Physical therapists are exercise experts, providing services for a wide range of people to optimise their physical ability. They prescribe exercise as part of a structured, safe, and effective programme. An important part of their role is to help people remain active as they age. More than any other profession, physical therapists (known in many countries as physiotherapists) prevent and treat chronic disease and disability in aging adults through specifically prescribed activity and movement. The World Health Organization encourages regular physical activity for older adults, because it has been shown to improve the functional status and quality of life in this group of individuals.

1. PHYSIOTHERAPY IN ACTIVE AGEING
AN AGE FRIENDLY INITIATIVE
DR ALAKANANDA BANERJEE
DHARMA FOUNDATION OF INDIA

2. Population Ageing in India
Projected to be 113 million, i.e. 8.9% of total
populations by the year 2016

3. •URBANISATION
• NUCLEARISATION OF FAMILY
•MIGRATION
•DUAL CAREER FAMILIES
PROBLEMS IN ELDERS: CAUSES

4. STRESSORS
(HEALTH AND SOCIAL PROBLEMS OF THE ELDERLY: A CROSS-SECTIONAL STUDY IN UDUPI TALUK,
KARNATAKA.A LENA, K ASHOK, M PADMA,1 V KAMATH, AND A KAMATH)
HEALTH
ISOLATIONFINANCES

5. ELDERLY CARE MODELS IN INDIA:
• VERY LITTLE EFFORT HAS BEEN MADE TO DEVELOP A MODEL OF
HEALTH AND SOCIAL CARE IN TUNE WITH THE CHANGING NEED
AND TIME
1. OLD AGE HOME
2. ASSISTED LIVING
3. RECREATION CENTRE
• OPPORTUNITY FOR INNOVATION IN SOCIAL SYSTEM
DEVELOPMENT, IS A MAJOR CHALLENGE.

6. ELDERLY CARE MODELS IN INDIA:
• ELDERLY SUFFER FROM MULTIPLE AND CHRONIC DISEASES.
• THEY NEED LONG TERM AND CONSTANT CARE.
• THUS A MODEL OF CARE PROVIDING COMPREHENSIVE HEALTH
SERVICES TO ELDERLY AT ALL LEVELS OF HEALTH CARE DELIVERY IS
IMPERATIVE TO MEET THE GROWING HEALTH NEED OF ELDERLY.
(NATIONAL PROGRAMME FOR THE HEALTH CARE OF THE ELDERLY (NPHCE) AN APPROACH TOWARDS ACTIVE AND HEALTHY
AGEING ,OPERATIONAL GUIDELINES, DIRECTORATE GENERAL OF HEALTH SERVICES MINISTRY OF HEALTH & FAMILY WELFARE
GOVERNMENT OF INDIA)

7. SOLUTION
• ELDERLY ACCESS TO AGE-FRIENDLY AND AFFORDABLE
INFORMATION AND SERVICES
• AGEING IN PLACE

8. HEALTH AND SOCIAL ISSUES
• Arthritis
• RESPIRATORY CARE
• CANCER
• CARDIOVASCULAR
• VISION/CATARACT
• BLADDER AND BOWEL
DYSFUNCTION
• NEUROLOGICAL DEFICITS
•ELDER ABUSE
•SOCIAL ISOLATION
•FINANCIAL
•LACK OPPORTUNITIES FOR RE EMPLOYMENT
•UNAWARENESS OF RIGHTS OF ELDERS.

9. ACTIVE AGEING
ACTIVE AGEING IS THE
PROCESS OF OPTIMIZING
OPPORTUNITIES FOR
HEALTH, PARTICIPATION AND
SECURITY IN ORDER TO
ENHANCE QUALITY OF LIFE
AS PEOPLE AGE.

10. VISION: DFI
ATTAINMENT OF UNIVERSAL ACCESS TO EQUITABLE,
AFFORDABLE AND QUALITY HEALTH CARE SERVICES,
ACCOUNTABLE AND RESPONSIVE TO ELDERLY NEEDS.

11. DHARMA FOUNDATION OF INDIA
• DHARMA FOUNDATION OF INDIA WAS REGISTERED IN 2010 AS A
CHARITABLE TRUST UNDER THE CERTIFICATE SECTION 60 OF THE INDIAN
TRUST ACT 1882 IN NEW DELHI ,BY A GROUP OF DEDICATED
HEALTHCARE PROVIDERS .
• THE MAIN OBJECTIVE OF THE ORGANIZATION IS TO WORK FOR WELLBEING
AND QUALITY OF LIFE FOR DISABLED AND VULNERABLE POPULATION OF
INDIA .

12. STAGES OF ELDER HEALTHCARE
• PREVENTIVE AND EARLY
DETECTION
• CURATIVE
• FOLLOW UP
• REHABILITATION/CHRONIC CARE

13. Missing
Health Systems in India
NGO/Trust/SCWO
Private
Hospital
Semi-Govt (Public)Hospital
Govt. Hospital
Curative care Preventive care
Suggested Preventive
Program
Absence of
government
policies
Community Care
Centre(CCC)
Allied Health Professionals
Sugar
Obesity
Pain
Blood pressure
Dementia

14. Healthcare in India
THE VARIOUS PROBLEMS FACED BY THE HEALTHCARE INDUSTRY
ARE SHORTAGE OF DOCTORS, NURSES AND INFRASTRUCTURES
LEADING TO UNAVAILABILITY OF COST EFFECTIVE AND
ACCESSIBLE CARE AT THE PRIMARY LEVEL...

15. NEED OF THE HOUR: INTEGRATED APPROACH TOWARDS
COMMUNITY WELLNESS
FORMULATED ON INTERNATIONAL RESEARCH AND KNOWLEDGE
BASED ON IMPORTANT PRINCIPLES AND GUIDELINES BY WHO
ACTIVE AGEING POLICY AND TOWARDS BUILDING AN AGE
FRIENDLY CITY.

16. OBJECTIVE
• WE COLLABORATE /HANDHOLD WITH NGOS AND OTHER ORGANIZATIONS
AT THE GRASS ROOT LEVEL TO IMPLEMENT STRATEGIC MODELS TO
OVERCOME PHYSICAL AND SOCIOLOGICAL BARRIERS
• OUR PROJECTS FOR OLDER PERSONS ARE CENTERED AROUND DEVELOPING
CARE MODELS BASED ON THE WHO GUIDELINES OF ACTIVE AGEING AND
TOWARDS BUILDING AGE FRIENDLY COMMUNITIES.
• THE STRATEGY SUPPORTS FULL PARTICIPATION AND INCLUSION OF OLDER
PERSONS IN THE LIFE OF THEIR COMMUNITIES.

17. MULTI SERVICE CENTRES(MSC) IN
COMMUNITY
Multi
Service
Centre
Preventive
PT/DIET
Recreation/day
care
Curative

18. OBJECTIVE (MSC)
• EMPOWER AND CREATE OPPORTUNITIES FOR COMMUNITY
DWELLING OLDER PERSONS TO PARTICIPATE IN THEIR HEALTH
AND SOCIAL ISSUES.
• DEVELOP HEALTH AND SOCIAL MODELS.

19. CHRONIC DISEASES
• A CHRONIC CONDITION IS A HUMAN HEALTH CONDITION OR DISEASE THAT IS
PERSISTENT OR OTHERWISE LONG-LASTING IN ITS EFFECTS OR A DISEASE THAT
COMES WITH TIME.
• THE TERM CHRONIC IS USUALLY APPLIED WHEN THE COURSE OF THE DISEASE
LASTS FOR MORE THAN THREE MONTHS.
• INCLUDE ARTHRITIS, ASTHMA, CANCER, COPD, DIABETES AND VIRAL
DISEASES SUCH AS HEPATITIS C AND HIV/AIDS.
Chronic diseases, World Health Organization, retrieved 2012-11-26

20. AGE-RELATED + CHRONIC DISEASE FACTS
• THE MAIN CHRONIC DISEASES DISCUSSED IN THIS REPORT ARE:
CARDIOVASCULAR DISEASES, MAINLY HEART DISEASE AND STROKE; CANCER;
CHRONIC RESPIRATORY DISEASES; AND DIABETES.
• THERE ARE MANY OTHER CHRONIC CONDITIONS AND DISEASES THAT
CONTRIBUTE SIGNIFICANTLY TO THE BURDEN OF DISEASE ON INDIVIDUALS,
FAMILIES, SOCIETIES AND COUNTRIES. EXAMPLES INCLUDE MENTAL DISORDERS,
VISION AND HEARING IMPAIRMENT, ORAL DISEASES, BONE AND JOINT
DISORDERS, AND GENETIC DISORDERS.
• MENTAL AND NEUROLOGICAL DISORDERS ARE IMPORTANT CHRONIC
CONDITIONS THAT SHARE A UNIQUE SET OF DISTINGUISHING FEATURES, AND
WHICH WERE REVIEWED RECENTLY BY THE WORLD HEALTH ORGANIZATION .
Preventing CHRONIC DISEASES a vital investment
http://www.who.int/chp/chronic_disease_report/contents/part2.pdf

21. Preventing CHRONIC DISEASES a vital investment
http://www.who.int/chp/chronic_disease_report/contents/part2.
pdf

22. THE HEALTH OF THE WORLD IS GENERALLY IMPROVING, WITH FEWER PEOPLE DYING FROM INFECTIOUS
DISEASES AND THEREFORE IN MANY CASES LIVING LONG ENOUGH TO DEVELOP CHRONIC DISEASES.
INCREASES IN THE CAUSES OF CHRONIC DISEASES, INCLUDING UNHEALTHY DIET, PHYSICAL INACTIVITY
AND TOBACCO USE ARE LEADING TO PEOPLE DEVELOPING CHRONIC DISEASES AT YOUNGER AGES IN THE
INCREASINGLY URBAN ENVIRONMENTS OF LOW AND MIDDLE INCOME COUNTRIES.
DISTURBING EVIDENCE OF THIS IMPACT IN MANY OF THESE COUNTRIES IS STEADILY GROWING. THEY
ARE ILL EQUIPPED TO HANDLE THE DEMANDS FOR CARE AND TREATMENT THAT CHRONIC DISEASES
PLACE ON THEIR HEALTH SYSTEMS AND SO PEOPLE DIE AT YOUNGER AGES THAN IN HIGH INCOME
COUNTRIES.
INDIVIDUALS AND THEIR FAMILIES IN ALL COUNTRIES STRUGGLE TO COPE WITH THE IMPACT OF
CHRONIC DISEASES, AND IT IS THE POOREST WHO ARE THE MOST VULNERABLE.
CHRONIC DISEASES INFLICT AN ENORMOUS DIRECT AND INDIRECT ECONOMIC BURDEN ON THE POOR,
AND PUSH MANY PEOPLE AND THEIR FAMILIES INTO POVERTY.
Preventing CHRONIC DISEASES a vital investment
http://www.who.int/chp/chronic_disease_report/contents
/part2.pdf
CHRONIC DISEASES

23. WHAT IS PHYSIOTHERAPY? (WCPT)
THE SCOPE OF PHYSICAL THERAPY PRACTICE IS NOT LIMITED TO
DIRECT PATIENT/CLIENT CARE, BUT ALSO INCLUDES:
• PUBLIC HEALTH STRATEGIES
• ADVOCATING FOR PATIENTS/CLIENTS AND FOR HEALTH
• SUPERVISING AND DELEGATING TO OTHERS
• LEADING
• MANAGING
• TEACHING
• RESEARCH
• DEVELOPING AND IMPLEMENTING HEALTH POLICY, LOCALLY, NATIONALLY AND
INTERNATIONALLY

24. WHAT IS PHYSIOTHERAPY? (WCPT)
• PHYSICAL THERAPISTS ARE EXERCISE EXPERTS, PROVIDING SERVICES FOR A
WIDE RANGE OF PEOPLE TO OPTIMIZE THEIR PHYSICAL ABILITY.
• THEY PRESCRIBE EXERCISE AS PART OF A STRUCTURED, SAFE, AND
EFFECTIVE PROGRAM. AN IMPORTANT PART OF THEIR ROLE IS TO HELP
PEOPLE REMAIN ACTIVE AS THEY AGE.
• MORE THAN ANY OTHER PROFESSION, PHYSICAL THERAPISTS (KNOWN IN
MANY COUNTRIES AS PHYSIOTHERAPISTS) PREVENT AND TREAT CHRONIC
DISEASE AND DISABILITY IN AGING ADULTS THROUGH SPECIFICALLY
PRESCRIBED ACTIVITY AND MOVEMENT.
(THE WORLD HEALTH ORGANIZATION)

25. PHYSIOTHERAPY FOR IMPROVING FUNCTIONAL
ABILITY IN ELDERS
OLDER ADULTS ENGAGED IN REGULAR PHYSICAL ACTIVITY
DEMONSTRATE IMPROVED:
• BALANCE
• STRENGTH
• COORDINATION AND MOTOR CONTROL
• FLEXIBILITY
• ENDURANCE

26. BENEFITS OF PHYSICAL ACTIVITY FOR OLDER ADULTS
• OVERALL, STRONG EVIDENCE DEMONSTRATES THAT COMPARED TO LESS ACTIVE
MEN AND WOMEN, OLDER ADULTS WHO ARE PHYSICALLY ACTIVE:
• HAVE LOWER RATES OF ALL-CAUSE MORTALITY, CORONARY HEART DISEASE, HIGH
BLOOD PRESSURE, STROKE, TYPE 2 DIABETES, COLON CANCER AND BREAST
CANCER, A HIGHER LEVEL OF CARDIORESPIRATORY AND MUSCULAR FITNESS,
HEALTHIER BODY MASS AND COMPOSITION;
• HAVE A BIOMARKER PROFILE THAT IS MORE FAVOURABLE FOR THE PREVENTION
OF CARDIOVASCULAR DISEASE, TYPE 2 DIABETES AND THE ENHANCEMENT OF
BONE HEALTH; AND
• EXHIBIT HIGHER LEVELS OF FUNCTIONAL HEALTH, A LOWER RISK OF FALLING, AND
BETTER COGNITIVE FUNCTION; HAVE REDUCED RISK OF MODERATE AND SEVERE
FUNCTIONAL LIMITATIONS AND ROLE LIMITATIONS.

27. Physiotherapy in Active Ageing
• PHYSICAL THERAPISTS ARE EXERCISE EXPERTS, PROVIDING SERVICES FOR A WIDE RANGE OF PEOPLE TO OPTIMIZE
THEIR PHYSICAL ABILITY.
• THEY PRESCRIBE EXERCISE AS PART OF A STRUCTURED, SAFE, AND EFFECTIVE PROGRAMME. AN IMPORTANT
PART OF THEIR ROLE IS TO HELP PEOPLE REMAIN ACTIVE AS THEY AGE. MORE THAN ANY OTHER PROFESSION,
PHYSICAL THERAPISTS PREVENT AND TREAT CHRONIC DISEASE AND DISABILITY IN AGING ADULTS THROUGH
SPECIFICALLY PRESCRIBED ACTIVITY AND MOVEMENT.
• THE WORLD HEALTH ORGANIZATION ENCOURAGES REGULAR PHYSICAL ACTIVITY FOR OLDER ADULTS, BECAUSE
IT HAS BEEN SHOWN TO IMPROVE THE FUNCTIONAL STATUS AND QUALITY OF LIFE IN THIS GROUP OF
INDIVIDUALS. (WWW.WHO.INT/DIETPHYSICALACTIVITY/FACTSHEET_OLDERADULTS/EN/)
http://www.wcpt.org/sites/wcpt.org/files/files/WPTDay-Active_Aging_C4.pdf

28. TRAINING ON SELF MANAGEMENT OF
HEALTH ISSUES BY PHYSIOTHERAPIST FOR
ELDERS IN THE COMMUNITY

29. STANDARD GUIDELINES FOR ORGANIZATIONS
FORM ELDER GROUPS:
• SMALL GROUPS OF 10-15 ELDER SUBJECTS.
• SELECTION OF VOLUNTARY ELDER MEMBERS AS A GROUP
LEADER/LOCAL SUPERVISOR.

30. COLLABORATIVE SESSIONS
• Activity:
• WORKSHOPS FOR EDUCATION/EMPOWERMENT OF ELDERS
WORKSHOPS
• THESE WORKSHOPS ARE TAKEN BY HEALTHCARE PROVIDERS,
SOCIOLOGISTS/FRIENDS OF ELDERS.

31. COLLABORATIVE SESSIONS
• COMMON HEALTH ISSUES.VIZ CARDIOVASCULAR, ARTHRITIS,
NEURODEGENERATIVE CONDITION, VISION AND HEARING.
• APPROPRIATE EXERCISE FOR MAINTAINING AND IMPROVING
STRENGTH, FLEXIBILITY, AND ENDURANCE.
• HEALTHY DIET (BY NUTRITIONIST)
• COMMUNICATING EFFECTIVELY WITH FAMILY, FRIENDS, AND HEALTH
CARE PROFESSIONALS
• BENEFITS OF ACTIVE AGEING

32. DISTRIBUTION OF BOOKLETS
BRIEFS OF THESE LECTURES ARE
TRANSLATED IN LOCAL LANGUAGES AND
DISTRIBUTED AS BOOKLETS TO THE ELDERLY
WHO ATTEND THE WORKSHOPS
Website: www.dharmafoundationofindia.org

34. Multi Specialty Centre (MSC)

35. SOCIAL INTERACTION WILL BE ENCOURAGED IN SMALLER
GROUPS IN THE MSC OR NEARBY THEIR HOUSES
EMERGENCY!!
GROUP LEADER CONDUCT
EXERCISES/RECREATIONAL
ACTIVITIES/DISCUSSIONS

36. 345 ELDER MEMBERS OF VNKS CHOSEN FOR STUDY

37. BENEFIT OF ACTIVE AGEING
• IT APPLIES TO BOTH INDIVIDUALS AND POPULATION GROUPS
• BASED ON THREE CONCEPTS: SELF CARE, MUTUAL HELP, SELF
PROMOTION
IMPROVED SOCIAL
PARTICIPATION
ACTIVE LIFE DECREASE
STRESS,ISOLATION,COGNITIVE
DECLINE
TAKING CARE OF OTHERS ADD PURPOSE
VOICING OPINION
ABOUT ELDER
PROBLEMS IN BIGGER
FORUMS

38. Chattarpur-New Delhi
Hyderabad-Secunderabad
New Barrackpore ,North 24 Paraganas,West Bengal
Navi Mumbai,Maharashtra
Haridwar,Uttar Pradesh
DFI in India

39. N=35 elders
N=16 Females
N=19 Males
Duration of Study-3 months

40. 2/15/201640
•CREATE AWARENESS ABOUT ELDER PROBLEMS.
•FALLS DUE TO IMBALANCE IN ELDERS.
•INTRODUCE TECHNOLOGY TO PREVENT FALLS IN ELDERS.
•VALUABLE FUTURE LEARNING OF THEIR OWN LIFE.
HIGH SCHOOL CHILDREN WORKSHOP

42. CHATTARPUR ,NEW
DELHI
ROADS, WATER WORKS AND
STREET LIGHTS WHICH WERE
HAZARDOUS FOR ELDERS
CAUSING MOBILITY
IMPAIRMENT DUE TO
UNFRIENDLY ENVIRONMENT
2011

43. ROADS, WATER WORKS,
ELECTRICITY REPAIRED
THROUGH EFFORTS OF
VNKS IN COLLABORATION
WITH LOCAL MLA
2013
CHATTARPUR
NEW DELHI

44. DISCUSSION
THE ABOVE RESULTS DEFINE THAT THERE WERE CHANGES
ELDERS PARTICIPATING IN GROUP EXERCISES IN NEIGHBOURHOOD
COMMUNITY CENTRES HAVE IMPROVED THEIR QUALITY OF LIFE.
PERIODIC, RESULT ORIENTED MEETING/SOCIALIZING OF ELDERS
HAVING SIMILAR PROBLEM, IN THIS CASE DIABETES SHOWED
IMPROVEMENT IN SOCIAL FUNCTIONS, EMOTIONAL WELL BEING
AND GENERAL HEALTH .

45. CONCLUSION
• ACCESS TO THE ENTIRE RANGE OF HEALTH AND SOCIAL SERVICES
THAT ADDRESS THE NEEDS AND RIGHTS OF OLDER ADULTS; AND
PROTECTION, DIGNITY AND CARE IN EVENTS THAT OLDER
ADULTS ARE NO LONGER ABLE TO SUPPORT AND PROTECT
THEMSELVES.
(ACTIVE AGEING AND INDEPENDENT LIVING SERVICES: CORE PROPOSITIONS LEADING TO A CONCEPTUAL
FRAMEWORK MARK LEYS, SOFIE DE ROUCK VRIJE UNIVERSITEIT BRUSSEL, (SMIT-MESO) )

46. CONCLUSION..CONTD
• EXERCISES ARE PROVEN TO BENEFIT CHRONIC NON
COMMUNICABLE DISEASE LIKE DIABETES ,THEREFORE DECREASES
RISKS OF CARDIAC, BRAIN STROKE, NEUROPATHY ETC
• GROUP EXERCISES OF ELDERS HAVING SIMILAR PROBLEM,
MAKES A BETTER COMRADESHIP AND UNDERSTANDING
AMONGST ELDERS.
• GROUPS OF ELDERLY SOCIALIZING WITH A SIMILAR PURPOSE , IS
AN IMPORTANT COMPONENT OF ACTIVE AGEING FRAMEWORK
WHICH IMPROVES QUALITY OF LIFE IN ELDERS.

47. CONCLUSION..CONTD
• WE HOPE WITH INTRODUCTION OF THE ACTIVE AGEING
PROGRAM, DFI CAN UTILIZE THE INEXPLICABLE RESOURCE OF
THE ELDER POPULATION IN INDIA THROUGH SELF CARE,
MUTUAL HELP AND SELF PROMOTION.
• OUR FUTURE PROPOSAL IS TO CREATE RESEARCH MODELS
NEEDS IN THE COMMUNITY TO UNDERSTAND BEST PRACTICES
FOR COMMUNITY CARE AND IMPROVEMENT IN QOL OF THE
ELDERLY IN INDIA.

48. WAY AHEAD
• NONMEDICAL INTERVENTIONS CAN ASSIST ELDERS IN COPING WITH AND ADAPTING TO CHANGES AS ONE
AGES.
• HEALTH AND SOCIAL SERVICES DELIVERED WITHIN A NEIGHBOURHOOD BY LOCAL PEOPLE IN LOCAL
ESTABLISHMENTS, AND COMMUNITY-BASED SUPPORT AND VOLUNTARY GROUPS CAN PLAY AN IMPORTANT
ROLE IN DELIVERING SUPPORT AND CARE TO OLDER PERSONS.
• THE SELF-MANAGEMENT AND COMMUNITY WELLNESS PROGRAM (MSC)WILL NOT CONFLICT WITH
EXISTING PROGRAMS OR TREATMENT AS IT IS DESIGNED TO ENHANCE REGULAR TREATMENT AND DISEASE-
SPECIFIC EDUCATION GIVEN BY CLINICIANS/FAMILY PHYSICIANS IN HEALTHCARE ORGANIZATION.


49. BENEFITS
• INTERVENTIONS OF GROUP ACTIVITIES AND SELF MANAGING
CO-MORBIDITIES HAVE IMPROVED MOBILITY AND QUALITY OF
LIFE OF ELDERS IN THE COMMUNITY.
• IT MAY FORM A COST EFFECTIVE WAY TO INTRODUCE
PREVENTION/EARLY DETECTION OF CO MORBIDITIES IN
ELDERS.
• THERE IS MORE AWARENESS ABOUT GOVERNMENT SERVICES
AND POLICIES AVAILABLE TO OLDER PERSONS.

50. Thank you!
Interested Physiotherapists May Contact
email: dharma.dfi@gmail.com
Mobile Number:+919811020093
Website: www.dharmafoundationofindia.org