Statement On Older People’s Care, launched in Korea

This statement prepared by the WONCA Special Interest Group on Ageing and Health was launched at the WONCA World conference held In Seoul in Korea.

“Family Doctors are core to the delivery of quality care for older people.”

Populations worldwide are ageing, and family doctors must be available and able to play a major role in care in their communities for people as they age. The family doctor should be the primary medical care provider for older people covering the full spectrum of older people’s care from health to end stage frailty, including for those in long term care facilities.

Why family doctors?

• Family doctors can provide cost effective, accessible, integrated care around the individual older person.
· Family doctors are trained generalists, accustomed to managing older people’s care which can be complex, involving multiple chronic diseases as well as acute presentations.
· Family doctors offer a longitudinal relationship with the patient, family and community, particularly valued by the older person.
· Family doctors must also assist with healthy and active aging through disease prevention and health promotion for older people.
· Family doctors provide continuity of care, including ongoing monitoring of care, with an understanding of many complex psychosocial issues. They can promote avoidance of overtreatment and over-medicalisation (quaternary prevention) and allow for discussion of palliative care.
· Family doctors are pivotal in providing a central point of contact and playing a coordinating role in care that may involve a multidisciplinary team.

What is needed to develop and sustain this role?

• A move from treating disease (and risk factors) to focusing on enabling functional capacity and restoring individual autonomy
• Proactive rather than reactive models of care of older people, aimed at timely identification of frailty including cognitive impairment.
• Older people and their carers should remain at the center of their care and their input should be incorporated throughout.
· Training should be designed for capacity building of family doctors with a blended learning approach to allow maximum access to teaching/learning and assessment resources.
· Workforce support – to ensure current and future family doctors and primary care teams are adequately supported to meet the needs of delivering healthcare to older populations.
· Specialist service alignment – appropriately aligning all health systems, including healthcare policy and financing - to support older people, family doctors and primary care teams in working with secondary care.
· Quality standards in the care of older people, particularly to inform models of care to keep frail seniors in their homes as long as possible. This requires ongoing education, research applicable to primary care of older people, input from family doctors, equity considerations and consensus between various healthcare levels.

How should we achieve this?

· WONCA calls on its partners in health to recognise and work towards excellence in ageing care, through implementing the key components of this policy.

References
Dyson B. NHS England. Improving general practice A call to action phase 1 report. 2014. https://www.england.nhs.uk/wp-content/uploads/2014/03/emerging-findings-rep.pdf (accessed 6 Apr 2016).

Kathleen M. Mathieson, Jennie Jacobs Kronenfeld, Verna M. Keith; Maintaining Functional Independence in Elderly Adults: The Roles of Health Status and Financial Resources in Predicting Home Modifications and Use of Mobility Equipment, The Gerontologist, Volume 42, Issue 1, 1 February 2002, Pages 24–31, https://doi.org/10.1093/geront/42.1.24

United Nations Global Issues – Ageing. http://www.un.org/en/sections/issues-depth/ageing/.accessed 07.08.2018