It is going to be nine months of the existence of the Gauri Kaul Foundation (GKF). It started in the far flung and under-served district Kupwara on the world heart day in September 2020. We started with our camps in various districts and have till date covered six, which includes one in Kakching district of Manipur bordering Burma. Our mission has been to optimise the treatment of high blood pressure, diabetes and existing heart diseases and their risk factors. The goal being to minimize heart attacks, strokes and chronic kidney disease in our population by applying preventive measures.
Preventive measures and optimal treatment need to start very early and continue lifelong. Elderly population, more than 65 years of age, is especially vulnerable to these events. This is especially true for the population with high blood pressure and diabetes. The prevalence of these problems is of the order of 45 percent and 15 percent respectively in the elderly. For this reason, we have decided to aggressively target this group. The medical team of GKF has launched a specific program named “Gauri Old Age Mission (GOAM) recently. Every Friday the Gauri Heart Centre conducts a special OPD for these individuals where a team led by a Geriatric consultant evaluates these persons. Those individuals often need a variety of customized tests for an early diagnosis. These are various non-invasive investigations like ECG, Stress tests, echocardiography, prolonged ECG monitoring upto a week and head up-tilt test to diagnose some causes of sudden fainting. All are available in the centre.
The senior citizens commonly have several problems, which need empathetic care by the medical personnel. Besides High blood pressure, diabetes and heart diseases there are a host of problems which need to be kept in mind when managing these patients who often have other age related co existing problems. Some of them are as follows:
Arthritis: A common problem leading to pain, swelling of joints especially knees with swelling and limited movements
Asthma: This leads to wheezing, breathlessness and coughing. Often gets aggravated in winter months
Chronic bronchitis: Leading to chronic cough for several months in a year. Often accompanied with fever and indiscriminate use of antibiotics and cough syrups. It is much more common in smokers.
Problems of vision including Blindness: This is often related to age related degeneration of the macula (a part of the retina). Besides this eye changes because of long standing diabetes are common accompaniments. Cataracts are also age related and are frequently seen.
Cancers: On an average, one out of three persons in the elderly usually develop cancer at some stage of life in elderly population.
Clots in the leg veins: Inactivity and prolonged periods of inactivity can lead to this. Migration of these clots to lungs can lead to catastrophic events like acute shortness of breath and even death.
Osteoporosis; A very common condition because of ageing and weakness of bones leading to brittle bones and fractures due to even minor falls. It is more prevalent in females after menopause.
Neurological diseases: Dementia,Parkinsonism, epilepsy and strokes.
All these problems are frequently encountered in the elderly either singly or in combinations and need to be kept in mind while evaluating this population for any disease. Inclusion of a Geriatric expert along with the cardiology team of the GKF will be of great help in optimising the treatment to the patient’s satisfaction and also in getting the best outcomes. There are at times interactions between drugs used for treatment of the above-mentioned problems and blood pressure, sugar lowering and blood thinning drugs. This has to be kept in mind while treating.
Specific outreach programs have been planned in various districts of Jammu and Kashmir where elderly patients referred through an organizing body consisting of Panchayat members or district administration or the district doctors will select100 elderly patients with diagnostic and management problems. These individuals will be examined, counselled and treated. All the expenses will be borne by a special GOAM fund created by voluntary donations from sources of industry and philanthropic organizations through their social responsibility budgets. In addition to a general examination and point of care tests, counselling and drug treatment will be provided by the GOAM, as far as possible. A follow up of these individuals will be maintained. A report of the observations made will be published and provided to all those concerned. All the Covid appropriate measures will be observed. A health talk on “How to Keep Heart Healthy” will also be delivered as a part of this program.
Senior citizens are a responsibility of the society and our foundation hopes this initiative of ours will go a long way in fulfilling our objective to have a healthy society at all ages with a good quality of life and very low heart disease related mortality.
The author is Founder Director Gauri Kaul Foundation, Recipient of Dr B C Roy Award and Padma Shri.