Author: Prof. Y. K. Sharma Dean cum Principal Rajiv Gandhi Govt Post Graduate Ayurvedic College and Hospital Paprola - Himachal Pradesh

1. Preventive Care in Geriatrics
Prof. Y. K. Sharma
Dean cum Principal
Rajiv Gandhi Govt Post Graduate Ayurvedic College and Hospital
Paprola - Himachal Pradesh

2.  Jara is state of becoming Ksheen (debilitated), physically and
psychologically weak as a result of old age usually after 60 years of
life. The word geriatrics too is derived from Latin word “geras”
meaning “to grow old”
 Aging is described as a progressive loss of adaptability with passage
of time so that individual is less and less able to react abruptly to
challenges from the external or internal environment. With time the
individual becomes progressively more frail and in need of increasing
support to maintain his or her autonomy.
Geriatrics or Jara -Definition:

3. • Average life span is increasing world while due to better health care and
death rate is falling.
• Even in developing country like India average life span has touched over 60
years.
• World population of the elderly is increasing and by the year 2050, adults
older than 65 years will comprise 1/5th of the global population. In India 7%
of the population are older than 60 years of age. According to an estimate
the likely number of elderly people in India by 2025 will be around 13%
• With high load of metabolic, infective, traumatic, surgical, pediatrics,
obstetrics patients on existing health care; to accommodate geriatric
ailments shall be too much and a serious challenge to meet by health care
institutions.
• With nuclear families taking shape and young people migrating for livelihood
from rural to urban, urban to metropolitan and from metropolitan cities to
foreign countries old are left to themselves to face the challenge of old age
including health care.
Why Preventive Geriatric Health Care ?

4. • Quality life
• Minimum hospitalization.
• Minimum financial burden for health sustaince.
• Continuing working actively for self, family, society and nation .
• Experience gained over the year becomes asset for society and nation.
• Physical, mental, social, religious health to the satisfaction of the
individual concerned.
• Life to years and not merely years to life.
What is desired to be achieved ?

5. Body system’s functional regression associated with:
Poor physical power
Poor immunological state
Poor endocrinal and metabolic support
Poor neuro-psychiatric state
Poor family, social and financial support
With added factors like
Poor diet
Poor physical activity
Poor health care availability
Etc.
Foundation of Health Challenges in Old :

6. Cataract – IOL
Denture loss – Artificial denture
Hearing loss – Hearing aid
Osteoarthritis – Joint replacement
Ataxia – Prosthetic support
BPH – TUR
But, what for brain, mind, autonomic and voluntary control over activities ?
Extended physical life may be vegetative in nature with low quality of life without
-Emotional component, Memory, Insight
-With Gross ataxia, Incontinence, Unproductively
Common Geriatric Ailments and Physical Remedies:

7. Physical care:
Through proper Swasthvritta, Dincharya, Ritucharya, Yoga,
Biological care :
Through required balanced diet, vitamins, essential minerals, specific drugs and
rasayanas like Ashwagandha, Chyavanprash, Amritprash, Shilajeet, Medhya
rasayana,
Mental and Spiritual care:
Mangal, Pranipatgamanam, Sadvritta, Aachar rasayana, Aparigraha, Family
support
Social care :
Government through economic support, old age care home, free traveling and
health insurance, legal support, terminal care. care through NGO’s
Geriatric care through ayurveda:

8. Factors responsible:
AILMENTS
Common GIT Ailments:
• Poor denture
• Reduced digestive functions
• Poor gut absorption
• Intestinal dysmotility
• Lowered mucosal immunity barrier
• Poor pelvic floor strength
• Poor sphincter control
• Frequent indigestion
• Gaseous abdomen
• Constipation/stool impaction

9. Indigestion:
Drugs:
Management:
• Improve denture
• Frequent small meals with nutritious contents
• Soft pulpy roughage rich diet.
• Dhadimashtak churna
• Ginger with Saindhav lavan
• Lavanbhaskar churna
• Eladi vati
• Chitrakadi vati
• Drakshasava
Etc.

10. Avoid constipating foods like:
Paneer, eggs, besan, maida, low roughage diet.
Avoid drastic purgatives like:
Jaipal , danti, snuhi, castor, kutki, preparations.
Use:
Stool Impaction:
Constipation:
• Isbhagul husk
• Triphala
• Haritiki
• Amaltas
• Abhyarishta
• etc.
• Evacuation enema
• Manual evacuation

11. Factors Responsible for Ailments:
Common ailments:
Respiratory System:
• Fixed chest cage and increased residual lung volume
• loss of cilliary mucosal clearance of respiratory tract.
• Loss of mucosal protection.
• Poor power of cough/expectoration.
• Self induced and environmental pollution.
• Confinement to bed.
• Dyspnoea on effort.
• Cough/expectoration.
• Frequent infections.

12. General:
Useful Medication:
Management:
• Regular deep breathing Pranayamic exercises.
• Avoid smoking and polluted environment.
• Avoid cold air.
• Regular steam inhalation .
• Frequent change in posture when confined to bed.
• Sitopladi and Talisadi Churna
• Vasavaleha
• Madhuyashthi, Tulsiadi, Gojihvadi Kashaya
• Use of Tankan, Narasar as expectorants.
• Use of Chayavanprash as protectant

13. Factors responsible:
Common ailments:
Management
Cardiovascular system:
• Atherosclerosis/arteriosclerosis.
• Reduced myocardial function.
• Rise in blood pressure.
• Obesity.
• Associated diseases like diabetes.
• Diet and life style advises
• Drug therapy
• Other measures
• Hypertension
• CHF
• IHD

14. Factors responsible for ailments:
Common ailments:
Urinary System:
• Poor concentration power of kidneys.
• Poor detrusor function.
• Poor mucosal barrier.
• BPH.
• Increased urinary frequency.
• BPH/Prostatic cancer.
• Retention of urine.
• Frequent urinary tract infections

15. General:
Drug therapy:
Surgical options.
Management:
• Moderation of fluid and diet intake.
• Bladder/Pelvic floor toning exercises.
• Varunadi Kashaya
• Trinpanchmool kashaya
• Chandraprabha vati
• Chandanasva
• Swetparpati
Etc.

16. Factors Responsible:
Major Ailments:
Neuropsychiatric Ailments:
• Reduced brain mass
• Nuclei degeneration
• Demyelination
• Senile changes in special senses.
• CVA
• Dementia/depression
• Ataxia/Parkinsonism
• Insomnia
• Impaired functions of higher senses like cataract, deafness, glaucoma, retinal degeneration etc.
• Neurological pains.
• Other sensory-motor deficits.

17. Loss of higher mental functions – Medhya rasayanas
Parkinsonism – Kapikachhu seed churna, Ashwagandha churna
Insomnia - Tagar, Vacha, Sarapgandha
Panchkarma supports
Management:

18. Factors Responsible:
Common Ailments:
• Muscle wasting
• Osteoarthrosis / spondylosis
• Falls and fractures.
Bone, Muscle and Joint Ailments:
• Decreased bone mineral density
• Reduced muscle mass, power and tone.
• Articular degeneration
• Physical inertia.

19. • Regular physiotherapeutic workup
• Prosthetic support
• Diet and drug support
• Surgical intervention when required.
• Yoga
• Other special measures
Common drug support:
• Ashwagandha
• Sankh and Praval bhasma
• Medicated oils application
Management:

20. Factors responsible:
• Poor epithelial turnover
• Loss of skin appendages
• Loss of sebaceous layer
Common ailments:
• Xerosis
• Atrophic dermatitis
• Frequent skin infections
• Senile purpura.
MANAGEMENT:
• Food rich in vitamins esp. Vit-D
• Improving skin moisture and sebaceous layer
• Regular Abhyanga.
• Drug therapy
• Care of skin appendages.
Cutaneous Ailments:

21. • Screen for hypertension, DM, CAD
• Prostate and colorectal cancers
• Breast and cervical cancer
• Dental ailments
• Stress
• Depression
• Stroke factors
Secondary Prevention of Old Age Related Disorders:

22. • Staying in family
• Open life in villages
• Less stress
• Regular physical activity
• Definite purpose of life
• Medical care at hand
Ideal Atmosphere for Healthy Ageing:

23. • Ahara – Milk, Snehapana, Madhur rasa, Low salt, Laghu aahara
• Rasayana
• Avoiding alcohol and smoking
• Avoiding fasting
• Avoiding sexual activity
• Regular exercise
• Avoiding hard exercising
• Regular cold water bath
• Day time sleep
• Regular abhyanga
• Social care
• Spiritual care
Factors that Sustain Life and Delay Jara:

24. THANK YOU