[Required competence in geriatrics in the view of the Competence Center for Geriatrics].
The geriatric patient is defined by a high specific risk that is taken into account by the special geriatric treatment concept. This risk relates to suffering from the permanent and significant loss of earlier functional independence caused by relatively trivial accessory conditions or other changes to the personal situation or falling in need of or increasing the need for care. It results from the geriatric patient's limited reserve capacities that are caused by physiological age-related limitations of organ and organ system reserves and/or manifested or at least latent functional impairments. A rather narrow definition of the geriatric patient based on this specific risk is a key criterion for the future systematic integration of geriatric care into the health service. In such a definition, use of the age component alone is adequate only from a very old age on. The high-risk group of geriatric patients narrowly defined in such a way also calls for primary medical geriatric case management: from commencement of a treatment throughout its entire course, from therapy to rehabilitation to longterm and outpatient care. This comprises first and foremost an comprehensive geriatric assessment and a treatment oriented primarily towards achieving quality of life and independence, medical treatment control including a systematic risk management system, continuous patient support, even in case of other temporary, specific treatments, the individual use of early rehabilitative treatments and the coordination of secondary treatment initiatives. Positioning geriatrics in the health care system in such a way means that the required skills extend beyond a general knowledge of geriatric medicine. Above all, high generic treatment expertise and experience in geriatric rehabilitation are also needed. Additionally, the guide and support function of the geriatrician demands a willingness to take special medical and ethical responsibility and an abundant ability to integrate and communicate. The education, training and development initiatives for attaining geriatric qualifications must satisfy these requirements. Lasting efficient geriatric care concepts also call for the appropriate skills in primary medical outpatient care.
Lübke
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Kompetenz-Centrums Geriatrie der GKV und ihrer Medizinischen Dienste beim MDK Hamburg, Hammerbrookstr. 5, 20097, Hamburg. norbert.luebke@kcgeriatrie.de
D000047:Academies and Institutes; D000368:Aged; D000369:Aged, 80 and over; D015577:Geriatric Assessment; D005853:Geriatrics / Q000592:standards*; D005858:Germany; D006299:Health Services for the Aged / Q000592:standards*; D006801:Humans; D011361:Professional Competence / Q000592:standards*; D018570:Risk Assessment / Q000379:methods / Q000592:standards*