Title: Primary Care and care for older persons: Position Paper of the European Forum for Primary Care
Authors: Boeckxstaens, P ×
De Graaf, P
Paulus, A
Van Raak, A
de la Cuesta, C
Rotar, D
Kaduskiewicz, H
Vedel, I
De Lepeleire, Jan
Ronse, J
Baeyens, JP
Hasseler, M
Visca, M
Groenewegen, P
Illife, S
Walker, UJ #
Issue Date: Dec-2011
Publisher: Radcliffe Medical Press
Series Title: Quality in Primary Care vol:19 pages:369-389
Abstract: ABSTRACT
This article explores how to address the needs of the
growing number of older patients in primary care
practice. Primary care is not a fixed organisational
structure but a combination of functional characteristics
which has developed variably in European
countries with differing responses to the emerging
needs of older persons. Multimorbidity, frailty, disability
and dependence play out differently in older
persons; a key challenge for primary care is to provide
a response that is adapted to the needs of individuals
– as they see them and not as the professional defines
them. Indeed, growing experience shows how to
involve older persons in taking decisions. Contrary
to popular opinion, older persons often rate their
quality of life as high. Indeed, comprehensive primary
care offers health promotion and prevention:
also older people may benefit from measures that
support their health and independence and some
case descriptions show this potential. Although
most people prefer to be in their own environment
(home, community) during the last stage of life,
providing end-of-life care in the community is a
challenge for primary care because it requires continuity
and coordination with specialist care. Successful
models of care however do exist. Delivering
seamless integrated care to older persons is a central
theme in primary care. Rather than disease management,
in primary care, case management is the
preferred approach. Proactive geriatric assessment
of individual medical, functional and social needs,
including loneliness and isolation, has been shown
to be useful and its place in primary care is the subject
of further research. Clinical practice guidelines for
multimorbidity are badly needed. Non-adherence
to medication, linked to multiple and uncoordinated
prescriptions, is a widespread and costly problem.
Successful approaches in primary care are being
developed, including the use of electronic patient
files.With the general practitioner (GP) as the central
care provider, primary care is increasingly teamwork,
and the role of nurses and other (new) professions
in primary care is developing constantly.
The composition and coordination of teams are two
components of one of the major complexities to
address: how to provide individualised care with
standardisation at organisation the level. (Lack of)
Coordination with specialist care remains a widespread
problem and needs attention from policy
makers and practitioners alike. Alignment with home
care and social services remains a challenge in all
countries, not least because of the different funding
arrangements between the services. Further priorities
for research and development are described
ISSN: 1479-1072
VABB publication type: VABB-1
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Academic Center for General Practice
× corresponding author
# (joint) last author

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