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Curriculum details of the four sessions of the postgraduate course in Geriatrics and Gerontology

Session 1: Principle of Geriatrics Care

Demography Epidemiology of ageing Epidemiology, Gender differences
Population projections, expected/projected
Prevalence and incidence of diseases/disorders present & Future
Heterogeneity of the older population.
Ageing process and physiology of ageing Age related changes in systems/organs
The nature of ageing
Consequences of ageing
Difference between chronological and biological ageing
Theories of ageing
Impairment, disability and handicap An understanding of the concepts and their implications for an ageing population.
Prescribing drugs Appropriate prescribing and adherence
Pharmacokinetics and pharmacodynamics in old age
Polypharmacy
Under-prescribing
Drug interactions
Principles of Modern Geriatrics Geriatric Assessment including:
Medical, affective, cognitive, functional status, social support, economic, and environmental.
Assessment instruments
MMSE , ADL, IADL , RAI-instruments, care planning, CAPs, neuropsychological assessment, nutritional assessment, clinical pathways,
clock test, Barthel index, GDS, Hamilton, pain scale;
Physical Examination & Diagnostics
Tests, such as up-and-go, balance tests, neurological tests, etc.
Technical imaging: MRI, etc.

Session 2: Geriatrics Giants Update

Geriatrics
Syndromes &
Conditions
Geriatric Giants
Incontinence
Delirium
Iatrogenesis, includes consequences of hospitalization & bed rest
Falls & Fractures
Osteoporosis
Alterations in the special senses including hearing and vision Impairment including functional
Failure to thrive
Immobility and gait disturbances
Pressure Ulcers
Sleep Disorders

Other important Conditions
Cancer in the elderly: Prostate, Breast
Cardiac: CHF/Ischemic heart diseases/CVS surgery
Stroke
Malnutrition
Pressure ulcers
Fecal impaction,
Postural hypotension
Dizziness/Syncope
Pre-operative assessment
Rehabilitation General principles of geriatric rehabilitation, including those applicable to patients with orthopaedic, rheumatologic, cardiac, and neurological impairments. These principles should include those related to the use of physical medicine modalities, exercise, functional activities, assistive devices, environmental modification, patient and family education, and psychosocial and recreational counseling.

Session 3: Optimizing the care trajectories of old patients

Community interface Community supports and their appropriate use
Appropriate use of residential care for elderly people
Community resources, prevention of institutionalization
Ethical Issues Advance Directives
Limitation of treatment, competency, guardianship
Wills and durable power of attorney
Decision-Making Capacity
Euthanasia, Assisted Suicide
Health Care Rationing
Palliative care & Pain Management
End-of-Life Care
Cultural aspects Participants should be familiar with the influence of culture and ethnicity on the aging process, health and disease perception, and access to medical care
Health Care
System
Health Care Financing: Mechanisms and Implications
Health services issues, health settings, health systems
WHO, country health policies
Home care/community care/general practitioners/nursing home care/community services/primary health care
Needs assessment for services
Quality of care, quality indicators
Abuse &
Neglect
Institutional Abuse
Physical abuse
Abuse and neglect of elderly, mentally frail people
Abuse, neglect and the Complaints system
Social services ‘Response to Abuse and neglect’
Acute care v Chronic care- where is the government heading with elderly care?

Session 4: Mood and cognitive disorders

Psycho Geriatrics Psychopathology, including:
Dementia
Affective disorders
Psychotic disorders, anxiety disorders,
Responses to medical illness, and substance abuse.
Under-reporting of symptoms and illnesses
Sexuality and aging
Suicide
Home safety
Adaptation to care in alternative living situations,
Social isolation, social support, caregivers burden
Atypical presentations Diseases that are especially prominent in the elderly or that have different characteristics in the elderly, including neoplastic, cardiovascular, neurologic,
musculoskeletal, metabolic, and infectious disorders.
Health promotion Primary prevention
Exercise, nutrition, vaccination etc
Secondary Prevention
Age appropriate screening & detection
Tertiary prevention strategies
Rehabilitation &chemoprophylaxis

 



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