Description of the Action
Geriatric Medicine (GM), which is the field of medicine that is concerned with the health and well-being of older adults, can play a crucial role in the alignment of health systems to the needs of the constantly growing older populations. However, countries have varying GM development backgrounds. This Action’s objective is the definition of the content of targeted education and training activities in GM for health care professional across various clinical settings, destined mainly for countries where GM is still emerging and adapted to the local context, the needs and assets of stakeholders and the pragmatic possibilities of involved settings.
This will be accomplished by the description of the state-of-the-art of GM education in involved countries, the identification of the global and more specific local needs regarding the development of GM-related clinical skills and competencies of medical doctors and allied healthcare professionals involved in the care of older people across all the spectrum of health care services, the definition of the content of training courses in GM destined for non-geriatricians, by adjusting international standards to local needs and pragmatic possibilities, and the dissemination of results on identified needs and proposed solutions to stakeholders, policy makers and the public. Countries with well-established GM systems will contribute with their experience and know-how in clinical and academic GM.
Pragmatic solutions that aim to address the specialized health care needs or older people, such as tailored education and training of existing workforce, are feasible, affordable and exponentially efficient, and, thus, highly relevant.
The main aim/challenge of the PROGRAMMING (PROmoting GeRiAtric Medicine IN countries where it is still eMerGing) COST Action is the definition of the content of educational programs on basic principles of care of older people, destined for professionals non-specialists in GM and adapted to the local context, the needs and assets of stakeholders and the pragmatic possibilities of involved settings.
The challenge of demographic change towards a growing share of older people is an unquestionable and worldwide phenomenon. Average life expectancy at 65 years on the European Union (EU) of 28 countries was 19.9 years in 2017 and epidemiological trends about a growing old population are similar all over Europe (1).
Moreover, the share of people 80 years and older is continuously growing. The opportunities that arise from increasing longevity will be largely dependent on the key factor of the health of these older populations, since along with this predictable phenomenon of prolongation of life comes, in many cases, an increased burden of disease and disability, which constitutes a major socioeconomic challenge for local health and social security systems and for the international community. World Health Organization (WHO) committed to a decade of concerted global action, the Decade of Healthy Ageing, from 2020 to 2030 (2). Strategic planning on ageing and health, as stated during the 69th World Health Assembly, also included the commitment of member countries to action on Healthy Ageing at a local level, to the alignment of health systems to the needs of older populations and to the development of sustainable and equitable systems for providing long-term care (3). Similarly, the report of the European Academy of Sciences, stated that it seems reasonable to develop sustainable and interprofessional care systems for the care of ageing societies (4). Geriatric Medicine (GM), which is the field of medicine that is concerned with the health and well-being of older adults (5), can play a crucial role in this strategy. A considerable part of disability and poor quality of life in the latest years of life is avoidable or effectively manageable. The main cause of disability are chronic non communicable conditions, many of which can be prevented or delayed by timely lifestyle, medical or environmental interventions (3). GM addresses not only physical, but also mental, emotional, social and environmental needs of the older person, emphasizing preservation of functional independence even in the presence of multiple chronic diseases. In the core of GM lies the Comprehensive Geriatric Assessment, which typically requires the collaboration of the multidisciplinary geriatric team, consisting not only of medical doctors, but also of allied health care professionals. The GM approach has been found effective in improving health, activity and function in frail older people, in reducing morbidity and mortality, in preventing hospital admission, and in delaying or postponing institutionalization (6-8). GM expertise is needed in all vertical—primary, secondary and tertiary—levels and also in the horizontal level of multi-professional teams. GM may act as key driver for innovation of health care, as foreseen also by WHO, and promote transformation of healthcare by delivering evidence-based care standards to all professions involved in the care processes across Europe and by aligning with integrated care and health co-production models (9-10). However, countries currently have varied geriatric infrastructure backgrounds (2,11-12) and every single older person, residing in European and proxy countries, does not seem to have the same opportunities of access to specialized health care services (13-15). Beyond economic and societal status variations across Europe and the wider neighbour area, health care and health professionals’ educational systems also vary widely among countries. Undergraduate education in GM seems globally underestimated in Medical Faculties of several European countries, especially Southern and Eastern European countries 2 and the proxy area, and at a post-graduate level, a high heterogeneity is observed (15,16). Currently, only a few Balkan countries have GM as a recognized medical specialty or subspecialty (11). Consequently, familiarization of health care professionals with basic principles of the specialized care of older people varies widely across Europe and reflects a low level of preparedness for pragmatic needs. The problem is even more pronounced, adding on the top of the EU health care workforce crisis (4). Raising public awareness about the added value of specialized geriatric care and geriatric literacy among health care professionals could lead to convincing governments and to the application of targeted global actions, at a local and broader international level, towards the enhancement of the health services and the quality of life of older people across Europe and the proxy area.