Aims

This course gives a global view of the older person, an a broad sense to geriatric medicine. The lectures are indeed given by doctors from different care environments : geriatricians, general practicioners and psychogeriatricians. To train the student to have a positive approach of elderly, the frequent obstacles to appropriate care are discussed, mainly the negative view of ageing (agism) and the pessimistic perception of the prognosis in frail elderly patients. Not only curative potential but also preventive and readaptative strategies are presented with the main objective to improve the functional condition of the geriatric patients.
Accordingly, the main geriatric syndromes (geriatric giants) are explained.
The future doctor should be able to identify the risk factors for frailty and functional decline and to manage appropriately the geriatric syndromes, if necessary in a multidisciplinary approach. He should be able also to follow up the age-related diseases and problems, to organise home care and to help for planning institutionalisation's when appropriate, and palliative care at end of life. The course is also aimed to give a medico-psycho-social, and humanistic view of the care to elderly.

Main themes

The course is introduced with demographic and epidemiological evidences. Frailty and functional decline are explained in an operational perspective. Physical exam and clinical approach of elderly is presented in different care environments. The treatments (parmacokinetics and dynamics) of the main age-related diseases (dementia, heart failure, osteoporosis…) are explained together with their evolution and main functional implications. The main geriatric problems (syndrome-oriented, geriatric giants) are deeply explained (Delirium, incontinence, falls, denutrition, drug related events, sensory problems, depression, anxiety..). Palliative care for end-stage diseases in elderly are also presented.

Content and teaching methods

This course is clinical and aimed to give the doctor a positive approach of the care for elderly. The perspective is functional and quality of life oriented. The main age-related diseases are explained, together with the specific problems related to polypharmacy and appropriate drug use in elderly. A particular focus is given on the geriatric syndromes the doctor should be able to recognise, prevent and manage.

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