Family doctors to be trained for the ‘age of ageing’

Press, 10 January 1987, Page 17

Family doctors to be trained for the ‘age of ageing’

From

THOMAS LAND

in Geneva

A group of universities has launched a collaborative programme for the training of family doctors in the mental health needs of old people. The project is co-ordinated by the World Health Organisation (W.H.0.). It follows a conference in Geneva attended by specialists, including New Zealanders, seeking ways to improve the effectiveness of communitybased preventive health measures supporting the rapidly growing population of the aging.

Centered at the University of Geneva Geriatric Institutions — a network concerned with education and research as well as treatment — the international training programme for non-psy-chiatrist doctors answers an urgent and growing global need.

Family doctors are usually among the first to identify mental health problems among their elderly patients, but in a widely based recent survey, at least a third of general practitioners interviewed expressed a need for additional training in psychiatry in order to deal with them adequately. This is one of several major specialist training programmes sponsored by the W.H.O. since the 1982 World Assembly on the Age of Aging, held in Vienna in

preparation for the doubling of the population of old people by the end of the century. Another W.H.0.-sponsored programme comprises a series of international courses on the epidemiology of aging held at the London School of Hygiene and Tropical Medicine for medical and social welfare planners, service providers, and academics from many countries. The second course in the series was held in London in September; it is to be followed by national and regional training projects and problem-orientated research. ' The first learning package developed in the Geneva-based programme includes two video cassettes and a manual on ways to detect, assess, and manage depressive disorders. The initial assessment on the educational impact of the package on doctors in non-psychiatric practice shows an improvement in the detection of depression, even when not severe, and in its differential diagnosis from other psychopathology, according to a discussion paper just published by the WJH.O. This method of instruction will

now be extended to other priority themes — such as attitudes to the terminally ill patient, mental confusion in the elderly, poor compliance of the older patient with treatment regimens, and the problems of families looking after a relative suffering from dementia.

A practical guide on mental disorders in old people is now being prepared for the nonspecialist health worker. A specialist spokesman for the W.H.O. comments: “In many countries, action to promote the physical, mental and social wellbeing of the elderly is being taken seriously for the first time.”

An important aspect of the global training programme is its relevance to the different cultures of the developing regions. By the year 2025, the poor countries are expected to have more than 70 per cent of the world population aged 60 years and over, and they will have to adapt to the demographic change in a much shorter period of time than that available to the industrial countries undergoing similar transitions earlier in history.