Expanding Geriatrics Clinical Services & Education
Geriatric Medicine in sub-Saharan Africa is in need of urgent development and expansion. A similar need exists to enhance and co-ordinate geriatric care to ill and frail older persons, and to train and support informal carers to such persons. Few resources are made available for the training and employment of specialists in geriatrics, or for the care of geriatric patients, and neither are resources available to train informal carers. A growing number of people is set to live to an advanced age, and will heighten a demand for services (particularly the management of chronic illnesses and disabilities) and put additional strain on already challenged public health systems.
The programme aims to work with the South African government, the governments of other SSA nations, African institutions and global agencies to develop a strategy to improve and expand clinical education and services in this field.
Current Research Projects
Projects currently carried out under ILCSA's three core programmes are the following:
- The practice and dilemma of the use of physical restraints in hospitalised older patients
An investigation carried out by Sebastiana Kalula and George Petros at Groote Schuur Hospital in Cape Town has generated knowledge to inform policy and practice in the use of physical restraints on older hospital patients. The study found current guidelines in this regard to be inadequate, or ambiguous, and followed only arbitrarily. The study findings, and recommendations for policy and practice are to be disseminated shortly. Contact Sebastiana Kalula for additional information.
- The prevalence and prevention of falls in community dwelling older persons
A large survey (n=837) with a 12-month follow-up carried out recently by Sebastiana Kalula in three randomly selected suburbs of Cape Town establish prevalence and incidence rates for falls in a multi-ethnic community dwelling population aged >65 years, and identified risk factors associated with falls. Prevalence rates were 26.4 per cent at baseline and 22 per cent at follow-up, but rates varied, unexpectedly, across three ethnic groups: from 42.9 per cent for whites, to 34.4 per cent for coloureds (people of mixed ancestry), to 6.4 per cent for black Africans. This finding raises questions for future inquiry of the role of ethnicity in falls. Risk factors associated with the falls were primarily health conditions linked to non-communicable diseases and/.or their treatment. Kalula makes recommendations for falls prevention policy and intervention (specifically, older persons' empowerment through physical exercise), and improved management of falls within clinical practice. Contact Sebastiana Kalula for additional information.
- Persons with dementia and their caregivers: Care and support needs and responses
The Memory Clinic operated by the IAA at Groote Schuur Hospital through the University of Cape Town maintains a client profile database, and conducts studies on clinic clients and their caregivers. A research and intervention study is being developed by IAA and ILCSA investigators on how to best meet the care and support needs of persons with dementia and their carers in the database in the community. Contact Sebastiana Kalula for inquiries.
Progress and output of each of ILCSA's programmes and projects are reported on the website from time to time. New programmes are described as they are identified and operationalised. Interaction between ILCSA co-ordinators, associates and investigators, national and international stakeholder institutions and organisations, and South Africans of all ages and walks of life are key to the achievement of ILCSA's programmatic goals.