Geriatric Medicine and Gerontology in Ireland
A brief overview
The elderly represent 11.5% of the population of Ireland, but Ireland will experience the second highest increase in its over-65 population in the European Union, with an anticipated growth of 26% by 2011. Under ancient Celtic civilization, the so-called Brehon laws were very enlightened in their view of the elderly. In modern times, policy in Ireland has been shaped by the report of a working group in 1988, The Years Ahead, which has been adopted as official policy. With the main aim of maintaining older people in their own homes in maximum health, the report outlines a comprehensive scheme of community, health and institutional measures. Many of these have been incorporated in the 2 blue-prints for future development of the Irish Health Services, known as Shaping a Healthier Future (1994) and Quality and Fairness (2001). For an excellent overview of the development of the Irish health services, see Health, Medicine and Politics. Useful summaries of the current health services are also available as a series of Health Fact Sheets from the Institute of Public Administration: Health Fact Sheet 3/96 deals with 1996 population projections, and there is a 1993 Health Fact Sheet on services for the elderly. A review in 2003 in the Journal of the American Geriatrics Society complements this profile.
Geriatric medicine has developed to become the largest specialty in Internal medicine in Ireland with 54 consultants based in general hospitals around the country. These include Dublin (18), Cork (5), Galway (2), Limerick (3) and 2 each in Letterkenny, Castlebar, Waterford, Wexford, Kilkenny, Clonmel and one each in Sligo, Cavan/Monaghan, Roscommon, Dundalk, Drogheda, Navan, Naas, Mullingar, Tullamore, Nenagh, Ballinasloe, Tralee, Bantry and Mallow. The professional association representing geriatricians is the Irish Society of Physicians in Geriatric Medicine, founded in 1979.
Psychiatry of Old Age has been developing since the late 1980's, and there are now consultant Psychiatrists of Old Age in Dublin and posts in Cork, Limerick, Ennis, Cavan, Waterford, Portlaoise and Donegal.
There are full and associate chairs in geriatric medicine (Prof Rose Anne Kenny, Prof Davis Coakley, Prof Desmond O'Neill) and Psychiatry of Old Age (Prof Brian Lawlor) at the Faculty of Health Sciences, Trinity College Dublin
Training for consultant physicians is in both internal medicine and geriatric medicine. In conjunction with the Royal College of Physicians in Ireland, the ISPGM has developed a Diploma in Medicine of the Elderly, a qualification designed for family doctors who would have responsibility for older people outside the general hospital, ie as the Medical Officer for an extended-care institution. Specialist training in the care of older people is also available for nurses, with a Diploma and Masters in Gerontological Nursing from Trinity College Dublin, diplomas in Gerontological Nursing at UCC, UCD and NUIG and a Certificate in Nursing for the Elderly from St Mary's Hospital in Dublin. A Certificate in Gerontology was organized as an extra-mural course by Maynooth University and the Irish Red Cross but has not taken place since 1995.
The boundaries between research in gerontology and geriatric medicine are not distinct in Ireland.
The Irish Gerontological Society is one of the oldest gerontological societies in the world. It holds its annual scientific meeting at the end of September each year and abstracts are published in the Irish Journal of Medical Science.
A large body of gerontological research has been commissioned by the National Council on Ageing and Older People, an advisory body to the Minister for Health founded in 1981. It has produced over 50 reports and these may be purchased from the Council.
Mercer's Institute for Research in Ageing was founded in 1987, funded in part by the Mercer's Hospital Foundation. This foundation carries on the mission of Mercer's Hospital, a voluntary hospital in Dublin, itself the main beneficiary of the world premiere of Handel's Messiah in Dublin in 1742! The institute is based in St James's Hospital, and has interests in dementia, metabolic bone disease and infectious diseases in the elderly.
The Irish Society of Physicians in Geriatric Medicine and the Irish Gerontological Society have been enthusiastic participants in the Section of Geriatric Medicine of the European Union of Medical Specialists. This is the statutory body representing medical specialists in the European Union and the Section has been in action since October 1997. A major part of the process has been the development of Standards for the Training of Geriatricians in the European Union and this has been agreed in Copenhagen in October 1999. An Irish geriatrician, Dr Cillian Twomey of Cork University Hospital has been the president of the European Union of Medical Specialists. The two organizations are also supporting the embryonic European Union Geriatric Medicine Society, which was launched at its first scientific meeting in August 2001 in Paris. The EUGMS has contributed a position statement to the UNECE, downloadable as a .pdf file.
The Years Ahead - a policy for the elderly. Report of the Working Party on Services for the Elderly. Dublin, The Stationery Office, 1988. Available from Government Publictions Sale Office, Molesworth St, Dublin 2, price IR£8.00.
Department of Health. Shaping a Healthier Future: a Strategy for Effective Healthcare in the 1990's. Dublin: Stationary Office, 1994.
Dublin Hospital Group
Barrington R. Health, Medicine and Politics in Ireland 1900-1970. Dublin, Institute of Public Administration, 1987. ISBN 0-906980-72-0.
Health Fact Sheets. Apply to Health Services Development Unit, Institute of Public Administration, Vergemount Hall, Clonskeagh, Dublin 6, Ireland. Tel +353 1 2697011, Fax +353 1 2698644.
O'Neill D, O'Keeffe S. Health care for older people in Ireland. J Am Geriatr Soc. 2003 Sep;51(9):1280-6
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