Pre-disposing factors for infections in elderly

Components of CGA

A 71-year-old female with longstanding history of episodic non-bilious projectile vomiting (mostly undigested food and saliva) presented with worsening of her symptoms and food intolerance during the previous six months. Over that time frame, she noted a sensation of food becoming stuck in her throat and progressive difficulty swallowing. This difficulty was initially related to solids and then progressively to liquids, which severely limited her food intake. She lost 8 kg since the symptoms started to worsen. She stays alone and does not smoke or drink alcohol. Her family history is noncontributory. On evaluation her upper GI endoscopy showed dilated esophagus and pooling of saliva and a tight GE junction. The barium swallow demonstrated dilated mid-distal esophagus with “bird beaking” appearance. Questions: What is the likely diagnosis? What test is needed to confirm the diagnosis? Outline the common modalities of management. 

An elderly man is brought by family to emergency room in obtunded state. He has been suffering from diarrhea for last 3 days. His comorbid illnesses are DM, hypertension. Off late his family has been observing some forgetfulness. How will you proceed for assessment of dehydration. What are the risk factors for dehydration in this patient? 

Define Inter-Generation Learning

What do you understand by vocational rehabilitation?

Write short note on challenges in rehabilitation of older adults

Write short notes on multidisciplinary rehabilitation team 

Elements of informed consent

Differentiate between a DNAR and Advanced Directive

6 years ago, 62 years old Megha was diagnosed with a neurodegenerative disorder in which there was destruction of motor nerves affecting the control of movement. In routine course, people with this disorder could not survive for more than 4 years resulting in death due to the inability of the inspiratory muscles to contract leading to suffocation. Presently Megha’s condition is steadily deteriorating and it is expected that she won’t be able to live through the month. She is anxious about the pain and suffering in her final hours. She requests her doctor to give her opioids in high doses for pain as soon as suffocation or choking starts to hasten her death and make it painless.
Questions:
1. What would you do if you are the treating physician?
2. As per the basic rules of ethics, the patient has the right to make this choice to maintain the autonomy. But does
it come under the legal prerogative of the treating physican?
3. Megha is trying to create obligations on the part of others to aid her so that she can exercise her rights of autonomy
and death with dignity. She is incapacitated physically to kill herself but should someone be FORCED to help
her?
a) This will be legally called as……………………………….?
b) Is it legally allowed in our country?
4. Will the Legalization of euthanasia be morally & ethically justified?
5. Can this procedure be the only alternative to terminal illness and associated pain, financial ruin and suffering?

A 79-years-old woman has been diagnosed with breast cancer. The Onco-surgeon in the hospital told her that she needs surgery, provides the consent form and requests her to sign it so that he can proceed with the surgery. The junior doctor is to retrieve the signed consent. What are the ethical considerations in this case?

Programme strategies of NPHCE

Concept of healthy aging

Channels of Communications 

Indira Gandhi national Old Age Pension Scheme

Assessment of gait in elderly

 Smart homes

Dhani Ram is a 67 years old person living in Delhi for past 20 years in a local slum. He was earning his daily living by doing odd jobs as head loader in and around whole sale markets. For the last couple years he has been suffering from severe pain in his limbs and is unable to do as much and get work every day. At times he experiences breathing difficulties. He lives with his wife and son. His son is also n unskilled daily wage worker. In the pandemic period his earning were severely affected. Of late it has become difficult for Dhani Ram to make his two ends meet and take care of his family’s essential needs. The son has also started drinking alcohol and started misbehaving with his parents. He wonders if the government can help him in his old age by giving him some monthly allowance to afford him a life with dignity. How do you think he can be helped. Elaborate on the scheme

Mr X 70 years old is a diabetic on only one oral hypoglycaemic agent and is regular with his check ups.His HbA1c done last month is 7.5%. His Mini mental state examination (MMSE) reports good cognitive functions. He goes for a brisk walk everyday for 45 minutes. Mention the physical tests that can be performed on him and the reference results