ITALY is one of the countries with more elderly people. With data in hand, there are 168,9 over 65, for every 100 young people: an index of old age from the new national record, as emerged from the Report, Istat 2019. A longevity that is accompanied by an important increase in the absolute number of over 75 with multiple chronic diseases, which often make it indispensable to have recourse to hospitals, with 1.3 million admissions per year and an average stay of 9 days, not counting the many sick complex between the ages of 65 and 75 years.
But the number of beds in geriatrics, just 3.560, it is not sufficient to withstand the shock wave, and also the management in the Emergency department of these patients who are “fragile” shows critical issues: in spite of the recourse to the Emergency room and subsequent hospitalization are almost always appropriate in the elderly, lack of separate lanes for these patients, often not able to wait for care, perhaps given on a stretcher. Finally, there are just 2,500 geriatricians, specialists suited to the management of targeted and effective patients is particularly complex and can reduce the risk of mortality and worsening disability. In short, many elderly are increasingly complex, few physicians with a specialization in ad-hoc and few beds to take care of a population that has need of answers, care to measure. For this reason, the Italian Society of Gerontology and Geriatrics (SIGG) Italian Society of Geriatrics Hospital and Territory (SIGOT), sounding the alarm and asking that it be given a greater availability of beds in geriatrics and are increased in first-Aid routes dedicated to geriatric patients. It is also necessary to establish the figure of the emergency nurses in geriatric, properly trained, and increase the number of seats for specialization in geriatrics. All indications are already available in black and white in the document “The use of geriatric patients in the Emergency department and at hospital admission”, prepared by a technical group established at the ministry of Health with the participation of the representatives of the two scientific societies. Document submitted on 28 march 2018 from the Ministry to the Commission for Health of the Conference of Regions and Autonomous Provinces, with the goal of advancing to the State-Regions Conference, to be definitively approved, but that, inexplicably, almost two years on it is still waiting to be scheduled in the Conference State-Regions. For this reason, the SIGG, and the SIGOT is addressed to the minister of Health Roberto Hope and to the president of the Regions Stefano Bonaccini why speed up the process for the approval of the document.
“Every year it grows, the absolute number of older adults and, therefore, also of the elderly sick that cater appropriately to the Emergency room and the hospital, explain Raffaele Antonelli Incalzi and Filippo Luca Fimognari , respectively presidents SIGG and SIGOT. Access to accident and Emergency, at the base of most of the shelters, amounted to between 230 and 300 thousand inhabitants in the age range that goes from 40 to 69 years and then take a leap, surpassing the 500 thousand between 75 and 80 years. And with the increase of age also corresponds to the load of many diseases and disabilities: for this reason the doctors of the Emergency room, when they decide to hospitalize the elderly, they do so advisedly, since it is almost always of patients in serious conditions. The management of the patient, however, is particularly complex in the face of the shortage of beds in geriatric and available. The directions provided by the Document address the ministerial would significantly improve the care for these patients and reduce the workload of the Emergency department”.
therefore, Becomes a strategic document drafted by the Ministry of Health, which contains valuable proposals for health care organisation aiming to improve the hospital care for the elderly, to be approved as soon as possible: “The risk they conclude, Antonelli Incalzi and Fimognari, is that you lose a valuable opportunity to improve the health care for the elderly in the Hospital, just at a time when the crowding of the Emergency room has become an emergency national health, especially as a result of the continuous growth of the elderly population”.
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