Systems of care in Neurology and the elderly's health are discussed during event in Rio de Janeiro

Rehabilitation clinic Sinapse and the National Union of Self-managed Health Institutions [UNIDAS] promoted on April 03, 2017, the event "Systems of Care in Neurology and the Health of the Elderly", in Rio de Janeiro, attracting managers, doctors and health professionals. Four lectures were given by specialists in neurological problems in the elderly, who addressed the themes of prevention, education, and care in the aggravation phase and in the rehabilitation of these patients.

Dr. Charles André, Associate Professor of Neurology at the Federal University of Rio de Janeiro [UFRJ] and a partner at Sinapse, spoke about "Care in Prevention and Community Education", addressing the importance of controlling risk factors in chronic noncommunicable diseases such as stroke, cancer, depression, dementias etc. (which are the cause for almost half the world's deaths). The professor highlighted the fact that, in underdeveloped countries, there is a disproportionate number of deaths from these diseases before the age of sixty, reaching almost half of the cases, compared to less than 30% in developed countries. According to the specialist, all these diseases have common risk factors, which can be obesity, diabetes, smoking and alcohol consumption. Thus, Brazil has signed a commitment with WHO, called "Plan 25-25", to reduce the mortality from these diseases by 25% in the next 25 years. "The challenges are many in Brazil and encompass not only the government, but the entire society, especially in terms of funding and coherent management of all these interventions", Dr. Charles added.

Dr. Daniel Paes Santos, Sinapse's technical director, then addressed the "Care in the Aggravation Phase, Exploring and Recognizing Therapeutic Limits" in his lecture. He talked about the impact of the systems of care on the elderly's health, providing a better clinical outcome and greater rationalization of costs. The neurologist advocated a more holistic view of the treatment and the importance of patient care ranging from primary prevention to neurological diseases, treatment in the acute phase, rehabilitation and reintegration of the elderly into society. Paes also highlighted Brazil's gloomy reality: the high level of third-party dependency of the elderly who leave the hospital after a stroke, being restricted and without access to a well-done rehabilitation process. "With the demographic transition the country is experiencing, with a large increase in the elderly population, the high dependence on third parties by the elderly translates into a major concern for Brazilian public health," the doctor said.

Physiotherapist Manuel Lopes gave a lecture on "Care in Rehabilitation and Reintegration in the Community," revealing that adequate rehabilitation can make post-hospital benefits and community integration more effectively. The physiotherapist showed that it is necessary to have a functional evaluation of the patient, using functional independence scales, to be able to trace the best reintegration strategies for each patient in the community after leaving the hospital. Lopes emphasized that, often, the greatest obstacle and determining factor for the non-integration of the elderly in society after a stroke is the decreased aerobic capacity, accompanied by a lack of motivation, and not so much the lack of coordination or other consequence of the disease - on which, traditionally, rehabilitation was focused. "Even with motor deficit, by improving the conditioning of the patient, reintegration will be faster and more effective", the physiotherapist commented.

The event's fourth lecture was given by Dr. Renata Aranha, MD and director of the Berkeley Institute, on the theme "Training in Systems of Care in Neurology: from Simulation to Reality". The specialist addressed the steps that comprise the process of professional training and how appropriate training can influence the performance of the professionals. In addition, she showed how the training process can be carried out in the context of virtual rooms, new technologies and how this is effective in developing medical protocols.

Paes, speaker and representative of Sinapse, one of the creators of the event, evaluated the lectures as very positive in the discussion of important issues related to the processes of care to the elderly, in order to increase perception capacity and the improve the treatment offered to these patients.

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