[Impact of population aging on the social and the health care system: need for a new model of long-term care].
Population aging is characterized by a marked increase in the number of subjects aged 80 years or more (the oldest old). In this group frailty is extremely common. Frailty is a recently identified condition resulting from a severely impaired homeostatic reserve, that places the elderly at the highest risk for adverse health outcomes, including dependency, institutionalization and death, following even trivial events. Geriatric medicine proposes an original methodology for the management of frail elderly subjects, the so called "comprehensive geriatric assessment", as well as a model of long-term care. These have been shown to reduce the risk of hospitalization and nursing home admission, with a parallel decrease in expenses and an improvement in the patient's quality of life. The effectiveness of the long-term care system depends on: 1) the availability of all the services that are necessary for the frail elderly, both in the hospital and in the community; 2) the presence of a coordinating team, the comprehensive geriatric assessment team, that develops and implements the individualized treatment plans, identifies the most appropriate setting for each patient and verifies the outcomes of the interventions; 3) the use of common comprehensive geriatric assessment instruments in all the settings; 4) the gerontological and geriatric education and training of all the health care and social professionals.
Senin
Umberto
U
Sezione di Gerontologia e Geriatria, Dipartimento di Medicina Clinica e Sperimentale, Scuola di Specializzazione in Geriatria, Università degli Studi di Perugia. geriat@unipg.it
Cherubini
Antonio
A
Mecocci
Patrizia
P
D000368:Aged; D000369:Aged, 80 and over; D016330:Frail Elderly; D015577:Geriatric Assessment; D006297:Health Services Accessibility / Q000458:organization & administration; D006299:Health Services for the Aged / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D008134:Long-Term Care / Q000458:organization & administration*; D017146:Models, Organizational; D011157:Population Dynamics