Universiteit Leiden

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Quality of life is sometimes more important to the elderly than a cure

Geriatrics needs to radically change. This is what Simon Mooijaart, Professor of Internal Medicine (specialising in geriatrics), will say in his inaugural lecture. Tailored solutions, collaboration and practitioners who are willing to listen lead to more independence and a better quality of life in older patients.

Mooijaart has seen interest in geriatric care grow throughout the field of medicine. ‘Doctors are mainly trained in hospitals to be organ and disease driven’, he says. ‘Medicine and hospitals have become really good at treatments that cure diseases, and everyone benefits from this, including the elderly.’

But Mooijaart calls for more emphasis on providing the tailored care. ‘What works for a 45-year-old man with one ailment may not be appropriate for an 85-year-old woman with several diseases. Older people differ greatly from one another too and can have different preferences: if they fall ill, some will want to try everything possible to be cured and live to an old age, whereas others will choose pain management or less intensive treatment. Both choices are personal and are equally good. We just have to think sooner in the process about what is right for which elderly patient.’

Tailored care

Doctors and care providers have to know older people well to offer them tailored care. A systematic picture of, for instance, patients’ independence, memory and mobility makes the differences between them clear. ‘That may take time but it pays for itself because it also gives us a better idea of what older people want, enabling us to act accordingly.’

From research, Mooijaart has learned that vulnerable elderly people sometimes undergo tough and expensive treatment that proves too much for them. ‘If we research the right treatment for the patient and focus on recovery, we stand to make gains, not so much in terms of a longer life for everyone as in greater independence and quality of life. This should also save money. There will be shortages of health professionals and money for tailored care in the Netherlands by 2030. The ratio of four people in work to one adult over 65 that was calculated in 2006 will have reduced to just two people in work to one adult over 65 by around 2040. More tailored care is needed for the elderly because it improves results for the patient and ensures the care continues to be feasible.’

LUMC Centre for Geriatrics

‘All healthcare providers should offer older people tailored treatment but a lot of research, teaching, training and healthcare innovation is still needed. We recently joined forces to create the LUMC Centre for Geriatrics. This is a collaboration between primary care physicians, hospital and nursing homes, nurses, academics and the elderly themselves, and will help us live by our motto of “Tailored geriatric care, anytime and anywhere”.’

Text: Tim Brouwer de Koning
Photo: Unsplash

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