•Age-friendly hospitals built with the elderly
in mind e.g. elevators, ramps, suitable stairs
with hand railings, non-slip flooring, rest
areas with comfortable seats, signs that are
large, clear and well lit.
•Geriatric services
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 39
40. •A workforce transformed to respond to
the needs of the aged
➢Changes in preservice training
➢Training and retraining of health workers
➢Multidisciplinary teams
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 40
Age-friendly health systems…2
41. •Ensuring access to appropriate medical products,
vaccines and technologies
•Addressing the problem of polypharmacy
•Readjustment of essential medicines list
•Availability and affordability of assistive devices
•Advanced technologies e.g. wearable devices,
robotic assistance, virtual social networks etc
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 41
Age-friendly health systems…3
42. •Policy reforms
•Health-financing policies in line with
universal health coverage
•Evolution of formal long-term care services
designed in a way that facilitates older
people’s autonomy and dignity and also
maintains their social networks
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 42
Age-friendly health systems…4
43. Addressing the social problems…1
Financial security
•Pensions, assets, social safety net
•Social protection is a fundamental human right.
•Reliance on social protection should not be
stigmatizing
•Example – social pension in Chile, universal
pension in Namibia
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 43
44. Housing problems
•Market-driven housing
•Social housing schemes
•Assisted-living facilities
•Continuing-care communities
•Shared-living arrangements
•Family
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 44
Addressing the social problems…2
45. •The United Nations’ Convention on the
rights of persons with disabilities and
optional protocol recognizes the equal right
of all persons with disabilities to live in their
community, to choose where and with
whom they want to live, and to not be
obliged to reside in a particular living
arrangement. (UN, 2006)
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 45
Addressing the social problems…3
46. •Home modifications
➢Physical accessibility e.g. removing obstacles
, providing mobility and safety aides (such as
grab bars in showers and near toilets)
➢Comfort
➢Safety e.g. nonslip flooring in bathrooms
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 46
Addressing the social problems…4
47. Elder abuse
•Multidisciplinary teams
•Helplines
•Monitoring of bank use
•Support for caregivers – training, information,
respite care
•Emergency shelter for victims
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 47
Addressing the social problems…5
48. Elder abuse
•Professional awareness campaigns
•Residential care policies to define and
improve standards of care
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 48
Addressing the social problems…6
49. Loneliness and social isolation
•Identification of those at risk e.g. those recently
bereaved or recently retired
•Create opportunities for meaningful social roles
and reciprocal relationships e.g. Experience
Corps in USA
•Improve access to information and
communication technologies
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 49
Addressing the social problems…7
50. Loss of status/social roles (ability to contribute)
•Volunteering
•Challenge ageism and create inclusive
environments that embrace age diversity
•Abolish mandatory retirement ages
•Support gradual retirement options and flexible
work arrangements
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 50
Addressing the social problems…8
51. •Consider incentives that encourage
employers to retain, train, hire, protect
and reward older workers
•Help older adults plan for the second half
of life and invest in lifelong learning
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 51
Addressing the social problems…9
52. Key requirements for healthy ageing
•A change in the way we think about ageing
and older people
•Creation of age-friendly environments
•Alignment of health systems to the needs of
older people
•Development of systems for long-term care
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 52
53. Case Study: AgeWell Programme,
CapeTown, South Africa…1
•A pilot project to develop community based
peer-to-peer support in CapeTown, South
Africa
•In Khayelitsha – South Africa’s largest
township and one of the poorest areas of
CapeTown – 28 older community members
were trained as peer supporters.
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 53
54. Case Study: AgeWell Programme,
CapeTown, South Africa…2
•Working in pairs, they made home visits
to 211 older people in their community.
•The visits aimed to foster companionship
and social support, and generate a sense
of community; they were also used to
identify health and social needs.
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 54
55. Case Study: AgeWell Programme,
CapeTown, South Africa…3
•Where needs were identified, older people
were referred to health-care providers or
social services.
•Referrals were generated using a
smartphone loaded with a screening
instrument that included basic questions in
addition to the observations made by the
peer supporters during the home visit
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 55
56. •A study assessed the benefits of this pilot
project and found multiple benefits (Besser
and Rohde, 2015)
•Older people who received home visits
showed significant improvements
•Older people’s ability to meet their basic
needs was enhanced
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 56
Case Study: AgeWell Programme,
CapeTown, South Africa…4
57. •Peer supporters’ abilities to learn, grow and
make decisions were enhanced
•Older people’s abilities to build and maintain
relationships were strengthened
•Older people’s ability to contribute to their
communities was enhanced
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 57
Case Study: AgeWell Programme,
CapeTown, South Africa…5
58. The ICOPE package of tools…1
•Integrated Care for Older People
•Launched on the International Day of
Older Persons 1 October 2019
•Purpose – to help health care and social
workers provide better care and support
for older people
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 58
59. •It provides evidence-based guidance on
interventions to manage common
declines in capacity in older age
•Recommendations were made based on
appraisal and synthesis of available best
evidence.
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 59
The ICOPE package of tools…2
60. •Recommendations were made in 3 major
areas
➢Declining physical and mental capacities
➢Geriatric syndromes associated with care
dependency
➢Caregiver support
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 60
The ICOPE package of tools…3
61. 61
Fig 2: ICOPE recommendations for declining physical and mental capacities
62. 62
Fig 3: ICOPE recommendations for declining physical and mental capacities
63. Awareness days for the elderly
•World Elder Abuse Awareness Day – June
15
•International Day for Older Persons –
October 1
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 63
66. The decade of healthy ageing (2020
– 2030)…1
•An opportunity for ten years of global
concerted, catalytic and collaborative
action to improve the lives of older
people, their families, and the
communities in which they live.
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 66
67. •The proposal for the decade shall be
discussed byWHO’s Executive Board at
their 147th meeting to be held in Geneva
in February 2020.
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 67
The decade of healthy ageing (2020
– 2030)…2
68. Individual response…1
•Adopt a healthy lifestyle
➢Be physically active
➢Eat a healthy diet
➢Avoid the harmful use of alcohol
➢Avoid smoking or using tobacco products
➢Have a positive outlook
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 68
69. •The earlier people adopt these
behaviours, the better their chances of
enjoying a healthy old age.
•“If I knew I was going to live this long, I’d
have taken better care of myself.” Mickey
Mantle
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 69
Individual response…2
70. “Good health adds life to years”
(World health day 2012 slogan)
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 70
71. Breaking limits
On 16 October 2011, Fauja Singh became
the first 100 year old to complete a
marathon
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 71
77. •“Once I step into that boxing ring at the
young age of 63, win, lose or draw, I
would make history as the oldest boxer
to fight and defend his title.”
•Bashiru LawrenceAli (aka BashAli)
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 77
79. Conclusion
•There are myriads of problems that come
with ageing.
•The problems as well as the solutions are
complex and demand a paradigm shift
that looks at old age as a privilege rather
than a predicament.
13-01-2020
Social geriatrics - Dr. Osahon Otaigbe 79
80. References
• Besser M and Rohde S, 2015. World Health Organization, Kobe Centre; Case study in South Africa:
AgeWell, a peer-support service in a community setting to improve well-being and health among
older persons living in a peri-urban township of CapeTown.
• National Population Commission (NPC) [Nigeria] and ICF, 2019. Nigeria Demographic and Health
Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.
• United Nations, 2006. Convention on the Rights of Persons with Disabilities and Optional Protocol.
NewYork: United Nations available at http://www.un.org/development/desa/disabilities/convention-
on-the-rights-of-persons-with-disabilities [accessed 12 January 2020).
• United Nations, 2017. Department of Economic and Social Affairs.World Population Ageing 2017:
Highlights. NewYork: United Nations available at
http://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Highlights.p
df [accessed 2 January 2020).
• World Health Organization, 2015. World report on ageing and health. Geneva: World Health
Organization available at https://apps.who.int/iris/handle/10665/186463 [accessed 2 January 2020]
• World Health Organization, 2018. Elder abuse fact sheets available at https://www.who.int/news-
room/fact-sheets/detail/elder-abuse [accessed 12 January 2020]
80