GERIATRICS IN SCANDINAVIA

Working as a Geriatrician in Sweden 

Life expectancy in Sweden is among the highest in the world: 79.9 years for men and 83.7 years for women. In Sweden, 5.2 per cent of the population is aged 80, which is slightly more than the EU average of 5.1 per cent. It follows from this that one of the main objectives for Swedish geriatric medical care is to minimise the limitations in activity due to illness and aging.

Today, there are 42 independent geriatric clinics as well as divisions in internal medicine clinics in Sweden. Many of these have acute care wards for an initial investigation of elderly patients, usually with further planning of care, and also wards for the rehabilitation of stroke and osteoporosis-related fractures as well as for palliative care.

In Sweden, it is important for the specialist to focus on the patient’s complete situation, i.e. the medical, functional, psychological, and social situation. Moreover, a cross-professional approach is essential, which requires coordination of interventions between different professions to meet the ageing patient’s complex needs.

Current healthcare studies show a growing demand for geriatricians, and there is a shortage in relation to available positions. Many geriatric clinics have an outpatient unit which is often specialised in osteoporosis, dementia (memory clinics), stroke or general geriatrics, among others. Private geriatric medicine clinics may only be found in the capital of Sweden, Stockholm, but almost all medical care –and especially geriatric care – in the country is financed publicly. Research in the geriatric field is quite developed and active in Sweden. There are six chairs in geriatric medicine located in Stockholm, Gothenburg, Malmoe, Linkoping, Uppsala, and Umea. While in Malmo and Gothenburg the research is mainly epidemiology in geriatrics and gerontology, in Umea it is clinical geriatrics (i.e. falls, delirium), while the units in Stockholm, Uppsala and Linkoping focus on dementia research. Almost all positions are in public universities and county hospitals, with experience in geriatric neurology surely representing an advantage in Sweden.

Working as a Geriatrician in Norway

Geriatrics in Norway have close connections with other specialities such as psychiatry, primary healthcare, neurology and rehabilitation. As a geriatrician practicing in Norway, you must have a holistic perspective. Geriatric patients do often suffer from several diseases and use many different medicines. The doctor has to consider the broad spectrum of health-related problems in order to provide the appropriate aid. The doctor must also work concurrently with the patient’s physical, psychological and social situation. For these reasons, it is essential to be collaborative and cooperate with a cross-disciplinary team.

Typical team members are doctors, nurses, physiotherapists and occupational therapists. Sometimes a speech therapist and a social worker are also included.

Treatment and rehabilitation must go on concurrently. The most common geriatric conditions you will face in Norway include dementia and stroke but also heart diseases (particularly heart failure), chronic obstructive pulmonary disease, arthrosis, Parkinson’s disease, osteoporosis and diabetes mellitus.

Norwegian geriatric research has improved remarkably both in terms of quality and quantity over the last ten years. Three out of four Norwegian universities have professorships in geriatrics, and a number of doctoral theses have been approved.

The demographic changes of the Norwegian population assure that the need for geriatricians will increase steadily in the coming years as the number of geriatricians is still too low.

Working as a Geriatrician in Denmark

There is an increasing need for geriatricians in Denmark due to the population’s higher average age.

There are 22 geriatric departments in Denmark. All departments have an emergency function and 90% of patients are immediate admissions. The period of hospitalisation has decreased from approx. 20 days to an average of 7-8 days over the last 8-10 years. Several geriatricians are employed in the common emergency admission departments, orthopaedic surgical departments, and neurological departments.

Working as a geriatrician in Denmark entails medical record-keeping, ward rounds, interdisciplinary conferences, conversations with patients and relatives, diagnostic conferences and outpatient departments.

Specialist doctors in geriatrics will work interprofessionally with other healthcare professionals including nurses, social workers, nutritionists, physical therapists, occupational therapists, pharmacists, and geriatric psychiatrists, and will focus on coherent patient pathways both internally at the department but also across sectors, in order to ensure optimal patient treatment and care. The most important collaborative specialities are the other internal medical specialities, gerontopsychiatry, neurology and orthopaedic surgery.

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