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A NOTE ON MANAGEMENT AND OTHER INTERVENTION MEASURES

The intervention measures consisted of medical treatment either at the PHC or through referral to the Govt. Rajaji Hospital, Psycho-social management (counselling and supportive psychotherapy), arranging of nutritional and economic support, offering the principles of health education and organising rehabilitation within the existing facilities. These are incorporated in the Training Programme to the PHC medical personnel and Multi Purpose Health Workers which have been referred to already.

Medical

It is not to be assumed that all old people are sick. In a study of 1598 subjects aged 60 + living in 200 villages in Tamil Nadu, Krishnan Nair (1980) reported on their health status as measured by mobility, sensory impairment, incapacity, self-perception of health and physician utilisation. Vast majority of the elderly, more than 4 in 5 failed to rate themselves as in good health. Health pessimism appears to be a predominant feature of the elderlies.

The subjects were attending either the main PHC at Kallandiri or its sub-centres. MPHWs made routine visits to the homes of these patients as well as those who did not attend the PHC enquiring about the progress, doling out the drugs and imparting general information on health education.

The treatment at the PHC was carried out through the special Geriatric Clinic of the ICMR functioning in the Primary Health Centre. 73% of the subjects were treated at the PHC level, while 18.5% were referred to specialists at the Govt. Rajaji Hospital; 1.1% of the subjects were treated as inpatients in the Govt. Rajaji Hospital for physical illness, while 0.5% as patients for psychiatric ailment. The conjoint treatment namely by the PHC staff and the visiting specialists was offered to 6.9%. The efficacy of the training imparted to the PHC MOs was testified by the fact that almost 3/4ths of the sample were managed at the PHC level.

Utilisation of Eye Camp Services

Dr. G. Venkatasamy, Director, Aravind Eye Hospital offered services for examination of the subjects and cataract extraction for those who needed. The staff of the Aravind Eye Hospital conducted special Eye camps at Kallandiri PHC, Othakadai and Karupayeeorani sub-centres. The services of the eye camps conducted by Aravind Hospital elsewhere in the PHC area during the intervention period were also utilised by the subjects. Of the 395 subjects utilising the geriatric clinic, 178 subjects (45.1%) availed of the consultation services in these camps, while 54.9% did not (as elicited in sub-sample survey II). In the latter category, the reasons offered were : Consultation

 
 Krishnan Nair, T. (1980) Older people in rural Tamil Nadu, Madras School of Social Work, Madras.
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