[Geriatrics--imbedding into the health care scheme of Germany]

In this paper, we first give an overview of the origins of geriatrics. We then give a description of the development of modern geriatrics in the United States and Great Britain, based on the work of Nascher and Warren. Finally, we give an account of the development of geriatrics in Germany. Clinical geriatrics, which first developed 20-30 years ago, has shown a high rate of growth in the last few years. However, recently there has been a slowing down in this rate of growth--if not a complete halt or, indeed, a counter-movement. The reasons for this somewhat negative development in the past five years are comprehensively discussed. In the last part of the paper, improvements which could be made in geriatrics are described, thus possibly achieving a uniform and self-assured provision of geriatric care in the future, in relation to four priority areas, with regard to outpatient and inpatient care. The first priority area is the care of geriatric patients at home and in nursing homes. To this end, geriatrics in priority areas will be promoted. The second priority is the development of geriatrics in hospitals (acute geriatrics departments and departments with rehabilitation as their focuses of activity). A third priority is geriatric rehabilitation clinics. Finally, we need a few geriatric centers in Germany (centers of excellence), geriatric departments with professorial positions and university clinics with geriatric departments in which geriatrics is taught and from which the impulse for research will be given.