It was almost midnight when the intensivist emerged from the intensive care unit (ICU) of a private hospital in Cairo to reassure Hend, a teacher in her late 30s, that her mother was stable and should be spending no more than two to three days under close supervision before being admitted to a ward.
While the doctor was confident that Nadia, Hend’s mother, was only suffering from “a typical and highly manageable surge in blood pressure”, Hend was determined to consult with her mother’s geriatrician. After repeated appeals, the intensivist finally and almost reluctantly bowed to her request.
“I know they feel they can handle everything, but through experience I know that a geriatrician has important input to my mother’s care,” Hend said. “I just want to make sure that they consult with the geriatrician on the case because there have been times when my mother was prescribed medication at the hospital that prompted disturbing side effects,” she added.
According to her experience of close to five years, “things have been much better” since Hend first started consulting with a geriatrician. She explained that in addition to being highly attentive to small and often barely noticeable symptoms, the geriatrician has been doing “a very good job” in synchronising the different prescriptions that Nadia has to follow for her diabetes and high blood pressure and any other problem including a simple cold or chest infection.
The Geriatric Hospital of the Faculty of Medicine at Ain Shams University in Cairo would have been Hend’s destination of choice had it not been for the need to avoid wasting time in traffic. This is the only university hospital for the elderly in the country. While other schools of medicine at other universities have been opening departments of geriatric studies and some have been providing geriatric consultations at their day clinics, none of the other 124 university affiliated hospitals in Egypt has a similar geriatric hospital.
Situated at the heart of a large medical complex in East Cairo, the hospital originally started as a department launched in the early 1990s by three professors of internal medicine who had a vision for the medical care for the then growing segment of elderly people among the Egyptian population. Today, this segment constitutes about 10 per cent of the 100 million plus population.
About two decades down the road, the department had established a small hospital with limited capacity before it turned into what has become a six-floor one with large wards for patients, a large ICU of 21 beds, a unit for intermediate care with about 10 beds, and another unit of palliative care that provides essential medical supervision for older people with advanced medical problems.
“It was with a very generous donation that we received from the mother of a young man, Ahmed Shawky, who died young, that we managed to provide the necessary finance for this significant and highly purposeful expansion,” said Nourhan Basiouni, deputy director of the hospital that carries the name of Ahmed Shawky.
Herself a geriatrician, Basiouni is convinced that older people “need the presence of a geriatrician when they get ill, especially for diagnosis and prescriptions.” “There are symptoms that older people do not show for certain ailments, and the lack of such presenting symptoms could be misleading for some physicians who are not used to treating older people,” she said.
“At times older people, or their families, tend to ignore certain developments, like recurrent forgetfulness, as ‘a natural sign of old age’ when it is possibly a sign of a specific medical problem that could be contained if promptly diagnosed and could worsen if neglected or compounded by the wrong medical prescription,” she explained.
“If an older person catches a cold when they have an undiagnosed urinary tract infection [UTI] they could end up with septic shock. Often enough if they go to a pulmonologist, they might just receive a prescription to remedy the cold without inquiring about possible symptoms of a UTI, which is very common among older people especially those who have been temporarily put on urine catheterisation,” Basiouni explained.
In such cases, the right diagnosis and attentive examination could be a life-saving matter. She added that most elderly people need to be examined by a team, and a geriatrician needs to be part of it.
Moreover, she added that when admitted into an ICU, especially for a relatively long period, older patients need to be offered physiotherapy and possibly psychological assistance to make sure that they exit the hospital in good shape and can retrieve all their functions.
Basiouni is happy that more younger graduates of the Faculty of Medicine at Ain Shams University are opting to specialise in geriatrics because this allows for more geriatricians to be present in emergency rooms (ERs) and in the in-patient wards of more hospitals, including both public and private.
MEMORY COUNTS: The discipline of geriatric medicine started in the early decades of the 20th century and was established by the middle of the century.
According to the medical definition of the term, geriatrics is the medical discipline that is concerned with the physical, mental, functional, and social aspects of disease as well as its acute, chronic, rehabilitative, or preventive treatment and care in patients of old or older age, including in the end-of-life period. The main goal of geriatric medicine is to promote health by preventing and treating diseases and disabilities in older adults.
“This is why we decided that it is important for our work to include a special unit particularly tailored to memory enhancement, because with old people the better their cognitive functions the easier is the management of many of their problems,” said Mohamed Shawky Khater, head of the Memory Unit at the Ahmed Shawky Hospital.
This unit, he explained, is designed both for prevention and for treatment as it provides training sessions for older people with potential or early memory problems and helps them avoid, control, or reverse these problems.
“With a higher average life expectancy and a higher risk of different levels of dementia forecast for older people, it is crucial to work on enhancing the cognitive functions of individuals to help them maintain their mental and physical functions,” Khater said.
According to the Central Agency for Popular Mobilisation and Statistics (CAPMAS), life expectancy for men has risen from over 68 years old in 2022 to over 69 years in 2025. CAPMAS noted that for women life expectancy has increased from over 73 years to over 74 years. Egypt’s aging population, which is currently assessed at around nine million, is expected to hit the 22 million mark by 2050.
At the same time, the World Health Organisation (WHO) projects a significant increase in dementia cases in Egypt as part of a global and regional trend, essentially due to increased life expectancy. The number of people with dementia is expected to increase from 57.4 million in 2019 to 152.8 million in 2050.
In Egypt, around two to five per cent of the population over 70 years of age suffer from some form of dementia. Around one fifth of individuals over the age of 80 suffer from it. The WHO has called for greater dementia awareness and education in response to increasing global prevalence. It has also called on all nations to develop national dementia plans. In Egypt, a Ministry of Health source said that work is already underway to create a national dementia registry.
“Increasing awareness and reaching out to those who need help is at the core of our work,” Khater said. A patient with better cognitive skills, he added, is more likely to remain independent and less prone to depression than a patient with declining cognitive functions.
“Moreover, it is easier for patients with better cognitive functions to express themselves, and this is crucial for them to register all sorts of physical problems and to be able to communicate these to their families and doctors, making treatment and recovery much easier,” he said.
He added that the Memory Unit is the place where individuals can get their cognitive functions assessed and where they can get medical help to overcome their present or future problems.
With this specific unit now entering its third year, Khater, who is seeing more older people at the Cairo Seniors Clinic that he established two years ago, is becoming more convinced than ever that a lot of problems can be avoided if there is sufficient awareness of dementia.
“I think awareness is starting to pick up, and when I look at where we are today compared to where we were around the year 2000 when I started to practice, I would say we are on the right path,” Khater said.
A special tribute is due to four medical doctors who initiated the discipline of geriatrics in Egypt “well before it started elsewhere in the region,” he said. These include Abdel-Moneim Ashour, Mohamed Al-Bakouri, Moatassem Salah, and Ahmed Kamel Mortagui, all names that should be accredited for developing this “increasingly crucial medical service in Egypt”.
Telemedicine is one of the key services provided by the Ahmed Shawky Hospital. This service started in 2020, and it has since expanded significantly. During Covid, from 9am to 9pm daily on telephone and WhatsApp number 01558572144, the hospital received the enquiries of patients or their families. Early advice is offered by phone, and then patients are directed to consult with the geriatrics departments at outpatient clinics.
According to Hoda Wahba, director of the Ain Shams Faculty of Medicine Virtual Hospital, there is a team of experienced doctors in all disciplines, including geriatrics, who offer diverse online services to help reach out to patients with movement difficulties or who live outside of Cairo, the latter being around 40 per cent of the regular patients.
“Often times, this can help the patient and their family from having to make repeated visits to outpatient clinics,” she said. She added that particularly for patients with dementia and their caregivers, the virtual hospital offers training courses to help fix behavioural side effects of their problems.
While some of these services are offered at affordable prices, Wahba said, most services are offered free of charge. “With older people, this has proved to be very important as it has encouraged more people to pursue remote medical help and be spared from having to be rushed to the ER or, worse, to the ICU,” she said.
Currently in the making is a medical package called Sohba (companionship) that allows for regular home visits and other medical services to be provided for patients who do not need to be hospitalised but just need medical help for treatment or rehabilitation in the comfort of their own homes.
According to Khater, rehabilitation is crucial to the services managed by the geriatric hospital. “Rehabilitation for older people is essential for their well-being in general, and it is not just about people who have suffered injuries but is also required for people who have long hospital admissions that interrupt their daily routines and functions,” he said.
PRIVATE FACILITIES: When Karim started to get worried about his father’s memory, he consulted a neurologist who suggested that the retired 85-year-old Hussein needed to get a bit of memory training.
A banker in his early 50s, Karim has a demanding job, and he needed to consider help for his father. Opting for the nearest service available, Karim suggested that his father attend the memory rejuvenation sessions of the Cairo Seniors Clinic.
While Hussein resisted in the beginning and argued that he did not have much time left, he ultimately surrendered when his wife, Nawal, decided that she would join him. A few months down the road, Karim said both his parents are in better health. With access to the other services at the medical centre, he added, his parents have also dropped the distrust that they were developing of regular medical checkups.
For other people who need more intense medical attention, Khater said, several private hospitals in Cairo and some other governorates have started to set up special wards for geriatric care in addition to including geriatricians in outpatient clinics.
According to Hisham Al-Menawi, one of the founders of the Fawkia Hospital, a private hospital dedicated to offering medical services for inpatients and outpatients, it is not just older patients who need a geriatrician’s help but also the families of these patients. “It varies of course, because in some cases we are talking about patients with mild cognitive symptoms and other times we are talking about bed-ridden patients who need a lot of careful care and attention,” he said.
It was after the personal experience that Al-Menawi, himself a plastic surgeon, and his two brothers, also physicians, went through with their parents that they launched Fawkia as a place to provide memory care, physical therapy, mental wellness, and other medical treatment for older people. While their father had to be hospitalised due to a paralysing illness, their mother developed Alzheimer’s.
The fact that both his parents were prominent medical doctors and that he and his two brothers were at a loss about giving them due care “was both painful and inspiring”, he said. “It made us think that something is missing in the structure of existing medical services, and this something is a place that can provide diverse levels of medical care for older people.”
In 2017, Al-Menawi and his brothers launched the first phase of their tribute to their parents: a private hospital equipped with all the necessary medical equipment, highly trained medical teams, and a sufficient level of care for older people. Situated in 6 October City, Fawkia has expanded to offer diverse medical services and to include a care home that offers medically supervised and assisted living services.
Clearly, this is a place that requires either generous health insurance or large medical savings. However, as Al-Menawi said, while some people may find the bills too expensive or simply unaffordable, for people who have to live overseas away from their aging parents, Fawkia is not necessarily expensive as it allows them to secure the kind of care and comfort that is required.
“Obviously, there is room for more services of this nature, and it is very important to include geriatric services in as many public and private health facilities as possible,” Al-Menawi said. He added that it is reassuring that geriatrics medicine is set to be included in the National Health Insurance that has been launched in some governorates, especially as many insurance companies do not offer services for people over the age of 70, “precisely the time when people are more in need of medical help,” he said.
Al-Menawi said that his “dream is to see elderly villages” in Egypt, which would consist of compounds of small serviced apartments that older people can move to for a less stressful and more pleasant social life.
BLOOMING SEASONS: The promotion of a pleasant social environment in parallel with tailored health services and activities for older people was the motive behind the launch of Blooming Seasons, a recently inaugurated centre in Maadi.
According to Yasmine Al-Shafei, one of the co-founders, the idea started when one of the others, an Egyptian dentist working in Canada, thought that there was a gap that needed to be filled, especially in dental care, between a country like Canada where even men and women nearing 100 years of age pursue dental care and Egypt where even younger people can see it as a luxury.
What was originally conceived of as an advanced and non-costly dental service for older Egyptians has expanded into what has become a two-floor centre that offers diverse medical care at affordable prices, “with patients being entitled to get at the onset a discounted service.”
“The idea is that we want to offer prime but affordable medical care to a very high standard compatible with that offered in the developed countries,” Al-Shafei said.
With the founders invested in providing the centre with the most advanced medical equipment, the money generated from those patients who wish to pay in full is used to partially cover the service for those who need a discount or those who get free services.
Not a charity or a private investment facility, Blooming Seasons is designed to encourage older people not to feel helpless about their medical issues and not to settle for an unfulfilling retirement. According to Menna Shawkat, a geriatrician and medical director of Blooming Seasons, it is about “a fusion of the multiple services that an older person could benefit from to stay healthy, alert, and fully functioning.”
“People will come to get a dental checkup or a physiotherapy session, and then they will be encouraged to get an overall checkup to assess their physical and cognitive health or choose to join an art therapy class,” Shawkat said. “The idea is about complementarity,” she added.
Since the opening of the centre in October, not long after the International Day for Older People, Shawkat said that it has been working to offer its services every day from 10am to 6pm. “This is a start, and we are hoping to expand our service hours,” she said.
In fewer than three months, social media and word of mouth about the health promotion check-up package have started to get people going to the centre. The flow has been enhanced owing to its diverse services that include dental repair, memory enhancement programmes, pre-and-early-dementia treatment, and women’s health programmes.
Shawkat said that a core concept of Blooming Seasons is to encourage older people to break away from the assumption that old age and ailments are synonymous. “This does not have to be the case, and this assumption has to be dropped,” she said.
* A version of this article appears in print in the 18 December, 2025 edition of Al-Ahram Weekly
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