Challenges and Achievements in Care for the Elderly

No one in the health sector knows that USA’s population is aging. The number of patients over 75 with complex health problems increases dramatically. In the geriatric rehabilitation unit where I work, it is common to see 25% of beds occupied by people over 90 years of age. In USA, it is estimated that there are over 4000 centenarians, and the 80 and over age group make up that population growth is the biggest one. Given this aging population, how do family doctors manage to provide high-quality care? The challenges are enormous, but there are also many successes on which to bet. Now days this is one fact that finding the right senior care facilities is not an easy task to do so, so we need assistance.

There is clearly a shortage of geriatric specialists in USA. What is less obvious is the essential role that family physicians play in caring for the elderly. Family physicians in clinics, hospitals and emergencies experience these changing demographics. Not only do Canadians live longer, they are also independent and active later in life – and they claim more rights than older generations of seniors. While family physician shortages have eased in some areas of the country, older patients rely heavily on the availability of family physicians. Many are severely affected by the lack of family physicians. Furthermore,

Skills, Training and Education

In response to the growing population of seniors, medical schools and residency programs have increased the experience of geriatric trainees. However, more representations are needed to improve exposure at all levels of training, and the curriculum in geriatrics varies considerably from one program to another 2 – 5. The larger classes make clinical experiences in specialist services less likely, given the small number of clinicians with enough experience to act as preceptors. On the other hand, I find that practicing family physicians and trainees are more motivated to provide the best care possible than when I started my career. We have a long way to go before all medical students and residents have experience and knowledge in the principles and practice of PPS, but the situation is improving.

Due to the difference of a course to another, the Canadian Geriatrics Society (CGS) has developed national core competencies for medical students 6. They will form the basis for family medicine learning objectives (developed by the CGS and the Seniors Care Program of the College of Family Physicians of USA) to ensure that residents are exposed to a range of geriatric the context of CanMEDS-family medicine competencies. These objectives should provide the motivation for all family medicine residents to work with skilled clinicians in diverse settings, including homes for the elderly.

A Position Statement, produced by the Seniors Care Program 7, emphasizes the need for academic departments of family medicine to recruit professors with recognized expertise in geriatric care or additional training in PAC, and those family physicians – who play a leading role in the care of the elderly – development of undergraduate and postdoctoral programs in geriatrics. The importance of training in a variety of settings was also emphasized, because clinical exposure influences career paths and improves confidence. It is difficult to say how many of these recommendations have been adopted.