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Healthy Aging Initiatives
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Improving Oral Health Practices of the Elderly in Brazil

2008: $39,760 to the Federal University of Santa Catarina in Brazil to develop the best oral health practices for adults and the elderly in Brazil. As life expectancy increases in the Brazilian population, the failure in providing oral care to the elderly implies the emergence of new and more severe problems in health. Both a lack of available services and lack of knowledge about proper dental care and the importance of care are considered worrisome as the population ages.

Principal research on this project was carried out in the municipality of Antônio Carlos, Brazil. The researchers identified the best oral health care procedures for the elderly in the scope of local health service; provided education and training on oral health care for the elderly to the staff of local health care units; conducted educational activities in oral health with adult and elderly populations, as well as their caregivers; and more.

The results of this work will soon be published in Portuguese and English in a booklet to be shared with providers, the elderly and caregivers. Their findings on best practices include:

  • Educational and training activities regarding Oral Health Issues should be integrated with other health issues and all educational practices and opportunities.
  • Conduct information campaigns in relation to the most common diseases that affect the oral health of the elderly, including oral cancer.
  • Develop oral health educational material specifically for the elderly.
  • Provide continuing education for dental professionals.
  • Remove physical barriers and improved accessibility in the health units.
  • Organize dental home care services to enable the attendance of those seniors who have more difficulty or cannot get to health units.
  • Promote interdisciplinary work with other health professionals (like nutritionist, psychologist) and social workers, in pursuit of comprehensiveness of care.

Strengthening the Teaching and Training of Geriatrics in Latin America:

2006: $48,410 to the Pan American Health Organization to conduct a course on frailty in Bogotá, Colombia by at least 30 faculty members in geriatrics, introduce geriatric care to local health care workers in their communities, and organize a forum on public health and aging in Bogotá.

2005: $94,422.50 to the Pan American Health Organization to continue the expanding network of Latin American universities that are establishing programs in aging, ALMA. The project components included:

A course on cardiovascular care of geriatric patients in Lima, Peru for 35 primary health care physicians from 13 Latin American countries followed by in-service training and consultation with physicians specializing in geriatrics and workshop participants.

A workshop for 34 primary care physicians from one health district in Peru to learn about geriatric health care.

Design and development of a pilot ALMA website.

Presentation on work in aging adult health care by ALMA, the Pan American Health Organization, and the Merck Institute of Aging to an international audience attending the 18th International Congress of Gerontology in Rio de Janeiro, Brazil.

2004: $93,400 to the Pan American Health Organization to strengthen the continuing education of 30 geriatricians from 12 Latin American countries who will return to their countries as trainers in nutrition and aging, promote and improve training of 45 attending physicians for primary care of older persons in Costa Rica, and initiate a quality improvement program for geriatric care in Costa Rica. After the training-of-trainers course, most (88%) geriatricians reported improvement in their ability to assess the nutritional status of their elderly patients and to counsel them on diet and nutrition. The trained primary care physicians in turn trained 1430 primary health care providers from 13 cities throughout Latin America. An estimated 50 health professionals and policy makers interested in aging attended the Public Health and Aging Forum, an ALMA feature, which analyzed plans and programs in Cost Rica to detect, diagnose, and treat malnutrition in older adults.

2002: $49,400 to the Pan American Health Organization to strengthen continuing education of geriatric physicians and promote and improve the training of primary care physicians in older adult care in Latin America through courses organized by the Latin American Academy of Medicine for Older Adults (ALMA) in Mexico City. The continuing education course focused on memory, and ended with a public health and geriatric medicine forum in which health professionals from the Pan American Health Organization, and national and local public health officials joined the course attendees and coordinators in discussions on challenges facing the public health system as it develops an aging appropriate system of care. The materials produced as part of for the 2002 Primary Care of Older Adults in El Salvador project were used during the training workshop for the primary care physicians.

Improving Health and Reducing Disability in Older Adults through Health Promotion and Prevention of Chronic Disease:

2006: $42,000 to the University of San Martín de Porres in Perú and the Gerontology and Geriatrics Association in Bogotá, Colombia to support capacity building for physicians, development of an in-care service training program, and development and testing of tool kits for management of chronic disease in older adults.

National Policies in the Area of Essential Drugs and the Elderly:

2002: $7200 to the Pan American Health Organization to analyze drug legislation and selection of drugs for the essential drug list based on health needs of older persons and to provide priority countries help in the development of drug medication policies for the elderly in Latin America and the Caribbean.

Formed a working group on drugs for the elderly within the Pan American Health Organization;

Reviewed existing national policies for drug selection for the essential drug list;

Distributed policy review to the Ministries of Health in Latin America and the Caribbean;

Analyze data on medication use and accessibility to health care from SABE survey;

Developed a strategy for providing priority countries in the region with the necessary technical assistance in the development of drug policies to support the health and well-being of the elderly taking into consideration the needs and resources of each country.

Primary Care of Older Adults in El Salvador:

2004: $49,417 to the Pan American Health Organization to expand geriatric training to the national level in El Salvador. Between 2003 and 2004, use of health services by older adults increased 20%―the largest increase among all age groups. Other notable outcomes include:

  • Development of a health promotion and aging module and other educational materials in geriatrics for training 155 trainers-of-trainers (community health promoters) in 27 district health areas;
  • Basic training in care of older persons;
  • Creation and distribution of:
    1. training materials to 532 health workers from 133 health facilities
    2. the Clinical Guide for Primary Health Care of Older Adults, tool kits for health care professionals, and a screening guide for geriatric conditions to 393 health facilities
    3. a guide for training the health care team to the trainers in each of the 27 district health areas
    4. a standardized clinical history form for older adults to all health facilities
    5. a pocket guide with tools for functional assessment of older adults to all health facilities
  • Hosted a public forum for all universities and training institutes in El Salvador to promote the inclusion of basic geriatrics in the curriculum and to advocate for a geriatric training program in the country.

2002: $43,500 to the Pan American Health Organization to improve access and quality of care of older adults in El Salvador by strengthening the capacity of the primary care system (SIBASI) and developing a network of community health leaders in San Salvador, La Libertad, and Chalatenango with skills to promote, protect, and care for the health of older persons.

  • Implemented the Model of Integrated Health Care for Older Persons in cooperation with the Ministry of Public Health and Social Assistance of El Salvador;
  • Trained clinical professionals at selected health care centers in caring for older persons;
  • Trained health promoters to identify the needs and problems of older adults and to teach older adults self-care skills;
  • Produced training materials, evaluation tools, and self-care cards to be used beyond the end of the project.

The State of Aging and Health in Latin America and the Caribbean:

2003: $22,000 to the Pan American Health Organization to analyze health conditions of older adults and the readiness of health systems to care for aging population in Latin America and the Caribbean and to publish the analysis' results for policy makers, planning offices, advocates, and the media. The State of Aging and Health in Latin America and the Caribbean report was produced in both English and Spanish, and recommends actions to bring about improved access to quality health care for the elderly. After its distribution to health professionals in 38 countries of the Americas, there was a 25% increase in the petitions for technical collaboration in aging from Ministers of Health.

 
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