[The need of providing a comprehensive civil service for the management of geriatric health care problems in the coming decades].
From (1) the Swiss population census 1980, (2) the calculations of the Swiss Federal Office of Statistics, referring to the probable age composition of the stable Swiss population from 1990 to 2025 (scenario 2A-86), (3) the meta-analysis of Jorm et al. [8] on the prevalence of dementia, and (4) a study of the Swiss Federal Office of Statistics on the nursing personnel employed by inpatient institutions for the care of the aged, it is concluded that the number of elderly patients suffering from moderate to severe dementia will increase in Switzerland from 48,000 to 92,000 during the years 1980-2020. In 1990 the nursing staff for the ambulatory and inpatient care of 62,900 patients with dementia numbered 17,100 full-time positions. The calculated need for such positions was 37,700 in 1990 and will be 55,200 in 2020. This major shortfall in nursing capacities, now and in the near future, can probably not be covered by an extension of extrahospital services and certainly not by increased training of nursing personnel. By analogy with the obligatory military service for young men in Switzerland, an obligatory civilian service for men and women, for the care of the aged, is therefore proposed.