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PubMed1998

[Research and education in geriatrics at German universities and colleges].

To assess the situation of geriatric research and education at German universities, a questionnaire was sent out to all medical faculties (n = 37). The response rate was 91.9% (n = 34). There are five universities with a geriatric chair (14.7%), one with a department of geriatric medicine within internal medicine, and two departments of geriatric psychiatry. At 15 universities geriatric research is established (44.1%), but only 12 universities report that geriatric contents are implemented in the teaching of medical students. The comparison of universities with and without geriatric chairs and departments showed big differences. Whereas all universities with geriatric chairs or departments conduct geriatric research and offer education in geriatric medicine, the others failed to do so. Only 26.9% (n = 7) have geriatric research and 15.4% (n = 4) offer medical teaching in geriatrics. There is a strong link between geriatric chairs, research, and pregraduate teaching. Geriatric medicine is established only at few universities. To improve the overall situation of geriatrics in Germany the implementation of further geriatric chairs and departments at universities seems to be necessary.

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PubMed2001

[Geriatrics--imbedding into the health care scheme of Germany].

In this paper, we first give an overview of the origins of geriatrics. We then give a description of the development of modern geriatrics in the United States and Great Britain, based on the work of Nascher and Warren. Finally, we give an account of the development of geriatrics in Germany. Clinical geriatrics, which first developed 20-30 years ago, has shown a high rate of growth in the last few years. However, recently there has been a slowing down in this rate of growth--if not a complete halt or, indeed, a counter-movement. The reasons for this somewhat negative development in the past five years are comprehensively discussed. In the last part of the paper, improvements which could be made in geriatrics are described, thus possibly achieving a uniform and self-assured provision of geriatric care in the future, in relation to four priority areas, with regard to outpatient and inpatient care. The first priority area is the care of geriatric patients at home and in nursing homes. To this end, geriatrics in priority areas will be promoted. The second priority is the development of geriatrics in hospitals (acute geriatrics departments and departments with rehabilitation as their focuses of activity). A third priority is geriatric rehabilitation clinics. Finally, we need a few geriatric centers in Germany (centers of excellence), geriatric departments with professorial positions and university clinics with geriatric departments in which geriatrics is taught and from which the impulse for research will be given.

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PubMed2005

Caring for older Americans: the future of geriatric medicine.

In response to the needs and demands of an aging population, geriatric medicine has grown rapidly during the past 3 decades. The discipline has defined its core values as well as the knowledge base and clinical skills needed to improve the health, functioning, and well-being of older persons and to provide appropriate palliative care. Geriatric medicine has developed new models of care, advanced the treatment of common geriatric conditions, and advocated for the health and health care of older persons. Nevertheless, at the beginning of the 21st century, the health care of older persons is at a crossroads. Despite the substantial progress that geriatric medicine has made, much more remains to be done to meet the healthcare needs of our aging population. The clinical, educational, and research approaches of the 20th century are unable to keep pace and require major revisions. Maintaining the status quo will mean falling further and further behind. The healthcare delivery and financing systems need fundamental redesign to improve quality and eliminate waste. The American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has identified five goals aimed at optimizing the health of older persons: To ensure that every older person receives high-quality, patient-centered health care; To expand the geriatrics knowledge base; To increase the number of healthcare professionals who employ the principles of geriatric medicine in caring for older persons; To recruit physicians and other healthcare professionals into careers in geriatric medicine; To unite professional and lay groups in the effort to influence public policy to continually improve the health and health care of seniors. Geriatric medicine cannot accomplish these goals alone. Accordingly, the Task Force has articulated a set of recommendations primarily aimed at the government, organizations, agencies, foundations, and other partners whose collaboration will be essential in accomplishing these goals. The vision described in this document and the accompanying recommendations are only the broad outline of an agenda for the future. Geriatric medicine, through its professional organizations and its partners, will need to mobilize resources to identify and implement the specific steps that will make the vision a reality. Doing so will require broad participation, consensus building, creativity, and perseverance. The consequences of inaction will be profound. The combination of a burgeoning number of older persons and an inadequately prepared, poorly organized physician workforce is a recipe for expensive, fragmented health care that does not meet the needs of our older population. By virtue of their unique skills and advocacy for the health of older persons, geriatricians can be key leaders of change to achieve the goals of geriatric medicine and optimize the health of our aging population. Nevertheless, the goals of geriatric medicine will be accomplished only if geriatricians and their partners work in a system that is designed to provide high-quality, efficient care and recognizes the value of geriatrics.

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PubMed2006

Interest in geriatric medicine in Canada: how can we secure a next generation of geriatricians?

In Canada, there is minimal training of geriatrics for physicians, a shortage of geriatricians, and extremely low numbers of students entering geriatrics. This study explored student interest in and barriers and enticements to geriatric medicine as a career choice. Medical students attending a university in Ontario, Canada, were surveyed in their first year (N=121), after a geriatric education session, and again in their second year (N=118) about their interest in a career in geriatrics. In the first year, less than 20% of students were interested in geriatrics; in the second year this decreased to 16%. In both years, female students were more interested than male students. Those students interested in geriatrics had higher hopes that their practice would involve primarily adults and seniors. Students not interested in geriatrics rated performing procedures and technical skills, not wanting to work with chronically ill patients, and caring for younger patients as important practice characteristics. Although the importance of prestige was low for all students, it was significantly higher for those not interested in geriatrics. Although changes to prestige, income, lifestyle, and length of residency training were identified as potential enticements to geriatrics, they were not major deterrents to a career in geriatrics. The findings suggest strategies that may affect student interest in geriatrics, such as increased and early student exposure to geriatrics with emphasis on fostering and nurturing student interest, consideration of various enticements to this specialty, and the development of health system-specific solutions to this problem. Knowledge of student and practice characteristics that increase the likelihood of selecting geriatrics as a specialty may allow for early identification and support of future geriatricians.

Adult↗
PubMed1996

Effects of an inpatient geriatrics rotation on internal medicine residents' knowledge and attitudes.

OBJECTIVE: The purpose of this study is to assess the effect of a geriatrics-focused acute medicine inpatient rotation and the presence or absence of a geriatrician as attending physician on knowledge about and attitudes toward older patients and the field of geriatrics. DESIGN: Randomized trial. INTERVENTION: A 4-week acute care inpatient internal medicine rotation at a university-affiliated Veterans Affairs Medical Center; experiences included caring for acutely ill, older medical patients, interdisciplinary team meetings, geriatrics-based noon conferences, interaction with geriatrics-trained nurse practitioners, and a syllabus of readings on geriatric medicine. PARTICIPANTS: Postgraduate year 1, 2, and 3 internal medicine residents were randomly assigned to one of three groups: (1) the intervention with a geriatrics-trained internist attending (n = 44); (2) the intervention with a non-geriatrics-trained internist attending (n = 25); or (3) no exposure to the intervention (n = 24). INSTRUMENTS: Knowledge was assessed using a 35-item test. Attitudes were evaluated using a 24-item questionnaire. RESULTS: There were no differences among the three groups of residents in pretest knowledge (p = .971, analysis of variance). There was a significant difference in the changes in scores from the pretest baseline among the three groups (group 1 = .030, group 2 = .051, group 3 = -.009; p = .039). Both groups assigned to the intervention showed significant improvement in knowledge (p = .011); the presence or absence of a geriatrics-trained attending physician did not alter the results. Resident attitude scores were generally positive and did not change after the intervention. CONCLUSIONS: An intensive integrated acute medicine rotation in geriatrics improved residents' knowledge of geriatric medicine. The presence of a geriatrics-trained attending physician was not necessary for this improvement. Residents' attitudes toward geriatric medicine and their geriatrics education were generally positive and were not influenced by this experience.

Adult↗
PubMed2005

The geriatric psychiatry workforce in 2002: analysis from the 2002 National Survey of Psychiatric Practice.

OBJECTIVE: Using the 2002 National Survey of Psychiatric Practice (NSPP), authors update demographic and professional work activities of a nationally representative sample of the psychiatric workforce who treat geriatric patients. METHODS: The sampling frame for the 2002 NSPP used the American Medical Association's Masterfile of Physicians. Professional, demographic, and patient data are compared between general and self-reported geriatric psychiatrists. Authors also present detailed analyses comparing high geriatric providers (HGPs; geriatric caseloads >20%), and board-certified geriatric psychiatrists (BCGPs). RESULTS: The proportion of HGPs in the 2002 NSPP was 26.0% of all respondents and was 28.1% among American Psychiatric Association (APA)-member respondents. Among the APA-member psychiatrists, this reflected a 55% increase from the 1996 NSPP. Of HGPs, 31.0% were certified in geriatric psychiatry. As compared with general psychiatrists, proportionally fewer men and American medical-school graduates were self-reported geriatric psychiatrists. Geriatric psychiatrists saw nearly three times as many geriatric patients and five times as many dementia patients as did their generalist counterparts. Mood-disorder patients were the largest treatment group, however. Investigators observed no significant differences in professional and practice characteristics between HGPs and BCGPs. CONCLUSIONS: About 1 in 4 psychiatrists in the 2002 survey are HGPs. Geriatric psychiatrists treat proportionally more geriatric patients than do generalists, but they do not have exclusively geriatric practices. The similarities between HGPs and BCGPs raise issues about the incentives for geriatric psychiatry certification, but not the need to train subspecialists to serve as faculty and community resources.

Adolescent↗
PubMedDate not supplied

Short-term training in geriatrics: an alternative for family medicine?

BACKGROUND: Family medicine has responded to the need for training in geriatrics by creating geriatric fellowships and by including geriatric education in residency and medical school curricula. Fellowships, in particular, require extensive time commitment by participating physicians. METHODS: We developed a 1-month geriatric training experience for academic family physicians. We surveyed previous participants in this short course to determine their subsequent level of activity in geriatrics, whether they had become certified in geriatrics, and other information about their academic experience in geriatrics. RESULTS: Eighty-one percent of graduates of this 1-month course had passed the geriatrics certification examination, compared to only 56% nationally. Graduates of the program were active as geriatric program directors and teachers of geriatrics, but there was limited activity in research or other scholarly activities related to geriatrics. CONCLUSION: Intensive short-term training in geriatrics meets some but not all of the needs for academic competency and productivity in geriatrics.

Education, Medical, Continuing↗
PubMed1984

[Geriatrics, a form of holistic health care. A bright spot in difficult financial economic times?].

Geriatrics has a functional aim, also in a clinical setting; it determines meaningful priorities in the process of diagnosis and treatment of the vulnerable elderly patient and is of a horizontal nature within the other specializations. Additional tasks of geriatrics are the development of adjusted methods for examination and treatment, the pursuing of early onset diagnostics, to supply specific information and the training of geriatric specialists. Clinical geriatric examination should only take place after evaluating the patient in his or her living conditions at home. The patient should thereby fulfil the geriatric trias, that no admission in a nursery home or psychiatric hospital is indicated, that examination at home or at the outpatient department is impossible and that an emergency situation necessitates admission. Ambulantory geriatric care is indispensable for the well functioning of a clinical geriatric department and the two should form an unbreakable tie, which could eventually be transformed into a personal union. A geriatric department in a general hospital is limited in its indications for the admission of geriatric patients, has high operating costs and should be restricted in size per regio, having a minimal capacity of 25 to 30 beds. The geriatric team is broad in composition and strong in coherence. The period of admission of the patient should not exceed six weeks. A regional social-geriatric circuit combines a geriatric department of a general hospital with the ambulantory social-geriatric service, the admission and indication committee of nursing homes into a well tuned system of provisions for the aged.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2006

[Expansion or reduction of geriatric care structures in Germany? A critical analysis on the significance of the official statistics and other surveys].

The legal survey basis for the hospital statistics of the Statistisches Bundesamt (German Federal Statistical Office) affecting the recording of data starting in the year 2002 has been also adjusted to improve the quality of information on geriatric care structures. The basic hospital statistics data for the year 2003 published in April 2005 report 171 geriatric hospital facilities for in-house treatment and 97 for partial in-house treatment as well as 74 geriatric rehabilitation facilities for inpatient treatment. In an additional internal investigation, another 46 geriatric rehabilitation facilities for outpatient treatment were ascertained for the year 2003. Compared to other, earlier surveys, the Statistisches Bundesamt reports an almost equal number of geriatric care facilities in the hospital sector, but a far lower number of such facilities in the sector of rehabilitation facilities for inpatient treatment, and therefore is highly incomplete. Hence, despite modified recording conditions, the official statistics do not provide a realistic representation of geriatric care structures. Under consideration of these limitations and corresponding corrections, the average geriatric care ratio (inpatient and partial inpatient or out-patient geriatric treatment places in hospitals and rehabilitation facilities per 10,000 persons aged 65 and above) amounted to 10.2 geriatric treatment units in 1997, 12.2 in 2000, and 12.3 in 2003. There were significant differences regarding the total capacity and the shares of different kinds of geriatric care structures in the individual federal states. All in all, that means that the expansion of geriatrics that had taken place until the year 2000 has slowed down significantly over recent years and has largely been limited to demographic adjustments. As far as the relevance of reliable numbers on the existence of geriatric care structures for requirement planning, secondary statistics, and state-related comparative analyses is concerned, the ongoing weaknesses of the hospital statistics must be taken into account when developing corresponding interpretations. They call for examining further improvements of the procedure of recording geriatric facilities for the official statistics. So far, they are no reliable basis for cross-sectional analysis.

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PubMed2005

Geriatric education in US schools of pharmacy: a snapshot.

OBJECTIVE: The objective of this study was to assess the structure, resources, and activities of academic geriatrics courses in U.S. pharmacy schools. DESIGN: A cross-sectional study. PARTICIPANTS: Schools of pharmacy in the United States identified through the American Association of Colleges of Pharmacy (AACP). The survey was e-mailed (May 2003) to the academic chairs of the clinical pharmacy department and/or the head of geriatric pharmacy practice at each of the 84 schools of pharmacy in the United States. MEASURES: The primary measure was to assess the nature and extent of geriatrics course content in the responding schools. In addition, we elicited information on the type of geriatrics material taught, faculty involvement, student population, type of school, academic requirements, and experiential education. The questionnaire items were based on the current course content in geriatrics courses taught at the institution. Content validity of the questionnaire was assessed by administering the survey to three survey experts (including one in geriatrics); their suggestions were incorporated in redesigning the questionnaire. RESULTS: A total of 42 (50%) out of 84 schools responded. All responding schools had some form of geriatric education incorporated into their curriculum. However, the depth and breadth of the geriatric curriculum reported by the responding schools did not seem to be that different from results obtained by a 1985-1986 survey. CONCLUSION: Geriatric education in pharmacy schools has not increased proportionally with the expected increase in the geriatric population in the United States. Schools of pharmacy should make geriatric education a priority because the majority of patients whom pharmacists need to monitor or counsel currently are, and will continue to be, 65 years and older. Compared with a past study, the focus of current geriatrics education in pharmacy schools does not seem to have improved much despite the increasing need for geriatric practitioners and drug misadventures in the elderly.

Journal Article↗
PubMed2002

Impact factor of medical journals: problems in geriatrics.

The Impact Factor (IF) is one of the most reliable methods for evaluating the quality of scientific journals. To date, no one has studied the IF of geriatric journals over time. Our aims were 1) to evaluate the IF trend of geriatric journals in general, and with respect to internal medicine, which is the nearest discipline, and 2) to assess the proportion of papers on common geriatric topics published in geriatric journals, with respect to other general periodicals. The current literature was studied to define what IF is and describe its good points and deficiencies. We then analyzed the situation regarding geriatric journals. A bibliometric analysis addressed the kind of journal interested in important geriatric themes (syncope, falls, hip fractures, delirium). Geriatric journals have a low IF, but their importance has been growing over the years. Despite this, papers regarding geriatric themes are published mainly in non-specific journals, and the number of publications regarding syncope, falls, hip fractures, and delirium has not increased during the period in question. In conclusion, it is difficult to use the IF for comparisons between different disciplines, in particular when the one under consideration (geriatrics and gerontology) is spread over a wide range of medical fields. The increase in IF of geriatric journals over time is the most important result of our analysis; this finding will encourage geriatric scientists to submit their papers to geriatric periodicals and will increase the specificity of the gerontological discipline.

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PubMed2005

[Important aspects of geriatric pharmacotherapy].

Drug prescription for geriatric patients is one of the most prevalent yet also one of the most difficult interventions in geriatrics. Although this article focuses solely on specific important aspects of geriatric pharmacotherapy, medication in clinical practice is only one type of geriatric intervention that needs to be embedded in a well-coordinated bundle of multidimensional interventions addressing functional and psychosocial aspects alike. Not every older patient is per se a geriatric patient, nor is each geriatric patient per se of very old age. Therefore, this article initially proposes a clinical definition of the geriatric patient before summarizing the most significant physiological age changes affecting pharmacokinetics and pharmacodynamics as well as summarizing the most prevalent risks associated with the age-correlated increase in multiple drug use in order to describe the background from which general principles of geriatric pharmacotherapy have evolved. The quality of geriatric pharmacotherapy must not only be determined by avoidance of any kind of over medication, but also by the avoidance of under medication as well as the avoidance of inappropriate drugs for elderly patients. Treatment failures do not only result from mere polypharmacy, but can also be due to under utilization of drugs as well as due to the prescription of inappropriate medications. In fact, the problem of under medication in certain age-correlated diseases (e. g. depression, dementia, pain) has rarely been addressed systematically in clinical or epidemiological studies until now. In order to improve quality and safety of geriatric pharmacotherapy, a group of experts in the field developed a set of explicit age-adjusted criteria for potentially inappropriate drugs in 1991. These criteria have been regularly updated thereafter until 2003 and focus on age-related aspects of specific drugs and dosages as well as on co-morbid states and co-medications. As long as geriatric patients are rarely included in clinical trials on drug effectiveness and drug safety, these criteria should be applied and used in clinical practice at least to identify any demand for a detailed explicit justification of a therapeutic decision not in line with the explicit criteria in order to enhance safety of drug treatment in geriatric patients.

Age Factors↗
PubMed2002

Evaluation of a guided protocol for quality improvement in identifying common geriatric problems.

OBJECTIVES: Many common geriatric problems are underrecognized and undertreated. A simple and reliable tool to facilitate a standard approach to evaluating geriatric patients might improve the quality of medical care delivered to geriatric patients. The objective of this study was to evaluate a standardized, semistructured quality-improvement protocol (the guided geriatric care protocol) for the assessment of common geriatric problems. DESIGN: Sequential comparison cohorts, with chart review to evaluate study measures before and after introduction of the guided geriatric care protocol. SETTING: The outpatient consultative geriatric assessment center of Yale-New Haven Hospital in New Haven, Connecticut. PARTICIPANTS: One hundred consecutive new patients before and 100 consecutive new patients after introduction of the guided geriatric care protocol. MEASUREMENTS: Number and type of problems identified and recommendations made during the clinical encounter, duration of the clinical encounter, clinician acceptance. RESULTS: The two patient groups were similar in sociodemographics, cognitive and functional status, and reasons for evaluation. Significantly more problems were identified after (mean 5.51) than before (mean 3.49) introduction of the guided geriatric care protocol (P< .001); likewise, significantly more recommendations were made after (mean 10.45) than before (mean 8.48) introduction of the protocol (P< .001). The duration of the clinical encounter did not differ significantly between the two groups. The protocol was well accepted by participating clinicians. CONCLUSIONS: Use of the guided geriatric care protocol assured a standard approach to evaluating common geriatric problems and may have led to the identification and treatment of more problems than usual care without increasing the duration of the clinical encounter. A quality-improvement tool that standardizes the evaluation of common geriatric problems, if validated in other clinical settings, holds the potential to improve the quality of care for vulnerable older patients.

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PubMed2004

[From the standpoint in department of geriatrics in university hospital].

Because Japanese society has increasing elderly persons and also has a low birth rate. Medical treatments and benefits will be severely limited in the future because of economic problems. I would like to look back on the history of Japanese Geriatrics Society and the many studies on geriatrics in Japan. The first annual meeting of Japanese Geriatric Society were held in 1959 and the Japanese Gerontology Society meeting was also held in the same year by Geriatric Society and Geriatric Sociology Association. It was held every two years, and now it consists of 6 associations, that is Geriatrics. Geriatric Sociology. Basic Gerontology, Geriatric Dentistry, Geriatric Psychiatry and Care Management Associations. I will introduce the activities of these associations, and also introduce the contribution of departments of geriatrics in Japanese universities. I will also show the system of medical examinations and treatment, the education curriculum for medical students and residency, and research composing of various theme such as basic gene therapy as well as the evaluation of terminal care for the elderly in our Department of Geriatrics, Nagoya University Graduate School of Medicine. Finally, I would like to propose future research plan between departments of geriatrics in Japanese Universities and the National Institute for Longevity Sciences, which will open next March.

Geriatrics↗
PubMed1993

The Yale Geriatric Care Program: a model of care to prevent functional decline in hospitalized elderly patients.

OBJECTIVE: To describe the structure and implementation of the Yale Geriatric Care Program, an innovative, nursing-centered model for developing geriatric nursing expertise throughout an acute-care hospital. DESIGN: Descriptive study of an intervention in a prospective cohort of patients. SETTING: University teaching hospital. PATIENTS: Two hundred forty four patients aged 70 years and older on four non-intensive care intervention units during the study period (July 9, 1990 to July 31, 1991). INTERVENTION: The Geriatric Care Program involved an integrated model of primary nurses, specially trained unit-based geriatric resource nurses, gerontological nurse specialists, and geriatric physicians. The intervention included surveillance and identification of frail older patients, unit-based geriatric educational programs for all nurses, special education and support for the geriatric resource nurses, and twice-weekly rounds of the Geriatric Care Team. RESULTS: The Geriatric Care Program has been successfully implemented on four units. The interventions ranged from general clarification of goals in 226 (92%) to specific recommendations for management of immobility in 100 (41%), bladder/bowel problems in 99 (41%), pressure ulcer treatment or prevention in 61 (25%), confusion evaluation or management in 62 (25%), and adjustment of medications in 43 (18%). Overall, 68% of the specific recommendations were documented to have been implemented. Barriers to implementation of the program have included initial difficulties with recruitment and retainment of geriatric resource nurses (due to high nursing turnover and the increased time commitment required), breakdown in communication and carryover of recommendations between nursing shifts, and obstacles to communication between the nursing and medical staff. CONCLUSIONS: An innovative model of care, in which geriatric nursing was integrated as part of standard nursing care on selected medical and surgical units, has been designed and implemented. Evaluation of the effectiveness and costs of this intervention are currently underway.

Activities of Daily Living↗
PubMed2003

A national survey on the current status of general internal medicine residency education in geriatric medicine.

OBJECTIVES: The dramatic increase in the U.S. elderly population expected over the coming decades will place a heavy strain on the current health care system. General internal medicine (GIM) residents need to be prepared to take care of this population. In this study, we document the current and future trends in geriatric education in GIM residency programs. DESIGN, SETTING, PARTICIPANTS: An original survey was mailed to all the GIM residency directors in the United States (N = 390). RESULTS: A 53% response rate was achieved (n = 206). Ninety-three percent of GIM residencies had a required geriatrics curriculum. Seventy one percent of the programs required 13 to 36 half days of geriatric medicine clinical training during the 3-year residency, and 29% required 12 half days or less of clinical training. Nursing homes, outpatient geriatric assessment centers, and nongeriatric ambulatory settings were the predominant training sites for geriatrics in GIM. Training was most often offered in a block format. The average number of physician faculty available to teach geriatrics was 6.4 per program (2.8 full-time equivalents). Conflicting time demands with other curricula was ranked as the most significant barrier to geriatric education. CONCLUSIONS: A required geriatric medicine curriculum is now included in most GIM residency programs. Variability in the amount of time devoted to geriatrics exists across GIM residencies. Residents in some programs spend very little time in specific, required geriatric medicine clinical experiences. The results of this survey can guide the development of future curricular content and structure. Emphasizing geriatrics in GIM residencies helps ensure that these residents are equipped to care for the expanding aging population.

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PubMed2003

Current status of predoctoral geriatric education in U.S. dental schools.

The elderly constitute the fastest growing segment of the U.S. population. Dental schools must educate dental students so that they are competent and confident in managing the treatment needs of elderly patients. Programs in geriatric dentistry have been developed in response to the changing oral health needs of growing numbers of older adults. The purpose of this online survey was to identify the current status of predoctoral geriatric dental education in U.S. dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the World Wide Web, and fifty-four US. dental schools were invited to complete the form. Data from completed questionnaires were submitted to the investigators via email. Following repeated phone calls and emails to urge school administrators to respond to the electronic questionnaire, a 100 percent response rate was achieved. All schools reported teaching at least some aspects of geriatric dentistry, and 98 percent had curricula that contain required didactic material. Sixty-seven percent of schools reported having a clinical component to geriatric dental teaching. Of these schools, the clinical content was required in 77 percent and elective in the rest. Thirty percent of schools reported a specific geriatric dentistry clinic within the school, and 11 percent had a remote clinical site. Sixty-three percent of schools have a geriatric program director or a chairman of a geriatric section. Over a third of schools indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has continued to expand over the last twenty years and has established itself in the U.S. predoctoral dental curriculum. The format of teaching the subject varies considerably among the dental schools. Although didactic teaching of geriatric dentistry has increased markedly in the last two decades, clinical experience, both intramurally and extramurally, did not keep pace.

Aged↗
PubMed2004

[The geriatric department in a general hospital].

Geriatric medicine encompasses different aspects including geriatric evaluation, geriatric rehabilitation, chronic institutional care and acute geriatric care. In the last few years, the place of the geriatric department in the realm of the general hospital has come under discussion. In Israel, most general hospitals have a geriatric department, but its characteristics vary from one hospital to another. It would seem that a geriatric department in a general hospital is obligatory, but it can only be complementary to the internal medicine department, not replace it. The geriatric department should provide services for elderly patients with special needs such as multi-faceted illness, acute illness combined with a loss in general and cognitive function and facilitate services for elderly patients with expectations of extended stay and/or chronic hospitalization, etc. In addition, integration should be encouraged between the department and chronic care institutions and it should act as an "umbrella consulting firm" to the different hospital departments that provide treatment for most of the patients that are 65 years old and above. Among the important functions of the geriatric department is the training of interns and the teaching of geriatrics in nursing schools. The existence of geriatric departments in general hospitals will help in preserving the status of internal medicine.

Aged↗