IL RUOLO DELLA FORMAZIONE NELLA COSTRUZIONE DI UNA CULTURA GERIATRICA E MULTIPROFESSIONALE: LA SCUOLA DI SPECIALIZZAZIONE

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1 IL RUOLO DELLA FORMAZIONE NELLA COSTRUZIONE DI UNA CULTURA GERIATRICA E MULTIPROFESSIONALE: LA SCUOLA DI SPECIALIZZAZIONE DR.SSA PAOLA FORTI RICERCATORE UNIVERSITÀ UNIVERSITÀ DI BOLOGNA ALMA MATER STUDIORUM UNIVERSITA DI BOLOGNA

2 Identità del Geriatra Excellence in clinical care Professionalism Expansion of knowledge related to health and aging Education of a health professions workforce to care for older persons Advocacy for older patients Leadership

3 Caring for Older Americans: The Future of Geriatric Medicine

4 British Geriatrics Society The Medical Undergraduate Curriculum in Geriatric Medicine Compendium document 5.1 (revised July 2007) 3.8 Communicate clearly and effectively with older patients, their relatives and colleagues from a variety of health and social care professions. These skills include: The ability to relate to patients, their families and carers. Be able to discuss with them their medical problems, plans for discharge and support, providing sufficient information in a way that is easy to understand. The ability to communicate with older people regardless of their background or disability. The ability to relate to older people with communication difficulties and to know how communication can be facilitated in these situations. The ability to work as a member of a team with colleagues, including General Practitioners, professions allied to medicine and representatives from social services. Recognise the importance of communicating effectively (verbal and written) with other members of the team to optimize patient care and treatment. Recognize the need to keep good medical records, documenting changes in progress and recording conversations with families and carers. The ability to communicate with patients and carers in potentially difficult situations such as breaking bad news or bereavement.

5 Caring for Older Americans: The Future of Geriatric Medicine

6 Anziano fragile Paziente complesso Approccio olistico Obiettivo qualità di vita Team orientato sul singolo paziente il cui compito precipuo è stilare il PAI Setting clinico Realtà complesse Richiesta capacità di sintesi e di armonizzazione Team orientato alla gestione del setting, il cui compito principale è la gestione delle risorse, l integrazione ed il coordinamento delle attività assistenziali. La sintonia tra i due team richiede un geriatra preparato alla gestione del personale

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8 Healthcare Professional Training: A Comparison of Geriatric Competencies: JAGS 2008; 56:1724 The vast majority of healthcare professionals, including those in geriatric specialties, learn in isolation from other professions, even though their clinical practice may place them side by side at the same site of care. In geriatrics, most healthcare professionals come to clinical rotations having had virtually no interdisciplinary training. Medical residents are less likely than nurse practitioners or social workers to perceive that the team offers positive benefits and more likely than nurse practitioners and social workers to feel that the purpose of the interdisciplinary team is to assist the physician in achieving treatment goals. Physicians are socialized to a strict hierarchical model and have little exposure to collaboration with other professionals. Efforts to coordinate academic programs and establish interdisciplinary experiences for students face barriers such as the perception of faculty that interdisciplinary courses and activities carry less weight than other activities in promotion and tenure decisions.

9 Healthcare Professional Training: A Comparison of Geriatric Competencies: JAGS 2008; 56:1724 Geriatrics models in acute and long-term care shows that, when educated together in geriatric teams, advanced practice nurses, medical residents, and social workers improve in attitude toward teams and team skills. Practitioners from each discipline should understand the scope of practice and competencies of the other disciplines with whom they work. Academic programs might consider developing discipline-specific recognition for interdisciplinary activities that reflect team building, conflict resolution, outcome measurement, and case management that reflect a mindset that focuses on team building rather than individual skills. There is a need to be inclusive when choosing healthcare disciplines to involve in coordinated academic geriatric initiatives. Geriatric interdisciplinary training and practice typically include medicine, nursing, and social workers and sometimes pharmacy, nutrition, and the rehabilitative therapies. Dentistry, however, is undervalued.

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11 Scuola di specializzazione in Geriatria Obiettivi formativi Lo Specialista in Geriatria deve avere maturato conoscenze teoriche, scientifiche e professionali: della cura del paziente anziano in tutti i suoi aspetti; dei processi di invecchiamento normale e patologico e della condizione di fragilità e disabilità dell anziano; di demografia ed epidemiologia dell invecchiamento; della fisiopatologia, della clinica e del trattamento delle malattie acute e croniche dell anziano e delle grandi sindromi geriatriche; della medicina preventiva, della riabilitazione e delle cure palliative per il paziente anziano; delle metodiche di valutazione e di intervento multidimensionale nell anziano in tutti i nodi della rete dei servizi, acquisendo anche la capacità di coordinare l intervento interdisciplinare nell ambito dell unità valutativa geriatrica con l obiettivo della cura globale del paziente anziano.

12 UNIVERSITÀ DEGLI STUDI DI BOLOGNA SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA

13 UNIVERSITÀ DEGLI STUDI DI BOLOGNA SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA

14 UNIVERSITÀ DEGLI STUDI DI BOLOGNA SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA

15 UNIVERSITÀ DEGLI STUDI DI BOLOGNA SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA

16 UNIVERSITÀ DEGLI STUDI DI BOLOGNA SCUOLA DI SPECIALIZZAZIONE IN GERIATRIA

17 La Scuola di Specializzazione in Geriatria tra Scilla e Cariddi... Università Scuola di Specializzazione In Geriatria SSN

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19 Planning healthcare for older people...