SUMMARY

The healthcare system faces, in the most developed countries, very important changes that stem from reasons such as the technological evolution and the population ageing. The last one is, besides, along with the migratory phenomenon, the most relevant social fact in the beginnings of the XXIst century. Aging brings about new challenges, especially when it comes to healthcare professionals that have received a training that barely fits the new scope of knowledge related to the needs and particularities of aging people. New or not so new specialties like geriatrics become relevant. New roles, especially in nursing, and a greater importance of other healthcare professionals like physiotherapists and occupational therapists are coming alight.

The goal of this article is to think about the impact of the population aging on healthcare professions and professionals.

According to the 2001 population census, 17,01% of population was 65 or over. As reported through the same census, the percentage of people between 0 and 14 years old and 15 and 64 years old was 14, 52 for the first case and 68,44 for the second one.

Subjective health declines as we age, but this decrease is more important among people over 75 years old than among those between 65 and 75. According to the data provided after the 2003 Health National Inquiry, in the group aged 60-64, the percentage of people with a good or very good auto-perceived health status was 51,2%, and that among those people aged 65-69 was 46,3%. Slight differences are found in the prevalence of the auto-perceived good health status between the 75-79 years old population (36,3%) and that of 80 years old and over (36,0%). Men show an auto-perception of a significantly better health status than that reported by women.

The training, especially for medical doctors, focuses on the diagnostics and the solving of acute conditions, while often forgetting to handle the chronic features or the consequences of the diseases, such as pain, delirium and incapacity. The problems genuine to old people like falls or dementias, sometimes difficult to manage, are poorly or only partially known by non geriatric specialized professionals.

The population aging has fostered a greater demand of the use of services, with a greater need of human resources. This increase of needs affects many professionals given the complexity and variety of services that old people use. This growth of the demand of professionals requires a proper offer of the last ones that is not always warranted.

The medical specialization has been a cornerstone in the improvement of the healthcare system and the training of the resident physicians, despite their inequalities, the best way to improve the system during the last two decades. However, in the meantime, the specialization has boosted a segmentation of professionals and sometimes certain “specialty” corporativism. The idea of “specialization” has decreased the value of the polyvalence that represent some generalist specialties like the Family Medicine, the own Internal Medicine or, to a certain extent, the specialty of Geriatrics. The focus must be both on the specialized education in geriatrics and the basic one for every medical student and, whatever the final model, on the training of all medical specialties.

When it comes to the geriatric patient care, nursing plays a major role. Its role is very important at all assistance levels (intensive care and ambulatory assistance) and in every preventive feature, but it is crucial for both at home and in-hospital long lasting treatments; it is, thus, the collective harboring the warranty for continued care services.