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ii Elderly Health Hand Book

CATATAN KESEHATAN PRA LANSIA/LANSIA

Catalogue.Ministry of Health.Republic of Indonesia

618.97Ind Indonesia. Ministry of Health.Republic of Indonesia.b Directorate General of Public Health Elderly Health Hand Book Jakarta: Ministry of Health.Republic of Indonesia. 2016

ISBN 978-602-416-086-9

I. TITLE II. GERIATRIC III. HEALTH SERVICES

ELDERLY HEALTH HAND BOOK

PHOTO4X6

Name :

Address :

Register No. :

Date of the first visit :

Primary Health Centre :

Elderly Integrated :Service Post

Songwriter:dr. Hardywinoto, SKM

MARS MASA TUA BAHAGIAA HAPPY OLD AGE SONG

0 3 4 5 6 5 4 / 5 . 3 . / 0 1 7 6 5 4 3 / 2 . . . / Ka mi pa ra u sia lan jut selu ruh In do ne sia

We are the older persons of Indonesia

0 2 3 4 5 4 3 / 4 . 2 . / 0 7 6 5 4 3 4 / 5 . . . /Mau tetap berdaya gu na ba gi di ri dan kluar ga

Eager to maintain useful, for ourselves and our family

0 3 4 5 6 5 4 / 5 . 3 . / 0 5 5 5 3 4 5 / 6 . . . / Tingkat kan hubungan so sial di da lam masya ra kat

Increase our social relationships in the community

0 6 7 2 1 7 6 / 6 . 5 . / 0 2 3 5 4 3 2 / 1 . . . / Bertaqwa ke pada Tu han yg melimpahkanRah mat

Devoted to God who blesses us with the Grace

Ref.

/ / 0 1 1 1 / 1 . 7 . 6 . / 0 6 7 2 1 7 6 / 6 . 5 . / Prik sa ke se ha tan mence gah penyakit da tang

Monitor our health to prevent diseases

0 1 1 1 / 1 . 7 . 6 . / 0 6 7 1 6 7 1 / 2 . . . / Dan kembang kan ho by se su ai ke mampu an

Develop our hobbies according to our capability

0 3 4 5 6 5 4 / 5 . 3 . / 0 1 7 6 5 4 3 / 4 . 2 . / Ba dan se hat jiwa kuat sambut masa yg kan datang

With a healthy body and strong soul, we welcome the future

0 2 3 4 5 4 3 / 4 . 2 . / 0 7 6 5 4 3 2 / 1 . . . / / Mutu hidup pun me ning kat ma sa tu a ba ha gia

Our quality of life improves,enjoyinga happy old age

3Elderly Health Hand Book

We would like to extend our praise to the Lord Almighty, who has given us the grace and blessings in order to complete this Elderly Health Hand Book. We would also like to say thank you to everyone involved in the development and revision process of this book.

The Elderly Health Hand Book is a revised version of the Elderly Personal Monitoring Health Book developed since 2005. The Elderly Health Hand Book is a tool to make records in health monitoring and early detection on health disorders or problems that occur in the Pre Elderly/Elderly and as a Information, Education and Communication (IEC) media for the Pre Elderly/Elderly, the caregiver, the family and the community regarding the Pre Elderly/Elderly health conditions.

The correct use of the Elderly Health Hand Book is expected to improve the quality of health services for the Pre Elderly / Elderly because we are able to obtain complete information on the health data of the Pre Elderly / Elderly through this book which would be useful for the Pre Elderly / Elderly themselves. This book also accommodates several substances related to the Pre Elderly / Elderly from related programs such as the Nutrition, Prevention of Non-Communicable Diseases, Mental and Intelligence Health, Hajj Health, Sports Health thus having greater benefits. Moreover, hopefully this book can have an impact on the increase of knowledge of the Pre Elderly /Elderly, caregiver, family and community about Older Persons’ health, encourage and empower the Pre Elderly / Elderly to live a healthy life, as well as play a role in every cycle of life and increase the Pre Elderly / Elderly access to quality health services.

Finally, we kindly hope that this Person’s Elderly Health Hand Book could bring benefits to us all, especially to the Pre Elderly / Elderly to generate healthy, active, independent and productive Older Persons.

Jakarta, October 2016Director of Family Health

dr. Eni Gustina, MPHNIP. 19630820 199412 2 2003

INTRODUCTION

Elderly Health Hand Book 5

The health provider explain the use of this book and to be applied by the Pre-Elderly/Elderly and their family.

The Elderly Health Hand Book must be read and comprehended, by the Pre-Elderly/Elderly and their family. Do not be ashamed to ask to the health provider or cadre if there are certain things that you might not understand.

The Elderly Health Hand Book must be maintained, do not destroy or lose it Because The Elderly Health Book contains health information and important notes concerning the Pre-Elderly/Elderly.

The Elderly Health Hand Book must be always carried When the Pre-Elderly/Elderly visit the Health Service facilities, including the Elderly Groups/Elderly Integrated Service Post (Posyandu Lansia/Posbindu).

The Elderly Health Book is intended for Pre-Elderly (aged 45-59 years old) and Elderly (aged 60 years old and above) which includes health records and numerous information on how to maintain the Pre-Elderly/Elderly health, thus well monitored.

Each Pre-Elderly/Elderly receives 1 (one) copy of The Elderly Health Hand Book. This book is available at any Elderly Groups/Elderly Integrated Service Posts Posyandu Lansia/Posbindu, Primary Health Centers and Hospitals.

GENERAL EXPLANATION

READ AND COMPREHEND

THE BOOK MUST BE

MAINTAINED

EXPLAIN THE ELDERLY

HEALTH HAND BOOK

ALWAYS CARRIED


GENERAL EXPLANATION 5

INTRODUCTION

TABLE OF CONTENTS 6

CHAPTER 1 IDENTITY 8

CHAPTER 2 MEDICAL HISTORY 10A. Family history 10B. Occupational history 10C. Family disease history 10D. Allergic history 11E. Residential analysis 12F. Immunization 12G. Past experience or current Disease/

current health problems 13H. Types of experienced surgeries 15I. Inpatient care in primary health center, hospital, etc. 15J. Home care/institution care/nursing care 15K. Currently or long-term consumed drugs 16L. Daily habit 16M. Social activities undertaken 20N. Current complaints 20O. Physical condition 21P. Mental health examination (see the results of

the elderly health assessment instruments) 25Q. Fitness level (see the results of the eldelry health

assessment instruments) 25R. Risk of falling assessment 25S. Nutrition status examination 26T. Independency level assessment 26U. Supporting examinations 26V. Conclusion 27W. Recommendations and follow-ups 27

6 Elderly Health Hand Book

TABLE OF CONTENTS


CHAPTER 3 HEALTH CONDITION AND COMPLAINTS RECORDS 28

PRE ELDELRY/ELDERLY HEALTH CHAPTER 4 DEVELOPMENT RECORDS 36

CHAPTER 5 MONITORING OF DRUG CONSUMPTION 52

HEALTH INFORMATION / IEC (INFORMATION, CHAPTER 6 EDUCATION AND COMMUNICATION) MATERIALS 58

A. Things to be noticed by the Pre-Elderly/Elderly 58B. Clean and healthy life behavior for Pre-Elderly/Elderly 60C. Complaints that need to be noticed 62D. Health problems occurring in Pre-Elderly/Elderly 64E. Balanced nutritional diet for Pre-Elderly/Elderly 72F. Physical activities for Pre-Elderly/Elderly 79G. Things to consider for Older Persons

who will travel far 85H. The role of family member to the Pre-Elderly/Elderly 86


TABLE OF CONTENTS


IDENTITYCHAPTER 1

8

Name :

Surname :

Sex : M F

Place/ date of birth : / /(age: years old)

Occupation :

Marital status : Married Not married

Widow Widower

Address :

Postal Code :

Telephone/Fax/Mobile Phone :

Residential status : Own house Children’s house

Social institution Nomad

Others (please mention) :

Religion :

Ethnicity :

Last education :

ID Number :

Blood type/rhesus :

Filled by the Pre-Elderly/Elderly/Family/Cadre Give a sign sign in the chosen boxR


IDENTITY

PERSON IN CHARGE (FAMILY THAT IS EASY-TO-CONTACT/CLOSEST PERSON):

Name :

Relation to the Elderly :

Address :

Postal code :

Telephone/Fax/Mobile Phone :

Hobbies :

Health insurance : National Health Insurance

Number :

Other insurance (please mention) :

Number :

Source of funds (living cost) :


MEDICAL HISTORY CHAPTER 2

Filled by the Health Provider during the first visit

A. FAMILY HISTORY1. Name of husband/wife : people

2. Number of children : people

3. Number of grandchildren : people

4. Number of great grandchildren : people

5. Number of children/family who livesin the same house or nearby : people

Please crossed out the unnecessary**

C. FAMILY DISEASE HISTORY

1. Diabetes : Yes/No 6. Stroke : Yes/No2. Hypertension : Yes/No 7. Anemia : Yes/No 3. Cancer : Yes/No 8. Chronic lung disease : Yes/No4. Asthma : Yes/No 9. Senile/ Dementia : Yes/No5. Heart disease : Yes/No 10. Suicidal attempt : Yes/No

11. Others (please mention) :

B. OCCUPATION HISTORY

Placeofwork Year Typeofoccupation Position

11Elderly Health Hand Book 11Elderly Health Hand Book

3. OTHER CAUSESa. Dush : Yes/Nob. Cold : Yes/Noc. Others (please mention) :

4. ALLERGIC DISEASES SUFFEREDa. Asthma : Yes/Nob. Eczema : Yes/Noc. Others (please mention) :

MEDICAL HISTORY

2. FOOD- BEVERAGESShrimp : Fish : Yes/No Yes/No

Crabs : Eggs : Yes/No Yes/No

Squids : Milk : Yes/No Yes/No


D. ALLERGIC HISTORY1. DRUGS

a. Penicillin : Yes/Nob. Streptomycin : Yes/Noc. Sulfa : Yes/Nod. Aspirin : Yes/Noe. Antalgin : Yes/Nof. Others (please mention) :

Please crossed out the unnecessary*


MEDICAL HISTORY

E. RESIDENTIAL ANALYSIS1. The house flooring :

a. Material : Soil Wood Cement

Tile Ceramic Others

b. Conditions : Uneven floor heights Wet

Slippery Non slippery ..............

2. Source of lighting : Existing None

Enough Not enough

3. Source of ventilation : Existing None

4. Source of clean water : Existing None5. Bathroom :

a. Flooring : Slippery Non slippery

Uneven floor heights

b. Toilet/Water closet : Sitting Squat

c. Handle : Existing None

d. Distance to the bed : meters

6. Stairs : Existing None

Steep Not steep

Handle : Existing None

F. IMMUNIZATION

TypesofImmunization Date/Year Information

Influensa Meningitis

Pneumonia


Give a sign sign in the chosen boxR


MEDICAL HISTORY

G. PAST EXPERIENCED OR CURRENT DISEASE/HEALTH PROBLEMS

NameofDisease/HealthProblems Existing None Year.....to..... Information

Hypertension

Diabetes Mellitus

Stroke Lung diseaseHeart disease

Gastric disease (ulcer)

Bronchial Asthma

Kidney and urinary tract disease

Enlarged prostate Cancer

Hepatitis

Arthritis

Uric acid

OsteoporosisVisual impairment Hearing loss

Dental and mouth disorders

Urination/Bowel Disorders

Anxiety Insomnia

Depression

Easily offended/ill-tempered

Change of behavior Easy to forget

Easily palpitated

Anemia (weak, weary, lethargic, tired, exhausted)

Eating disorder Others (please mention)

14



H. TYPES OF EXPERIENCED SURGERIES

TypeofSurgery Year Information

I. INPATIENT CARE IN PRIMARY HEALTH CENTER (PHC), HOSPITAL, ETC.

Location Illness Year Durationof InformationTreatment

J. HOME CARE/ INSTITUTION CARE/ NURSING CARE

Location Illness Year Durationof Treatment

MEDICAL HISTORY


K. CURRENTLY OR LONG - TERM CONSUMED DRUGS

Prescribed Non-prescribed* Dose Durationof consumption

* Supplements/herbal/drugs bought personally

L. DAILY HABITS1. COMMON HABITS

Habits Yes No Information

Regular physical trainings x/week

Vegetables and fruit consumption x/day

Water consumption glass/day

Coffee/ tea consumption x/daySweetener consumption x/dayHerbal consumption Please mention :

Bersirih or Menginang habit (chewing materials such as nut, betel, gambier, tobacco, clove and lime stone) x/week

Alcoholic beverage consumption glass/day

Smoking cigarette/day

Others (please mention)

MEDICAL HISTORY

Morning 06.00-08.00 AM

Staple foods

Animal source foods

Vegetarian source foods

Vegetables

Fruits

Oil

Sugar

Salt

Snacks 10.00 AM

Snacks

Afternoon12.00-13.00PM

Staple foods

Animal source foods


Vegetables

Fruits

Oil

Sugar

Salt

Snacks 16.00 PM

Snacks

Evening 18.00-19.00 PM

Staple food

Animal source foods


Vegetables

Fruits

Oil

Sugar


a. Eating pattern history in the last 24 hours

Time and food dissemination

per day

Food menu

Foodmaterial

Amount

Weight (grams)

Energy(kcal)

Carbo-hydrate(grams)

Protein(grams)

Fat(grams)

Nutrient content

HM

2. EATING PATTERN HISTORY

MEDICAL HISTORY


Snacks 21.00 PM

Snacks

Total Nutritional Intake

Nutritional Needs (RDA/ Recommended Daily Allowance)

% RDA (RecommendedDaily Allowance)

Total drink per day

Explanation:HM = Household Measures: Cup, tablespoon (tbsp), teaspoon (tsp), slice large (L), medium (M), small (S), etc.

MEDICAL HISTORY

Time and food dissemination

per day

Food menu

Foodmaterial

Amount

Weight (grams)

Energy(kcal)

Carbo-hydrate(grams)

Protein(grams)

Fat(grams)

Nutrient content

HM

b. Eating pattern history in the last 1 week (Food Frequency Form)

Food material InformationFood Material Frequency/ Week

Never

Less than once/week

1-2times/w

eek

3-6times/w

eek

Morethan6tim

es/week

1 2 3 4 5 6 7Staple food Rice, noodles/vermicelli, macaroni, cassava, yam, corn, potatoes, bread, biscuits, crackers

Side Dish (source of animal protein)Fresh fish, canned fish (sardine, tuna, etc), fresh shrimp, beef, preserved meat (corned beef), sausage, chicken, liver, eggs, meat-balls, innards, etc)


MEDICAL HISTORY


1 2 3 4 5 6 7

Side Dish (source of vegetable protein)fibersoybean cake or tempeh, tofu, oncom, legumes (soybeans, peas, red beans, etc)

Vegetables greens, bean sprouts, carrot, tomato, eggplant, etc

Fruits

Milk and dairy products Skim milk, full cream milk, yoghurt, cheese, ice cream, etc

Oil/substitute,fried food, animal lard, coconut milk

Min

yak

Kela

pa

Never

Less than once/week

1-2times/w

eek

3-6times/w

eek

Morethan6tim

es/week



M. SOCIAL ACTIVITIES UNDERTAKEN

N. CURRENT COMPLAINTS

MEDICAL HISTORY


1 2 3 4 5 6 7

Supplements under consumption

Sugar: Canned drinks, granulated sugar, honey, brown sugar, sugar stone

Explanation:Columns 2-6 are filled with the type and frequency of the food materials. Column 7 is to be filled by concluding the food material and supplements consumed by the Elderly in a week:• Never• Less than once a week = Seldom• 1-2 times a week = Seldom• 3-6 times a week = Often• More than 6 times a week = Often

Typeofactivities Frequency

Never

Less than once/week

1-2times/w

eek

3-6times/w

eek

Morethan6tim

es/week


O. PHYSICAL/CONDITION

1. NUTRITIONAL STATUS

a. Weight (W) : kg

b. Height (H) : cm

c. Knee height (KH) : cm

d. Seat height (SH) : cm

e. Arm span (AS) : cm*Choose Either OneThe body mass index based on Knee Height, Arm Span andSeat Height could be found in the BMI table in the technicalinstructions guideline

Weight (kg)Body Mass Index (BMI) =

Height (m) x Height (m)

Body Mass Index (BMI) = = =

MEDICAL HISTORY

Classification of the nutritional status based on what is adapted in Indonesia

BMI Category NutritionalStatus

< 17.0 Severe weight loss Very underweight

17.0 - < 18.5 Mild weight loss Underweight

18.5 - 25.0 Normal weight Normal

>25.0 - 27.0 Mild overweight Overweight

> 27.0 Excess weight Obesity

Source: Balanced Nutrition Guidelines 2015

22 Buku Kesehatan Lansia

f. Abdominal circumference

Male : cm (recommended: < 90 cm)

Female : cm (recommended: < 80 cm)

Conclusion :

2. VITAL SIGN

a. Pulse : x/minute

b. Tension : Sitting position : mmHg Sleeping position : mmHg

c. Breathing : x/minute

d. Temperature : 0C

e. Awareness :

f. Pain : Existing None

MEDICAL HISTORY


a. HEAD

1). Eyes o Vision impairment

- Right : +/- ( )

- Left : +/- ( )

2). Ears o Hearing impairment

- Right : +/- ( )

- Left : +/- ( )

3). Nose :

4). Throat :

5). Oral cavity

- Teeth :

- Tongue :

- Gum :

- False teeth :g

6). Others (please mention) :

b. NECK

1). Thyroid gland :

2). Lymph nodes :

c. CHEST

1). Heart :

2). Lungs :

3). Breast :

3. PHYSICAL EXAMINATIONS

Date

Physician examiner

MEDICAL HISTORY


d. BACKBONE

Bent/Crooked/ Lumps, etc. :

e. ABDOMINAL

1). Gastric :

2). Liver :

3). Spleen :

4). Others (Please mention) :

f. GENITALS

g. ANUS

h. EXTREMITY

1). Superior Extremity

- Right :

- Left :

2). inferior Exstremity

- Right :

- Left :

MEDICAL HISTORY

P. MENTAL HEALTH EXAMINATION (see the results of the Elderly HealthAssessment Instrument)

1. Emotional disturbance : Yes No

2. Geriatric DepressionScale (GDS) Score :

3. Cognitive- Memory : decline ( + / - )

- Power of thought : decline ( + / - )

- Speaking : Fluent Non-fluent

4. Behavioral disorders : Yes No

5. Global Cognitive Examination(Choose one)- Mini Mental Status Examination

(MMSE) Score :

- Mini Cog and Clock Drawing Test Score :

- Abbreviated MentalTest (AMT) Score :


MEDICAL HISTORY


Q. FITNESS LEVEL (see the results of the Elderly Health Assessment Instrument)

Good Fair Bad

R. FALL RISK ASSESMENTScore :


MEDICAL HISTORY

S. NUTRITION STATUS EXAMINATION

Mini Nutritional Assessment(MNA) Score :

T. INDEPENDENCY LEVEL ASSESMENT

1). Barthel Index of Activity Daily Living (ADL) Score*

2). Lawton Instrumental Activities of Daily Living (IADL) Score*

*Please select one

U. SUPPORTING EXAMINATIONS

a. Radiology :

b. Laboratory :

c. EKG :

d. Others :


MEDICAL HISTORY

V. CONCLUSION

a. FunctionalStatus:

Independent (A)

Mild/Moderate Dependency (B)

Severe Dependency (C)

b. NutritionalStatus : Normal Over Under

Risk of Malnutrition : Yes No

c. Mental Status : Normal Depression Suspect Dementia


d. List of problems :

W. RECOMMENDATIONS AND FOLLOW-UPS


CHAPTER 3HEALTH CONDITION AND COMPLAINTS RECORDS

Date HealthCondition/Complaints Information/Follow-up

Filled by the Pre-Elderly/Elderly/Family/Cadre


HEALTH CONDITION AND COMPLAINTS RECORDS




Elderly Health Hand Book30


CHAPTER 4PRE-ELDERLY/ELDERLY HEALTH DEVELOPMENT RECORDS

1Visit 2 3 4 5

Date

Complaints

Vital signs

• Blood Pressure

- High

- Normal

- Low

• Pulse

Independency Level

• Barthel Index of ADL

• Lawson IADL

Fall Risk

Nutritionalstatus

• W/H/KH/SH/AS*

• BMI

- Over

- Normal

- Under

• MNA


PRE-ELDERLY/ELDERLY HEALTH DEVELOPMENT RECORDS

(The diagnosis is based on complaints and action including conducted counselling and follow-up recommendations)Filled by the Health Provider

6 7 8 9 10 11 12



1Visit 2 3 4 5

Mental Health Status**

• GDS

• Mini Cog/MMSE/AMT*

Fitness Level

Laboratory • HB

• Cholesterol

• Blood sugar

• Uric acid

• Others

Health Provider’s notes/diagnosis

Case Management

* Pick either one** Examined once a year



6 7 8 9 10 11 12




1Visit 2 3 4 5

Date

Complaints

Vital signs

• Blood Pressure

- High

- Normal

- Low

• Pulse

Independency Level


• Lawson IADL

Fall Risk

Nutritionalstatus

• W/H/KH/SH/AS*

• BMI

- Over

- Normal

- Under

• MNA



6 7 8 9 10 11 12



1Visit 2 3 4 5


• GDS


Fitness Level

Laboratory • HB

• Cholesterol

• Blood sugar

• Uric acid

• Others


Case Management




6 7 8 9 10 11 12




1Visit 2 3 4 5

Date

Complaints

Vital signs

• Blood Pressure

- High

- Normal

- Low

• Pulse

Independency Level


• Lawson IADL

Fall Risk

Nutritionalstatus

• W/H/KH/SH/AS*

• BMI

- Over

- Normal

- Under

• MNA



6 7 8 9 10 11 12

Elderly Health Hand Book46


1Visit 2 3 4 5


• GDS


Fitness Level

Laboratory • HB

• Cholesterol

• Blood sugar

• Uric acid

• Others


Case Management




6 7 8 9 10 11 12




1Visit 2 3 4 5

Date

Complaints

Vital signs

• Blood Pressure

- High

- Normal

- Low

• Pulse

Independency Level


• Lawson IADL

Fall Risk

Nutritionalstatus

• W/H/KH/SH/AS*

• BMI

- Over

- Normal

- Under

• MNA



6 7 8 9 10 11 12



1Visit 2 3 4 5


• GDS


Fitness Level

Laboratory • HB

• Cholesterol

• Blood sugar

• Uric acid

• Others


Case Management

* Pick either one ** Examined once a year



6 7 8 9 10 11 12


MONITORING OF DRUG CONSUMPTION

CHAPTER 5

Filled by Pre-Elderly/Elderly/Family/Cadre

DateName of

drugAmount of drug

Time of control

Infor-mationMor-

ning Noon After-noon Night

DirectionsTime



DateName of

drugAmount of drug

Time of control

Infor-mationMor-


DirectionsTime


CHAPTER 6HEALTH INFORMATION, EDUCATION, AND COMMUNICATION (IEC) MATERIALS

b. Decrease of memory I.e.: Easily forget, does not feel thirsty, reduced appetite, reduced hours of sleep

1. IDENTIFY CHANGES IN THE ELDERLY

d. Balance disorders I.e.:Easily fall

A. THINGS TO BE NOTICED BY THE PRE-ELDERLY/ELDERLY

a. Decrease of body strength I.e.: Easily tired, wrinkled skin, tooth loss/ loose tooth, reduced saliva

e. Decrease of immunity I.e.: Easily infected

f. Indigestion I.e.: Easily prone to diarrhea, constipation, bloated

c. Hearing/ vision reduced


HEALTH INFORMATION, EDUCATION, AND COMMUNICATION (IEC) MATERIALS

2. SELF PREPARATION TO ENTER THE PRE-ELDERLY/ELDERLY PERIOD

a. Accept it as a natural process

e. Prepare funds for living expenses and health insurance (National Health Insurance or other form of insurance)

c. Remain faithful with a legitimate partner, improve harmonious relationships in the family, friendship and participation within the community

b. Increase patience, positive thinking and optimistic, and increase self-esteem through activities/ work according to ability

d. Prepare a safe and comfortable living environment

f. Improve health by practicing the Clean and Healthy Life Behavior or PHBS



3. Nutrition settings/balanced diet - Eat a variety of food - Diet according to the recommended nutritional needs based on health conditions which include carbohydrate, protein, fat, vitamins and mineral - Increase vegetable and fruit consumption to fulfill the need of vitamin, mineral and fiber - Increase source of calcium: fresh fish, fresh anchovy, green vegetables (spinach, broccoli, mustard greens, cassava leaves, fern leaves, etc.), fruits (orange, banana, guava, papaya, mango, avocado, red apple, strawberry, dragon fruit, etc.), soybeans and high calcium milk - Drink enough water minimum 2 liters (8 cups) per day.

4. Maintain regular body hygiene (take a bath twice a day with soap), and use clothes, and shoes which are comfortable and safe.

2. Have routine medical check-up, at least once a year, for early detection of chronic disease, and consume medicine as recommended by the health provider

1. Get closer to God Almighty

B. CLEAN AND HEALTHY LIFE BEHAVIOR FOR PRE-ELDERLY/ELDERLY

5. Maintain dental health and oral hygiene (brush teeth twice a day), take off and clean artificial teeth every day.



10. Continue to do activities that sharpen the brain/ intelligence such as: playing chess, fill in crosswords, reading a book, dancing, playing music, story-telling, socializing, etc.

7. Avoid cigarette/tobacco smoke, and addictive substances (do not smoke, drink alcohol, smoke marijuana)6. Get used to do:

- Physical activities (walking, washing, sweeping, etc.) - Physical exercise (exercise, walking, swimming, etc.) At least 30 minutes a day, 3 times a week.

8. Develop hobbies according to personal capability such as: - Arranging flowers/gardening - Painting - Dancing - Cooking - Knitting - Doing safe and comfortable recreation (travel, watching movies, etc.)

9. Enough rest and manage stress well



1Immobility/

Decrease of moving ability: limitation of

motion, low back pain, joint pain

6Dental and oral

disorders

7Inanition : Nutritional disorders: no appetite, less or excess of weight

4Infection: Coughing

more than 2 weeks or repeatedly, fever

3

8Insomnia

2Instability : Prone to falling and fracture

C. COMPLAINTS THAT NEED TO BE NOTICED

5Impairement of visual

and hearing etc.

Incontinentia urine and alvi: incontinentia

urine, urinating irregularly, constipation,

uncontrolled defecation, etc.

Gangguan Buang Air Kecil dan Buang Air Besar: mengompol, Buang Air Kecil tidak

lancar, sembelit, Buang Air Besar tidak

terkontrol, dan lain-lain


9Intellectual

Impairement : Often forget, confused

11Impotence

12Anemia signs

16Abnormal lumps

17Continuous excess

of blood or fluid out of the vagina

10Isolation : Lonely

and secluded

15Severe headache,

dizzy spinning

14Swollen foot, tingling

legs, often thirsty

13Shortness of

breath, chest pain




It is a state where the condition of systolic blood pressure is ≥ 140 mmHg and or the diastolic pressure is ≥ 90 mmHg. Hypertension often occurs without any symptoms, thus the patient does not feel ill.

1. HYPERTENSION

a. Stroke (brain blood vein disorder) that can make the person paralyzedb. Kidney failurec. Heart failured. Visual Impairment

COMPLICATIONS THAT OCCUR WHEN UNCONTROLLED

a. Reduce the consumption of food containing too much salt (snack, crackers, instant noodles, fritters, salted food, smoked food, canned food)b. Think and act positivec. Manage stress in a good mannerd. Routine health check-up at the health facilitye. Taking medication regularly as directed by the physiciand. No smoking

WAYS OF PREVENTION

a. Headacheb. Fatiguec. Nausea and vomitingd. Difficulty breathinge. Shortness of breath (puffed)f. Agitated

g. Blurred visionh. Vision problemsi. Easily angeredj. Tinnitusk. Insomnial. Heavy feeling in the nape

SIGNS AND SYMPTOMS

D. HEALTH PROBLEMS OCCURING IN PRE-ELDERLY/ELDERLY



It is a disorder where there are high blood sugar levels (more than 200 mg/dl).

2. DIABETES MELLITUS

BEWARE!!Avoid Low Blood Sugar Levels

COMPLICATIONS THAT OCCUR WHEN UNCONTROLLED

a. Eye abnormalities : Visual impairment and prone to cataractb. Skin abnormalities : Itchy, carbuncle, slow-healing wound to skin tissue damage (can cause amputation)c. Nerve abnormalities : Tingling and numbness extremitiesd. Kidney abnormalities : Whole body swollene. Heart abnormalities : Chest pain, difficulty to breath, whole body swollenf. Teeth abnormalities : Rocking teeth

SIGNS AND SYMPTOMS

.........................

a. Frequent urinationb. Increased thirstc. Extreme hungerd. Unexplained weight losse. Fatiguef. Tingling extremitiesg. Slow-healing sores

WAYS OF PREVENTION

Good diet with balanced nutrition:a. Consume lots of vegetables and enough fruitsb. Limit the consumption of sweet, salty and fatty foodsc. Eat breakfastd. Do enough physical activities and maintain normal body weighte. Have enough rest



Hypertension and Diabetes Mellitus cannot be fully cured but can be managed

and controlled, it is IMPORTANT!!

to do routine medical check-ups at the health facility!!

It is a chronic pulmonary disease which is signed by blocked airways in the respiratory tract, which may worsen overtime and irreversible.

SIGNS AND SYMPTOMS

a. Shortness of breathb. Chronic cough with phlegmc. Wheezingd. Fatigue

WAYS OF PREVENTION

a. No/ quit smokingb. Avoid allergens: dust, smoke, etc.

3. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)



WARNING!!1. If you find one of the symptoms above

“GO DIRECTLY TO THE HOSPITAL” (In the first 3 hours if possible)

2. The first-aid period obtained greatly determines the patient’s recovery expectations

3. Avoid recurrent strokes as they will cause more severe disability

It is a condition of reduced supply of oxygen to the brain that occurs due to blockage or rupture of blood vessels in the brain, causing damage and death of the brain tissue.

a. Headacheb. Sudden weakness and numbness on one side of the body (Hemiparesis)c. Asymmetric lipsd. Trouble talkinge. Balance disorder and consciousnessf. Decline in consciousnessg. Farsightedness or sudden visual impairmenth. Swallowing disorder

Controlling the risk factors (blood pressure, blood sugar, cholesterol, at a normal level)

SIGNS AND SYMPTOMS

WAYS OF PREVENTION

4. STROKE



It is a chronic inflammatory disease of the airways that causes over reaction of the bronchus, which causes periodic attacks such as wheezing, shortness of breath, chest tightness, and coughing especially at night or early morning. There is a variation of periodic attacks and could return to normal with or without treatment.

a. Chronic cough with phlegmb. Shortness of breath and wheezingc. Family history with asthma or allergies detected

SIGNS AND SYMPTOMS

5. BRONCHIAL ASTHMA

It is a heart disease that occurs due to the constriction of coronary blood vessels in the heart that can cause heart attacks.

a. Pain on the left chest, left shoulder, left arm, upper back, lower neck and jaw, and sometimes in the pit of the stomachb. Shortness of breathc. Cold sweat, weak feeling, palpitations, and sometimes fainting

a. Avoid food containing fat (cholesterol)b. No/quit smokingc. Avoid the consumption of sweet food or drinksd. Increase the consumption of vegetables and fruitse. Routine physical activities and exercisef. Routine medical check-up

SIGNS AND SYMPTOMS

WAYS OF PREVENTION

6. CORONARY HEART DISEASE (CHD)



It is an inflammation of one or more joints. The type of joint disease often occurring in the elderly are Osteoarthritis and Gout Arthritis.

SIGNS AND SYMPTOMS

a. Stiffness and pain in the jointsb. Redness and swelling of the jointsc. Decrease/limited range of motion

WAYS OF PREVENTION

a. Reduce body weightb. Reduce the consumption of fatty foods including frittersc. Reduce the consumption of innardsd. Reduce the consumption of lentils, canned food, fermented food and drinks (tape, palm wine, etc.), seafood except fish.e. Regular physical exercise

8. ARTHRITIS

It is a disease which is signed by a decrease in the density of the bone, therefore becoming fragile and easily broken when impacted.

SIGNS AND SYMPTOMS

a. Prone to fallingb. Pain felt in the bonesc. Movement disordersd. Posture disorder (stoop posture)

WAYS OF PREVENTION

a. Consume food and drinks containing enough calcium (wet anchovies, fish, milk, cheese, green vegetables, tempeh, etc.)b. Enough sun exposurec. Regular activities and physical exercise (osteoporosis exercise)

7. OSTEOPOROSIS

femoral neck stress fracture



It is a sad and distressed feeling that occurs more than 2 weeks.

9. DEPRESSION

a. Moody/Gloomy/disability to feel happyb. Unsociablec. Loss of interest or pleasure in activities once enjoyed and no initiative d. Pessimistice. Over worried

a. Engage in social and community activities (recreation, group religious activities, regular social gathering)b. Regular physical activities independently based on abilityc. Positive thinking (thankful, good thoughts)d. Acceptance (whole-hearted)

WAYS OF PREVENTION

It is a condition where there is a continuous decline of the mental ability, getting worse which include short-term memory loss, language proficiency setbacks, intellectual setbacks, change of behavior and other brain functions that interfere with daily activities.

10. SENILE (DEMENTIA)

a. Forgetful of current experiencesb. Failing disorientation of the time, place, numbers and objectsc. Difficulty finding the right wordsd. Keep on repeating words or questionse. Unsteady emotions (easy to get angry)f. Difficulty in doing daily activities

SIGNS AND SYMPTOMS WAYS OF PREVENTION

a. Engage in activities that stimulate the brainb. Develop useful hobbies and activitiesc. Regular physical activities independently based on abilityd. Maintain social community activitiese. Consume nutritious food and balanced diet (vegetables, fruits, fish)

SIGNS AND SYMPTOMS



It is the period of permanent menstrual cessation for at least 1 year

a. Weary, headache, dizzy, sleepless, difficulty to concentrateb. Hot flashes on the face and, body and sweatsc. Pain felt in the bonesd. Heart palpitationse. Irregular appetitef. Digestive problemsg. Ceasing of the menstrual cycleh. Vaginal dryness

a. Accept menopause as a natural process experienced by every womenb. If there are any complaints, consult with health providersc. Increase the consumption of the vegetables, fruits, lentils especially soybeans (tempeh, tofu)d. Consume fish oil, olive oil if available, canola oil

11. MENOPAUSE

WAYS OF PREVENTION

SIGNS AND SYMPTOMS

12. ANDROPAUSE

WAYS OF PREVENTION

It is a situation where there are complaints related to the decrease in androgen hormone function that occurs in all men.

a. Decreased of sexual desire (libido)b. Decreased erection ability c. Lack of energy/strength to perform sports or workd. Decreased strength or muscle endurance

a. Accept andropause as a natural process experienced by every menb. If there are any complaints, consult with health providersc. Increase the consumption of the vegetables, fruits, lentils especially soybeans cake (tempeh, tofu)d. Consume the fish oil, olive oil if available, canola oil

SIGNS AND SYMPTOMS



E. BALANCED NUTRITIONAL DIET FOR PRE-ELDERLY/ELDERLY

Wash your

hands

Play Soccer

Weight monitoring

Walk Exercise Cycle

Sweep

drink 8 cups of water

Limit the consumption of sugar, salt and oil

BALANCED NUTRITIONAL TUMPENG (CONE-SHAPED RICE DISH)

2-4portions

Sugar

Salt

Oil

3-4portions 2-3portions

3-4portions



10 MESSAGES OF BALANCED NUTRITION

1 Be grateful & enjoy many diet variations

2 Consume many Vegetables & enough fruits

3 Consume high proteinside dishes regularly

4 Consume a varietyof staple food regularly

5 Limited intake of the sweet, salty and fatty food

7 Drink enoughand sufficient amountof water regularly

8 Read the labelson food packagings

9 Wash your hands with soap and running clean water

10 Engage in enough physical activitiesand maintain a normal body weight

6 Eat breakfasthabitually

BALANCED NUTRITION FOR

HEALTHY ANDWELL-ACHIEVED

NATION


d r i ^

j fk v^hdl obkd


My Food PlateOne time serving

SIDEDISHES FRUITS

STAPLEFOOD VEGETABLES

WASH YOUR HANDS BEFORE MEAL

LIMITED INTAKE OF THE SWEET, SALTY, AND

FATTY FOOD

MINERAL WATER

1/2 PlateFruits & Vegetables

1/2 Plate MoreSide Dishes Staple

Food1/3 2/3


2. LIMITATIONS OF FOOD INGREDIENTS FOR THE OLDER PERSONS

1. The consumption of Sugar, Salt and Oil (SSO) in the daily processing of food is based on the recommendation (S4S1O5), which means: a. The Sugar Consumption intake at most is a maximum of 4 table spoons (50 grams/day) b. The Salt Consumption is a maximum of intake at most 1 teaspoon (2 grams/day) c. The Fat Consumption is a maximum of intake at most 5 table spoons of vegetable oil (67 grams/day)

2. Suggestion of sodium source food intake: preserved food such as canned fish and meat, carbonated/soda drinks.

1. RECOMMENDED FOOD INGREDIENTS FOR THE OLDER PERSONS

a. Staple Food as a source of carbohydrates, benefits as energy such as rice (mashed brown rice, white rice, etc.), corn, yam, cassava, sago, potato, taro, breadfruit, vermicelli, noodle, wheat bread and oatmeal.b. Side Dishes as a source of proteins, fat and mineral. 1. Animal source food: fish (recommended are anchovies, mackerel fresh and wet etc.), skinless chicken, non-fatty beef meat, low fat milk and eggs etc. 2. Vegetarian source food: tempeh, tofu, legumes and their other form of processingc. Colored Vegetables as a source of vitamins and minerals and also fiber such as spinach, water spinach, carrots, broccoli, yellow pumpkin, chayote, and other fresh vegetablesd. Colored Fruits: papaya, banana, sweet oranges, avocado, apple, etc.e. Iron source food such as cow liver, chicken liver, chicken meat, beef meat, green vegetables (spinach) and legumesf. Calcium source food such as fish (example wet and fresh anchovies), green vegetables (leaf mustard, cassava leaf, fern leaves etc.) and fruits (orange, banana, guava, papaya, avocado, apple, strawberry, dragon fruit etc.)g. Drink at least 8 cups of water daily




EXAMPLE OF DAILY MEAL

Time Menu

Household Weight (grams) Measures

(HM)

Morning Rice ¾ cup 100

Boiled egg with 1 item 50 tomato sauce, basil 1 medium-sized 50 and cucumber 1 cup 100 Papaya 1 medium piece 150

Morning snack Banana 1 piece 75 Lunch Rice 1 cup 150 Anchovies 2 table spoons 50 Processed Tempeh 1 piece 50 (coconut milk 25 ml) Vegetables 1 cup 100 (vegetables) + 10 (young coconut) Orange 1 medium piece 100

Afternoon snack Boiled/sweet potatoes 1 medium slice 100

Dinner White/brown rice ¾ cup 100 Roasted chicken 1 piece 50 Sweetened tempeh 1 piece 30 Sour vegetable soup 1 cup 100 Melon 1 medium piece 150

Night snack Low fat milk 1 cup 25 (150-200 ml) or based on the milk serving direction

Nutritionalvalues: energy + 1528 kcal, protein 62 grams (16%), fat 46 grams (26%), carbohydrate 226 grams (58%), vitamin A 1817µg, iron 9.5 mg, calcium 500 mg, phosphate 1235 mg.



3. MENU FOR PRE ELDERLY/ELDERLY WITH COMPLICATIONS

Time ElderlyWithNoTeeth ElderlyWithConstipation Morning Chicken steamed rice Porridge Poached egg (fried with water) Boiled egg (white) Tomato juice Carrot juice

Morning Snack Green bean porridge Papaya

Noon and Night Mushy rice Mushy rice Sweet chicken liver stew Fish brine/pindang Steamed/pepes tofu Stir-fry tempeh Boiled chayote Spinach clear soup

4 PM Banana Mango juice Talam cake (mixture of coconut Oatmeal biscuit and warm tea milk, rice flour and tapioca flour)

1. Consume a variety and nutritional food2. Avoid intake the food containing too much fat, sugar, salt and preserved food3. Consume high fiber foods (vegetables and fruits)4. Small sliced vegetables, cook until soft if necessary, minced meat, smoothed fruits (blender or grate)5. Prepare food in a small portions and frequent, 3 main meals and 3 snacks recommended6. Drink at least 8 cups of water to fulfill the need of water intake 7. Eating together can increase one’s appetite8. Intensify the taste of your meal by using a variety of spices in order to reduce the use of salt, for example by using red onions, garlic, ginger, turmeric, pepper, sugar, lime, etc.

4. THINGS TO CONSIDER IN FOOD PREPARATION



5. PROBLEMS OFTEN FACED BY ELDERLY CAUSING NUTRITIONAL PROBLEMS

1. Teeth problems: gum disease, toothless, and ill-fitting denture/false teeth that causing difficulties in chewing food such as meat, fruits and vegetables.

2. Decreased sensitivity to the taste and aroma of food, causing the older persons tending to like foods that are too salty and sweet, which is bad for their health.

3. Decreased sensitivity to thirst, causing the elderly to be at risk of dehydration or lack of body fluid.

4. Certain intakes of drugs cause nausea and reduce the appetite.

e. Loneliness and depression occur in elderly causing laziness to eat.

F. PHYSICAL ACTIVITIES FOR PRE-ELDERLY/ELDERLY

Older persons are encouraged to do daily physical activities and physical exercises to maintain their body’s health and fitness.

a. Physicalactivitiesare any form of body movements that can increase the release of strength or energy.

For example: gardening, sweeping, cleaning-up the house, playing with grandchildren, etc.

b. Physical exercise is a form of planned, structured and continuous physical activities with repetitive body movements aimed to increase physical fitness.

For example: exercise, brisk walking, jogging, cycling, swimming, etc.

By doing good, correct, measurable, regular physical exercise according to the rules of health consequently one will benefit from:a. Improving flexibility and body balance to reduce the risk of falling and injuryb. Increasing metabolism to maintain the ideal weight and prevent obesityc. Strengthening the bone mass, not only to reduce chronic joint pain on the

hips, back, and knees, but also to avoid osteoporosisd. Increasing the work and function of the heart, lungs and blood vesselse. Increasing the immune activity against diseases by the increase of the

immune management systemf. Increasing the psychological well-being and self-confidenceg. Controlling stress, anxiety and depression

1. THE BENEFITS OF PHYSICAL EXERCISE FOR PRE-ELDERLY/ELDERLY





3. PHYSICAL EXERCISEa. EXAMPLES OF STRETCHING EXERCISE

Examples of Stretching Exercise for Pre-Elderly/ElderlyPicture 1Both hands placed on the hips, put your head close to your right shoulder. Maintain that position during 8 counts for 10 seconds. Repeat it with the opposite position.

1

2. RULES AND PHASES OF PHYSICAL EXERCISE FOR PRE-ELDERLY/ELDERLY

a. Exercise can be conducted anywhere with attention to the weather, healthy, safe, comfortable, non-polluted, and low-risk of injury environment.

For example: in a flat-floored building or field, with no puddle and not slippery.

b. Physical exercise can be conducted in phases based on the level of physical activity, health condition and physical fitness so as not to cause adverse impacts.

c. Physical activity starts with warming up sessions with 5-10 minutes stretching, followed by the main activity for 20-40 minutes (heart and lungs endurance exercise, muscle strength and balancing exercise), finished by a 5-10 minutes cooling session.

d. Measurable physical exercise is conducted by: - Measure Exercise Heart Rate to achieve 60-70% from maximum heart rate which is 96-112 per minute. - Talking test: While exercising if you seem to be panting while talking then the exercise has exceeded the recommended intensity.

e. Regular physical exercise should be conducted in stages with a 3-5 frequency per week with a day of rest interval.

f. Older persons with health problems should only perform physical exercise under the supervision of a doctor.



Picture 2The right hand holds on to the left shoulder, and the right elbow elevated using the left hand and pushed to the back, making the right arm muscle stretched. Maintain that position during 8 counts for 10 seconds. Repeat it with the left arm.

Picture 3Fold the right arm above you, the right hand touches the back behind your head. The left hand holding the right elbow until the side muscle of your right arm becomes stretched. Maintain that position during 8 counts for 10 seconds. Repeat it with the left arm.

Picture 4Put both hands together on your chest, push straightly forward until the muscles of your side arms become stretched. Maintain that position during 8 counts for 10 seconds.

Picture 5Place both hands together above your head, push straightly upward suntil the muscles of your side arms become stretched. Maintain that position during 8 counts for 10 seconds.

Picture 6Fold both arms and put them against a wall, put your forehead on the palms of your hands, put the end of your right foot against the wall, fold your right leg, your left leg straightly backwards, until the muscles of your left leg become stretched. Maintain that position during 8 counts for 10 seconds. Repeat it with the opposite leg.

6

4

5

2

3



b. EXAMPLES OF MUSCLE STRENGTHENING EXERCISE FOR PRE-ERLY/ELDERLY

Picture 1Exercise to strengthen the feet, knees, the hips and back muscles. The position starts by sitting on a chair (refer to the picture), with both arms on the hips. Stand-up and regain the sitting position. Repeat this movement 8 times.

Picture 2Exercise to strengthen the arm and shoulder muscles. The position starts by sitting on a chair (refer to the picture). Both arms are straightly placed on the side with your two hands clenched or holding 330 or 660 ml mineral water bottles. Straightly elevate both arms on the side until they reach the same height as your hips, and return to the first position. Repeat this movement 8 times.

Picture 3The position starts by standing straight with one hand holding on to a chair, looking straight forward. Elevate your right leg straightly to the side, and return to the first position. Repeat this movement 8 times, and also to your left leg.



Picture 4The position starts by standing straight with one hand holding on to a chair, looking straight forward. Elevate your right leg straightly to the back, and return to the first position. Repeat this movement 8 times, and also to your left leg.

Picture 5 The position starts by standing straight with one hand holding on to a chair, looking straight forward. Fold your right leg backwards, and return to the first position. Repeat this movement 8 times, and also to your left leg.

Picture 6The position starts by standing straight with one hand holding on to a chair, looking straight forward. Fold your right leg in front of you until it reaches the same height as your hips, and return to the first position. Repeat this movement 8 times, and also to your left leg.



4. THE TYPES OF EXERCISES NOT RECOMMENDED FOR PRE-ELDERLY/ELDERLY

a. More than a 60 minutes physical exerciseb. Holding breath movementsc. Jumping movementsd. Weight exercises with heavy weight e. Physical exercise that disturb the balance such as standing-up with one foot without holding on

c. EXAMPLES OF BALANCE EXERCISE FOR PRE-ELDERLY/ELDERLY

Stand-up straight and look straight forward. Walk straight forward following a 10 meters straight line. Repeat back and forth 4- 8 times.



G. THINGS TO CONSIDER FOR OLDER PERSONS WHO WILL TRAVEL FAR

Tips for older persons who are willing to travel 1.Makesureyouleaveinafitbody/condition When travelling more than 3 days it is best that you visit your doctor, inform your travel plan and ask for your medical prescription for the travel.

2.Learncloselyorexactlyaboutthecity/destinationthatyouwillbeheadingto This is related to the weather condition there. Adjust your attires to the weather at your destination.

3.Learnaboutthetravellingtimeandanyotheralternativetransportation mode Use comfortable clothing during your travel. If it requires for you to endure a long travel and use public transportation, please make sure that toilets are available. Consider travelling during day time, because older persons tend to catch a cold during the night. If necessary bring adult/disposable diapers

4. Drinkenoughwatertoavoiddehydration Older persons who are exposed to high or low temperatures, experience a descent in their ability to adapt themselves. When older persons are exposed to high temperature, they will over sweat, on the contrary when exposed to low temperature, they may over urinate. Both of these situations might put them at risk of dehydration, therefore it is best to keep a bottle of water during the travel.

5. Do not eat carelessly/haphazardly Older persons offer suffer from digestive problems, eating in guaranteed clean places and wash your hands before and after your meals could avoid you a get the stomach ache.

6. Bringsomeidentification Always bring your identification, along with your children’s or relative’s phone number that can be contacted. Always stay with your group when travelling in groups.


7. Bring your own medicine Those suffering from specific illness are suggested to bring their own medicine and drink vitamins to maintain a fit stamina if necessary.

8.Immunization Immunizations are required when visiting endemic areas of certain communicable diseases (for example the meningitis immunization to visit areas of Saudi Arabia, etc.).

9. Do not bring too many baggage Bring necessary items only. Put your items in a portable luggage/handbag, having wheels or in a backpack.

H. THE ROLE OF FAMILY MEMBERS IN REGARDS TO THE PRE-ELDERLY/ELDERLY

1. Respect and appreciate to older persons 2. Remain patient and wise in regards to older persons’ behaviors 3. Give affection, time and attention 4. Do not consider them as a burden 5. Give them the opportunity to live together 6. Invite them to family gatherings 7. Help fulfill their needs (money, recreation) 8. Remind and assist them to monitor their health regularly at the health facility 9. Encourage them to live a clean and healthy life 10. Provide and give healthy foods according to the balanced nutritional principles by considering their condition and taste11. Avoid indoor or outdoor injuries to occur12. Frequent communication with the older persons and other family members


GRAPH OF BODY MASS INDEX (BMI)

CONTRIBUTORS dr. Eni Gustina MPH (Directorate of Family Health), N. Nurlina Supartini, SKp, MPH (Sub-Directorate of Elderly Health), dr. Arya Govinda, Sp.PD-KGER (K) (Geriatric Division, Department of Internal Medicine RSCM-FKUI), Dr. dr. Martina WiwieSpKJ(K) (Geriatric Psychiatric Division, Department of Psychiatry RSCM-FKUI), dr. Wanarani Alwin, Sp.KFR-K (Geriatric Division, Department of Medical Rehabilitation RSCM-FKUI), dr. Nurul Ratna Mutu Manikam M.Gizi, Sp.GK (K) (Department of Nutrition FKUI-RSCM), dr. Edi Rizal Wahyudi, SpPD, K.Ger (K) (Geriatric Division, Department of Internal Medicine RSCM-FKUI), dr. Eni Riangwati, Sp.KO (Directorate of Sports and Occupational Health), Sri Nurhayati SKM (Directorate of Community Nutrition), dr. Upik Rukmini, MKM (Directorate of Primary Health Care), Faizah (Directorate of Primary Health Care), dr. Tristiyenny (Directorate of Non-communicable Diseases Prevention and Control), drg. ErnawatiRoesli (The Health Determinant Analysis Center), dr. Ari Setyaningrum (Directorate of Sports and Occupational Health ), dr. Wira Hartiti, M.Epid (Sub-Directorate of Elderly Health), Wahyuni Khaulah, SKM, M.Kes (Sub-Directorate of Elderly Health), drg. Noor Setyawati, MM (Directorate of Mental Health and Narcotics, Alcohol, Psychotropic Drugs and other Addictive Substances Prevention and Control), dr. Milwiyandia, MARS (Sub-Directorate of Toddlers and Preschoolers Health), dr. M. Sari Dewi (Directorate of Non-communicable Diseases Prevention and Control), Yenni Yuliana (Sub-Directorate of Toddlers and Preschoolers), Yussiana Elza, SKM, M.Si (Health Determinant Analysis Center), dr. Tini Setiawan, M.Kes (WHO), Diah Handayani (Directorate of Primary Health Care), dr. Innes Ericca (Hajj Health Center), dr. Nurul Larasati (Center for Ageing Studies University of Indonesia/CAS UI), Lili Indrawati (CAS UI), Dinni Agustin (CAS UI), Ns. Nur Hayati DH (CAS UI), drg. Widyawati Garini, M.Kes (Directorate of Health Promotion and Community Empowerment), Ribka Ivana Sebayang. SKM.MKM (Sub-Directorate of Elderly Health), dr. Hadiyah Melanie (Sub-Directorate of Elderly Health), dr. Melda Gloria Manurung (Sub-Directorate of Elderly Health), Ingrat Padmosari, SKM. M.Epid (Sub-Directorate of Elderly Health), dr. Savaart Hutagalung, MARS (Sub-Directorate of Elderly Health), dr. Windyanti (Sub-Directorate of Elderly Health), Wulan Sri Damayanti S.Kep Ners (Directorate of Primary Health Care), drg. Supartinah (DIY Provincial Public Health Office), Diah Dwiningsih, ST, M.Farm (West Java Provincial Public Health Office), Hasanah, SKM (Directorate of Sports and Occupational Health), Arie Meutia Nada, SKM (DKI Jakarta Provincial Public Health Office), dr. Desliana Wulansari (Central Jakarta City Public Health Office), drg. Melia Feria (East Jakarta City Public Health Office), dr. Ari Mufisdah Sari (Gondosuman Primary Health Center, Yogyakarta City), Hj. Khaeriyah, S.Kep (Krengkeng Primary Health Center, Indramayu District), Elly Setiawati (Cipayung Sub-District Primary Health Center), Della Rosa, SKM, MKM, dr. Ima Nuraina (Sub-Directorate of Elderly Health)

SECRETARIAT TEAMIrvan Danu Arifianto, Amd (Sub-Directorate of Elderly Health), Midyawati Ahmad, Amd.Kep (Sub-Directorate of Elderly Health), Suhendi (Sub-Directorate of Elderly Health), Abdul Muis Soeharto, Amd (Sub-Directorate of Elderly Health), Retno Wulan Handayani, SKM (Sub-Directorate of Elderly Health).

DESIGN AND LAYOUTWahyu Handayani, Gamilah Pahlawati

DIRECTORATE OF FAMILY HEALTH DIRECTORATE GENERAL OF PUBLIC HEALTH

MINISTRY OF HEALTH REPUBLIC OF INDONESIA2017

AB

HAGI

A

erat badan berlebihan dihindari{avoid being overweight}

turlah makan dengan gizi seimbang{make a nutritionally-balance deating plan}

indari faktor-faktor risiko Penyakit Tidak Menular {PTM}: tekanan darah tinggi, penyakit kencing manis, penyakit jantung koroner, dll{avoid non-communicable diseases’ risks factors: high blood pressure, diabetes, coronary heart disease, etc.}

gar terus berguna, lakukan kegiatan/hobi yang bermanfaat sesuai kemampuan{continue to be useful by being involved in activities/hobbies based on ability}

erak badan teratur wajib terus dilakukan{always conduct regular exercise)

man dan taqwa ditingkatkan serta kelola stress{enhance faith and piety, also manage stress}

wasi dengan melakukan pemeriksaan kesehatan secara teratur{monitor through regular health check ups}

THE OLDER PERSON’S MOTTOBAHAGIA = HAPPY

Source : R. Boedhi - Darmojo. modified.

TOWARDS HEALTHY, INDEPENDENT, ACTIVE AND PRODUCTIVE OLDER PERSONS

618.97 ind bkesga.kemkes.go.id/images/pedoman/buku lanjut usia...use comfortable clothing during...

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