Health
Service
Standard
For Elderly
(Hospitalize)
Presented By
-Mirantika Audina-
                     -Geriatic Patients-
                                 Elderly patients with multiple disease due
                                 to multifactor causes that require
                                 integrated health service with
                                 multidisciplinary approach
 It is clear that health
   services at old age               In the National Standard for Hospital
are different themself               Accrediation (SNARS) states that
from othe population                 hospital needs to hold a geriatric
                  group              service according to the type of
                                     geriatric service level such as simple,
                                     complete, perfect and plenary
Principles Of Health Services in Elderly
                 -Holistic Principle-
          An elderly patient must be seen as a whole person, including the
          psychological (psychological) and socio-economic environment
          >>geriatric studies is used in diagnose the disease in elderly
             The holistic nature contains meaning either vertically (begin from
             community service to the highest referral service) or horizontally.
             (work cross-sectorally)
                 Services must cover preventive, promotive, curative, and
                 rehabilitative aspects. 4 levels of disease in elderly (WHO):
                 disease, impairment, disability and handicap
                                                                        Workplace where each
                                                                         member depend on
                                                    Multi-
                                                                        others to achieve the
Principles of Procedure                           discipline                 same goal
and Management In                                                       Periodically a meeting
                                                                         is held between team
Team                                                                    members to conduct an
                                                                           evaluation of work
                                                                             Create and
                                                 Various health            harmonization of
 The geriatric team is a form of             disciplines that jointly       concepts and
 multidisciplinary collaboration that        carry out treatment for    harmonization of actions
 works in an interdisciplinary manner in        elderly patients
 achieving the objectives of the geriatric
 ministry that are carried out                Consists of doctors,
                                             socio-medical workers,
                                               nurses, nutritionist,
                                               physiotherapist, ect             Inter-
                                                 Making and                   discipline
                                             harmonizing concepts
Implementation of Geriatric Health
            Service
  All health efforts    Local hospitals that        The hospital,
related and carried       have carried out       depending on the      The concept of health
      out by the       geriatric services are      type of service     services in the elderly
community must be      tasked with fostering     available, provides   population is planned
  sought to play a       geriatrics in their      various services     and implemented.
role in handling the      territories, either      for the elderly,    To strive for a
    health of the       directly or indirectly       carried out       sustainable holistic
       elderly            through primary           between the        principle, broadly the
                       health care guidance         geriatric unit     service to health at the
                                                                       age can be divided as
                                                                       follows
Community Based          Hospital Based           Hospital Based
 Geriatric Health          Community              GeriatricHealth
     Service             Geriatric Service           Service
The concept of elderly health services,
starting from the level in the community, to
the highest referral in the hospital with a
complete geriatric service
(Placement): is a type of service, in which a
geriatric unit in a hospital after conducting an
assessment of a patient, provides
recommendations to the patient to be accepted
into an elderly institution, especially if the
institution is implemented by / or receives
subsidies from the government
The level of services provided by
the hospital can be divided as:
    01   Simple
         Assessment, consultation, examination, counseling, and
         supervision to the Primary Helath Care
       02    Medium
             Provided polyclinic and day-hospital
             clinics
           03    Complete
                 Provided elderly ward with acute illness
               04     Plenery
                      All types of services are provided at a
                      complete level coupled with the presence
                      of an elderly ward with chronic diseases
Implementation of Geriatric Service in Hospital
          -Building Requirement-
                must be wide
                enough to make
                it easier for                           Hallway and
                patients / visitors                     room lighting
                to pass in a                            must be bright
                wheelchair or                           but not
                bed                                     dazzling
      Street           Door            Electricity         Lighting           Floor
 must be strong                   must be sufficient                     ust be flat, easy
 enough, flat,                    with power                             to clean but not
 not slippery and
 provided a         b             reserves if one day
                                  requires additional
                                  lighting so
                                                         d               slippery, if there
                                                                         are steps or stairs
                                                                         to be clearly
                                                                                                Building
                                                                                               Construction
 special path for                 stabilizers are                        visible with
 patients /                       needed to ensure                       different tile
 visitors with                    voltage stability,                     colors to prevent
 wheelchairs                      equipped with an                       falls
                                  electric generator
   ..cont. Building construction
                                                                   uses a toilet seat
                       must be permanent                         with a handle on the
must be strong and      and strong and       must be adequately right and left. Shower
  easy to clean        should be brightly        ventilated       is equipped with a
                            colored                               seat and a handle
     Ceiling                  Wall              Ventilation             Bathroom
                                              must be given safety
                                                                        and Toilet
rovided in each room                         and wood or aluminum
   for examination,      to avoid the        (leuning) which serves   must be sufficient
 treatment and other possibility of danger /   as a handle for the     and meet the
        rooms               trauma.                  patient           requirements
       Sink             Avoid sharp                Safety                  Water
                           angel                   handle
Implementation of Geriatric Service in Hospital
               -Room Needs-
      Acute
     Geriatric
      Ward             The care ward is divided into men and women
                       with bells installed on each wall of the bed;
                        Intensive space with a minimum of 1 (one)
                        bed, divided into male and female (adapted to
                        ability and development)
                        Doctor’s Room
                        Acute rehabilitation room
Implementation of Geriatric Service in Hospital
               -Room Needs-
      Acute
     Geriatric
      Ward             nurse room, with a location that allows the nurse
                       to see all patients who are in care
                        bathrooms and toilets whose numbers are
                        appropriate and equipped with facilities and
                        requirements for elderly patients
                        bathrooms / toilets specifically for nurses and
                        visitors
                        small meeting rooms; and warehouse
Implementation of Geriatric Service in Hospital
               -Room Needs-
     Day Care
      Room             a break room with a bed and a high-backed chair
                       equipped with a foot support
                        action / check room if needed
                        space for exercise / gymnasium / light exercise
                        daily activity simulation room (small kitchen with
                        equipment, restroom and others)
Implementation of Geriatric Service in Hospital
               -Room Needs-
     Day Care
      Room
                       recreation / hobby room, concurrent dining room
                        WC / bathroom whose amount is adjusted to the
                        number of visitors and staff
                        room for assessment and socialization
                        occupational therapy rooms; and living room,
                        furniture and pantry set.
                                ..cont. Room Needs
Medical rehabilitation                                    similar to a chronic care
facilities and infrastructure                             room but consists of
in accordance with                                        pavilion-like rooms / rooms
equipment for day care, has                               that aim to provide privacy
a large enough garden with                                for elderly patients with
a sunbathing area for             Chronic                 facilities such as libraries,
                                                Respite
patients and equipped with        Geraitric               socializing spaces and parks
                                                 Care     for walking exercises
a pond with running water          Ward
                                                          (mobilization parks)
                                                          a treatment room for
                                                          palliative patients in
consisting of: 1) team leader       Staff’s   Hospice
                                                          hospitals. Medical hospice
room; 2) member room; 3) 1          Room       Care       care rehabilitation facilities
(one) meeting room for the                     Room       and infrastructure in
team; 4) employee break                                   accordance with equipment
room and pantry; and 5)                                   for day care
small rooms for employees.
Equipment Requires
Equipment Requires
         Service Flow
-Simple Level Geriatric Service-
                  Hospitals with simple geriatric services may
                  do inpatient care, but because there is no
                  special care room, that is acute geriatric care
                  room, it can be treated in an ordinary care
                  room.
  Service Flow in
    Hospital with
Complete Geriatric
          Service
Service Flow in
Hospitals with
Perfect Level
Geriatric
Services
Flow of Services
in Hospitals with
Full Level
Geriatric
Services
                        Monitoring and Evaluation
                      Functional Status
                            is measured from
                            the time the patient                                             05
 Length of Stay             is hospitalized until
                            the time of return                               04
average length of stay
of geriatric patients \is                               03
12 days
                                   02
                                                                                          Patient
             01                                                         Re-               Saisfaction
                                                                        hospitalization
                                                                                          is measured when
                                              Quality Of Life           is re-treatment   the patient returns
                                                                        after returning   home with an
                                      ust use instruments that are
                                                                        home from the     instrument that can
                                      able to assess health-related
                                                                        hospital.         accurately measure
                                      quality of life (health related
                                      quality of life = HRQoL                             patient satisfaction
Conclusion
Given the various specificities of travel and disease appearance in the elderly,
there are 2 main principles that must be met in order to carry out health services
for the elderly, namely the HOLISTIC / complete approach as well as teamwork
and management.
The implementation of elderly health
services is divided into 3 categories,
                                               In an Emergency Department or          In order to be able to provide
namely geriatric health services in the
                                               other polyclinic, if the sufferer      maximum inpatient health
community, geriatric health services in
                                               turns out to be a Geriatric            services to the elderly, it must
hospital-based communities, and hospital-
                                               sufferer, it will be referred to the   meet several standards both
based geriatric health services
                                               Geriatric department (which can        from buildings, equipment,
                                               be handled by an internal (+) /        integrated geriatric teams and
The geriatric service procedure is that        geriatric specialist) who will         appropriate monitoring and
health services at the community level run     carry out geriatric assessment         evaluation.
by Puskesmas, private practice doctors,
and family doctors at one stage can refer
patients to hospitals that have Geriatric
services, or to specialist polyclinics in
other fields.
   Thank You
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