Preventive Aspects of Geriatric Medicine

With an increasing world population of elderly people and with the present young long-term sick surviving into old age, there will in the future be many more frail and disabled elderly people. Illness in old age is often erroneously attributed to ageing itself, and the importance of correct diagnosis is emphasised. Disease in the elderly can start quietly and in an atypical way, and commonly more than one pathological process is present at the same time. With advancing age more individuals are disabled, and many of the illnesses found are minor and remediable. In order to detect disease at an early stage, the traditional self-reporting of symptoms by the patient to the doctor is not advised in the case of elderly people, and the seeking-out process of routine visiting by a health visitor is suggested. The aim is to keep older individuals healthy and happy in their own homes for as long as possible. More education is required for medical and paramedical personnel, for those responsible for the design and planning of communities and homes, and for the elderly themselves. Pre-retirement training courses, hobbies and craft centres, and re-employment bureaux are described. A plea is made for re-orientation of the training of medical students and nurses towards longer term illness with the consequent implication of continuing care.