PREVENTIVE CARE IN ELDERLY

To prevent disability and maintenance of functions

Sharon Gondodiputro dr., MARS.,MHDept. Of Public Health Faculty of

MedicineUnpad

PREVENTIVE CARE IN ELDERLY

To prevent disability and maintenance of function ….> quality of life (physical, mental, social, economy)

Sharon Gondodiputro dr., MARS.,MHDept. Of Public Health Faculty of

MedicineUnpad

Pendekatan Wellness

1. Fisik : menjaga kesehatan fisik: quality of life : makanan yang baik, olahraga teratur, perawatan kesehatan dan menggunakan pelayanan kesehatan yang sesuai

2. Emosional: mampu mnegekpresikan perasaan dan dapat menerima perasaan orang lain dan positive thinking

3. Intelektual: melalui pendidikan formal atau informal, serta kegiatan kognitif : membaca, menulis, melukis

4. Sosial: berkontribusi terhadap lingkungan dan masyarakat, mampu hidup berdampingan secara harmonis dengan sesama

5. Vokasional: mampu memberdayakan diri dalam berbagai aktivitas, baik secara relawan maupun pekerjaan yang membuahkan penghasilan atau kepuasan

6. Spiritual: mampu menghargai dan mensyukuri hidup dan kehidupan

Pembagian umur lansia?

No 45-59 Years (PRE SENIUM) 1 Physical They should know the

consequences because of agingPeriodically health examinationPhysical activityNutrition

2 Mental/Spiritual/Emotional

Ready to face process of aging

3 Social Emptynest to retirementHobbies development

4 Economy/Vocational Maybe still work ...... > savings

No 60-70 Years1 Physical Periodically health

examinationPhysical activityNutritionAids devices

2 Mental/Spiritual/Emotional

Mental status assessment

3 Social Emptynest, retirement, death of spousesSocial activities : hobbies, community

4 Economy/Vocational Savings or dependent to their children

No > 70 Years1 Physical Periodically health examination

Physical activityNutritionAids devicesCare givers ??? Home environment assessment ??

2 Mental/Spiritual/Emotional

Mental status assessment

3 Social Emptynest, retirement, death of spousesSocial activities : hobbies, community

4 Economy/Vocational

Savings????

GUIDING through the intricacies of the health care delivery system (technological procedures)

COORDINATING with multidisciplinary teams ADVOCATING choice CONSULTING decision making process COLLABORATING with family caregivers SUPPORTING the patient and family

caregivers especially in the situations where care givers is labor intensive and demanding

ROLES OF CLINICIANS

How and where to care our older people ????

How and where to care our older people ????

OUR HOME ????

NURSING HOME/panti werdha ?

HOSPITAL ?

• CARE GIVER• ENVIRONMENTA

L ASSESSMENTIS THERE ANY??? IF NOT ?????

COSTLY

COMMUNITY BASED HOSPITAL BASED

Community approach for elderly

POSBINDU (Pos Pembinaan Terpadu ) or Posyandu Lansia

POSBINDU

DefinitionSuatu wadah pelayanan kepada lanjut usia di masyarakat, yang proses pembentukan dan pelaksanaannya dilakukan oleh masyarakat bersama LSM, lintas sektor pemerintah dan non pemerintah, dengan menitik beratkan pada upaya preventif dan promotif.

Kegiatan

1.Kegiatan pengukuran berat badan, tinggi badan (BMI)

2.Kegiatan pemeriksaan tekanan darah3.Kegiatan pemeriksaan kadar HB, gula

darah dan kolesterol darah ( 6 bulan sekali)

4.Kegiatan konseling dan penyuluhan kesehatan, gizi

5.Konseling usaha ekonomi produktif6.Kegiatan aktivitas fisik/senam

seminggu sekali

Proses Kegiatan Posbindu

Registrasi dan

pencatatan oleh kader

Tinggi badan, berat badan (BMI)

Pengukuran tekanan darah, lab sederhana,

terapi

Konseling individu

Informasi dan kegiatan sosial Sambil menunggu

giliran dilakukan penyuluhan kelompok

Enter Exit

1

2 3

4

5

Predictors of caregiver burden

THE PATIENT

is demented and/or disruptive

is highly dependent on the caregiver

Predictors of caregiver burden

THE CAREGIVERfeels guilty about anger and resentment toward the patienthad a conflictual relationship with the patient before the illnessdoes not understand much about the patient’s conditionhas his/her own illness and/or disabilityis depressed, isolated or lonelyhas poor relationhips with other family membershas little personal time away from caregiving

Predictors of caregiver burden THE FAMILY

denies the patient’s diagnosisleaves most of the caregiving to one personis in conflicthas few financial resourceshas conflictual relationship with the medical providers

Predictors of caregiver burden

THE CLINICIAN

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