Long term care for older patients: challenges in countries with emerging Geriatric Medicine

Long term care for older patients: challenges in countries with emerging Geriatric Medicine

Face-to-face event Skopje 15-16 February 2024

The first face-to face event in 2024, part of the annual activities of the PROGRAMMING COST Action 21122 was held in Skopje, North Macedonia (NM) on the 15-16 of February 2024, at the Holiday Inn Hotel. Macedonian Association for Geriatric Medicine – MZGM, member of the Macedonian Medical Association, was a co-organizer and a host of this two-day event with international participation.

The program of the event addressed topics related to long-term care (LTC), which is as an essential part of an integrated continuum of health care, especially within the context of population ageing. According to the WHO definition, “Long-term care includes a wide range of medical services and social and personal support for people with significantly reduced intrinsic capacity (due to mental or physical illness or disability) to maintain an adequate degree of functional ability to preserve basic rights and human dignity.”

Integrated and person-centered healthcare and long-term care services should respond to the diverse needs and preferences of seniors experiencing declines in functional ability and they should be developed with focus on sustainability and resources’ availability, as well as, educational needs of the involved healthcare professionals.

Dr. Marina Kotsani, head of the ROGRAMMING CA 21122, and Dr. Biljana Petreska-Zovic, president of the Macedonian Association for Geriatric Medicine – MZGM opened the event with brief introduction presentations on the structure of the CA and its goals and the path of the adult patient in the healthcare system in NM – from primary health care to long-term care, respectively. The event was hybrid with opportunity to participate onsite and online, and was attended by over 100 participants – doctors from various settings, nurses, caregivers, aligned health care professionals, representatives from the universities and other stake holders.

The program of the event consisted of Focus Group research, lectures, panel discussions and the visit of two different structured LCT facilities.

The round tables and lectures on the first day, referred to medical topics significant for long-term care, game-changing interventions, namely – assessment of a nutritional status, oral health in older adults and the problem of polypharmacy, as well as end-of-life and palliative care and state-of-the art of caregiving, focusing on the person-centered and tailored health care.

Prof. Karolina Piotrowicz (Poland), Prof. Anastasia Kosioni (Greece) and Dr. Ksenia Arbanas (Croatia), Dr. Dimitrije Jakovljevic (Finland) and Dr. Sibel Chavdar (Turkey) shared their experiences and presented data from ongoing researches. The sessions were moderated by Prof. Anne Ekdahl (Sweden) and Prof. Sonja Genadieva Stavric (NM), d-r Mohamed Salem (Malta) and d-r Lidija Pavleska (NM).

Panel discussions on the second day – Stakeholders and policymakers’ sessions was dedicated to two different but equally important areas – 1* Promotion of Geriatric Medicine through education and training of health professionals and 2* Models of long-term care in N. Macedonia.

The guest in the 1* session was the representative of the WHO, Dr. Anne Johansen, who briefly presented activities of the WHO in helping the processes of better health care for the older adults by strengthening the educational capacities in NM.

Prof. Dr. Elizabeta Zisovska (NM), collaborator of the WHO, held very interesting lecture on models of informal education in adulthood. Prof. Dr. Julija Zivadinović-Bogdanovska, vice dean for teaching at the Faculty of Medicine in Skopje presented how the GM is covered in the existing curricula for undergraduate studies for doctors, physiotherapists and speech therapists. She also presented the recently developed subspecialization curricula in GM which is going to start in 2024. The GM is not recognized as a distinct specialty in NM. Moderators of this very important session were Prof. Dr. Marija Vavlukis, vice dean for science at the Faculty of Medicine in Skopje and Prof. Dr. Mirko Petrovic, the president of EuGMS. The session was followed by very vivid discussion and experiences were exchanged about the study models in GM in different countries in Europe.  

In the second part – 2* Models of long-term care and social aspects, Prof. Dr. Mome Spasovski, Head of the Institute of Social Medicine, Faculty of Medicine in Skopje, and Prof. Dr. Gordana Ristevska-Dimitrovska, High medical school for nurses, Faculty of Medicine in Bitola, presented the current LTC models in NM, challenges and weaknesses, as well as, the possibilities for improvement and development in the future. (legislative, resources etc.). Session was moderated by the Prof. Nenad Bogdanovic.

President of the Macedonian Association of the Internal Medicine, Dr Aleksandar Manolev, President of the Macedonian Union of Nurses – Ms. Gordana Beshlioska, as well as the representative from the Macedonian Red Cross gave their valuable contribution in the rich discussion that followed.

The important part of the event was, also, a 90-minute workshop-research – “Focus Groups on Educational needs of ‘first-line’ stakeholders “. Focus group 1: Educational needs of health care professionals working in different settings regarding Geriatric Medicine, consisted of doctors specialists from LCT facilities and GPs and was moderated by Dr. Pavlinka Milosavlevic and Assoc. Prof. Stefan Arsov. Focus group 2: Care givers’ educational needs in LCT facilities was moderated by nurse Vesna Popov, and nurse Meri Terzieva. The qualitative data from the Focus Groups research will be further analyzed.

The two-day activities included a visit to the public Specialized Hospital for Geriatric and Palliative Medicine 13 November Skopje and the Private Nursing Home “Idila”. The goal was to demonstrate the existing resources and the long tradition of organized medical geriatric and palliative health care for the most vulnerable category of older  adults. The Specialized Hospital 13 Noemvri (formerly Institute of Gerontology) celebrated its 65th anniversary in 2023.

The event was closed with a short performance by the doyen of Macedonian folk music, Ms. Zaharinka Milosavljevic and the choir of pensioners, who performed several Macedonian folk songs.  

Such a unique event, on the this very current topic – Geriatric Medicine and Long-Term Care, under the umbrella of the extensive European international project – PROGRAMMING COST Action 21122, happened for the first time in our country. Its role and importance in encouraging, fostering and improving the processes of education in the field of geriatric medicine, exchangе of knowledge and experience, expert’s international cooperation will be seen even more in the future.

Biljana Petreska-Zovic,
President of the Macedonian Association for geriatrics medicine MAGM

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