Change in Medical School: Emphasis On Care of Seniors (USA)

Wave of change in medical schools puts emphasis on care of seniors
By Alice Dembner
Globe Staff

By 2030, Americans age 65 and older are expected to account for about 20 percent of the nation's population, up from 12 percent now. Grants from two foundations and the Association of American Medical Colleges, awarded over the last eight years, have fueled the curriculum changes to meet the expected need for geriatric expertise.

"The vast majority of medical schools had little geriatrics until recently," said Rani Snyder, senior program officer for the Donald W. Reynolds Foundation, which has awarded nearly $60 million to 30 schools, including Brown, Harvard, and Boston universities. "Almost all our grantees are now making it integral."

At Harvard Medical School, students learn early on about end-of-life care, and practice basic doctoring skills at a nursing home. Boston University has added a unit on hip fractures to its required coursework. And the University of Massachusetts Medical School in Worcester, which received a grant from the medical colleges association, mandates that students discuss drug costs with visitors to the local senior center.

At UMass, there is new emphasis on another key issue in elder care - providing treatment continuity as elders move from hospital to home. BU, which has required students to take a geriatrics rotation for more than 50 years, is beefing up instruction about issues that are not strictly medical - such as elder abuse and helping patients walk or sleep better.

Rita Elquist, a 77-year-old resident of Winslow Gardens, has taught Brown medical student Daniel Cho another important lesson: how resilient some older people are. Elquist spent the holidays in a hospital and nursing facility, but returned home in good spirits, cracking jokes about toasting the New Year with orange juice and Lorna Doone cookies. Elquist said she hopes to teach Cho to listen to his older patients and be straight with them.

"Especially when you're elderly, you need to know the severity of what's going to happen to you," she said.