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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 seniors.

Health problems

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 enquired into.

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,

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