Preventive Care in Geriatrics
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The document discusses the aging process, termed 'jara,' highlighting the challenges faced by the elderly and the increasing elderly population globally and in India. It emphasizes the importance of preventive care for geriatric health, focusing on enhancing quality of life, reducing healthcare burdens, and promoting autonomy through a combination of physical, mental, and social support. The paper outlines various common ailments in geriatrics and suggests Ayurvedic remedies and lifestyle modifications to aid in their management.
Preventive Care in Geriatrics
- 1. Preventive Care in Geriatrics Prof. Y. K. Sharma Dean cum Principal Rajiv Gandhi Govt Post Graduate Ayurvedic College and Hospital Paprola - Himachal Pradesh
- 2. Jara is state of becoming Ksheen (debilitated), physically and psychologically weak as a result of old age usually after 60 years of life. The word geriatrics too is derived from Latin word “geras” meaning “to grow old” Aging is described as a progressive loss of adaptability with passage of time so that individual is less and less able to react abruptly to challenges from the external or internal environment. With time the individual becomes progressively more frail and in need of increasing support to maintain his or her autonomy. Geriatrics or Jara -Definition:
- 3. • Average life span is increasing world while due to better health care and death rate is falling. • Even in developing country like India average life span has touched over 60 years. • World population of the elderly is increasing and by the year 2050, adults older than 65 years will comprise 1/5th of the global population. In India 7% of the population are older than 60 years of age. According to an estimate the likely number of elderly people in India by 2025 will be around 13% • With high load of metabolic, infective, traumatic, surgical, pediatrics, obstetrics patients on existing health care; to accommodate geriatric ailments shall be too much and a serious challenge to meet by health care institutions. • With nuclear families taking shape and young people migrating for livelihood from rural to urban, urban to metropolitan and from metropolitan cities to foreign countries old are left to themselves to face the challenge of old age including health care. Why Preventive Geriatric Health Care ?
- 4. • Quality life • Minimum hospitalization. • Minimum financial burden for health sustaince. • Continuing working actively for self, family, society and nation . • Experience gained over the year becomes asset for society and nation. • Physical, mental, social, religious health to the satisfaction of the individual concerned. • Life to years and not merely years to life. What is desired to be achieved ?
- 5. Body system’s functional regression associated with: Poor physical power Poor immunological state Poor endocrinal and metabolic support Poor neuro-psychiatric state Poor family, social and financial support With added factors like Poor diet Poor physical activity Poor health care availability Etc. Foundation of Health Challenges in Old :
- 6. Cataract – IOL Denture loss – Artificial denture Hearing loss – Hearing aid Osteoarthritis – Joint replacement Ataxia – Prosthetic support BPH – TUR But, what for brain, mind, autonomic and voluntary control over activities ? Extended physical life may be vegetative in nature with low quality of life without -Emotional component, Memory, Insight -With Gross ataxia, Incontinence, Unproductively Common Geriatric Ailments and Physical Remedies:
- 7. Physical care: Through proper Swasthvritta, Dincharya, Ritucharya, Yoga, Biological care : Through required balanced diet, vitamins, essential minerals, specific drugs and rasayanas like Ashwagandha, Chyavanprash, Amritprash, Shilajeet, Medhya rasayana, Mental and Spiritual care: Mangal, Pranipatgamanam, Sadvritta, Aachar rasayana, Aparigraha, Family support Social care : Government through economic support, old age care home, free traveling and health insurance, legal support, terminal care. care through NGO’s Geriatric care through ayurveda:
- 8. Factors responsible: AILMENTS Common GIT Ailments: • Poor denture • Reduced digestive functions • Poor gut absorption • Intestinal dysmotility • Lowered mucosal immunity barrier • Poor pelvic floor strength • Poor sphincter control • Frequent indigestion • Gaseous abdomen • Constipation/stool impaction
- 9. Indigestion: Drugs: Management: • Improve denture • Frequent small meals with nutritious contents • Soft pulpy roughage rich diet. • Dhadimashtak churna • Ginger with Saindhav lavan • Lavanbhaskar churna • Eladi vati • Chitrakadi vati • Drakshasava Etc.
- 10. Avoid constipating foods like: Paneer, eggs, besan, maida, low roughage diet. Avoid drastic purgatives like: Jaipal , danti, snuhi, castor, kutki, preparations. Use: Stool Impaction: Constipation: • Isbhagul husk • Triphala • Haritiki • Amaltas • Abhyarishta • etc. • Evacuation enema • Manual evacuation
- 11. Factors Responsible for Ailments: Common ailments: Respiratory System: • Fixed chest cage and increased residual lung volume • loss of cilliary mucosal clearance of respiratory tract. • Loss of mucosal protection. • Poor power of cough/expectoration. • Self induced and environmental pollution. • Confinement to bed. • Dyspnoea on effort. • Cough/expectoration. • Frequent infections.
- 12. General: Useful Medication: Management: • Regular deep breathing Pranayamic exercises. • Avoid smoking and polluted environment. • Avoid cold air. • Regular steam inhalation . • Frequent change in posture when confined to bed. • Sitopladi and Talisadi Churna • Vasavaleha • Madhuyashthi, Tulsiadi, Gojihvadi Kashaya • Use of Tankan, Narasar as expectorants. • Use of Chayavanprash as protectant
- 13. Factors responsible: Common ailments: Management Cardiovascular system: • Atherosclerosis/arteriosclerosis. • Reduced myocardial function. • Rise in blood pressure. • Obesity. • Associated diseases like diabetes. • Diet and life style advises • Drug therapy • Other measures • Hypertension • CHF • IHD
- 14. Factors responsible for ailments: Common ailments: Urinary System: • Poor concentration power of kidneys. • Poor detrusor function. • Poor mucosal barrier. • BPH. • Increased urinary frequency. • BPH/Prostatic cancer. • Retention of urine. • Frequent urinary tract infections
- 15. General: Drug therapy: Surgical options. Management: • Moderation of fluid and diet intake. • Bladder/Pelvic floor toning exercises. • Varunadi Kashaya • Trinpanchmool kashaya • Chandraprabha vati • Chandanasva • Swetparpati Etc.
- 16. Factors Responsible: Major Ailments: Neuropsychiatric Ailments: • Reduced brain mass • Nuclei degeneration • Demyelination • Senile changes in special senses. • CVA • Dementia/depression • Ataxia/Parkinsonism • Insomnia • Impaired functions of higher senses like cataract, deafness, glaucoma, retinal degeneration etc. • Neurological pains. • Other sensory-motor deficits.
- 17. Loss of higher mental functions – Medhya rasayanas Parkinsonism – Kapikachhu seed churna, Ashwagandha churna Insomnia - Tagar, Vacha, Sarapgandha Panchkarma supports Management:
- 18. Factors Responsible: Common Ailments: • Muscle wasting • Osteoarthrosis / spondylosis • Falls and fractures. Bone, Muscle and Joint Ailments: • Decreased bone mineral density • Reduced muscle mass, power and tone. • Articular degeneration • Physical inertia.
- 19. • Regular physiotherapeutic workup • Prosthetic support • Diet and drug support • Surgical intervention when required. • Yoga • Other special measures Common drug support: • Ashwagandha • Sankh and Praval bhasma • Medicated oils application Management:
- 20. Factors responsible: • Poor epithelial turnover • Loss of skin appendages • Loss of sebaceous layer Common ailments: • Xerosis • Atrophic dermatitis • Frequent skin infections • Senile purpura. MANAGEMENT: • Food rich in vitamins esp. Vit-D • Improving skin moisture and sebaceous layer • Regular Abhyanga. • Drug therapy • Care of skin appendages. Cutaneous Ailments:
- 21. • Screen for hypertension, DM, CAD • Prostate and colorectal cancers • Breast and cervical cancer • Dental ailments • Stress • Depression • Stroke factors Secondary Prevention of Old Age Related Disorders:
- 22. • Staying in family • Open life in villages • Less stress • Regular physical activity • Definite purpose of life • Medical care at hand Ideal Atmosphere for Healthy Ageing:
- 23. • Ahara – Milk, Snehapana, Madhur rasa, Low salt, Laghu aahara • Rasayana • Avoiding alcohol and smoking • Avoiding fasting • Avoiding sexual activity • Regular exercise • Avoiding hard exercising • Regular cold water bath • Day time sleep • Regular abhyanga • Social care • Spiritual care Factors that Sustain Life and Delay Jara:
- 24. THANK YOU