Gerontological Care
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Under Gerontological Care ( English transfer: Gerontological support, care and maintenance ), the interprofessional and interdisciplinary care of very elderly people with increased frailty understood.
aims
The aim of gerontological support, care and care is to maintain the best possible quality of life until the very old person dies. His social environment is taken into account as well as the social circumstances and the framework conditions under which gerontological support, care and nursing are offered. Gerontological Care is based on the current developments in gerontology, palliative medicine and care , geriatrics , geriatric psychiatry , nursing science and social work .
Basic understanding
The basic understanding of gerontological support, care and nursing is based on the following central statements:
- Increased frailty as well as acute and chronic health problems are always integrated into individual life plans and collective life situations.
- In the elderly , health complaints due to the simultaneous presence of frailty and various health problems ( multimorbidity ) are more than problems that can only be treated medically. It is also about questions of personal or social images of old age , social coexistence, saying goodbye or alleviating suffering.
- Health complaints should always be understood and addressed taking into account the resource of the very old.
- Interdisciplinary and transdisciplinary perspectives based on a multidimensional image of man are central to professional care for older people. Such an image of man encompasses physical, mental, psychological, social, cultural and spiritual aspects of being human.
- The aim of caring for very old people is to support them in coping with everyday life independently with a view to optimizing their quality of life.
- Caring for very old people always includes dealing with one's own finitude, one's own dying and death.
Social and health policy challenge
In view of the demographic developments towards a society with a long life, the professional as well as personal examination of questions of aging and the very old is becoming more and more important. What is certain is that the increasing life expectancy is mainly reflected in a strong increase in the segment of the very old. The lengthening of the lifespan turns out to be predominantly an increase in the years of relatively healthy, disability-free aging. There is some evidence for the developed by Stanford medical James F. Fries in 1980 thesis of compressed morbidity (Engl. Compressed morbidity ). According to this, after a long phase of healthy aging, largely independent of outside help, the time, which is often characterized by chronic illnesses and care dependency, can be compressed to the last phase of life. Nevertheless, the increase in average age inevitably brings with it a strong increase in the number of people who as very old people enter a phase of frailty, multimorbidity and thus also the need for increased support, accompaniment and care.
As hopeful as the health prospects for the third age phase, from around 65 to 80 years, have become, the "mourning pile" of a life with often marked physical and psychosocial restrictions in the last phase of life as the very old from around the age of 80 remains . This is a challenge to be accepted and mastered - for the elderly affected themselves, for their relatives and carers, for the social security systems, for health policy and for society in general. François Höpflinger and Valérie Hugentobler's conclusion cannot be avoided: "The number of very old women and men will increase massively, and this will remain a significant health policy challenge even if the need for care in old age appears late or less".
Educational and organizational challenges
These social and health policy challenges also affect social and health organizations. The aim is to develop institutional services that allow people to lead a life with the highest possible quality of life even in old age, integrated into social relationships and into participation in the life of society as a whole. The task is to provide a wide range of professional support services that enable people with a high degree of frailty and multimorbidity to be taken seriously in terms of their resources and deficits and to be respected in terms of their dignity and their claim to autonomy . In order to do justice to this fact, a special qualification of the professionals is required.
Professional accompaniment, support and care of very old people with increased frailty and multimorbidity is a very complex task that requires, in addition to appropriately adapted organizational living and framework conditions, a correspondingly broadly based professional and personal competence. It has long been recognized that there is a need to catch up in terms of education in the long-term care of very old people. Various new training and further education offers have arisen or are currently coming onto the market that want to address the deficit here. In doing so, however, it seems essential to get clarity about the requirements and educational profile required today and the paradigms that must necessarily underlie it. As much as medical care is a central aspect of what is required today for professional care for very old people with increased frailty, it falls short as a profile for the training and further education that is necessary today. The demand requires not only to perceive the elderly in a reductionist way from the perspective of their physical or psychological deficits, but also to accept them more comprehensively in terms of their personal resources and limitations, their individual situation in the world of life and their participation in the life of society as a whole. Interdisciplinary cooperation plays a central role here. If educational offers are not to fall short in view of the specific challenges in practice, in view of the latest scientific findings and on the background of the international discussion about the corresponding professional and vocational training developments, they must rest on 6 basic pillars, which together determine the educational profile required today :
- Social Gerontology
- Geriatrics and geriatric psychiatry
- Nursing science
- Palliative care
- Ethical and socio-political perspective.
Training concepts Gerontological Care
Due to the tasks of these different disciplines and professions, it becomes clear that what is at stake today can be described as interprofessionally provided '' Gerontological Care ''. Only on the basis of this concept will it be possible to design offers for training and further education that meet today's requirements in practice and the latest scientific developments. The care concept proves to be a central bridge between the disciplines and professions described above. In Switzerland, a Master of Advanced Studies in Gerontological Care can be obtained as part of a postgraduate course .
literature
- Baltes, PB (1996), On the Future of Aging: Hope with Black Ribbon , in: MM Baltes & L. Montada (Ed.), Productive Life in Old Age , Frankfurt: Campus, 29-68
- Brückner, M., & Thiersch, H. (2005), Care and Lifeworld Orientation . In W. Thole (ed.), Social Work in Public Space , Wiesbaden, 137-149
- Fries, JF (1980), Aging, natural death, and the compression of morbidity , N Engl J Med 303 (3): 130-135
- Höpflinger, F. & Hugentobler, V. (2005), Familial, Outpatient and Inpatient Care in Old Age. Perspectives for Switzerland , Bern: Huber
Individual evidence
- ^ JF Fries: Aging, natural death, and the compression of morbidity , N Engl J Med 303 (3), 1980, pages 130-135
- ↑ PB Baltes: About the future of aging: Hope with black ribbon. In: MM Baltes & L. Montada (eds.): Productive Life in Old Age , 1996, Campus, pages 29-68
- ^ François Höpflinger, Valérie Hugentobler: Familial, outpatient and inpatient care in old age. Perspectives for Switzerland , Huber, 2005, page 28
- ↑ M. Brückner, M., H. Thiersch: Care and lifeworld orientation . In W. Thole (Ed.): Social work in public space , Wiesbaden, 2005, pages 137–149