Geriatric Need hierarchyDr. D. Dutta Roy

Psychology Research UnitIndian Statistical Institute, Kolkata –

700108Web:http://www.isical.ac.in/~ddroy

E-mail: ddroy@isical.ac.inLecture at CMIG, Kolkata

22.12.2010

History Modern geriatrics in the United Kingdom really began with the

"Mother" of Geriatrics, Dr. Marjorie Warren. Warren emphasized that rehabilitation was essential to the care of older people. She developed the concept that merely keeping older people fed until they died was not enough- they needed diagnosis, treatment, care and support. She found that patients, some of whom had previously been bedridden, were able to gain some degree of independence with the correct assessment and treatment.

Another "hero" of British Geriatrics is Bernard Isaacs, who described the "giants" of geriatrics: incontinence, immobility, impaired intellect and instability. Isaacs asserted that if you look closely enough, all common problems with older people relate back to one of these giants

Geriatric Need hierachy

PHYSIOLOGICAL NEEDS

Geriatric nutrition It includes foods that are

tasty, but at the same time have a higher energy and nutrient content. Food should not elevate blood pressure, develop constipation. It should normalize level of cholesterol.  

Massage

Massage

Massage

Safety needs

Home Assessment I) Social Information

II) Caregiver InformationIII) Patient's HealthIV) Head InjuryV) Activities of Daily LivingVI) History of FallsVII) VisionVIII) HearingIX) DentitionX) Bowel/BladderXI) SexualityXII) NutritionXIII) CommunicationXIV) Usual daily activities (with exercise)XV) Sleeping XVI) FinancesXVII) Home Safety ChecklistXVIII) Current MedicationsXIX) Care resources/agencies

Geriatric utensils

Geriatric rooms

Geriatric commode

Geriatric commode

Social Needs

Social need assessment

Use projective test

Marital Counseling Analyze love pattern: Love as

dependency, sadistic love,love as a rescue fantasy, compulsive love,love for the unattainable object, celibate love,critical love,loving for partner’s parents, revengeful love – any of which lead to extramarital affairs and marital breakdown.

Assess the degree to which the prpblem is due to ignorance about sex, cultural taboos, myths, poor communication, sexual failures, unrealistic concepts of success or undue performance pressure.

Social need fulfillment

Performing Art Therapy

Performing art therapy

Movement therapy

Animal assisted therapy

Esteem Need

Computer games

Games

Yoga

Self-actualization

Meditation