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(Aims and objectives, Material and methods and preparatory phase)

The project on the 'Health Care of the Rural Aged' (Phase II) was a continuation of the parent project 'Problems of the Aged Seeking Psychiatric Help' (Phase I) that was carried out in the Institute of Psychiatry, Govt. Rajaji Hospital and Madurai Medical College, Madurai for a period of 3 years from 1st April 1981.

The report on the Phase I has been published by the Indian Council of Medical Research (Venkoba Rao, 1987). The Phase I study included 150 subjects aged 60 + and matched controls. The main conclusions of the study were: (1) Those aged 60 + formed 3% of the total outpatient attendance at the Institute of Psychiatry, Madurai Medical College, Madurai. (2) The psychiatric disorders in the elderly comprised two major groups namely Affective Disorders and Psycho Organic Syndromes. (3) Forty-three per cent of the study group suffered from Depressive illness. (4) Associated physical illness (26%) and handicaps (67%) were observable in the study group. In the controls, they both accounted for 45%. (5) There was no appreciable difference in the family composition between both the groups as measured by Family Jointness Scale. (6) Lack of family and social integration distinguished the study from the control group. Lack of family integration could occur even amongst those living in the family. Hence living within the family did not guarantee integration. Conversely living alone did not signify isolation. (7) The study group experienced twice the num- ber of sad life events than the controls. Within the study group, the highest number of distressing events were observed in the depressives. (8) The followup was possible in 97.3% of index cases. The outcome data following intervention at the end of the year revealed a favourable prognosis in Affective Disorders, especially Depression. The mortality was considerable in cases of acute organic syndrome and dementia.

The Phase II study commenced on 1st April 1984 and terminated on 28th February 1988.

The general objectives of the study were :

  1. To evolve a strategy for providing a comprehensive health care to the aged individuals in the rural community;
  2. Extension of mental health services to the aged in the rural community and
  3. To develop a feasible model for the delivery of health services to the rural aged utilising the existing health infrastructure.

The specific objectives were :

1. to determine the pattern of physical and mental morbidity in the rural aged and identify the associated socio-demographic and psycho-social variables;
2. to develop simple methods of identification of geriatric cases requiring medical help in the community;
3. to equip the Primary Health Centre staff with the necessary skills for detection, management and referral of common medical problems seen in the aged;
4. to provide health education for promotion of health of the aged people;

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