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Community of practice for healthy longevity: reconfiguring geriatric care during a pandemic

2021; Elsevier BV; Volume: 2; Issue: 5 Linguagem: Inglês

10.1016/s2666-7568(21)00056-8

2666-7568

Sanghamitra Pati, Rajeshwari Sinha, Pranab Mahapatra,

Global Health Care Issues

William Arbey Gutiérrez Cortes and Cesar Augusto Rivera Tovar, in their recent Comment,1Gutiérrez Cortes WA Rivera Tovar CA Human talent in geriatrics in Colombia and its relevance for the management of COVID-19.Lancet Healthy Longev. 2021; (published on February 21.)https://doi.org/10.1016/S2666-7568(21)00005-2Summary Full Text Full Text PDF PubMed Google Scholar urged the creation of a cadre of geriatrics health workers in Colombia. The authors describe how geriatricians, being far too few in number, faltered in meeting the demands of caring for people aged 60 years or older during the COVID-19 pandemic. This is an important concern, because older people are of increased susceptibility to any adversity and are the most at risk during a catastrophic situation.2Kshatri JS Palo SK Bhoi T Barik SR Pati S Associations of multimorbidity on frailty and dependence among an elderly rural population: Findings from the AHSETS study.Mech Ageing Dev. 2020; 192111384Crossref PubMed Scopus (3) Google Scholar Commensurate with population ageing, health systems in low-income and middle-income countries (LMICs) have tried in the past decade to address the steadily rising complex health-care needs and challenges of the growing number of older adults.2Kshatri JS Palo SK Bhoi T Barik SR Pati S Associations of multimorbidity on frailty and dependence among an elderly rural population: Findings from the AHSETS study.Mech Ageing Dev. 2020; 192111384Crossref PubMed Scopus (3) Google Scholar The low number of geriatricians, as noted by Gutiérrez Cortes and Rivera Tovar, is an issue not confined to Colombia; rather this problem is prevalent throughout LMICs, because geriatric medicine has traditionally remained an unattractive career specialty for clinicians. In many LMICs, the number of physicians is far less than the optimal standard, which means there are few health-care professionals specialising in geriatrics to meet the high volume of care demands. Differences in resource availability and in financial, social, and cultural issues have culminated in different models of delivering geriatrics health services in these settings, with varying degrees of capacity building. Our overview of geriatrics medical training in India noted the non-mainstreaming of geriatric health within undergraduate medical education, the feeble existence of a clinical geriatrics discipline, and a handful of accredited courses as the crucial contributors to the paucity of the geriatrics health workforce.3Pati S Sharma A Pati S Zodpey S Teaching of geriatric health in India: mapping the terrain.Gerontol Geriatr Educ. 2017; 38: 92-103Crossref PubMed Scopus (3) Google Scholar Also, the COVID-19 pandemic has placed unprecedented stresses on health-care delivery, with caring for the geriatric population being the most compromised area. Our study4Pati S Mahapatra P Kanungo S Uddin A Sahoo KC Managing multimorbidity (multiple chronic diseases) amid COVID-19 pandemic: a community based study from Odisha, India.Front Public Health. 2021; 81026Crossref Scopus (4) Google Scholar exploring multimorbidity management during the COVID-19 pandemic found that many older adults had substantial care challenges, with disrupted and deficient delivery of health services. The majority of older adults expressed the need for personalised precision care of their long-standing illness complexities, and wanted the health-care system also to respond to any other eventualities that arose.4Pati S Mahapatra P Kanungo S Uddin A Sahoo KC Managing multimorbidity (multiple chronic diseases) amid COVID-19 pandemic: a community based study from Odisha, India.Front Public Health. 2021; 81026Crossref Scopus (4) Google Scholar Professionals in geriatric health need to possess wide-ranging skills to address the routine complexities associated with ageing and, more importantly, need to have the clinical competencies to manage critical emergencies occurring in this frail population.5Sinclair AJ Abdelhafiz AH Age, frailty and diabetes–triple jeopardy for vulnerability to COVID-19 infection.EClinicalMedicine. 2020; 22100343Summary Full Text Full Text PDF PubMed Scopus (25) Google Scholar Training existing staff is not enough to achieve these standards; health systems need to be realigned to deliver both acute critical care and chronic slow-paced care, in synchrony, creating a cultural space for a community of practice to promote healthy longevity.4Pati S Mahapatra P Kanungo S Uddin A Sahoo KC Managing multimorbidity (multiple chronic diseases) amid COVID-19 pandemic: a community based study from Odisha, India.Front Public Health. 2021; 81026Crossref Scopus (4) Google Scholar We wish to see our older adults living healthy and living long! We declare no competing interests. Human talent in geriatrics in Colombia and its relevance for the management of COVID-19The COVID-19 pandemic has caused a substantial increase in treatment in hospital for patients with pneumonia and multiorgan disease. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can be asymptomatic or can cause a wide range of symptoms and life-threatening sepsis.1 Full-Text PDF Open Access