Yes I believe it is, however it is not getting as much media attention and financial investment as it needs. Social care need is increasing yet the funding and staffing levels required are years behind and must be boosted to prevent suffering and complications of inadequate support.

Geriatric Psychiatry, as we know it in some regions of Sweden, is an important part of the medical structure around the elderly with psychiatric illnesses and also around the younger individuals struck by dementing disorders.

G.P. ideally works hand in hand with neurology, psychiatry and geriatric medicine  and with several other specialties, as we have seen it happen in southern Sweden. 

Being responsible for the neuropathology in the same area, I want to recognize the value of highly  specialized colleges in Geriatric Psychiatry, in terms of skillful investigations and diagnostic work as well as of providing care.

I propose that Geriatric Psychiatry, a specialty as such, should finally be generally recognized and given all the space it needs to do good for those in need for their expertise. 

In the developing country like Nepal there is no geriatric doctor nor a geriatric nurse. I am a social gerontologist working in this field since last more than a decade.  I have also seen many doctors are not interested to go in the geriatric field. As the population ageing is the problem of all the country, sure geriatric medicine will be popular in developing country also but it will take time.

Mark,Elisabat and Hom,

Absolutely, it is the responsibility of the  Government /NGO's to care of the elderly who served the respective countries and at the same time the question of funding and necessary infrastructure (Hospitals,medications and staffing) is definitely a question mark.

The allocation of budget for the elderly care must be taken up after careful evaluation of the need by this population.Here i want to point out that the responsibility of the family is a paramount importance in empathize with the geriatric and should not be considered as a burden.  

The science of geriatric medicine is advancing but generally not the numbers of practitioners in the field. Few medical schools in the U.S. have a specialty in geriatrics. The Gerontological Nurse Practitioner certification as recently been discontinued and the certification that is in its place is now a combined Adult/Gerontological. In my more than 40 years of teaching in nursing education I have found it difficult to interest students in the practice of gerontological nursing. Combating ageism and valuing the older population could likely assist in enhancing the interest of students and practitioners in this area. 

Indeed Geriatric Medicine has its origin in the needs imposed by the demographic change during the XX century. However,'  to day, more than  50 years after its beginnig

it has  accumulated  much knowledge in treating as well as preventing and in offering

efficient  supporting medical services . This recquires resources but in a certain way it  saves resources and provides essential care and help to the elderly patients and their care givings.

Dear Sultan,

Thank you for your question. It would seem that the emphasis and importance placed on providing care and resources to elderly people, and the concurrent training of Geriatricians to look after them is going through a "U shaped" curve over the last 50-60 years.

In the early 1900s, work in this area really started in earnest with the formation of the National Health System in UK in 1948 by Aneurin Bevan, and the creation of the British Geriatric Society by Marjorie Warren and colleagues in 1947.

They both complemented each other as the NHS provided the means to enable to delivery of comprehensive Geriatric services to all based on need and funded by central taxation. The importance of this cannot be over emphasised, as often then those whom needs help the most can afford it the least, particularly for a majority of the elderly and very elderly in those days who do not have access to the benefits of pensions, state subsidies not the ability to afford private health care insurance or private health services prior to the second world war.

Services were streamlined across the country and available locally, close to where the elderly patients were. Also, the sheer scale of the NHS (i.e. every citizen and resident of the United Kingdom were it's pateints) brought with it the benefits of the economy of scale and allowed the provision of care to be rolled out on a large scale.

It was fertile land for the development and delivery of geriatric medicine.

With the passage of the NHS Bill (aka Health and Social Care Act) in 2012, the funding landscape will change drastically in the coming years.

 Care of Geriatric patients may still be a moral necessity, but it now carries with it the imperative to reduce costs of care and services. What is "efficient" and what is "necessary" is of course subjective and open to interpretation.

In developed countries, the availability of state pensions, state subsidies and personal savings will allow the access of the elderly and very elderly to services. However, in developing countries, there will likely be a generation whom will not be able to find the funds for these, nor have a sizeable political voice.

However, I believe that when the more well educated and financially more capable "Baby boomer" generation (1946-1964) and beyond joins the rank of the "Geriatric" population (i.e. >65), the importance of providing for an excellent geriatric healthcare service will become a political imperative once again. 

Hence the"curve" and attention will rise once more.

Dear Sandra,

I empathise with you as regards the difficulties that you face in attracting young clinical trainees. Similar picture is emerging with medical trainees. In truth and fairness, it is a difficult field to work in, having to deal with many end of life issues and the impact of chronic illnesses on frail elderly people, many living in difficult financial and social circumstances. Furthermore, the financial rewards and recognition for work in this very important area is often lacking.

Still I find it inspiring that there are people like yourself who can see the need for well trained clinical staff to look after the older patients. Many of the Geriatric nurses and assistants whom I work with both in UK and Singapore find great satisfaction in their work, and this remains the dominant factor for choosing and remaining in Geriatric nursing. I do my best to help by recognising their efforts, supporting them at work and encouraging all to further develop their skills and knowledge.

Last but not least, I have observed that a clinical focus on "independent living", "functional optimisation" rather than supporting dependency in isolation, and timely switching to palliative care for appropriate critically ill patients helps to promote optimism and reduce emotional "trauma" for the nursing and multidisciplinary staff, particularly those whom have just joined us.

I am sure there must be some research in this area but apologise for not having one to share at present..

I have to confess that I am a Geriatrician because of my love for Medicine, solving complex problems and of course, a love for the very elderly amongst us. I find great satisfaction in seeing them being able to continue an independent existence, full of dignity and free from pain and other distressing symptoms.

Best regards to you as you carry on forth to promote this vital area of nursing!

Dear S Chew, Well Said.