TaiChi Untuk Perawat MW

7/24/2019 TaiChi Untuk Perawat MW

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TRAINING OF TRAINERS TAICHI

Martina WS Nasrun

Menjaga Imunitas dengan

Berlatih Teratur

5 April 2014, Senior Club , PIK, Jakarta


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Imunitas vs Aktivitas

Daya Tahan Tubuh Manusia Menurun disebabkan

oleh aktivitas Virus, Kuman, Jamur, polutan, sinarradiasi, perubahan metabolik, perubahan genetik,

dsb

Balance

AktivitasImunitas

Man


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Tujuan Pelatihan: TOTTujuan Umum:

1. Mampu menerangkan konsepperilaku hidup bersih sehat

2. Mampu menjelaskan konsepRumah Sehat ?

3. Mampu melakukan Taichi untukKesehatan secara rutin

4. Mampu mengajarkan Taichi untukKesehatan

5. Mampu melakukan Kebaikan !

Caranya:

1. Belajar2. Belajar,

membaca-mendengar-

melihat-berpikir-Berbicara

3. Berlatih 30tiap Hari 3 bl

4. Implementasi

5. Pasti Bisa !


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Tujuan Sesi 5 April141. Mampu menerangkan

Imunitas / Daya Tahan2. Mampu menjelaskan Aktivitas

Bermanfaat dan Teratur

3. Mampu merancang Program

Aktivitas untuk Lanjut Usia4. Mampu mengevaluasi

kemajuan/kemunduran darifungsi Kognitif & Perasaan

5. Mampu menolong orang !

Belajar

Berlatih Berani Coba

Bergerak Maju

Berputar

Berbalik

Berjalan

Berbicara

Berperasaan Berbuat Baik

Act

Now


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Aset / Modal Perawat OS di Indonesia

Sabar

Senyum Syukur

TIR (Tulus-Ikhlas-Rela)

TLC (tender-love-care)

RP (Ramah dan Peduli)

RKS (Rawat as Keluarga Sendiri)

. 3S2T2R


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Aset Lokal, Jawab Tantangan Global

Merawat ODD (orang dengan demensia)

Rawatan Paliatif Pendampingan Lansia

Pendampingan OMM (orang menjelang meninggal)

orang dengan Hendaya Fisik-Psikik-Sosial(disabilitas)

Merawat anak berkebutuhan khusus

Merawat lansia dengan penyakit akut, penyakitkkronis, penyakit jiwa, penyakit terminal, dll.


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Dementia worldwide - Indonesia

3/29/20147 mws_gp_pergemi_14

1

million

2

million

3

million


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Global Challenge of Dementia1. Diagnostic Strategy

2. Management Strategy

3. Prevention Strategy

3/29/2014

8

1. Advocacy

2. Raising awareness

3. Training care-workers

mws_gp_pergemi_14


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Caregiving Need great Demand National

Regional

The Quality of Care?

Act Now by TOT

Advocation All Stakeholders


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Analisis Kesehatan Lansia(> 60 th)


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Cause of Death (COD)penyebab kematian usia lanjut


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Tabel 13.

Proporsi Penyebab Kematian Kelompok Umur 55-64 Tahun dan 65 tahun+

di 12Kabupaten/Kota, Tahun 2012

No Penyebab kematian 55-64 tahun

(n=4523)

Penyebab Kematian 65 tahun +

(n=10809)

1 Cerebrovascular diseases 20.6 Cerebrovascular diseases 22.4

2 Ischaemic heart diseases 10.4 Ischaemic heart diseases 8.9

3 Diabetes mellitus 9.1 Other heart diseases 7.7

4 Other heart diseases 7.6Chronic lower respiratory

diseases7.5

5 Respiratory tuberculosis 6.9 Hypertensive diseases 5.9

6 Hypertensive diseases 4.5 Respiratory tuberculosis 5.3

7 Chronic lower respiratory diseases 4.1 Diabetes mellitus 5.0

8 Kronic kidney disease 3.6Remainder of diseases of the

nervous system4.6

9Remainder of diseases of the

digestive system2.9

Remainder of diseases of the

digestive system3.3

10 Sirosis Hepatis 1.8Diarrhoea and gastroenteritis of

presumed infectious origin2.9


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Tabel 13.

Proporsi Penyebab Kematian Kelompok Umur 55-64 Tahun dan 65 tahun+

di 12Kabupaten/Kota, Tahun 2012

No Penyebab kematian 55-64 tahun

(n=4523)

Penyebab Kematian 65 tahun +

(n=10809)

1 Cerebrovascular diseases 20.6 Cerebrovascular diseases 22.4

2 Ischaemic heart diseases 10.4 Ischaemic heart diseases 8.9

3 Diabetes mellitus 9.1 Other heart diseases 7.7

4 Other heart diseases 7.6Chronic lower respiratory

diseases7.5

5 Respiratory tuberculosis 6.9 Hypertensive diseases 5.9

6 Hypertensive diseases 4.5 Respiratory tuberculosis 5.3

7 Chronic lower respiratory diseases 4.1 Diabetes mellitus 5.0

8 Kronic kidney disease 3.6Remainder of diseases of the

nervous system4.6

9Remainder of diseases of the

digestive system2.9

Remainder of diseases of the

digestive system3.3

10 Sirosis Hepatis 1.8Diarrhoea and gastroenteritis of

presumed infectious origin2.9


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Burden of disease usia lanjut


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LIFE CYCLE BOD USILA

INDONESIA DALYs PREDIKSI 2010

USIA 75 TAHUN +


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LIFE CYCLE BOD USILA


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Prevalensi Morbiditas dan Disabilitas Lanjut Usia di Indonesia,

2007


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a apan em angunan m g

Rencana Pembangunan Jangka Panjang

Nasional (RPJPN) 2005-2025


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TAHAPAN

RENCANA PEMBANGUNAN JANGKA PANJANGKESEHATAN (RPJPK) 2005-2025(Kepmenkes 375 thn 2009 ttg RPJP Bidang Kesehatan 2005-2025)

RPJM 4

(2020-2024)

RPJM 1

(2005-2009)

Bangkesdiarahkan untukmeningkatkan

akses dan mutuyankes

RPJM 3

(2015-2019)Akses masyarakatterhadap yankesyang berkualitastelah mulai

mantap

Akses masyarakatthp yankes yang

berkualitas telahmenjangkau danmerata di seluruhwilayah Indonesia


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Tantangan, strategi dan sasaran yg tertulis

pada Dokumen RPJPK sp 2025No Tantangan Strategi Sasaran

1. Msh Tingginya AKI, AKB dan

pertumbuhan penduduk + miskin

1. Bangkesnas

berwawasan nas

1. Meningkatnya UHH

69 73,7

2. Beban ganda: penyakit baru, jiwa,kecelakaan, NCD, kecelakaan kerja,

perubahan iklim &cemarling, gaya

hidup tak sehat dan napza

2. Pemberdayaanmasy dan daerah

2.Menurunnya AKB 32.3 15,5

3. Desentralisasi dan komitmenpemerintah belum memadai dan

lemahnya manajemen pemb kes

3. Pengembanganupaya dan

pembiayaan kes

3. Menurunnya AKI262 74

4. Pemberdayaan masy msh lemah,

PHBS masih kurang sekali

4. Pemberdayaan

& pengemb. SDM

kes

4. Menurunnya gizi

kurang balita 26 9.5

5. Kesenjangan kualitas dan cakupan

yankes, pembiayaan kes dg SJSN,

logistik dan obat yg belum merata

5. Penenggulangan

kedaruraran kes

6. SDM kesehatn baik kuan& kual


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Sistem Kesehatan Nasional 2012

Ascobat Gani/June 2013


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Agenda Post-2015 yang

terkait bidang kesehatan22

3. Provide qualityeducation and

lifelong journey

3a. Increase by x% the proportion of children able to access and complete pre-primary education

4. EnsureHealthy Lives

4a. End preventable infant and under-5 deaths

4b. Increase by x% the proportion of children, adolescents, at-risk adults and older people that are fully

vaccinated

4c. Decrease the maternal mortality ratio to no more than x per 100,000

4d. Ensure universal sexual and reproductive health and rights

4e. Reduce the burden of disease from HIV/AIDS, tuberculosis, malaria, neglected tropical diseases and

priority non-communicable diseases

5. Ensure foodsecurity and good

nutrition

5a. End hunger and protect the right of everyone to have access to sufficient, safe, affordable, andnutritious food 1, 2

5b. Reduce stunting by x%, wasting by y%, and anemia by z% for all children under five

5c. Increase agricultural productivity by x%, with a focus on sustainably increasing smallholder yields and

access to irrigation

5d. Adopt sustainable agricultural, ocean and freshwater fishery practices and rebuild designated fish

stocks to sustainable levels

5e. Reduce postharvest loss and food waste by x%

6. AchieveUniversal Access

to Water and

SAnitation

6a. Provide universal access to safe drinking water at home, and in schools, health centers, and refugee camps

6b. End open defecation and ensure universal access to sanitation at school and work, and increase access to

sanitation at home by x%

6c. Bring freshwater withdrawals in line with supply and increase water efficiency in agriculture by x%, industry by

y% and urban areas by z%

6d. Recycle or treat all municipal and industrial wastewater prior to discharge


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Kerangka Teori:

Continuum of Care

Pemeriksaan

Kehamilan

Persalinan,

nifas

&

neonatal

Pelayanan

bagi

bayi

Pelayanan

bagi balita

Pelayanan

bagi anak

SD

Pelayananbagi

anak

SMP/A

&

remaja

P4K

Buku KIA

ANC terpadu

Kelas Ibu Hamil

Fe & asam folat

PMT ibu hamil

TT ibu hamil

Inisiasi Menyusu Dini

Vit K 1 inj

Imunisasi Hep B

Rumah Tunggu

Kemitraan Bidan Dukun

KB pasca persalinanPONED-PONEK

ASI

eksklusif

Imunisasi

dasarlengkap

Pemberian

makan

Penimbangan

Vit

A

MTBS

Pemantauan

pertumbuhan&

perkembangan

PMT

Penjaringan

Bln

Imunisasi

Anak

Sekolah

Upaya

Kes

Sklh

PMT

Kespro

remaja

Konseling:

GiziHIV/AIDS,

NAPZA

dll

Fe

1000h

ariper

tamakeh

idupan

Konseling

Pelayanan

KB

PKRT

Pelayanan

PUS

&

WUS

Lansia

Kualitas

Degenerasi


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Kerangka Konsep

Lifecycle approach7. Lansia

6. Ibu hamil

1. Bayi

2. Balita

3. Usia sekolah

4. Remaja

5. Usia produktif


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Apakah IMUNITAS ? Daya tahan tubuh terhadap Penyakit

Host, Agent and Environment

Host

Agent

Lingkungan


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Imunitas TubuhHumoral

Antibodi ? Antigen?

Imunoglobulin: G

A E

M

D

Autoimun

.

Seluler

Limfosit Sel T

Sel B

Sel NK ..


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Sifat Biologik Imunoglobulin pada Manusia

Ig G Ig A Ig M Ig D Ig E

Sifat utama Cairan tubuh

ekstravaskuler, u/

melawan

jasad renik

dan toksin

Menembus

plasenta

Sekresi

selaputlendir-

darah, u/

melindungi

permukaaan

tubuh

Aglutinator

yg sangatefektif,

dihasilkan

pada awal

respons

imunpertahanan

garis depan

efektif

terhadap

bakteremia

Terdapat

padapermukaan

limfosit

Terbentuk

pada infeksiparasit,

penyebab

gejala

alergi

atopik

Ikatan

sitofilik pd

makkrofag

& polimorf

+ _ _ _ _


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Adakah hub Aktivitas dg Imunitas? Sholat Tahajud meningkatkan imunitas

Exercise memperbaiki imunitas Berkesenian membuat semangat hidup

Bersosialisasi membuat diri lebih mantap

Berbagi pengalaman (Sharing) meringankan stres

Reminiscence memperbaiki Mood

Rutin, Terstruktur &Teratur


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Tai Chi dan ImunitasMedical-dictionary.thefreedictionary.com/tai+chi

CachedTai Chi Definition. T'ai chi is a Chinese exercisesystem that uses slow, smooth body movements toachieve a state of relaxation of both body and mind.

Boost Your Immune System Naturally with Tai Chi -Prevention.com

www.prevention.com/...your-immune-system-naturally-tai-chi CachedA Tai Chi workout is a natural health

remedy for boosting immunity and avoiding commoncolds. Try this 20-minute no-sweat routine fromPrevention Magazine.


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..about TaiChi www.peacerivertaichi.com/taichi.html CachedDefi

nition. Tai chi is a ... can be helpful in achieving astate of physical and mental relaxation while also

strengthening the cardiovascular and immune ...

www.opposingviews.com/i/studies-yoga-and-tai-chi...immunity CachedWikipedia--a resource I use

only very carefully and with a critical eye--has a

fairly good definition of the ... We know Tai Chihas ... twice the level of immunity.


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www.taichiforeveryone.net/main/taichi.htm Cach

edDEFINITION OF TAI CHI . Tai Chi falls easilyinto at least four major categories: martial arts,meditation, medicine, and exercise. Much like theart form itself, Tai ...

en.wikipedia.org/wiki/Tai_chi_chih CachedTai chichih is a series of 19 movements and 1 pose thattogether make up a meditative form of exercise to

which practitioners attribute physical and spiritualhealth ...


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Imunitas Psikologis ?

Coping Mechanism: R, P, I, S, PA, dsb Cara Pikir: Positif vs Negativ

Cara Pandang: Persepi Diri dan Lingkungan

Cara Bersikap: . ?

Cara Mendengar .. KATANYA ???


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Sikap Orang Positif adalah: SMRT

Tetap Sejuk di tempat yang panas

Tetap Manis di tempat sangat pahit

Tetap Rendah hati meski telah sukses

Tetap Tenang di tengah badai yang paling hebat

Pemenang

Kehidupan


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The Power of Mind Mind and Body is Unity

Mindfulness, self awareness Meditasi-Yoga

ACT (Acceptance Commitment Therapy)

CBT (Cognitive Behavior Therapy) Psikoterapi

Hypnosis Sugesti Diri

Positive Thinking

Pikir Kata - Laku


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Aset Budaya Bangsa Indonesia: BBBBB

Ber-Gotong Royong semut

Berketuhanan YME

Berperikemanusiaan belas kasih

Bersatu kita teguh, bercerai .

Ber-Musyawarah & Mufakat

Berkeadilan menyeluruh


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SAP TO PREVENT DEMENTIA IN THE

AGE FRIENDLY COMMUNITY

Martina WS Nasrun

Asosiasi Psikogeriatri Indonesia (API)


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Structured

Activity

Program

For WHOM ?

What Activity?

How to create? Can PWD do it?

Where do we can access this SAP?37


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Magnitude of AD problem:

Medico-Psycho-Social impact

Family Caregiver Burden

High Cost (treatment care & medicine)

High functional disability

Lost of independency Behavior problems

Mistreatment, abuse, neglect etc

Reduce QOL (PWD & caregiver)

Long good bye ..


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Indonesia demographic Profile

Indicator 1950 1980 2010 2030 2050

Population

(thousand)

79.538 151.108 239.600 279.666 296.885

0-4 (%) 14,3 14,7 8,8 6,7 5,6

5-14 (%) 24,8 25,8 17,8 13,4 11,8

15-24 (%) 20 20 17,6 14,5 12,3

24-59 (%) 30,4 30,4 40 37,2 22,9

> 60 (%) 6,2 5,4 8,9 16 24,8

> 65 (%) 4 3,4 6,1 10,7 18,6

> 80 (%) 0,3 0,3 0,8 1,5 4

Source: Population division of the department

of economic and social affairs of the UNsecretariat . World Population prospects: 200639

Persentage of mental emotional disorder


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Persentage of mental emotional disorder

(SRQ-20) di Indonesia

(Riskesdas 2007, litbangkes

)

40

age

33.7

39.1

wanita > laki2,tidak sekolah, tidak kerja tinggal di

desa

26.3%MED 65+


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AD DEMENTIA:A CHALLENGE OR A BURDEN? ?


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What can we do ???

..

...

42


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Advocating

ADI Global

Chapter

NCD summit 2011: joint

statement 11 NGOs

ADI

Kyoto

Raising Awareness


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Raising Awareness

AD Global challenge1 new case every 4 seconds


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People With Dementia in Day Center

with SAP

SAP Principle:


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SAP Principle:Goal, approach, happy/interesting, voluntary, enthusiasm, stimulate, fit to

the person or group

t

Day Center In House / Hospital

46


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SAP at home

47


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Structured Activity Program

Well plan for the person / group Fit to their culture, education & background

Has a realistic & clear goal / target

Knowledge of person asset and deficit

Knowledge of client capability and disability

Activity Staff (facilitator)

Evaluation sheet

Feed back to the family / caregivers 48

Assessment of mental & physical


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Assessment of mental & physical

capacity of senior citizen Who ? people at risk, age 55 75 +

When? if there is a decline in daily function What? judgment, memory, psychomotor, balance, etc

Where? General Hospital, Primary Care, Specialized

Clinic, Day Center ? How?

Regular check up

Assess by competence staff Early Awareness ..

49


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How ?JUST DO IT

Screening: AD & Pre- AD (MCI)

Prevention: modifiable risk factor w/whatever ACTIVITY as long as ROUTINE

ITS TIME FOR ACTION !

Strategic Plan & Collaboration

WHO ?

All stakeholders Society, NGO, SC,

Government, Experts, Family Caregiver,

PWD, private sector, etc


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ADVOCAC


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ADVOCAC

Y


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CAPACITY


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CAPACITY

BUILDINGStandardized Module & Action Plan


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TOT

Taichi untukPerawat &

Fisioterapis

SCIPIK

PWD d f il IN ACTION ABG


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PWD and family IN ACTION: ABG

Advokasi

Bina-suanaGerakkan

Continuing Action - - -

P t T t E l ti


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Post Test Evaluation

1. Mampu menerangkan Imunitas / Daya Tahan

2. Mampu menjelaskan Aktivitas Bermanfaat danTeratur

3. Mampu merancang Program Aktivitas Lanjut Usia

4. Mampu mengevaluasi kemajuan/kemunduran darifungsi Kognitif & Perasaan

5. Mampu menolong orang !


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T i k ih


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Terima kasih

TaiChi Untuk Perawat MW

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