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Needs of elderly
PRESENTATION BY
Ms. Poornima Nahar
Clinical Instructor,
CON, DMCH, LDH.
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A profession in geriatric social work
continues to be territory with a frontier that
just keeps growing. This work
provides a real opportunity to actually make a
positive difference in the lives of older adults
& their family members.
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Major challenge facing society is how we can maintain health
and quality of life in an ageing population .
Once you reach the dreaded 70s all sorts of ailments seem to
dog your footsteps. The well being of an individual does not merely pertain to
physical health but also to mental health.
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HOW TO CARE FOR ELDERLYHOW TO CARE FOR ELDERLY
Many people are wary of elderly people.
The reality is everyone gets old, and, as
we age, our bodies begin to lose that
youthful essence. SO, It's important
to give them respect and compassion.
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HOW TO CARE FOR ELDERLYHOW TO CARE FOR ELDERLY
The first thing to remember whencaring for an elderly person is that
their physi l ic l ppe r ce has
rse e . Hearing, vision and touch
You may need tospeak louder.
You w ill al so need to mak eallowance for their poor vision.
Furthermore, the elderly are oftenmore sensitive topainand touch.
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HOW TO CARE FOR ELDERLYHOW TO CARE FOR ELDERLY
SecondSecond ofof allall,, the elderly begin to losecontrol over certain aspects of their life
including bodily f ctions and memory.
You need to remember that this is not theirfault, and it is probably more frustrating for
them than it is for you. So,
Be sensitivebeunderstanding and
be discreetabout their trouble.
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HOW TO CARE FOR ELDERLYHOW TO CARE FOR ELDERLY
ThirdThird,, an elderly people will go throughemotional changes as well.
They will also be frustrated about becoming
dependent on someone else ,especially after
an entire lifetime of doing things themselves.
They may want to talk about it or may not; YouYou needneed totobebe compassionatecompassionate andand listenlisten
YouYou needneed totorespectrespect theirtheir wisheswishes..
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HOW OLD AGE INSULTS A PERSONHOW OLD AGE INSULTS A PERSON
Loss ofphysic
alattracti
ve-ness
Loss ofsuppor
tingperson
s
Lossof
statu
s
L
loss ofuseful
andrespect
edroles
Loss ofphysic
alhealth
andvigor
Changes inliving
environ-ment
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ASPECTS
3.SOCIAL3.SOCIAL2.2. PSYCHOPSYCHO--
LOGICALLOGICAL
1.PHYSICAL1.PHYSICAL
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PHYSICAL ASPECTSPHYSICAL ASPECTS
As aging occurs, certaincertain physicalphysical changeschanges occ rocc r inin allall individualsindividuals hichwhichareare normalnormalpartpartofofagingaging processprocess..
The rate and degree of change varies among individuals.
LifestyleLifestyle ,nutrition,nutrition ,, economiceconomic statusstatus ,social,social environmentenvironment andand limitedlimited
accessaccess toto medicalmedical carecare cancan havehave anan effectseffects..
IfIf anan individualindividual cancan recognizerecognize thesethese changechange asas aa normalnormal partpart
ofof aging,aging, thethe individualindividual cancan usuallyusually learnlearn toto copecope withwith thethe
changeschanges..
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Integumentary systemIntegumentary system
MostMost obviousobvious effectseffects ofof agingaging areare seenseen inin thethe
integumentaryintegumentary systemsystem..
ProductionProduction ofof newnew skinskin cellscells decreasesdecreases &&
sebaceoussebaceous andand sudoriferoussudoriferous glandsglands becomebecome lesslessactiveactive ..
TheThe hairhair losesloses colorcolor andand hairhair lossloss occursoccurs.. TheThe
skinskin becomesbecomes lessless elasticelastic andand drydry ..
TheThe nailsnails becomebecome thick,thick, toughtough andand brittlebrittle..
CirculationCirculation toto skinskin decreasesdecreases andand causescauses
coldness,coldness, drynessdryness andand poorpoor handlinghandling ofof injuredinjured
tissuetissue ..
HypothermiaHypothermia cancan bebe aa seriousserious problemproblem forfor
elderlyelderly..
PHYSICAL ASPECTSPHYSICAL ASPECTS
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PHYSICAL ASPECTSPHYSICAL ASPECTS
INTEGUMENTARY SYSTEMINTEGUMENTARY SYSTEM--NEEDS Good skin, nail, hair care is essential
Mild soaps should be used
Bath oils, lanolin lotions are recommended to
combat dryness and itching
Partial baths on alternate days are recommended
Any sores or injury to skin should be cared for
immediately.
Proper diet, exercise, good hygiene, decreased
exposure to sun and proper skin care helps slow and
even decrease the normal physical changes in the
integumentary system
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PHYSICAL ASPECTSPHYSICAL ASPECTS
MUSCULOSKELETAL SYSTEM
As aging occurs, muscle lose tone, volume, strength.
Osteoporosis and arthritis is the most common
problems.
The rib cage becomes more rigid and vertebral
column press close together.
These changes cause the elderly people to
experience a gradual loss in height, weight and
decreased mobility.
Sense of balance is less and falls occur easily and
results in fractures of arms, legs and hips.
Fine finger movements like buttoning clothes or
tying shoes are difficult to perform.
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MUSCULOSKELETALMUSCULOSKELETAL SYSTEMSYSTEM--NEEDSNEEDS
ROM exercises help to maintain muscle strength.
Encourage them to exercise as much as their
physical condition permits.
A diet rich in protein, calcium and vitamins isneeded to slow loss of minerals from bones and
maintain muscle structure.
Bars in the bathrooms, hand rails in the halls &
use of walkers and quad canes is frequently
recommended Well fitted shoes with non slip soles and flat heels
should be worn to prevent falls
A consultation with occupational therapist can
provide elderly individuals with information on
latest adaptive devices to maintain independence
PHYSICAL ASPECTSPHYSICAL ASPECTS
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PHYSICAL ASPECTSPHYSICAL ASPECTS
The safety of t
he elderly is a major concern in ourlives, as falls and fire are common accidents among
the older generation.
Precautionary steps taken at home are
General precautions
-Use nightlights for the stairs and hallways. Use illuminatedlight switches. Clap-on, clap-off light systems are
particularly convenient.
- Stay organized and tidy. Keeping things in generally the
same place will facilitate in, not only locating them, but also
creating a route around the house to which one can
accustom oneself.- Keep the phones in easy reach in the kitchen, the living
room, and the bedroom. Consider keeping a wireless
phone. Have a list of emergency numbers handy.
These rules of thumb should tighten home security for the
elderly.
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Falls
Falls,Falls, trips,trips, andand slipsslips areare somesome ofof thethe mostmost frequentfrequent
causescauses ofof physicalphysical injuryinjury inin thethe elderlyelderly.. To lower the
risk of falls, consider the following safeguards.
Install solidhandrails on the stairs, in the bathroom, etc.
Putnon-slip mats on the bathroom floorandin the tub
Place low-pile rugs in allhazardous areas and putnon-
slip mats underall rugs.
Thresholds to anydoorway should be as low as possible.
Keep all wires and cables tucked in and/or close to the
walls.
Check that there are no holes in the yard area. Check
that there are no loose boards on the porch.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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Home fires are also quite common in homes of the
el erly. Here are a few ti s to counter such hazar s.
Check the fire alarms frequently to be certain they are in
good working order. Change the batteries as soon as it is
discovered they are dead.
eep a fire extinguisher close at hand.
Maintain any and all exits clutter-free.
Use kitchen appliances that are clearly marked. All the
knobs and switches should be easily understood and
accessible. Make sure no electrical appliances are near any sinks or
bathtubs.
Check the wires of all appliances. They should all be
properly insulated.
Use safety plugs for electrical sockets that are not in use
PHYSICAL ASPECTSPHYSICAL ASPECTS
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CIRCULATORYCIRCULATORY SYSTEMSYSTEM
Heart muscles become less efficient at pushing
blood into arteries .
Blood vessels become narrow and blood flow tobrain and other vital organs decreases.
Blood pressure may increase or decrease.
They are aware of changes when exercise, stress,
excitement, illness and other similar events call forincrease in oxygen demand.
During these periods they experience weakness,
dizziness, numbness in hands and feet and rapid
heart rate
PHYSICAL ASPECTSPHYSICAL ASPECTS
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CIRCULATORYCIRCULATORY SYSTEMSYSTEM--NEEDS
Need to avoid strenuous exercises and need
rest periods during day.
Need moderate exercise, according to
individuals ability to tolerate, does stimulate
circulation and prevent formation of
thrombus or blood clot.
If Hypertension is present, a diet low in salt isrecommended
PHYSICAL ASPECTSPHYSICAL ASPECTS
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RESPIRATORY SYSTEM
Respiratory muscle becomes weaker with age .The rib
cage becomes more rigid.
The alveoli, air sacs in the lungs, become thinner and
less elastic which decreases the exchange of gasesbetween the lungs and the blood stream.
The bronchioles, or air tubes in the lungs also loss
elasticity. Changes in larynx leads to weaker voice.
These changes cause the elderly individuals to
experience dyspnea or difficult breathing. Breathing
becomes rapid and they have difficulty coughing up
secretions .
This makes them more prone to respiratory infections
like pneumonia, cold , emphysema and bronchitis.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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NERVOUS SYSTEM
Blood flow to brain decreases and their progressive loss
of brain cells.
This interferes with thinking, reacting, interpreting and
remembering.
The sense oftaste, vision , hearing diminish.
Nerve endings are less sensitive and there is a decreased
ability to response to pain and other stimuli.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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PHYSICAL ASPECTSPHYSICAL ASPECTS
Sensory impairment
50%of older people suffer
from deterioration o f eye
sight. Vision cause problem in
reading small print and
seeing objectatdistance.
There is decrease inperipheral vision and night
vision.
Elderly individuals are more
prone to cataract and
glaucoma.
NEEDS
Spectacles are worn & Large printed
books are provided bymany libraries
Lighting needs to be good and colors
light and cheerful. This helps
compensate for failing eyesight and
improves mood
Use sheer curtains orpolarized glass to
minimize windowglare.
Use contrasting colors to help
differentiate depth
Medical treatment for cataract and
glaucoma
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PHYSICAL ASPECTSPHYSICAL ASPECTS
Hearing impairments
Hearing impairments are
less frequent but can be
annoying to all concerned .
The individual may speak
more loudly than normal,
sk for words to be
repeated Inability t o hear high
fre uency sounds such as
ringing ofa telephone
NEEDS
If a person has hearing aid make
sure they are on and working
Speak normally or lower the pitch ofyour voice
Minimize all the background noise
& sit face to face to facilitate lip
reading
Use pictures ,models or writtenkeywords to reinforce verbal
teaching
Select video or slides or tape
presentation that use speakers with
deeper voices
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Cognitive impairment
Individuals with deficits inmemory, language, abstract
thinking and judgments
have great difficulties
executing ADLs.
These individuals needs
supervision and cueing.
NEEDS
Slow the pace and allow extra time for
the person to response & give examples
related to life experiences Reinforce with printed material & keep a
diary and get into the habit of using it
regularly
Alarm clocks & electronic memory aids
are also available(Alarm buzzer can be
programmed to remind the user atappropriate time)
Have a wipe clean note board in the
house and keep notes into it
Mnemonics is another way of improving
memory(images and pictures seem
easier to recall words)
PHYSICAL ASPECTSPHYSICAL ASPECTS
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URINARY SYSTEM
In elderly individuals as there is decreased sensation and also due than to
muscle weakness they does not empty their bladder completely and urine
is retained ,causing bladder infections.
Nocturia or urination at night is common
Males frequently experience enlargement of prostate gland ,loss of muscle
tone results in incontinence or inability to control urination .
Many individuals decrease fluid intake to cut down on the frequent need
to urinate. This cause dehydration, kidney disease and infection.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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URINARY SYSTEM-NEEDS
Encourage to increase fluid intake to improve kidney function
To prevent nocturia most fluids should be taken beforeevening
Regular trips to bathroom, wearing easy to remove clothing,and using absorbent pads can help in mild incontinence.
Some elderly needs bladder training programs to increasebladder capacity and leads to more control over urination.
An indwelling catheter may be needed if all urinary control islost
PHYSICAL ASPECTSPHYSICAL ASPECTS
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ENDOCRINE SYSTEMENDOCRINE SYSTEM Changes in endocrine system results in
increased production of some hormones, such as parathormone and thyroid
stimulating hormones and
decreased production of other hormones, such as thyroxin ,estrogen,progesterone and insulin.
As Hormones affect many body functions, several physical changes mayoccur.
The immune system of body is less effective
The BMR decreases, resulting in complaints of feeling cold, tired and less alert
Intolerance to glucose can develop resulting in decreased blood glucose levels.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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ENDOCRINE SYSTEMENDOCRINE SYSTEM--NEEDS
Proper exercise,
adequate rest,
Medical care for illness,
a balanced diet and
a healthy lifestyle all help to increase the effects causedby changes in hormone activity.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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REPRODUCTIVE SYSTEMREPRODUCTIVE SYSTEM
The decrease of estrogen and progesterone in female
decreases in vaginal secretions. Vaginal infectionsbecome more common.
Decreasing levels of testosterone in the male slow
the production of sperm. The seminal fluids areproduced in smaller amounts
Sex desire and need do not diminish with age.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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REPRODUCTIVE SYSTEMREPRODUCTIVE SYSTEM--NEEDS
The health care workers must
respect the privacy of elderly
married couples
Allow them to meet their sexualneeds as in long-term care facilities
they are not allowed to live together.
PHYSICAL ASPECTSPHYSICAL ASPECTS
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Studies have shown that older people perform less well on
intelligence tests when compared with younger ones.
Memory loss is feature commonly associated with old age.
When this occurs in elderly individual who are already
stressed by physical changes or circumstances, it can be
traumatic.
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Stress or depression caused by physical and psychosocial
changes
Use of chemicals or alcohols .Some medications and drugs
which can sometimes accumulate in body and causeconfusion and disorientation
kidney disease which interferes with electrolytebalance
liver disease which interferes with metabolize
Even poor nutrition or lack of fluid intake caninterfere with mental ability
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Other diseases or damages that can cause permanent confusion ordisorientation are:
CVA (which damages brain cells).
Arteriosclerosis (a condition in which the walls of blood vesselsbecome thick and lose their elasticity)
Dementia also called as brain syndrome (loss of mental ability)
Alzheimers disease (form of dementia that causes progressivechanges in brain cells.)
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AA primaryprimary concernconcern isis toto provideprovide safesafe andand securesecure environmentsenvironments
Dangerous objects suchsuch asas drugs,drugs, poison,poison, scissors,scissors, knives,knives, razors,razors, andand guns,guns,
powerpower tools,tools, cleaningcleaning solutionsolution andand matchesmatches andandlighterslighters shouldshould bebe keptkeptoutout
ofof reachreach and in a locked area.
If the individual tend to wander, doors and windows should be secure. InIn
severesevere casescases specialspecial sensorssensors mustmust bebe attachedattached toto thethe legleg oror wristwrist ofof thethe
disorienteddisorientedindividualindividual..
Meals, baths, dressing, walks, and bed time should eacheach occuroccur atat
approximatelyapproximately thethe samesame timetime eacheach dayday..
Activities should be kept asas simplesimple asas possiblepossible and last for short period of
time
Loud noises, crowded rooms and excessive commotion can cause the
individual to become agitated and even more disoriented.
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RealityReality orientationorientation consistsconsists ofof activitiesactivities thatthat helphelp totopromotepromote awarenessawareness ofof person,person , time,time, andand placeplace.. SomeSomeaspectsaspects ofof realityrealityorientationorientation areare::
Be calm and gentle when approaching the individual
ddress the person by the name theyprefer.
voidthe terms such as sweetie, honey, baby
State your name and correct the person if he or shecalls you wrong name
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Speak slowly and clearly and ask simple and clear andsimple uestions
Never rush orhurry the individual
Repeat instructions patiently. llow time for the individualto respond.
Encourage conversation about familiar things or currentevents
Encourage use o f T.Vor radio but avoid over stimulatingthe individual
Make sure individualuses sensoryaids such as glasses andhearing aids
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Make constant references to daytime and place. e.g.,it is 8:00 Tuesdaymorning andtime forbreakfast
Use clock ,calendars and information boards to pointout time, dayandactivities
Make a constantandlimitedroutine
Keep the individual oriented to day night cycles.uring the day encourage the person to wear regularclothes. lso open the curtains andpointout sunshine.
t night close the curtains, use night lights andpromote rest.
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The socialneeds which are common to all individuals are
EmotionalEmotionalsecuritysecurity andandaffectionaffectionmetby receiving love and byliving in the worldwhere things are predictable .
SocialSocial recognitionrecognition andand statusstatus met by receiving respect frompeople who counts in one world
A sensesense ofofworthworth andand selfself respectrespect, met by living up to onesideals.
Ade uate foodfood ,clothing,,clothing, sheltershelterandand healthhealthThese needs are notmetandthe reason lie in the fact thatboth
the human body and human society insult the person as hegrows olderand make itdifficult forhim to meethis needs.
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Adjustment to death of spouse-
If a woman loses her husband, she may have to
move from her house to smaller place, learn about business matters,
and above all she has to learn to be alone.
If a man has the same adjustment to make to loneliness , he
may have to learn to cook,
keep house and to keep his clothes in order.
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Adjustment to death of spouse-
The solution of this task run through the range of living on alone in the oldhome,
moving into a smallhome, living in a rooming house,
moving in with brotheror sisters,
living with children,
remarrying,
going to an olds people home.
Every solution re uires unlearning ofoldways and learningofnew ways, ata time when learning comes harder than itdidin earlier years.
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Adjustment to loss of employment and reduced income
In a society a jobjob isis thethe axisaxis ofof lifelife for most men and for many
women. If the occupation goes, the individual feel that hedoes not count & he is not a worthy member of society.
SomeSome peoplepeople fill fill thethe vacuumvacuum createdcreated byby retirementretirement inin theirtheir
liveslives withwith usefulusefulandandinterestinginteresting leisureleisure timetime activityactivity
findfindaa partpart timetime jobjob whichwhich keepskeeps themthem busybusyandandhappyhappy..
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Adjustment to decrease physical vigor
The human body ages in almost every one of its cells and
cellular systems.
The cells gradually lose their self repairing properties
They slow down in their nutritional processes.
TheThe individualindividual mustmust learnlearn newnew wayway ofo f lifelife thatthat isis inin
harmonyharmonywithwith hishis decreaseddecreasedstrengthstrength andandhealthhealth..
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Satisfactory social roles, which bring social recognitionand self respect
It lies within the power of the individual to create forhimself some of the satisfying social roles , suchsuch asas thosethose ofof friendfriend,,
membermemberofof socialsocial cli ue,cli ue,
constructiveconstructive useruserofof leisureleisure time,time,
informedinformedcitizencitizen ,, activeactive churchchurch membermember..
Care provided to elderly individual should allow asmuch independence as possible.
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A chance to earn a living or economic security
Older people need economic security, but under
existing conditions relatively few of them can live in
reasonable comfort on their own life time savings.
TheyTheyneedneedwork,work, ifif theytheyareare ableable toto work,work, oror
AA systemsystem ofof pensionspensions whichwhich givesgives themthem reasonablereasonable
economiceconomic securitysecurity..
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Social and recreational facilities
Just as the community provides recreational facilities andleadership to meet the needs of youth, so it should meet the
needs of older people with analogous facilities through
municipalmunicipal recreationrecreation departments,departments,
churches,churches,
schoolsschools andand
clubsclubs..
At a minimum, the older people require meeting places,equipments for games, leadership for recreation instruction in
art and crafts.
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Making satisfactory physical living arrangements
The principal values that older people look for in housing are
quiet,
privacy,
independence ofaction,
nearness to relatives andfriends,
residence among own culturalgroup,
cheapness,
closeness to transportation lines and
communal institutions.
MostMost peoplepeople tendtend toto clingcling toto establishedestablished housinghousing arrangementsarrangements untiluntil theythey
becomebecome veryveryunsatisfactoryunsatisfactory..
AllowAllow themthem toto bringbring theirtheir favoritefavorite piecespieces ofof furniture,furniture, pictures,pictures, television,television,
radiosradios andand otherother personalpersonal itemsitems toto longlong termterm facilitiesfacilities.. ThisThis willwill allowallow
individualindividual toto adjustadjust toto newnewenvironmentsenvironments andandtoto copecope withwith changeschanges ..
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Health services
For older people therethere shouldshould bebe guaranteedguaranteed healthhealthserviceservice toto whichwhich theythey cancan turnturn asas aa mattermatterofof rightright..
Whether this is financial through an insurance
company or through public supported fund .
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Providing care to elderly can be challenging but rewarding
experience.
The needs of elderly dont differ greatly from the needs of any other
individual. They have same physical and psychological needs as any
other person at any age .
these needs are sometimes intensified by physical and psychological
changes that disrupt normal life pattern.
When this occur, the el erly in ivi ual
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