Professional Documents
Culture Documents
Geriatric Health Nepal
Geriatric Health Nepal
problems and
solutions
including
community based
rehabilitation
Presenter:
Santoshi Paudel
MPH 2023
CPH and CM
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Geriatrics
The term geriatrics originates from the Greek geron meaning "old man", and iatros
meaning "healer".
Geriatrics: A branch of medicine that deals with the problems and diseases of old age
and the medical care and treatment of aging people.
Its main aims:
o to promote health
o to prevent and treat diseases
o to prevent the disabilities in older adults.
• World Assembly on aging adopted, as its main focus of concern, the population
aged 60 or over as elderly population.
• The United Nation agreed cutoff is 60+ years to refer to the older population.
• In context of Nepal, people who are 60 years and above. (Senior Citizen Act 2063)
What could be the difference between the term geriatrics and elderly?
Geriatrics refers to the branch of medicine whereas elderly is a demographic term used to
1400
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800 761
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1960
260 2021
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Source: World Social Report, 2023
2050
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Global scenario contd…
Source: World
Social Report,
2023
Source: CBS
3. National Health 6.20 In accordance with the concept of health across the
Policy lifecycle, health services around safe motherhood, child health,
adolescence and reproductive health, adult and senior citizen
shall be developed and expanded
9. Geriatric Health To motivate senior citizens to lead a healthy life and to create
Service Strategy, awareness at the family and community level to increase
2078 health-promoting work.
11. Procedure for Senior As per the Senior Citizens Act 2006, at least two seats are
Citizens in Public reserved for the senior citizens and concession of at least Fifty
Transport-2014 percent on the passenger fare
Vision: “A meaningful, quality and healthy life for all senior citizens”
Goal: To enable senior citizens to lead active and quality lives on the basis of
optimum health protection and effective health service delivery.
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Strategies
1. Motivate senior citizens for healthy living and enhance awareness at family and community
levels to reinforce health promoting actions. (Objective 1)
2. Strengthen and expand the health protection system for senior citizens. (Objective1)
3. Increase access to, and the affordability and utilization of quality health services and assistive
devices by senior citizens. (Objective 1)
4. Develop a senior citizen-inclusive health system to address the health needs of senior citizens in
an appropriate manner. (Objective 2)
5. Motivate and enhance the professional and technical competence of health personnel to provide
quality geriatric health services effectively and efficiently.
6. Expand and strengthen innovative and implementable social health insurance reform measures
to respond to the needs of senior citizens and their family members. (Objective 2)
7. Mainstream and institutionalize the health concerns of senior citizens into the health system at
all levels. (Objective 3)
8. Strengthen coordination and harmonization across spheres of government andacross sectors for
the effective delivery of geriatric health services. (Objective 3)
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Integrated care for older people (ICOPE) ?
• The identification of older people in the community with priority conditions
associated with declines in intrinsic capacity can be done with the help of the
integrated care for older people (ICOPE) screening tool.
• WHO’s novel concept called Intrinsic Capacity (IC) focuses on assessment of
one’s physical and mental abilities i.e. cognition, mobility, psychological, vitality,
and sensory functions.
Guiding documents:
• Guidelines on Integrated Care for Older People (ICOPE), 2017;
• Handbook: Guidance on person-centred assessment and pathways in primary care,
2019 provide recommendations for community-level interventions and clinical
practice , respectively
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six priority conditions associated with declines in
intrinsic capacity
• The ICOPE approach aims:
support health and care workers to detect
declines in older people’s intrinsic capacity
in community and primary care settings by
conducting person-centred assessments;
and developing personalized care plans
with older people.
Provides an opportunity to empower and
engage older people in their health and
care.
• Assessment and management of each of these
conditions as well as social care needs are
included
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The ICOPE approach: a five-step person-centred
assessment and care pathway
• Psychosocial Problem
• Economical issue
• Cataract
• Refractive errors
• Osteoarthritis
• Chronic Obstructive
Pulmonary Disease
• Diabetes
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Psychological problems: Psychological problems:
• Depression • Elder abuse
• Anxiety • Change in societal roles
• Delirium • Multiple losses
• Dementia • Financial constraints
• Alzhiemers • Agism
• Loneliness
• Social Isolation
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Social and emotional issues: Economical issues:
• Loss of autonomy • Economically poor/financial
• Grief, fear, Loneliness dependence
• Lack of social network • Feeling of helplessness,
worthlessness, joblessness,
• Homelessness, Disappointment
• Financial constrains
• Increased Urbanization and Migration
• Due to Migration of productive
• Increased International migration for citizen workload increases
labor and educational purposes
• Inadequate social security fund
• Decrease in Morality
• Lack of autonomy on financial
• Shift from Joint family to Nuclear decision making at family
family (CBS
• Lack of recognition
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Problems/Challenges on
Geriatric health in Nepal???
• Lack of sufficient support from the state, both in terms of healthcare services and
social assistance.
• Elderly individuals encounter financial insecurity and social neglect, adding to the
difficulties of maintaining a decent quality of life in the absence of comprehensive
support systems.
• Old age homes are not operating according to the standard and are deprived of
proper care, support and basic need for comfortable survival
• Lack of an integrated approach in developing programs targeting geriatrics is
evident.
• Elderly individuals, especially those living in the poorest areas are facing financial
hardship or discrimination, do not have access to health and social care programs
• Convey the message of love and respect through words and action
• make room for open discussion between young and old generation
• Train the children to develop the habit of listening to the wishes and interest of
• Encourage local communities to initiate programs for the senior citizens on the basis of
felt need.
• Highlight the profiles of notable elderly citizen and acknowledge them focusing on
their achievements and successful stories and skills.
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2. Community Role
• Geriatric experience sharing sessions at educational institutes
• Run day care center for elderly in every locality with enough chance to interact with
people with different age groups
• Need to increase access to proper medical care specifically among elderly people in
the rural and remote areas. for this, local community support groups (e.g. mothers’
groups, clubs, religious groups) in collaboration with local health authorities could
organize outreach medical care services.