Introduction to gerontology

Gerontology

Gerontology is the science that studies aging, old age and the elderly from a multidisciplinary point of view and from normality, involving health, social and psychological sciences.

Etymologically, the word "gerontology" (and its derivatives) comes from the Greek "gerontos" the notable people of the town. But although throughout history the valuation of the elderly and aging has had defenders and scholars (Plato, Aristotle, Francis Bacon), it was not until the middle of the 20th century that geriatrics as it is currently conceived was established.

Today gerontology gains importance due to the progressive aging of Western societies and the increasing consumption of resources of all kinds (medical, social, welfare, cultural, etc.) carried out by older people.

The primary objectives of gerontology are not only to increase the years of life, longevity, but to add life to the years, increasing the quality of life of the elderly.

We can divide gerontology into several branches, depending on the aspect of aging that they deal with:

• biological or experimental gerontology: studies the biological process of aging, as well as the factors that can modify it. It aims to know both the intimate mechanisms of aging and its etiopathogenesis.
• Social gerontology: study of the causes and effects of the aging process in society.
• Gerontopsychology: Study the psychological and psychiatric aspects of the elderly. It is the science that tries to describe, explain, understand and modify the attitudes of the aging subject.
• Clinical gerontology or geriatrics: It is the medical branch whose purpose is the prevention and diagnosis of diseases of old age, their cure, rehabilitation and reintegration of the patient in their usual environment.

Geriatrics

Geriatrics deals with the study of diseases in older people and their specific treatment, since ailments in the elderly present differently from younger adults and its approach and treatment must be adapted to their needs. It could be compared to what pediatrics does in children.

Going point by point, the goals of geriatrics are:

• Prevent disease and health disorders in an active way.
• Avoid dependency. The disease can leave disability and dependence as sequels, so it is necessary to prevent it from evolving towards chronicity; the elderly who reach absolute dependency should be strictly unavoidable.
• Comprehensive assistance. It must take care of all the medical, functional, mental, and social problems of the elderly through a comprehensive, programmed and exhaustive geriatric assessment with the multidisciplinary collaboration of other professionals integrated in a team with the geriatrician.
• Rehabilitate. You should try to regain patients who have already lost their physical or social independence and try to maintain and return the elderly to their community.
• Provide progressive care for the elderly. From the onset of their illness to completing the rehabilitation of this process and returning to their previous baseline situation, the elderly may have different care needs depending on the moment. These needs must be met by counting on different levels of care: hospital, home care, rehabilitation or convalescence units, long-stay units or residential centers.

For the proper management of the geriatric patient, the presence of these levels is necessary to locate the appropriate resource and at the appropriate time for each patient.

In order to meet these objectives, geriatrics has a way of acting and instruments that are its own, which are:

• Comprehensive Geriatric Assessment. It is the diagnostic process in geriatrics to establish a plan of objectives and care in the elderly, which is the main thing and on which all actions in a specific patient should be based. Of course, this care plan has to be plastic and modifiable depending on changes in the patient's needs, it has to be a reassessable process. It must attend to all the dimensions that can influence its health:
  • medical problems including aspects of nutrition, state of the sense organs, oral health, geriatric syndromes, etc.
  • Evaluation of functional capacities.
  • mental assessment, attending to the cognitive and affective problems of the elderly.
  • social valuation, attending to the situation and social needs of the individual.
• Multidisciplinary team. It involves the integration of a team of several professionals: geriatrician, nurse, physiotherapist, occupational therapist, psychologist and social worker. They must work in a coordinated way around the goals and care plan established for each elderly person.
• Assistance levels. Adapted to the different disease situations of the patients, as has been commented. It is important that in the care and treatment of the elderly the different levels of care have fluid and dynamic communication.