Preventive geriatric care model: A dire necessity in recent times!

Nilanjana Ghosh; Dipankar Debnath

doi:10.4103/jssrp.jssrp_10_21

CARE MODEL

Year : 2021 | Volume : 2 | Issue : 2 | Page : 29-31

Preventive geriatric care model: A dire necessity in recent times!

Nilanjana Ghosh¹, Dipankar Debnath²
¹ Department of CM and FM, AIIMS, Guwahati, Assam, India
² Consultant Physician, Geriatric Medicine, Director, Sixty Plus Clinic Private Limited, Kolkata, West Bengal, India

Date of Submission	21-May-2021
Date of Acceptance	16-Jun-2021
Date of Web Publication	23-Aug-2021

Correspondence Address:
Nilanjana Ghosh
Department of CM and FM, AIIMS, Guwahati, Assam
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jssrp.jssrp_10_21

Abstract

A holistic concept of providing regular health check-up, reinforcing their intent to a healthy and happy living, taking care of them with a day care center and communicating to their family members both in station and outstation every fortnight regarding their health status is the aim of the project. A benefit to community and forming a strong self-sustaining wise peer group who will turn into an asset than a liability for a community is the sole motto of the project. In the aforesaid context to create a geriatric-friendly society, this preventive geriatric care model was envisaged.

Keywords: Capacity building life skill support, preventive care

How to cite this article:
Ghosh N, Debnath D. Preventive geriatric care model: A dire necessity in recent times!. J Surg Spec Rural Pract 2021;2:29-31

How to cite this URL:
Ghosh N, Debnath D. Preventive geriatric care model: A dire necessity in recent times!. J Surg Spec Rural Pract [serial online] 2021 [cited 2023 Mar 31];2:29-31. Available from: http://www.jssrp.org/text.asp?2021/2/2/29/324479

Background

Geriatric medicine is a separate discipline as the population is on rise. Morbidities aggravate and the values are changing in terms of modernization making living of geriatrics challenging. They face physical problems, mental health issues, loneliness and are unable to sustain daily living leading to depression and intent to confinement. Many researchers have concluded they need special care not only for health but also in different facets of life.^[1],[2]

Siliguri is an area where the recent modernization has taken its toll. Many high-rises are coming up where elderly people stay in comfortable flats but without any caregiver or with working family members. Such an issue has long been not studied on this part and geriatric morbidity is on rise. Unlike big metro cities creches and elderly homes are nonexistent making the living of elderly even more confined.

A holistic concept of providing regular health check-up, reinforcing their intent to a healthy and happy living, taking care of them with a day care center and communicating to their family members both in station and outstation every fortnight regarding their health status is the aim of the project. A benefit to community and forming a strong self-sustaining wise peer group who will turn into an asset than a liability for a community is the sole motto of the project.^[3],[4]

In the aforesaid context to create a geriatric-friendly society, this preventive geriatric care model was envisaged with the following objectives:

Objectives

To assess quality of life among the geriatric study population
Need assessment and gap analysis of the designated geriatric care services received from health care facility among study population
To assess perception of societal support received among the study population
Implementing a preventive geriatric care model and determining if any significant change was found in quality of life among the study population post intervention.

Method of Model Implementation on a Pilot Mode

A pilot study of descriptive cross-sectional type with mixed method approach may be conducted in an Urban Health Training Centre (UHTC) which will be the field practice area of the concerned medical college to which the primary investigator belongs. Study duration will be a 1-year project with 5 months for data collection pre- and post-intervention and 2 months in between for opening the fully functional center.

All geriatric population in the area residing will be enlisted in accordance to eligibility criteria will be the study population. Study participants will be enrolled after their consent and brief sensitization, aiming to enroll by complete enumeration of all the geriatric people attending the geriatric outpatient department (OPD) during the study period. Data will be collected on all OPD days from the eligible study subjects for 6 months by interview method both before and after the intervention.

The operational feasibility of opening a community-friendly geriatric care center will be assessed from local people of eminence other relevant and related higher authorities. Local councilor, Deputy II CMOH, and Medical Officer in charge of Urban Health Leading Pharmacy retailer shop and a private medical doctor residing in the area will also be interviewed in depth for weighing out feasibility and taking measures for implementing the fully functional preventive geriatric care model. Along with community health volunteers (CHV) and Auxiliary nurse midwife (ANMs) posted there in the ward will be sensitized regarding the project and benefits explained and their full cooperation sought.

Study techniques will be record review, interview method and capacity building of the staffs with evidence-based training module for volunteering CHV whereas study tools applied will be the questionnaire for assessing quality of life (QOL) of elderly – using WHO QOL BRIEF^[1] both pre and post intervention.

Predesigned pretested semi-structured questionnaire validated by experts for Need assessment of the various identified services in the community provided by primary health care centers
Gap analyasis will be done regarding the utilization pattern of various services and reasons ascertained using the questionnaire.

A. VITAL QLSE^[5] questionnaire will be used to assess the social support received by the elderly apart from the designated care services relevant records. Societal support received can be assessed by quality time from family and neighbors, physical assistance, financial assistance, protection from elderly abuse.

Plan of Implementation of the Model in Community

It is imperative that a preventive geriatric care model will require some additional tools and settings like a dedicated team of at least three trained CHV in two batches

They will be required to do periodic house-to-house visits of the elderly people, collect health data and other relevant information, assess any emergency and provide essential preventive, curative, and rehabilitative support. They would refer to a local resident doctor if they feel the need or else create a database of the health records and periodically submit it each week to the medical team visiting UHTC from the concerned medical college
Provide a 24 × 7 helpline number for emergency. Moreover, they will in turn in each week then visit the families designated and communicate the findings, its relevance to them or their children who stay outside the city.

Services Proposed

Providing screening services and counseling services to strengthen the existing system
Register the data and provide monitoring and mentoring services to community
Performing trend analysis every quarter for 2 years
Introducing newer implementations like.

Kobo App installation for monitoring. Mentoring, artificial intelligence
Continued capacity building of CHV
A dedicated geriatric pharmacy alongside the main pharmacy and a trained compounder
Modifying the existing location to integrated homes (where children and geriatrics come)-initially to be started as daycare centers operating twice weekly manned by trained doctor and trained CHVs. Physical health checkup, screening, counseling being done the main objective is to improve social interactions, form peer group, encourage discussions on various topics and improving mental health. A trained yoga trainer will be instructed to give them practice for half an hour a motivational talk session will be organized once every quarter
A geriatric health card will also be made and maintained to understand the compliance of treatment and adherence to monitoring tools
Family members will be informed of the regular health check-ups done and advised for the next moves against a nominal charge. For those whose family members stay outside city, they will be regularly updated every fortnight. An emergency contact number will be provided to them from the center
Providing a red alert button to elderly connected with nearby ambulance and a CHV number so that on pressing it immediate assistance can be sought even in the person stays alone.

Data Collection Procedure

A sensitization will be done after taking the required ethical clearance and voluntary consent. A project plan will be formulated priorly and communicated with local authorities responsible for the implementation of data collection. Local people will be sensitized and purpose and benefit of the study explained.

Capacity building of CHVs using GoI modules will be done on prefixed dates ensuring maximum attendance
Registers and apps will be maintained for baseline data collection for gap and need assessment. Door to door service will be given after a house-to-house survey will be done
Services will be delivered and the community center will be strengthened. One team will cater 10 families in 1 day and will be functional twice a week apart from Tuesday, day of visit of team from NBMCH who will visit the families based on feedback of CHV team. Two teams will operate in the designated study area.

Data will be collected every quarter and trend analysis done. Qualitative study regarding a change in perceptions and attitudes and uptake of new ideas will also be studied.

Acknowledgment

The study acknowledges the support of Dr. Pritam Roy (WHO) for the idea and Prof. (Dr.) Tulika Goswami Mam for the support extended in the designing phase of the study. It acknowledges support of Dr. Dipankar Debnath, owner of 60 plus clinic in Kolkata.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Karmakar N, Datta A, Nag K, Tripura K. Quality of life among geriatric population: A cross-sectional study in a rural area of Sepahijala District, Tripura. Indian J Public Health 2018;62:95-9. [PUBMED] [Full text]
2.	United Nations. Global Issues: Ageing. UN. Available from: http://www.un.org/en/globalissues/ageing/index.shtml. [Last accessed on 2016 Jul 20].
3.	Population Composition. Census of India. Chapter – 2. Available from: http://www.censusindia.gov.in/vital_statistics/srs_report/9chap%202%20-%202011.pdf. [Last accessed on 2017 Oct 27].
4.	Government of India. Ministry of Statistics and Programme Implementation. Elderly in India-Profiles and Programmes; 2016. Available from: http://www.mospi.nic.in/sites/default/files/publication_reports/ElderlyinIndia_2016.pdf. [Last accessed on 2017 Oct 27].
5.	Barua A, Mangesh R, Kumar HN, Mathew S. A cross-sectional study on quality of life in geriatric population. Indian J Community Med 2007;32:146-7. [Full text]