Second Postgraduate Course
Session 1 , Nov 3-6, 2006
Principles of Geriatrics & Gerontology

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.

Second Postgraduate Course
Session 1 , Nov 3-6, 2006
Geriatrics Syndromes, conditions and Réhabilitation

Geriatrics syndromes & Conditions

Geriatric Giants

• Incontinence
  
• Delirium
  
• Iatrogenesis, include 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.

Second Postgraduate Course
Session 3 , Nov 2-5, 2007
Health Care Services for the Elderly

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 vs Chronic care- where is the government heading with elderly care?

Second Postgraduate Course
Session 4 , Apr 18-21, 2008
Pyschogeriatrics and Health Promotion

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 presentation 

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.

Primary prevention
Exercise, nutrition, vaccination etc

Secondary Prevention
Age appropriate screening & detection

Tertiary prevention strategies
Rehabilitation & chemoprophylaxis

Research teaching and research projects for the participants
This will start from the first session and conclude in the last session

Research

A basic understanding of research design and research methodologies related to geriatric medicine, including critical evaluation of medical literature.

One aspect of research teaching is to make the participants get involved in one project during the two year period.  In the previous course the group were involved in working with RAI instruments which was interesting. We will follow the same in the coming course with some modifications.