PREVENTIVE CARE IN ELDERLY To prevent disability and maintenance of function ….> quality of life (physical, mental, social, economy) Sharon Gondodiputro dr., MARS.,MH Dept. Of Public Health Faculty of Medicine Unpad

Pendekatan Wellness Fisik : menjaga kesehatan fisik: quality of life : makanan yang baik, olahraga teratur, perawatan kesehatan dan menggunakan pelayanan kesehatan yang sesuai Emosional: mampu mnegekpresikan perasaan dan dapat menerima perasaan orang lain dan positive thinking Intelektual: melalui pendidikan formal atau informal, serta kegiatan kognitif : membaca, menulis, melukis

Sosial: berkontribusi terhadap lingkungan dan masyarakat, mampu hidup berdampingan secara harmonis dengan sesama Vokasional: mampu memberdayakan diri dalam berbagai aktivitas, baik secara relawan maupun pekerjaan yang membuahkan penghasilan atau kepuasan Spiritual: mampu menghargai dan mensyukuri hidup dan kehidupan

Mental/Spiritual/Emotional Social No 45-59 Years (PRE SENIUM) 1 Physical They should know the consequences because of aging Periodically health examination Physical activity Nutrition 2 Mental/Spiritual/Emotional Ready to face process of aging 3 Social Emptynest to retirement Hobbies development 4 Economy/Vocational Maybe still work ...... > savings

Mental/Spiritual/Emotional Social No 60-70 Years 1 Physical Periodically health examination Physical activity Nutrition Aids devices 2 Mental/Spiritual/Emotional Mental status assessment 3 Social Emptynest, retirement, death of spouses Social activities : hobbies, community 4 Economy/Vocational Savings or dependent to their children

Mental/Spiritual/Emotional Social No > 70 Years 1 Physical Periodically health examination Physical activity Nutrition Aids devices Care givers ??? Home environment assessment ?? 2 Mental/Spiritual/Emotional Mental status assessment 3 Social Emptynest, retirement, death of spouses Social activities : hobbies, community 4 Economy/Vocational Savings????

ROLES OF CLINICIANS 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

How and where to care our older people ???? OUR HOME ???? NURSING HOME/panti werdha ? HOSPITAL ? CARE GIVER ENVIRONMENTAL ASSESSMENT IS THERE ANY??? IF NOT ????? COSTLY COMMUNITY BASED HOSPITAL BASED

Community approach for elderly POSBINDU (Pos Pembinaan Terpadu ) or Posyandu Lansia

POSBINDU Definition Suatu 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 Kegiatan pengukuran berat badan, tinggi badan (BMI) Kegiatan pemeriksaan tekanan darah Kegiatan pemeriksaan kadar HB, gula darah dan kolesterol darah ( 6 bulan sekali) Kegiatan konseling dan penyuluhan kesehatan, gizi Konseling usaha ekonomi produktif Kegiatan aktivitas fisik/senam seminggu sekali

Proses Kegiatan Posbindu Enter Exit Informasi dan kegiatan sosial 5 Sambil menunggu giliran dilakukan penyuluhan kelompok Proses Kegiatan Posbindu 4 Registrasi dan pencatatan oleh kader Konseling individu 1 Tinggi badan, berat badan (BMI) Pengukuran tekanan darah, lab sederhana, terapi 2 3

Predictors of caregiver burden THE PATIENT is demented and/or disruptive is highly dependent on the caregiver

Predictors of caregiver burden THE CAREGIVER feels guilty about anger and resentment toward the patient had a conflictual relationship with the patient before the illness does not understand much about the patient’s condition has his/her own illness and/or disability is depressed, isolated or lonely has poor relationhips with other family members has little personal time away from caregiving

Predictors of caregiver burden THE FAMILY denies the patient’s diagnosis leaves most of the caregiving to one person is in conflict has few financial resources has conflictual relationship with the medical providers

Predictors of caregiver burden THE CLINICIAN ??