Caring for retirees: It's more fun in the Philippines
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There is a growing elderly population both in the US and Philippines that is straining healthcare resources. The Philippines has a limited number of geriatricians, about 100, to care for over 5 million senior citizens. Various levels of geriatric care and facilities exist in the Philippines, including hospital, outpatient, home care and nursing facilities. However, further improvements are still needed, such as accreditation for chronic care facilities and incorporating geriatrics training for medical and nursing students.
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Caring for retirees: It's more fun in the Philippines
- 1. MARC EVANS M. ABAT, MD, FPCP, FPCGM Internal Medicine-Geriatric Medicine Head, Center for Healthy Aging, The Medical City
- 2. These are the ones expected to be retiring These are the ones expected to support the retirees As the years go by, more retirees will have to be supported by relatively finite resources
- 3. Biochemical composition changes Physiologic capacity decreases Decline in homeostasis Susceptibility to disease increases Mortality increases with age
- 4. The Elderly (age 65 and over) • 13% of the U.S. population in 2002 • 36% of total U.S. personal health care expenses Healthcare is a major factor affecting decisions regarding retirement. • average health care expense was $11,089 per year for elderly people but only $3,352 per year for working-age people (ages 19-64)
- 5. Where does the Philippines stand with regard to geriatric care?
- 6. Outline • Doctors • Levels of Care • Geriatric Services • Medical Facilities • Nursing and Caregiving Staff • Allied Professionals • Summary
- 7. There are about 100 recognized geriatricians or specialists for the elderly in the Philippines!
- 8. As of 2007, for the 5.8 million senior citizens in the Philippines (6.5% of the total population), there would be…. 1 geriatrician for every 58,000 senior citizens!
- 9. Geriatricians come from different backgrounds • Internal Medicine • Family Medicine • Other specialties • General practitioners
- 10. Specialization in Geriatrics Hospital-Based Fellowship Program Hospital-Based Fellowship Program Modular Program
- 11. Accreditation as a Geriatrician Complete Residency Training in Internal Medicine • 3 years Pass Internal Medicine Specialty Board Exams • May be completed during Geriatrics Fellowship Geriatric Medicine Fellowship • 2 years Pass Geriatric Medicine Specialty Board Exam
- 13. How about the non-geriatricians? • Recognition of the uniqueness of the elderly physiology and disease process • Need to modify and tailor specialty knowledge • Acceptance of interdisciplinary care and the role of geriatricians
- 14. Geriatrics in Medical Training • Gradual incorporation of geriatric medicine in the medical curriculum – University of the Philippines-College of Medicine – Ateneo School of Medicine and Public Health – St. Luke’s Medical Center-Quasha College of Medicine – University of the East College of Medicine • Proposed incorporation of questions in the Medical Board Examinations
- 15. Regional Partnership in Geriatrics • Involvement in the Asia-Pacific Geriatric Network – Philippines, Hong Kong, Malaysia, Taiwan, Indonesia, Australia and New Zealand
- 16. Levels of Care In-patient or hospital-based geriatric care Out-patient or clinic-based geriatric care
- 17. Chronic Care Settings Home Care Nursing Facility
- 18. Geriatric Services • Acute disease-based geriatric care • Chronic care • Executive check-ups • Longevity medicine vs. anti-ageing medicine • Cosmetic medicine • Instrumentation and Procedures
- 20. Other Facilities • What we have – Assisted living facilities – Nursing care facilities • What we do not have – Sub-acute or transitional facilities
- 21. • There is no clear agency for accreditation and monitoring of facilities for chronic care. • Currently, the Philippine College of Geriatric Medicine and the Philippine Society for Geriatrics and Gerontology is advocating for this.
- 22. Nursing Staff • Some degree of specialization, although not as structured as in other countries – Gerontology nurses – Oncology nurses – Wound Care and Stoma nurses • “private duty nurses” – Home care – Procedures and instrumentation
- 23. Nursing Education and Accreditation • Incorporation of topics on geriatrics and gerontology in nursing curriculum – University of the Philippines-College of Nursing • Nursing associations – Philippine Nursing Association – Gerontological Nurses Association of the Philippines – Association of Private Duty Nurse Practitioners
- 24. Caregivers • Technical Education and Skills Development Authority (TESDA) mandate on caregiving industry – School accreditation, monitoring and auditing – Minimum program competencies – Graduate assessment and certification
- 25. Allied Professionals • Growing interest in application of geriatric and gerontologic principles in the practices of – Physical and Occupational Therapy – Speech and Swallowing Therapy
- 26. Geriatrician
- 27. Geriatrician
- 28. Summary • There is a growing population of retirees abroad • Healthcare is an important factor in decisions regarding retirement • The Philippines IS capable of providing good geriatric care – Personnel – Levels of Care – Facilities • Further enhancements regarding accreditation and monitoring have to be instituted
Editor's Notes
- In the US and for many other developing countries, advances in healthcare has progressively increased life expectancy The populations are getting older and the proportion of elderly citizens is getting bigger For the most part, this means that there will be a larger number of older individuals that will eventually be dependent on the younger population for their needs after retirement However, as a consequence of this also and due to ever changing economic conditions, more older people are either extending their working years or are coming out of retirement to go back to work and support themselves In both scenarios, it is clear that due to finite resources, there is growing need for retirees to be able to allocate their resources cost-effectively in order to support their retirement years, in esssence, getting “more bang for their bucks”!
- Aging is inevitable and there would be many accompanying physiologic and pathologic changes as one grows old As one grows older, changes that begin at a molecular level eventually cascade to changes in physiologic capacity and a decline in the ability to respond to stress. This leads to susceptibility or emergence of disease states which therefore increases the likelihood of further morbidity and death
- Therefore, it is but rational to think that as one retires and grows older, more resources are expected to be spent on health care. In 2002 for example, the elderly make up about 13% of the US population and yet take up as much as 36% of US personal health care expenses. Average health care expenses for an elderly American is about 3x as much as that for a younger individual. Therefore, it is but rational also to think that foreign retirees, in the face of rising healthcare costs and finite financial resources, would opt to retire in countries where quality healthcare is available at reasonable and globally competitive costs.