Shaukat Ali Jawaid
Increased awareness, early diagnoses, appropriate treatment facilities with tremendous advances in medical technology has reduced morbidity and mortality from various diseases. At the same time overall development has also increased the life span in many countries all over the world. This has led to manifold increase in the elderly population. People live longer but it has also created some problems as those suffering from chronic diseases have special requirements. All this means that we need to develop and promote the specialty of Geriatric Medicine to look after this elderly population.
Geriatric Medicine is a discipline that focuses on the healthcare of older people. It includes diagnosis, treatment, prevention of diseases as well as rehabilitation and the care of the aging body. There are only a few physicians who deal in geriatric medicine and it is still not a recognized specialty in Pakistan. General hospitals are already under heavy pressure and in view to too much rush of patients, elderly people fail to receive comprehensive care. At present Aga Khan University Hospital in Karachi is reported to be running an Out Patient Clinic and also offers teaching and training. Shifa International Hospital in Islamabad also offers geriatric care services to some extent. However, there are no dedicated rehabilitation centers for elderly patients who suffer from stroke or fracture. A vast majority of these elderly people suffer from diseases like diabetes, arthritis and hypertension.
The challenges for developing the discipline of geriatric medicine include the cultural and social barriers to elderly care, limited awareness among the general public, economic constraints in providing specialized health care. Moreover, there is hardly any research being conducted in geriatrics in Pakistan at present.
The discipline of Geriatric Medicine, specialty of Geriatric Nursing along with other specialized nursing are very well developed in many countries of the world. However, as stated above, at present there are only two institutions in Pakistan which provide geriatric care to some extent. We need to promote these specialized services benefitting from the experience of those countries which have already made lot of progress in these areas.
Elderly people most often suffer from lot of co-morbidities and besides specialized nursing care, they also need too many drugs to take care of their various ailments. In some cases, they may not be able to even take correct medication at their own and need help, guidance and assistance. Those taking care of these elderly also needs to be properly looked after so that they do not suffer from burnout syndrome.
College of Physicians & Surgeons Pakistan as well as medical universities leadership should take an initiative in this regard and start training programmers for specialized training in Geriatric Medicine. Pakistan Nursing Council should also look into it and make arrangements for training of nurses in specialized fields like Psychiatric Nursing, Geriatric Nursing. Benefitting from the experience of other countries, we can make a beginning. It will also create new opportunities for the medical and nursing profession.
Developing specialized geriatric services will take some time. Hence in the meantime geriatric care should be integrated into primary healthcare system. Special geriatric care clinics can be established in major hospitals all over the country. We should also provide funding for research in geriatric. Medical institutions and healthcare facilities should try to have some partnership with international organizations for knowledge sharing. Medical professionals should be offered some incentives to specialize in geriatrics as there are potential benefits of improved elderly care to the society.
