This Article Full Text (PDF) Services Download to citation manager PubMed PubMed Citation

HIGH TECH AND HIGH TOUCH

Geriatric Research Group Brescia Italy

To the Editor:

We would like to contribute to the discussion opened by the editorial of John Morley on the technological future of geriatrics (1).

We recently started, inside our Geriatric Unit at Poliambulanza Hospital in Brescia, an intensive care project on four beds equipped with high-tech instruments (for monitoring, noninvasive ventilation, and so forth). This fact and the history of our group, coming from long-term care but recently deeply involved in the development of acute wards for elderly individuals, gives us the opportunity of discussing technology from the side of users and not from that of critics without experience (2).

We feel that opposing high tech to high touch in geriatrics, that is, modernity against romanticism or machines against hands and heart, is culturally without a future. Our profession must handle both young-old people (mostly with preventive problems in whom the use of sophisticated techologies is necessary for an accurate prognosis and programs of activities) and frail old-old with a reduced residual function and a limited life expectancy (in whom technology is mainly involved in treatment). Both conditions need geriatric expertise and its cultural background, made up of a sense of time and respect for memory, a multidimensional perspective, and the ability to construct programs taking into consideration the soft and hard components of human life. The ability to utilize machines is necessary to be at the same level as other medical specialists, since technology leads to the development of all scientific disciplines. However, we should profess our pride also for the less-measurable components of the profession, that is, the ability to transform into therapeutical procedures both the evidence-based and the "narrative" components of a modern approach to medicine.

In this perspective, we agree with Robert Kane's comment that "care would be apportioned by need, not by age" (3). This statement could be rephrased as follows: "geriatric care is for the young-old and old-old, for acute and chronic care, for those with a high reserve level and for the frailest." Ours is a noble profession, although with low reimbursement levels, inducing geriatricians to adopt a broad, nonmodest, high-profile medical attitude.

Acknowledgments

Address correspondence to Renzo Rozzini, MD, Geriatric Research Group, via Romanino 1, 25122 Brescia, Italy. E-mail: renzo.rozzini{at}iol.it

References

Morley JE. Mobility performance: a high-tech test for geriatricians [Editorial]. J Gerontol Med Sci.. 2003;58A:M712-M714. Rozzini R, Sabatini T, Trabucchi M. The network for elderly care in Italy: only a correct use of acute wards allows an overall functioning of the health care system. J Gerontol Med Sci.. 2003;58A:M190-M191. Kane RL. The future history of geriatrics: geriatrics at the crossroads. J Gerontol Med Sci.. 2002;57A:M803-M805.

This Article Full Text (PDF) Services Download to citation manager PubMed PubMed Citation