As the world observed the International Day of the Older Person on Sunday, October 1 2017, the World Health Organisation (WHO) has called for a new approach to providing health services for older people.
In a recent publication, the WHO highlights the role of primary care and the contribution community health workers can make to keeping older people healthier for longer. The UN organisation also emphasises the importance of integrating services for different conditions.
“By the year 2050, one in five people in the world will be aged 60 and older,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “It’s our goal to ensure that all older people can obtain the health services they need, whoever they are, wherever they live.”
Yet, even in the rich world, people may not be getting the integrated services they need. In a survey of 11 high-income countries, up to 41% of older adults (age ≥65 years) reported care coordination problems in the past two years.
WHO’s new “Guidelines on Integrated Care for Older People” recommend ways community-based services can help prevent, slow or reverse declines in physical and mental capacities among older people. The guidelines also require health and social care providers to coordinate their services around the needs of older people through approaches such as comprehensive assessment and care plans.
“The world’s health systems aren’t ready for older populations,” says Dr John Beard, Director of the Department of Ageing and Life course at WHO.
“Everyone at all levels of health and social care, from front-line providers through to senior leaders, has a role to play to help improve the health of older people. WHO’s new guidelines provide the evidence for primary care workers to put the comprehensive needs of older people, not just the diseases they come in to discuss, at the centre of the way they provide care.”
Older adults are more likely to experience chronic conditions and often multiple conditions at the same time. Yet today’s health systems generally focus on the detection and treatment of individual acute diseases.
“If health systems are to meet the needs of older populations, they must provide ongoing care focused on the issues that matter to older people – chronic pain, and difficulties with hearing, seeing, walking or performing daily activities,” adds Beard. “This will require much better integration between care providers.”
Some countries are already making smart investments guided by WHO’s Global Strategy on Ageing and Health.
Brazil has implemented comprehensive assessments and expanded its services for older adults; Japan has integrated long -term care insurance to protect people from the costs of care; Thailand is strengthening the integration of health and social care as close as possible to where people live; while the Ministry of Health in Vietnam will build on its comprehensive health care system and the large number of elderly health care clubs to better meet the needs of older people in their communities. In Mauritius, the Ministry of Health provides universal health coverage for older adults including a network of health clubs and primary care clinics with more sophisticated services in hospitals. The United Arab Emirates are meeting the health needs of older people by creating more age-friendly cities. In France, a new WHO Collaborating Centre called Gerontopole, located in the Toulouse University Hospital, is helping to advance research, clinical practice and training on Healthy Ageing.
“Integrated care can help foster inclusive economic growth, improve health and wellbeing, and ensure older people have the opportunity to contribute to development, instead of being left behind,” concluded Dr Beard.