PHYSIOTHERAPY IN ACTIVE AGEINGAN AGE FRIENDLY INITIATIVE

DR ALAKANANDA BANERJEEDHARMA FOUNDATION OF INDIA

Population Ageing in India

Projected to be 113 million, i.e. 8.9% of total populations by the year 2016

• URBANISATION• NUCLEARISATION OF

FAMILY• MIGRATION• DUAL CAREER FAMILIES

PROBLEMS IN ELDERS: CAUSES

STRESSORS

(HEALTH AND SOCIAL PROBLEMS OF THE ELDERLY: A CROSS-SECTIONAL STUDY IN UDUPI TALUK, KARNATAKA.A LENA, K ASHOK, M PADMA,1 V KAMATH, AND A KAMATH)

HEALTH

ISOLATIONFINANCES

ELDERLY CARE MODELS IN INDIA:

• VERY LITTLE EFFORT HAS BEEN MADE TO DEVELOP A MODEL OF HEALTH AND SOCIAL CARE IN TUNE WITH THE CHANGING NEED AND TIME

1. OLD AGE HOME2. ASSISTED LIVING3. RECREATION CENTRE

• OPPORTUNITY FOR INNOVATION IN SOCIAL SYSTEM DEVELOPMENT, IS A MAJOR CHALLENGE.

ELDERLY CARE MODELS IN INDIA:

• ELDERLY SUFFER FROM MULTIPLE AND CHRONIC DISEASES.

• THEY NEED LONG TERM AND CONSTANT CARE.

• THUS A MODEL OF CARE PROVIDING COMPREHENSIVE HEALTH SERVICES TO ELDERLY AT ALL LEVELS OF HEALTH CARE DELIVERY IS IMPERATIVE TO MEET THE GROWING HEALTH NEED OF ELDERLY.

(NATIONAL PROGRAMME FOR THE HEALTH CARE OF THE ELDERLY (NPHCE) AN APPROACH TOWARDS ACTIVE AND HEALTHY AGEING ,OPERATIONAL GUIDELINES, DIRECTORATE GENERAL OF HEALTH SERVICES MINISTRY OF

HEALTH & FAMILY WELFARE GOVERNMENT OF INDIA)

SOLUTION

• ELDERLY ACCESS TO AGE-FRIENDLY AND AFFORDABLE

INFORMATION AND SERVICES

• AGEING IN PLACE

HEALTH AND SOCIAL ISSUES

• Arthritis• RESPIRATORY CARE• CANCER• CARDIOVASCULAR• VISION/CATARACT• BLADDER AND BOWEL

DYSFUNCTION• NEUROLOGICAL

DEFICITS

• ELDER ABUSE

• SOCIAL ISOLATION

• FINANCIAL

• LACK OPPORTUNITIES FOR RE

EMPLOYMENT

• UNAWARENESS OF RIGHTS OF ELDERS.

ACTIVE AGEING

ACTIVE AGEING IS THE PROCESS OF OPTIMIZING OPPORTUNITIES FOR HEALTH, PARTICIPATION AND SECURITY IN ORDER TO ENHANCE QUALITY OF LIFE AS PEOPLE AGE.

VISION: DFI

ATTAINMENT OF UNIVERSAL ACCESS TO EQUITABLE, AFFORDABLE AND QUALITY HEALTH CARE SERVICES, ACCOUNTABLE AND RESPONSIVE TO ELDERLY NEEDS.

DHARMA FOUNDATION OF INDIA

• DHARMA FOUNDATION OF INDIA WAS REGISTERED IN 2010 AS A CHARITABLE TRUST UNDER THE CERTIFICATE SECTION 60 OF THE INDIAN TRUST ACT 1882 IN NEW DELHI ,BY A GROUP OF DEDICATED HEALTHCARE PROVIDERS .

• THE MAIN OBJECTIVE OF THE ORGANIZATION IS TO WORK FOR WELLBEING AND QUALITY OF LIFE FOR DISABLED AND VULNERABLE POPULATION OF INDIA .

STAGES OF ELDER HEALTHCARE

• PREVENTIVE AND EARLY DETECTION

• CURATIVE• FOLLOW UP• REHABILITATION/CHRONIC

CARE

Missing

Health Systems in India

NGO/Trust/SCWO

Private Hospital

Semi-Govt (Public)Hospital Govt. Hospital

Curative care Preventive care

Suggested Preventive Program

Absence of government

policies

Community Care Centre(CCC)

Allied Health ProfessionalsSugarObesityPainBlood pressureDementia

Healthcare in India

THE VARIOUS PROBLEMS FACED BY THE HEALTHCARE INDUSTRY ARE SHORTAGE OF DOCTORS, NURSES AND INFRASTRUCTURES LEADING TO UNAVAILABILITY OF COST EFFECTIVE AND ACCESSIBLE CARE AT THE PRIMARY LEVEL...

NEED OF THE HOUR: INTEGRATED APPROACH TOWARDS COMMUNITY WELLNESS

FORMULATED ON INTERNATIONAL RESEARCH AND KNOWLEDGE BASED ON IMPORTANT PRINCIPLES AND GUIDELINES BY WHO ACTIVE AGEING POLICY AND TOWARDS BUILDING AN AGE FRIENDLY CITY.

OBJECTIVE

• WE COLLABORATE /HANDHOLD WITH NGOS AND OTHER ORGANIZATIONS AT THE GRASS ROOT LEVEL TO IMPLEMENT STRATEGIC MODELS TO OVERCOME PHYSICAL AND SOCIOLOGICAL BARRIERS

• OUR PROJECTS FOR OLDER PERSONS ARE CENTERED AROUND DEVELOPING CARE MODELS BASED ON THE WHO GUIDELINES OF ACTIVE AGEING AND TOWARDS BUILDING AGE FRIENDLY COMMUNITIES.

• THE STRATEGY SUPPORTS FULL PARTICIPATION AND INCLUSION OF OLDER PERSONS IN THE LIFE OF THEIR COMMUNITIES.

MULTI SERVICE CENTRES(MSC) IN COMMUNITY

Multi Service Centre

Preventive

PT/DIETRecreation/day care

Curative

OBJECTIVE (MSC)

• EMPOWER AND CREATE OPPORTUNITIES FOR COMMUNITY DWELLING OLDER PERSONS TO PARTICIPATE IN THEIR HEALTH AND SOCIAL ISSUES.

• DEVELOP HEALTH AND SOCIAL MODELS.

CHRONIC DISEASES

• A CHRONIC CONDITION IS A HUMAN HEALTH CONDITION OR DISEASE THAT IS PERSISTENT OR OTHERWISE LONG-LASTING IN ITS EFFECTS OR A DISEASE THAT COMES WITH TIME.

• THE TERM CHRONIC IS USUALLY APPLIED WHEN THE COURSE OF THE DISEASE LASTS FOR MORE THAN THREE MONTHS.

• INCLUDE ARTHRITIS, ASTHMA, CANCER, COPD, DIABETES AND VIRAL DISEASES SUCH AS HEPATITIS C AND HIV/AIDS.

 Chronic diseases, World Health Organization, retrieved 2012-11-26

AGE-RELATED + CHRONIC DISEASE FACTS• THE MAIN CHRONIC DISEASES DISCUSSED IN THIS REPORT ARE: CARDIOVASCULAR DISEASES, MAINLY HEART DISEASE AND

STROKE; CANCER; CHRONIC RESPIRATORY DISEASES; AND DIABETES.

• THERE ARE MANY OTHER CHRONIC CONDITIONS AND DISEASES THAT CONTRIBUTE SIGNIFICANTLY TO THE BURDEN OF DISEASE ON INDIVIDUALS, FAMILIES, SOCIETIES AND COUNTRIES. EXAMPLES INCLUDE MENTAL DISORDERS, VISION AND HEARING IMPAIRMENT, ORAL DISEASES, BONE AND JOINT DISORDERS, AND GENETIC DISORDERS.

• MENTAL AND NEUROLOGICAL DISORDERS ARE IMPORTANT CHRONIC CONDITIONS THAT SHARE A UNIQUE SET OF DISTINGUISHING FEATURES, AND WHICH WERE REVIEWED RECENTLY BY THE WORLD HEALTH ORGANIZATION .

Preventing CHRONIC DISEASES a vital investmenthttp://www.who.int/chp/chronic_disease_report/contents/part2.pdf

Preventing CHRONIC DISEASES a vital investmenthttp://www.who.int/chp/chronic_disease_report/contents/part2.pdf

THE HEALTH OF THE WORLD IS GENERALLY IMPROVING, WITH FEWER PEOPLE DYING FROM INFECTIOUS DISEASES AND THEREFORE IN MANY CASES LIVING LONG ENOUGH TO DEVELOP CHRONIC DISEASES.

INCREASES IN THE CAUSES OF CHRONIC DISEASES, INCLUDING UNHEALTHY DIET, PHYSICAL INACTIVITY AND TOBACCO USE ARE LEADING TO PEOPLE DEVELOPING CHRONIC DISEASES AT YOUNGER AGES IN THE INCREASINGLY URBAN ENVIRONMENTS OF LOW AND MIDDLE INCOME COUNTRIES.

DISTURBING EVIDENCE OF THIS IMPACT IN MANY OF THESE COUNTRIES IS STEADILY GROWING. THEY ARE ILL EQUIPPED TO HANDLE THE DEMANDS FOR CARE AND TREATMENT THAT CHRONIC DISEASES PLACE ON THEIR HEALTH SYSTEMS AND SO PEOPLE DIE AT YOUNGER AGES THAN IN HIGH INCOME COUNTRIES.

INDIVIDUALS AND THEIR FAMILIES IN ALL COUNTRIES STRUGGLE TO COPE WITH THE IMPACT OF CHRONIC DISEASES, AND IT IS THE POOREST WHO ARE THE MOST VULNERABLE.

CHRONIC DISEASES INFLICT AN ENORMOUS DIRECT AND INDIRECT ECONOMIC BURDEN ON THE POOR, AND PUSH MANY PEOPLE AND THEIR FAMILIES INTO POVERTY.

Preventing CHRONIC DISEASES a vital investmenthttp://www.who.int/chp/chronic_disease_report/contents/part2.pdf

CHRONIC DISEASES

WHAT IS PHYSIOTHERAPY? (WCPT)

THE SCOPE OF PHYSICAL THERAPY PRACTICE IS NOT LIMITED TO DIRECT PATIENT/CLIENT CARE, BUT ALSO INCLUDES:

• PUBLIC HEALTH STRATEGIES• ADVOCATING FOR PATIENTS/CLIENTS AND FOR HEALTH• SUPERVISING AND DELEGATING TO OTHERS• LEADING• MANAGING• TEACHING• RESEARCH• DEVELOPING AND IMPLEMENTING HEALTH POLICY, LOCALLY, NATIONALLY

AND INTERNATIONALLY

WHAT IS PHYSIOTHERAPY? (WCPT)

• PHYSICAL THERAPISTS ARE EXERCISE EXPERTS, PROVIDING SERVICES FOR A WIDE RANGE OF PEOPLE TO OPTIMIZE THEIR PHYSICAL ABILITY.

• THEY PRESCRIBE EXERCISE AS PART OF A STRUCTURED, SAFE, AND EFFECTIVE PROGRAM. AN IMPORTANT PART OF THEIR ROLE IS TO HELP PEOPLE REMAIN ACTIVE AS THEY AGE.

• MORE THAN ANY OTHER PROFESSION, PHYSICAL THERAPISTS (KNOWN IN MANY COUNTRIES AS PHYSIOTHERAPISTS) PREVENT AND TREAT CHRONIC DISEASE AND DISABILITY IN AGING ADULTS THROUGH SPECIFICALLY PRESCRIBED ACTIVITY AND MOVEMENT.

(THE WORLD HEALTH ORGANIZATION)

PHYSIOTHERAPY FOR IMPROVING FUNCTIONAL ABILITY IN ELDERS

OLDER ADULTS ENGAGED IN REGULAR PHYSICAL ACTIVITY DEMONSTRATE IMPROVED:

• BALANCE• STRENGTH• COORDINATION AND MOTOR CONTROL • FLEXIBILITY • ENDURANCE

BENEFITS OF PHYSICAL ACTIVITY FOR OLDER ADULTS

• OVERALL, STRONG EVIDENCE DEMONSTRATES THAT COMPARED TO LESS ACTIVE MEN AND WOMEN, OLDER ADULTS WHO ARE PHYSICALLY ACTIVE:

• HAVE LOWER RATES OF ALL-CAUSE MORTALITY, CORONARY HEART DISEASE, HIGH BLOOD PRESSURE, STROKE, TYPE 2 DIABETES, COLON CANCER AND BREAST CANCER, A HIGHER LEVEL OF CARDIORESPIRATORY AND MUSCULAR FITNESS, HEALTHIER BODY MASS AND COMPOSITION;

• HAVE A BIOMARKER PROFILE THAT IS MORE FAVOURABLE FOR THE PREVENTION OF CARDIOVASCULAR DISEASE, TYPE 2 DIABETES AND THE ENHANCEMENT OF BONE HEALTH; AND

• EXHIBIT HIGHER LEVELS OF FUNCTIONAL HEALTH, A LOWER RISK OF FALLING, AND BETTER COGNITIVE FUNCTION; HAVE REDUCED RISK OF MODERATE AND SEVERE FUNCTIONAL LIMITATIONS AND ROLE LIMITATIONS.

Physiotherapy in Active Ageing

• PHYSICAL THERAPISTS ARE EXERCISE EXPERTS, PROVIDING SERVICES FOR A WIDE RANGE OF PEOPLE TO OPTIMIZE THEIR

PHYSICAL ABILITY.

• THEY PRESCRIBE EXERCISE AS PART OF A STRUCTURED, SAFE, AND EFFECTIVE PROGRAMME. AN IMPORTANT PART OF THEIR

ROLE IS TO HELP PEOPLE REMAIN ACTIVE AS THEY AGE. MORE THAN ANY OTHER PROFESSION, PHYSICAL THERAPISTS

PREVENT AND TREAT CHRONIC DISEASE AND DISABILITY IN AGING ADULTS THROUGH SPECIFICALLY PRESCRIBED ACTIVITY

AND MOVEMENT.

• THE WORLD HEALTH ORGANIZATION ENCOURAGES REGULAR PHYSICAL ACTIVITY FOR OLDER ADULTS, BECAUSE IT HAS BEEN

SHOWN TO IMPROVE THE FUNCTIONAL STATUS AND QUALITY OF LIFE IN THIS GROUP OF INDIVIDUALS.

(WWW.WHO.INT/DIETPHYSICALACTIVITY/FACTSHEET_OLDERADULTS/EN/)

http://www.wcpt.org/sites/wcpt.org/files/files/WPTDay-Active_Aging_C4.pdf

TRAINING ON SELF MANAGEMENT OF HEALTH ISSUES BY PHYSIOTHERAPIST FOR ELDERS IN THE COMMUNITY

STANDARD GUIDELINES FOR ORGANIZATIONS

FORM ELDER GROUPS:• SMALL GROUPS OF 10-15 ELDER SUBJECTS.

• SELECTION OF VOLUNTARY ELDER MEMBERS AS A GROUP LEADER/LOCAL SUPERVISOR.

COLLABORATIVE SESSIONS

• Activity: • WORKSHOPS FOR EDUCATION/EMPOWERMENT OF

ELDERSWORKSHOPS

• THESE WORKSHOPS ARE TAKEN BY HEALTHCARE PROVIDERS, SOCIOLOGISTS/FRIENDS OF ELDERS.

COLLABORATIVE SESSIONS • COMMON HEALTH ISSUES.VIZ CARDIOVASCULAR, ARTHRITIS,

NEURODEGENERATIVE CONDITION, VISION AND HEARING.

• APPROPRIATE EXERCISE FOR MAINTAINING AND IMPROVING STRENGTH, FLEXIBILITY, AND ENDURANCE.

• HEALTHY DIET (BY NUTRITIONIST)

• COMMUNICATING EFFECTIVELY WITH FAMILY, FRIENDS, AND HEALTH CARE PROFESSIONALS

• BENEFITS OF ACTIVE AGEING

DISTRIBUTION OF BOOKLETS

BRIEFS OF THESE LECTURES ARE TRANSLATED IN LOCAL LANGUAGES AND DISTRIBUTED AS BOOKLETS TO THE ELDERLY WHO ATTEND THE WORKSHOPS

Website: www.dharmafoundationofindia.org

Multi Specialty Centre (MSC)

SOCIAL INTERACTION WILL BE ENCOURAGED IN SMALLER GROUPS IN THE MSC OR NEARBY THEIR

HOUSES

EMERGENCY!!

GROUP LEADER CONDUCT EXERCISES/RECREATIONAL

ACTIVITIES/DISCUSSIONS

345 ELDER MEMBERS OF VNKS CHOSEN FOR STUDY

BENEFIT OF ACTIVE AGEING

• IT APPLIES TO BOTH INDIVIDUALS AND POPULATION GROUPS

• BASED ON THREE CONCEPTS: SELF CARE, MUTUAL HELP, SELF PROMOTIONIMPROVED SOCIAL

PARTICIPATION

ACTIVE LIFE DECREASE STRESS,ISOLATION,COGNITIVE

DECLINETAKING CARE OF OTHERS ADD PURPOSE

VOICING OPINION ABOUT ELDER PROBLEMS IN BIGGER FORUMS

Chattarpur-New DelhiHyderabad-SecunderabadNew Barrackpore ,North 24 Paraganas,West BengalNavi Mumbai,MaharashtraHaridwar,Uttar Pradesh

DFI in India

N=35 elders

N=16 FemalesN=19 Males

Duration of Study-3 months

05/01/202340

• CREATE AWARENESS ABOUT ELDER PROBLEMS.• FALLS DUE TO IMBALANCE IN ELDERS.• INTRODUCE TECHNOLOGY TO PREVENT FALLS IN ELDERS.• VALUABLE FUTURE LEARNING OF THEIR OWN LIFE.

HIGH SCHOOL CHILDREN WORKSHOP

CHATTARPUR ,NEW DELHI

ROADS, WATER WORKS AND STREET LIGHTS WHICH WERE HAZARDOUS FOR ELDERS CAUSING MOBILITY IMPAIRMENT DUE TO UNFRIENDLY ENVIRONMENT

2011

ROADS, WATER WORKS, ELECTRICITY REPAIRED THROUGH EFFORTS OF VNKS IN COLLABORATION WITH LOCAL MLA

2013

CHATTARPUR NEW DELHI

DISCUSSION

THE ABOVE RESULTS DEFINE THAT THERE WERE CHANGESELDERS PARTICIPATING IN GROUP EXERCISES IN NEIGHBOURHOOD COMMUNITY CENTRES HAVE IMPROVED THEIR QUALITY OF LIFE.

PERIODIC, RESULT ORIENTED MEETING/SOCIALIZING OF ELDERS HAVING SIMILAR PROBLEM, IN THIS CASE DIABETES SHOWED IMPROVEMENT IN SOCIAL FUNCTIONS, EMOTIONAL WELL BEING AND GENERAL HEALTH .

CONCLUSION

• ACCESS TO THE ENTIRE RANGE OF HEALTH AND SOCIAL SERVICES THAT ADDRESS THE NEEDS AND RIGHTS OF OLDER ADULTS; AND PROTECTION, DIGNITY AND CARE IN EVENTS THAT OLDER ADULTS ARE NO LONGER ABLE TO SUPPORT AND PROTECT THEMSELVES.

(ACTIVE AGEING AND INDEPENDENT LIVING SERVICES: CORE PROPOSITIONS LEADING TO A CONCEPTUAL FRAMEWORK MARK LEYS, SOFIE DE ROUCK VRIJE UNIVERSITEIT BRUSSEL,

(SMIT-MESO) )

CONCLUSION..CONTD• EXERCISES ARE PROVEN TO BENEFIT CHRONIC NON

COMMUNICABLE DISEASE LIKE DIABETES ,THEREFORE DECREASES RISKS OF CARDIAC, BRAIN STROKE, NEUROPATHY ETC

• GROUP EXERCISES OF ELDERS HAVING SIMILAR PROBLEM, MAKES A BETTER COMRADESHIP AND UNDERSTANDING AMONGST ELDERS.

• GROUPS OF ELDERLY SOCIALIZING WITH A SIMILAR PURPOSE , IS AN IMPORTANT COMPONENT OF ACTIVE AGEING FRAMEWORK WHICH IMPROVES QUALITY OF LIFE IN ELDERS.

CONCLUSION..CONTD

• WE HOPE WITH INTRODUCTION OF THE ACTIVE AGEING PROGRAM, DFI CAN UTILIZE THE INEXPLICABLE RESOURCE OF THE ELDER POPULATION IN INDIA THROUGH SELF CARE, MUTUAL HELP AND SELF PROMOTION.

• OUR FUTURE PROPOSAL IS TO CREATE RESEARCH MODELS NEEDS IN THE COMMUNITY TO UNDERSTAND BEST PRACTICES FOR COMMUNITY CARE AND IMPROVEMENT IN QOL OF THE ELDERLY IN INDIA.

WAY AHEAD

• NONMEDICAL INTERVENTIONS CAN ASSIST ELDERS IN COPING WITH AND ADAPTING TO CHANGES AS

ONE AGES.

• HEALTH AND SOCIAL SERVICES DELIVERED WITHIN A NEIGHBOURHOOD BY LOCAL PEOPLE IN LOCAL

ESTABLISHMENTS, AND COMMUNITY-BASED SUPPORT AND VOLUNTARY GROUPS CAN PLAY AN

IMPORTANT ROLE IN DELIVERING SUPPORT AND CARE TO OLDER PERSONS.

• THE SELF-MANAGEMENT AND COMMUNITY WELLNESS PROGRAM (MSC)WILL NOT CONFLICT WITH

EXISTING PROGRAMS OR TREATMENT AS IT IS DESIGNED TO ENHANCE REGULAR TREATMENT AND

DISEASE-SPECIFIC EDUCATION GIVEN BY CLINICIANS/FAMILY PHYSICIANS IN HEALTHCARE ORGANIZATION.

BENEFITS

• INTERVENTIONS OF GROUP ACTIVITIES AND SELF MANAGING CO-MORBIDITIES HAVE IMPROVED MOBILITY AND QUALITY OF LIFE OF ELDERS IN THE COMMUNITY.

• IT MAY FORM A COST EFFECTIVE WAY TO INTRODUCE PREVENTION/EARLY DETECTION OF CO MORBIDITIES IN ELDERS.

• THERE IS MORE AWARENESS ABOUT GOVERNMENT SERVICES AND POLICIES AVAILABLE TO OLDER PERSONS.

Thank you! Interested Physiotherapists May Contact

email: dharma.dfi@gmail.com

Mobile Number:+919811020093Website: www.dharmafoundationofindia.org