SlideShare uma empresa Scribd logo
1 de 76
Promoting Health in Older Adults Reynel Dan L. Galicinao
AGING normal process of time-related change, begins with birth and continues throughout life ,[object Object]
Subjectively: how a person feels
Functionally: changes in physical or mental capabilities,[object Object]
Categorizing the Aging Population
Care Settings for Elders
1. Acute Care Facilities Protect the health of the older adult and return to his/her previous level of independence ,[object Object]
ED
CCU,[object Object]
Intermediate care
Skilled care units
Alzheimer’s units,[object Object],[object Object]
Nurse-run clinics
Adult day care,[object Object]
1. Wear-and-Tear Theories Vital parts run down with time  -> aging  -> death The faster you live, the quicker you die ,[object Object],[object Object]
3. Free-radical Theory
4. Genetic Theories Organism is genetically programmed for a predetermined number of cell divisions, then organism dies
5. Cross-Linking Theories Irreversible aging of proteins (collagen)  -> failure of tissues & organs
6. Immunological Theories Immune system becomes less effective with age, resulting in reduced resistance to infection & diseases
PHYSIOLOGICAL AGING
A. Integumentary ↑skin dryness, pallor, fragility Progressive wrinkling & sagging of skin Brown “age spots” (lentigo senilis) ↓perspiration
Thinning & graying of scalp, pubic, axillary hair Slower nail growth; ↑ thickening & brittle Loss of SQ fat
Health Promotion Strategies Optimal nutrition Adequate hydration Lotion after bath
Avoid products with alcohol/perfume Assess frequency of bathing Sun screen lotions with SPF ≥ 15 Observe for skin changes & seek medical consultation
Wide-brimmed hat, sun visor, sunglasses No strong detergent to launder clothes
Avoid rough-textured clothing & highly starched linens ,[object Object],[object Object]
Health Promotion Strategies Pace teaching Encourage visitors with hospitalization
Enhance sensory stimulation With sudden confusion, look for cause
C. Musculoskeletal ↓ speed & power of muscle contractions Joint stiffness
Loss of ht (stature) -> kyphosis
Loss of bone mass -> osteoporosis -> pathologic fractures Impaired balance
Health Promotion Strategies Slow rising from a resting position Regular exercise
High-calcium diet Limit phosphorus intake Calcium & vitamin D supplements as prescribed
D. Sensory/Perceptual Loss of visual acuity ↑ sensitivity to glare; ↓ ability to adjust to darkness Arcus senilis Lens opacity (cataract)
Presbyopia Presbycusis ↓ sense of taste (sweet) ↓ sense of smell ,[object Object],[object Object]
Adequate indoor lighting with area lights and nightlights Large-print books Magnifier for reading
Avoid night driving Contrasting colors Avoid glare of shiny surfaces and direct sunlight Hearing examination Reduce background noise
Face person; enunciate clearly Speak with a low-pitched voice Use nonverbal cues Encourage use of lemon, spices, herbs
E. Pulmonary ↓ ability to expel foreign/accumulated matter ↓ lung expansion less effective exhalation ↓ vital capacity
↑ residual volume Difficult, short, heavy, rapid breathing (dyspnea) after intense exercise
Health Promotion Strategies Regular Exercise No smoking Adequate fluids to liquefy secretions
Yearly influenza immunizations Avoid exposure to URTI
F. Cardiovascular ↓ cardiac output & stroke volume (during ↑ activity) -> SOB on exertion & pooling of blood in extremities
↓ elasticity, ↑ rigidity of arteries ↑ diastolic & systolic BP Orthostatic hypotension
Health Promotion Strategies Regular exercise Pace activities ,[object Object]
Low-fat, low-salt diet ,[object Object]
G. Gastrointestinal ↓ salivation Delayed swallowing time ↑ tendency for  	indigestion & 	constipation
Health Promotion Strategies Small, frequent meals Ice chips, mouthwash Brush, floss,  	massage gums  	daily
Regular dental care Sit up and avoid heavy activity pc Limit antacids
High-fiber, low-fat diet Limit laxatives Toilet regularly Adequate fluids
H. Urinary ↓ filtering ability of the kidney; impaired renal function
Less effective concentration of urine Nocturnal frequency Retention of residual urine
Health Promotion Strategies Adequate fluid intake (8-10 glasses of non-caffeinated liquid) Avoid bladder-irritant foods (sugar, caffeine, alcohol, chocolate, artificial sweeteners, spicy & acidic food) Pelvic muscle exercise
I. Genitals
Health Promotion Strategies ,[object Object]
Provide privacy to promote intimacy,[object Object]
J. Immunological ↓ immune response; ↓ resistance to infections Poor response to immunization ↓ stress response
Health Promotion Strategies Avoid exposure to infection Up to date influenza, pneumonia immunizations
K. Endocrine ↑ insulin resistance ↓ thyroid function
Health Promotion Strategies Balance diet Regular exercise Ideal body wt Blood sugar test
Psychosocial Theories of Aging
1. Disengagement Theory Mutual withdrawal Reduces society’s pressure Reduces # of people whom elderly interacts
2. Activity Theory Best way to age:  ,[object Object],[object Object]
Psychosocial Aging
Erikson’s Psychosocial Stage Ego integrity vs. Despair
Peck’s Developmental Task of Aging
Retirement Can be a time when projects or recreational activities can be pursued Can be a difficult time of adjustment
Economic Change Adequate financial resources enable the older person to remain independent
Grandparenting Provide sense of continuity family heritage, rituals, folklore, support
Relocation Older client has many living options depending on income, health status, activity level, level of independence, family or other support systems
Maintaining Independence & Self-Esteem It is important for them to look after themselves even if they have to struggle to do so Encourage them to do as much as possible for themselves & maintain safety
“I’m getting so old that my friends in heaven will think I didn’t make it.”
Facing Death & Grieving Loss is an inevitable part of life; the longer a client lives, the more losses will be experienced.
The setting sun is as beautiful  as the rising sun. —Japanese proverb
Thank you! ☺

Mais conteúdo relacionado

Mais procurados

Mais procurados (20)

Geriatrics
Geriatrics Geriatrics
Geriatrics
 
1. geriatic nsg nursing care and older clients f - copy
1. geriatic nsg  nursing care and older clients f - copy1. geriatic nsg  nursing care and older clients f - copy
1. geriatic nsg nursing care and older clients f - copy
 
Care of elderly people
Care of elderly peopleCare of elderly people
Care of elderly people
 
Older adult
Older adultOlder adult
Older adult
 
Care of elderly ill people
Care of elderly ill peopleCare of elderly ill people
Care of elderly ill people
 
Seniors Exercise Presentation
Seniors Exercise PresentationSeniors Exercise Presentation
Seniors Exercise Presentation
 
Assessment of the Geriatric Patient
Assessment of the Geriatric PatientAssessment of the Geriatric Patient
Assessment of the Geriatric Patient
 
Active aging
Active agingActive aging
Active aging
 
Mobility Awareness Among Aging Population
Mobility Awareness Among Aging PopulationMobility Awareness Among Aging Population
Mobility Awareness Among Aging Population
 
Gerontology
GerontologyGerontology
Gerontology
 
Healthy and Active Ageing
Healthy and Active AgeingHealthy and Active Ageing
Healthy and Active Ageing
 
10 Myths and Facts About Aging
10 Myths and Facts About Aging10 Myths and Facts About Aging
10 Myths and Facts About Aging
 
Factors Affecting Elderly Health
Factors Affecting Elderly HealthFactors Affecting Elderly Health
Factors Affecting Elderly Health
 
Elder abuse and neglect presentation
Elder abuse and neglect presentationElder abuse and neglect presentation
Elder abuse and neglect presentation
 
Assessment of the elderly
Assessment of the elderlyAssessment of the elderly
Assessment of the elderly
 
Care of elderly
Care of elderlyCare of elderly
Care of elderly
 
Elderly Care
Elderly CareElderly Care
Elderly Care
 
Aging-related Changes
Aging-related ChangesAging-related Changes
Aging-related Changes
 
Cognition in aging
Cognition in agingCognition in aging
Cognition in aging
 
Preventive Care in Geriatrics
Preventive Care in GeriatricsPreventive Care in Geriatrics
Preventive Care in Geriatrics
 

Destaque (20)

Cyberbullying2
Cyberbullying2Cyberbullying2
Cyberbullying2
 
Health Problems
Health ProblemsHealth Problems
Health Problems
 
Cyberbully ppt
Cyberbully pptCyberbully ppt
Cyberbully ppt
 
osteoporosis
osteoporosisosteoporosis
osteoporosis
 
Internet Addiction
Internet AddictionInternet Addiction
Internet Addiction
 
Chapter Six
Chapter SixChapter Six
Chapter Six
 
Chapter12
Chapter12Chapter12
Chapter12
 
Health promotion and social media final dec
Health promotion and social media final   decHealth promotion and social media final   dec
Health promotion and social media final dec
 
Health promotion
Health promotionHealth promotion
Health promotion
 
House dust mite allergy
House dust mite allergyHouse dust mite allergy
House dust mite allergy
 
Allergies hayfever
Allergies hayfeverAllergies hayfever
Allergies hayfever
 
Cyberbullying
CyberbullyingCyberbullying
Cyberbullying
 
Wound healing
Wound healingWound healing
Wound healing
 
Health Education
Health EducationHealth Education
Health Education
 
Wound care
Wound careWound care
Wound care
 
Cyber bullying
Cyber bullyingCyber bullying
Cyber bullying
 
Soft tissue injuries
Soft tissue injuriesSoft tissue injuries
Soft tissue injuries
 
Anxiety Disorders
Anxiety DisordersAnxiety Disorders
Anxiety Disorders
 
Muscle Injury , Inflammation & repair
Muscle Injury , Inflammation & repair Muscle Injury , Inflammation & repair
Muscle Injury , Inflammation & repair
 
Is Internet Addiction Real? - Facts & Stats
Is Internet Addiction Real? - Facts & StatsIs Internet Addiction Real? - Facts & Stats
Is Internet Addiction Real? - Facts & Stats
 

Semelhante a Promoting health in older adults

Chapter 033
Chapter 033Chapter 033
Chapter 033bholmes
 
Care of Elderly.pptx
Care of Elderly.pptxCare of Elderly.pptx
Care of Elderly.pptxSamta Soni
 
Wellness in Golden Years by Dr V K Chopra
Wellness in Golden Years by Dr V K ChopraWellness in Golden Years by Dr V K Chopra
Wellness in Golden Years by Dr V K ChopraMedanta - The Medicity
 
CARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptx
CARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptxCARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptx
CARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptxDelphyVarghese
 
441847252-Health-promotion-ppt.ppt
441847252-Health-promotion-ppt.ppt441847252-Health-promotion-ppt.ppt
441847252-Health-promotion-ppt.pptChrisendyHakim2
 
Health profile for youngs
Health profile for youngs Health profile for youngs
Health profile for youngs Arefin Muhammad
 
Nursing management of the- medical surgical nursing-1 UNIT 14.pptx
Nursing management of the- medical surgical nursing-1 UNIT 14.pptxNursing management of the- medical surgical nursing-1 UNIT 14.pptx
Nursing management of the- medical surgical nursing-1 UNIT 14.pptxJyotiBhagat31
 
Unit vi care of elderly persons m.sc ii yrs
Unit vi care of elderly persons m.sc ii yrsUnit vi care of elderly persons m.sc ii yrs
Unit vi care of elderly persons m.sc ii yrsanjalatchi
 
Health assessment part 1 history takiong in english
Health assessment part 1   history takiong  in englishHealth assessment part 1   history takiong  in english
Health assessment part 1 history takiong in englishMY STUDENT SUPPORT SYSTEM .
 
Health assessment part 1 history takiong in english
Health assessment part 1   history takiong  in englishHealth assessment part 1   history takiong  in english
Health assessment part 1 history takiong in englishMY STUDENT SUPPORT SYSTEM .
 
aging and its social medical implications
aging and its social medical implicationsaging and its social medical implications
aging and its social medical implicationsKinza466
 
chapter-17-power-points1.ppt
chapter-17-power-points1.pptchapter-17-power-points1.ppt
chapter-17-power-points1.pptArifSabtaAji1
 
Tech factor challenge 2016 aging in place workshop presentation slides (compi...
Tech factor challenge 2016 aging in place workshop presentation slides (compi...Tech factor challenge 2016 aging in place workshop presentation slides (compi...
Tech factor challenge 2016 aging in place workshop presentation slides (compi...Jit Seng Tan
 
Women health webinar-5-12
Women health webinar-5-12Women health webinar-5-12
Women health webinar-5-12CinchYourState
 
END OF LIFE CARE- all ages deserve quality end of life care
END OF LIFE CARE- all ages deserve quality end of life careEND OF LIFE CARE- all ages deserve quality end of life care
END OF LIFE CARE- all ages deserve quality end of life careSandhya C
 

Semelhante a Promoting health in older adults (20)

Chapter 033
Chapter 033Chapter 033
Chapter 033
 
Care of Elderly.pptx
Care of Elderly.pptxCare of Elderly.pptx
Care of Elderly.pptx
 
Wellness in Golden Years by Dr V K Chopra
Wellness in Golden Years by Dr V K ChopraWellness in Golden Years by Dr V K Chopra
Wellness in Golden Years by Dr V K Chopra
 
CARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptx
CARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptxCARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptx
CARE FOR OLD AGE ANP SEMINAR in nursing aspectanp.pptx
 
441847252-Health-promotion-ppt.ppt
441847252-Health-promotion-ppt.ppt441847252-Health-promotion-ppt.ppt
441847252-Health-promotion-ppt.ppt
 
Health profile for youngs
Health profile for youngs Health profile for youngs
Health profile for youngs
 
Nursing management of the- medical surgical nursing-1 UNIT 14.pptx
Nursing management of the- medical surgical nursing-1 UNIT 14.pptxNursing management of the- medical surgical nursing-1 UNIT 14.pptx
Nursing management of the- medical surgical nursing-1 UNIT 14.pptx
 
Unit vi care of elderly persons m.sc ii yrs
Unit vi care of elderly persons m.sc ii yrsUnit vi care of elderly persons m.sc ii yrs
Unit vi care of elderly persons m.sc ii yrs
 
health awareness
health awarenesshealth awareness
health awareness
 
Lesson 3 health the art of aging
Lesson 3 health the art of aging Lesson 3 health the art of aging
Lesson 3 health the art of aging
 
Health assessment part 1 history takiong in english
Health assessment part 1   history takiong  in englishHealth assessment part 1   history takiong  in english
Health assessment part 1 history takiong in english
 
Health assessment part 1 history takiong in english
Health assessment part 1   history takiong  in englishHealth assessment part 1   history takiong  in english
Health assessment part 1 history takiong in english
 
aging and its social medical implications
aging and its social medical implicationsaging and its social medical implications
aging and its social medical implications
 
Preventive geriatrics
Preventive geriatricsPreventive geriatrics
Preventive geriatrics
 
chapter-17-power-points1.ppt
chapter-17-power-points1.pptchapter-17-power-points1.ppt
chapter-17-power-points1.ppt
 
Tech factor challenge 2016 aging in place workshop presentation slides (compi...
Tech factor challenge 2016 aging in place workshop presentation slides (compi...Tech factor challenge 2016 aging in place workshop presentation slides (compi...
Tech factor challenge 2016 aging in place workshop presentation slides (compi...
 
Women health webinar-5-12
Women health webinar-5-12Women health webinar-5-12
Women health webinar-5-12
 
Tips for Healthy Aging
Tips for Healthy AgingTips for Healthy Aging
Tips for Healthy Aging
 
MAINTAINING A HEALTHY LIFE.doc
MAINTAINING A HEALTHY LIFE.docMAINTAINING A HEALTHY LIFE.doc
MAINTAINING A HEALTHY LIFE.doc
 
END OF LIFE CARE- all ages deserve quality end of life care
END OF LIFE CARE- all ages deserve quality end of life careEND OF LIFE CARE- all ages deserve quality end of life care
END OF LIFE CARE- all ages deserve quality end of life care
 

Mais de Reynel Dan

Central venous catheter access for hemodialysis
Central venous catheter access for hemodialysisCentral venous catheter access for hemodialysis
Central venous catheter access for hemodialysisReynel Dan
 
Arteriovenous access for hemodialysis Review Questions
Arteriovenous access for hemodialysis Review QuestionsArteriovenous access for hemodialysis Review Questions
Arteriovenous access for hemodialysis Review QuestionsReynel Dan
 
DOH at Your Service
DOH at Your ServiceDOH at Your Service
DOH at Your ServiceReynel Dan
 
Battling COVID 19 in Zamboanga del Sur
Battling COVID 19 in Zamboanga del SurBattling COVID 19 in Zamboanga del Sur
Battling COVID 19 in Zamboanga del SurReynel Dan
 
Mental Health: Stress Management in Focus
Mental Health: Stress Management in FocusMental Health: Stress Management in Focus
Mental Health: Stress Management in FocusReynel Dan
 
AV Vascular Access - Hemodialysis
AV Vascular Access - HemodialysisAV Vascular Access - Hemodialysis
AV Vascular Access - HemodialysisReynel Dan
 
Decreasing dialysis provider patient conflict
Decreasing dialysis provider patient conflictDecreasing dialysis provider patient conflict
Decreasing dialysis provider patient conflictReynel Dan
 
Continuing care of the dialysis patient
Continuing care of the dialysis patientContinuing care of the dialysis patient
Continuing care of the dialysis patientReynel Dan
 
Arteriovenous vascular access complications
Arteriovenous vascular access complicationsArteriovenous vascular access complications
Arteriovenous vascular access complicationsReynel Dan
 
Dialysis patients’ responsibilities
Dialysis patients’ responsibilitiesDialysis patients’ responsibilities
Dialysis patients’ responsibilitiesReynel Dan
 
Dialysis patients’ bill of rights
Dialysis patients’ bill of rightsDialysis patients’ bill of rights
Dialysis patients’ bill of rightsReynel Dan
 
Working with kidney disease
Working with kidney diseaseWorking with kidney disease
Working with kidney diseaseReynel Dan
 
Cardiac arrest in the dialysis unit
Cardiac arrest in the dialysis unitCardiac arrest in the dialysis unit
Cardiac arrest in the dialysis unitReynel Dan
 
Integrative teaching as mode of instructional delivery
Integrative teaching as mode of instructional deliveryIntegrative teaching as mode of instructional delivery
Integrative teaching as mode of instructional deliveryReynel Dan
 
Republic act no 9293
Republic act no 9293Republic act no 9293
Republic act no 9293Reynel Dan
 
Grading and reporting
Grading and reportingGrading and reporting
Grading and reportingReynel Dan
 
Complications of hemodialysis
Complications of hemodialysisComplications of hemodialysis
Complications of hemodialysisReynel Dan
 
Understanding renal failure
Understanding renal failureUnderstanding renal failure
Understanding renal failureReynel Dan
 
Kaya Nimo Magplano - Family planning
Kaya Nimo Magplano - Family planning Kaya Nimo Magplano - Family planning
Kaya Nimo Magplano - Family planning Reynel Dan
 
Understanding dengue
Understanding dengueUnderstanding dengue
Understanding dengueReynel Dan
 

Mais de Reynel Dan (20)

Central venous catheter access for hemodialysis
Central venous catheter access for hemodialysisCentral venous catheter access for hemodialysis
Central venous catheter access for hemodialysis
 
Arteriovenous access for hemodialysis Review Questions
Arteriovenous access for hemodialysis Review QuestionsArteriovenous access for hemodialysis Review Questions
Arteriovenous access for hemodialysis Review Questions
 
DOH at Your Service
DOH at Your ServiceDOH at Your Service
DOH at Your Service
 
Battling COVID 19 in Zamboanga del Sur
Battling COVID 19 in Zamboanga del SurBattling COVID 19 in Zamboanga del Sur
Battling COVID 19 in Zamboanga del Sur
 
Mental Health: Stress Management in Focus
Mental Health: Stress Management in FocusMental Health: Stress Management in Focus
Mental Health: Stress Management in Focus
 
AV Vascular Access - Hemodialysis
AV Vascular Access - HemodialysisAV Vascular Access - Hemodialysis
AV Vascular Access - Hemodialysis
 
Decreasing dialysis provider patient conflict
Decreasing dialysis provider patient conflictDecreasing dialysis provider patient conflict
Decreasing dialysis provider patient conflict
 
Continuing care of the dialysis patient
Continuing care of the dialysis patientContinuing care of the dialysis patient
Continuing care of the dialysis patient
 
Arteriovenous vascular access complications
Arteriovenous vascular access complicationsArteriovenous vascular access complications
Arteriovenous vascular access complications
 
Dialysis patients’ responsibilities
Dialysis patients’ responsibilitiesDialysis patients’ responsibilities
Dialysis patients’ responsibilities
 
Dialysis patients’ bill of rights
Dialysis patients’ bill of rightsDialysis patients’ bill of rights
Dialysis patients’ bill of rights
 
Working with kidney disease
Working with kidney diseaseWorking with kidney disease
Working with kidney disease
 
Cardiac arrest in the dialysis unit
Cardiac arrest in the dialysis unitCardiac arrest in the dialysis unit
Cardiac arrest in the dialysis unit
 
Integrative teaching as mode of instructional delivery
Integrative teaching as mode of instructional deliveryIntegrative teaching as mode of instructional delivery
Integrative teaching as mode of instructional delivery
 
Republic act no 9293
Republic act no 9293Republic act no 9293
Republic act no 9293
 
Grading and reporting
Grading and reportingGrading and reporting
Grading and reporting
 
Complications of hemodialysis
Complications of hemodialysisComplications of hemodialysis
Complications of hemodialysis
 
Understanding renal failure
Understanding renal failureUnderstanding renal failure
Understanding renal failure
 
Kaya Nimo Magplano - Family planning
Kaya Nimo Magplano - Family planning Kaya Nimo Magplano - Family planning
Kaya Nimo Magplano - Family planning
 
Understanding dengue
Understanding dengueUnderstanding dengue
Understanding dengue
 

Último

Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Dipal Arora
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...vidya singh
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋TANUJA PANDEY
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...narwatsonia7
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Call Girls Gwalior Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableDipal Arora
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...perfect solution
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Genuine Call Girls
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...tanya dube
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...Taniya Sharma
 

Último (20)

Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Call Girls Gwalior Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
 

Promoting health in older adults