Contact with the elderlies
The Multi Purpose Health Workers by virtue
of their vocation know all the house- holds in their catchment
area. In addition to knowing the families in connection with
the specific programmes like family planning, immunization,
TB and Leprosy control allotted to them, they should also
ascertain, whether any older individuals are living in the
homes they visit. It has been said to the credit of a competent
MPHW that she knows her wards as a shepherd knows his sheep.
Once it is known that an elderly person lives in the family,
the worker has to approach him or her in a way different from
the one which she employs in tackling others in the rural
area. While encountering the aged people, the MPHW should
realise that they have sensory handicaps like visual defect
and impairment of hearing. Additionally they are slow in their
grasping and understanding as well as in their physical activity.
Hence it is essential to talk to them slowly to enable them
to understand what is spoken to them. Haste is to be avoided.
A careful and a patient listening to the elderly is of utmost
importance. During the conversation, personal enquiries about
the old man himself, his family, his activities in his earlier
years and his present health may please the elderly and enable
a good rapport with the worker. The elderly subjects very
much desire, not only to talk to others, but also to be enquired
about themselves. The skin of the old person is dry, inelastic
and carries folds. This makes him feel unattractive. Hence
it will add to their happiness if one touches them physically,
either by a shake-hand or by a pat on the shoulder. Rapport
is easier if due importance is given to the elderly as the
It is not uncommon for the aged individual
to have more than one complaint. Multiple systems in the body
are involved. For example, the elderly person may complain
of difficulty in vision, but in addition may have pain in
the joints and sleeplessness. Another one may complain of
hearing impairment, breathlessness and slowness in activity.
On an average, an elderly individual has three or four complaints
and more than two diseases. Very few elderly people admit
of good health, as already indicated (20% of the elderlies
are free from health problems). Among the health problems,
eye conditions take the top rank. Next comes the joint diseases,
affecting especially the knee joints, Joints of the spine,
shoulder, etc. Impairment of hearing is common. Symptoms pertaining
to the heart, and lungs manifest as giddiness, breathlessness,
pain in the chest, cough with expectoration, Asthma. Blood
Pressure is to be recorded and hypertension is not uncommon.
His cough and breathlessness may interfere with the sleep.
The elderly male may have difficulty in voiding urine. This
may indicate an enlargement of the prostate and this causes
residual urine, which may be a cause of infection and a complaint
of burning urination. They may have complaints pertaining
to gastro-intestinal system involving appetite, constipation
and diarrhoea etc. Lack of teeth may result in swallowing
food without proper chewing and result in digestion problems.
Skin diseases are common among the aged and they have to be
Among the psychiatric problems, Depression
is the commonest disease. The depressed individual lacks interest
and may be found to withdraw himself or herself from others..
He lacks appetite and complaints of constipation and sleeplessness
are common, especially in the early hours of the morning.
He entertains ideas of guilt,