Active aging will save health finances – 17th EUGMS Conference in Athens
Is there a secret in some elderly people who grow up with a calm, clear mind and quality of life? The healthy aging and autonomy ultimately elements of an advanced society that ensures adequacy and equivalent access to health services to all its citizens; How many years of life expectancy is expected to reduce the pandemic? Because Greece is one of the oldest countries in Europe and with a serious problem in its demographic, it has not yet been recognized as a specialty Geriatrics?
The above questions are expected to be asked in an important one pan-European conference, the 17th organized in Athens and specifically at the Concert Hall, by EUGMS (European Society of Geriatric Medicine), from 11 to 13 October.
Autonomy and active aging are the axes of Geriatrics
“Autonomy and health are the right of every citizen and the recognition and introduction of Geriatric and Gerontological knowledge and clinical practice in Greece is an urgent need, not only for an auspicious future but also for an economically viable tomorrow, emphasize two representatives of the Hellenic Society for the Study and Research of Aging (EEMEG) Elder lady Katerina Tzanetakou and the Elderly MD Mr. Konstantinos Stolakis. And they add:
“Given that there are few trained doctors in geriatrics and respectively few specialized other health specialties in gerontology, the state could “give the green light” to the recognition of these branches which would primarily allow the function of these few specialists as trainers and advisors of other medical specialties and other health specialists when they are not active in these ages. It is difficult to manage and establish a new (for our country) specialist sector, if it is not recognized within a health system “.
Let us listen below to Mrs. Tzanetakou and Mr. Stolakis, because they have important things to say to us:
The planetary rulers and Queen Elizabeth
“Recent examples such as the last two US prime ministers, but also the Queen Elizabeth Exhibition of indicators of the current reality of increased life expectancy, which leads to being able (under certain conditions) to be healthy, creative, active and autonomous at older ages.
The sense of autonomy is central to the survival of the human and not just species. Whatever our state of health, being able to automatically do small things like getting out of bed without help and not being able to take care of ourselves in our daily lives is very important for all ages. Especially for the 3rd age where the concept of autonomy is usually put by factors of health and increased vulnerability.
About vulnerability and vulnerability
Vulnerability, as defined by the WHO, is a clinical recognition of a condition in which a person’s ability to respond to stressors is limited due to increased vulnerability. This vulnerability is attributed to a discount (age dependent) on the normal reserves and functions of many systems and organs.
Vulnerability management in order to measure the possibilities of autonomy after 65, is the subject of the branches of Geriatrics (as a branch of medicine) and Gerontology – as a specialization of other schools (social, humanities, health).
“These industries are primarily aimed at improving the quality of life but also longevity and active aging (both in research and at the clinical level).”
The importance of Geriatrics in PHC
Regarding Geriatrics at the level of PHC but also why Gerontology and Geriatrics as a specialty from the Medical Pantheon are absent, our interlocutors state the following:
“At the level of primary health care, the science of Geriatrics and Gerontology is a necessity as it is promoted prevention and active aging and ensures the therapeutic continuity and the interconnection between structures and various other health services, completing, facilitating and further strengthening the institution of the family doctor and the interdisciplinarity that requires the management of the elderly patient.
Comprehensive geriatric assessment is the “first stop” in vulnerability managementAs the patient is examined in many ways the Geriatrician can individualize the treatment taking into account the age discount of the systems. However, in addition to clinical measurements and methods, other relevant factors such as the environment or social support are considered and are part of this multidimensional approach.
At the hospital level, medicine has ensured a specialized treatment with a positive impact on the best outcome, the reduction of complications, mortality, days of hospitalization and the world. Embracing an interdisciplinary approach of the patient, Geriatrics involves and coordinates various specialties for the optimal and personalized management of the patient.
In our country the recognition of these branches as a specialty or specialization is absent. We are now one of the few European countries where the very recognition of such specialties and skills is non-existent. Specialized Geriatrics to operate only informally, for export and academic-research. Respectively are the data for the School of Gerontology.
Nutrition and health finances
Perhaps with complete ignorance of health economics one could assume that this is how we save money as a state, by not investing in specialization or structures for the elderly. But the truth is very different. If one considers the costs of the system from the management of the health of the elderly (eg through a simple non-diagnostic malnutrition) one will understand how even a seemingly small factor can significantly and in the long run burden the system in costs from complications. Regarding only a study conducted in 2015 in England malnutrition – unmanaged – in the elderly in the period 2011-2012 cost £ 19.6 billion in the health systemA cost that could largely be decided by targeted assessment and prevention at these ages.
What is the final total cost if we calculate the complications, the days of hospitalization but also the loss of those we love?
The elderly in the role of carer and the absence of structures
In addition, in some cases the cost is an indirect reason for the loss of employees of relatives – caregivers, etc. who may be called to take on the role of caregivers of these people (without the necessary knowledge or support) at the expense of their own health (psychological and physical ) but perhaps also their professional course (hence their own financial autonomy). In Greece the role of the elderly in the family is usually active and supportive, as many grandparents are also caregivers children during parental work hours or offer support in a variety of ways directly or indirectly.
The cost of the absence of structures and specialties extends to other levels besides the financial, work or emotional that concern us all regardless of age. Life expectancy in the western world is gradually increasing and Greece from the European countries is in the EU average. However, in terms of the Years of Healthy Survival of our country, which was slightly below the European average in 2008 and does not seem to have fallen several positions during the long economic crisis in the country. Recently, would we have the same image of ICU importers for those over 65 if there were such specialization structures in our country? To what extent did the lack of these structures affect the clinical course and subsequently the limited measures taken for all of us regardless of age?
Useful information for aging
- Increasing aging affects both leaves, with the average life expectancy being 77.6 years for men and 82.9 for women (data for 2012). However, the healthy life years after 65 have been declining over the last decade, from 10.3 and 10.2 years in 2006 to 7.3 and 8.6 years for women and men respectively. (K. Paschos, M. Malliarou, P. Bamidis. 2016)
- With the increase of the expectation proportional increase of the appearance of various geriatric diseases and syndromes such as dementia, osteoporosis, sarcopenia, vulnerability, falls, fractures, multidrugs, diversity required holistic and interdisciplinary approach that only geriatrics offers.
- Physiology and pathophysiology change with age, requiring specialized medical knowledge offered by geriatrics.
- Geriatrics offers a holistic view of the individual, both physical / mental well-being and mental, but also the environment in which the individual lives.
- Geriatrics is primarily aimed at improving the quality of life but also longevity and active aging.
- Geriatrics can be a cornerstone and foundation for PCT as it requires the creation and interconnection of structures and services that ensure the continuity of treatment.
- Geriatrics is directly related to the concept of prevention.
- At the hospital level, medicine has provided a specialized treatment with a positive impact on reducing mortality, hospitalization days, better outcome and reduction of complications, maintaining functionality and quality of life, while saving resources.
- During the pandemic, the lack of geriatrics in the country made its absence felt. Covid-19 is mostly a geriatric infectious disease affecting and infecting the most vulnerable and older age groups. Lack of geriatric care and treatment of infected patients by SARSCov 2, increased mortality in this age range, reduced the life expectancy of survivors and their quality of life, after making them vulnerable or more vulnerable, leaving them permanently problem or disability, increasing the incidence.
- At the same time, compulsory quarantine, in the absence of medical care and treatment, has made many people vulnerable and more vulnerable both to themselves and to other diseases with a negative impact on health, quality of life and life expectancy, with a huge social and financial costs.
- Geriatrics also, being a branch of medicine that deals with the third period and completion of the human life cycle, where it is not possible to cure it that will offer the appropriate palliative care and will ensure a decent and as high as possible closure of this cycle.
- Horses do not kill them when they grow old. And it is inadmissible in today’s societies that there are no modern “Kaades”. The adoption and introduction of Geriatrics in Greece is an urgent need.
The geriatric specialization in a state and continent that is constantly aging is as useful and necessary as its opposite, pediatrics. Because, the modern elderly should be active, healthy, creative and productive, supporting and teaching the young, being an active and healthy cell of society.