Home >> IAG Events & Initiatives >> Other Initiatives >> UN ECE

IAG Events & Initiatives

Access to Health Care - Education and Training of Primary Health Care Workers regarding Older Persons

Presentation to UN Economic Commission for Europe Ministerial Conference on Ageing, Berlin, Germany, September 12, 2002

By Gloria M. Gutman, PhD
President, International Association of Gerontology

Chairman and Ministers:

The over 1000 NGOs who met in Madrid in April, 2002 at the time of the 2^nd World Assembly on Ageing represented a broad cross-section of civil society, including professional as well as grass-roots organizations. It is indeed an honour to speak on their behalf about the second of the three priority directions in the Plan of Action: advancing health and well being in old age and in particular, about access to health care and the role of education and training of primary health care workers regarding older persons.

The demographic success of ageing brings with it a number of challenges. For a significant proportion of older people combinations of different serious disease processes accompany old age and the treatment of each condition is complicated by the presence of others.  This "multiple pathology" plus the atypical presentation of disease is at the core of the knowledge base for medicine in old age.  Combine this with the social constructs around ageing and ill health or disability as well as the importance of the diagnostic and therapeutic environment (i.e. access to health care) it becomes clear that education and training are key components.

For all but the most sick, medical and social care should be provided within primary care and in a domestic setting. For an increasing number of older people however their lives are also blighted by violence and neglect. Within the above paradigm key issues are:

• Education of older people themselves to empower them in issues concerned with health, well-being and the promotion of active ageing.

• Education of family and other informal care givers.

• Education and training of students in all the health- and social-care fields about ageing, prevention and management of age related conditions and the concepts of active ageing and the life course approach - i.e. promote positive attitudes of ageing across the lifespan

• Education and training of primary health care workers with this same knowledge base plus the importance of a patient centred and patient friendly primary care environment.

• Education of specialists in geriatric medicine and geriatric psychiatry and other health professionals to train and support primary health care workers.

• Education issues to be addressed include many macro phenomena e.g. the issue of poverty, social security systems and pensions as well as adequate transport provision, long term care provision and the special needs of older women and older people with mental health problems.

At the basis of good education and training must be respect for older people. This respect is manifest through providing access to and provision of health care when it is needed as a basic right.  In addition older people have the right to live life in security and dignity, free from abuse, neglect, exploitation and discrimination.

The NGOs that participated in Madrid include some whose mandate and focus is on gerontology and geriatrics research and education. They stand ready to assist governments of countries within the ECE region and elsewhere with the development, delivery and evaluation of education and research about ageing and health for a broad range of health- and social-care providers.  As well, they can provide assistance with the development of sustainable health systems and services and with the implementation of policies and programs that will be tools in the prevention of elder abuse and neglect. Other NGOs that stand ready to serve have a track record of success in grass-roots education of informal caregivers and older persons in self-care and mutual aid.

Another way in which NGOs can assist is via their communication and human resources networks. With new developments in information technology, education and health care backup can be provided to primary care workers in rural and remote areas so that older persons can have access to the services that they need where they live rather than having to relocate. Often, however, it is the local NGO that is the lynch pin in identifying key workers and linking them with enabling resources.