Geriatric Medicine in Hong Kong: Why and How?

Abstract

<p>The elderly population (aged 65 and above) in Hong Kong has been growing from 5.5% in 1976 to 10.3% in 1996. To meet the growing need for medical services for elderly people and to arouse interest in special medical care for elderly people, the first government Geriatrics Unit was opened in 1975 at Princess Margaret Hospital (PMH), which has been the cradle for geriatricians in Hong Kong since its inception. In 1979, the consultant geriatrician at PMH was appointed honorary clinical lecturer of the Hong Kong University (HKU) and Geriatric Medicine included in the undergraduate curriculum. Clinical bedside teaching in Geriatrics for HKU medical students started at PMH in 1981 followed by those of Chinese University of Hong Kong in 1988, which had its first professor in Geriatric Medicine in 1994. The Hong Kong Geriatrics Society was founded in 1981 as a professional association in the field of geriatric medical care. The Hong Kong Association of Gerontology was founded in 1986 to promote collaboration among different fields of workers in the care of elderly people. The major reason for the establishment of the geriatrics specialty is not simply the increase in numbers of old people, but rather the increase in knowledge of old people, and the need for special attitude and organizational skills. Geriatric Medicine emphasizes on a holistic approach by caring a whole person (not just her parts) interacting with her environment (physical as well as psychosocial) over a period of time (not just an acute episode in the hospital). The expertise of geriatricians is therefore three-fold: first, awareness of the different presentation, course and the management of illness in the biologically aged person; second, the organisation of hospital-based services appropriate to such patients; and third, the co-ordination of health and social services. Undergraduate and postgraduate training in Geriatric Medicine are thus geared towards these aims. As at March 2000, there are 74 specialist geriatricians (1.11 per 10,000 elderly population aged 65 years or over) and 34 trainees in Geriatric Medicine in Hong Kong. There are two full-time academic posts (1 professor, 1 associate professor) in Geriatric Medicine. Out of the 43 public hospitals in Hong Kong, 23 hospitals (12 acute & 11 extended care) are provided with geriatric services led by 22 consultants in Geriatric Medicine. The range of geriatric services provided include acute assessment and care, rehabilitation, long-term care, geriatric out-patient clinic, geriatric day hospital, and community geriatric services. Some geriatric units also provide special services such as stroke unit, orthogeriatrics, psychogeriatrics, memory clinic, fall clinic, continence clinic, syncope clinic, diabetic clinic, stroke clinic, arthritis clinic, and Parkinson’s disease clinic. Despite the progress we have made, Geriatric Medicine in Hong Kong has yet to face future challenges in respect of education, research and services.<br></p>