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PSYCHO-SOCIAL

On Khatri's Family Jointness Scale, 64% (N = 1218) belonged to 'Not at all Joint' category and on the other hand, the rest were variously classified under 'completely joint' (N = 140,7.3%), 'Verymuch joint' (N = 102, 5.3%), 'Somewhat joint' (N = 142,7.4%) and 'Slightly joint' (N = 308, 16.1 %). Thus some degree of 'jointness' was noticeable in 36% of the cases. Four hundred and eighty-eight subjects (25.5%) were found to be living alone, of whom about 4% (N = 9) did so by choice. The rest (N = 1422,.74.5%) were living with some family members or other. A good integration of the elderly into family was noted in 71% of the cases (N = 1365). While 22% were isolated (N = 418), the remainder were integrated in a poor way. More than half of the sample (N = 1029, 54%) were socially well integrated, while a moderate integration prevailed in 34.7% (N = 663). The rest were either poorly integrated (N = 127) or isolated (N = 4).

INTERVENTION

The intervention consisted of management of physical and psychiatric symptoms at PHC, or by referral to GRH, psychosocial measures (counselling on family and social integration; individual supportive psychotherapy) and arranging for nutritional and economic support, imparting health education and enabling rehabilitation within the existing facilities. The subjects were generally catered to at PHC Geriatric Clinic by the project staff in association with the PHC staff. Wherever indicated, referrals were made to the Govt. Rajaji Hospital for detailed investigation and treatment. A geriatric clinic was also functioning in the ICMR Centre for Advanced Research on 'Health and Behaviour', at Govt. Rajaji Hospital, Madurai. Cases of 'Cataract' forming the highest number were attended to by organising special Eye facilities in the PHC and Cataract surgery was advised to many, but was accepted by a few. All these subjects were provided with spectacles following cataract extraction. In the study group of 1910 subjects, 217 (11.4%) being eligible were receiving economic and nutritional support in terms of 'Old Age Pension' and Chief Minister's Nutritious Noon Meal Programme, a set of clothes twice in the year on Pongal and Independence days. The available records at the PHC showed 811 elderlies to be receiving such supports in the entire study area. The impact of these various intervention measures on the elderlies are discussed in the sub-sample survey 11 carried out for that purpose.

HEALTH EDUCATION

Health education formed an essential part of the intervention. The MPHWs were trained for this by the project staff. Health education was imparted in the Geriatric Clinic at the PHC/ Sub-centres and also in the field. In the Geriatric Clinic the elderly were attended to both individually and in groups. Patients were asked to assemble in groups in the Geriatric Clinic for the purpose. The charts and posters are dis- played in the clinic and read out and explained to the patients by the project staff. PHC staff too joined such programmes. The education was carried out on similar lines in the field during the routine field visits of the MPHWs both individually and in groups collected around common meeting places. In addition, there is a Block

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