Transcript Which Patients should be under the care of Geriatricians?

Which Patients should be under
the care of Geriatricians?
D.M.Beaumont
Rationale

Query from member as to whether guidance
exists
 Choose and Book
 Need for publishable descriptors to assist
lay people and Health professionals
understand scope of speciality
Suggested Categories

1.Frailty related health problems
 2.Patients with specific conditions common
in advanced age but not exclusively
 3.Frail older patients who present to other
specialities but need input from
Geriatricians
 4. Vulnerable older patients where ethical
and legal issues are likely to arise
1.Frailty related health
problems

Acute presentations with loss of function e.g.
delirium, deteriorating self care, falls, found on
floor admissions,sudden incontinence
 Care home residents,EMI home residents
 Patients with chronic disease affecting functional
status ,e.g. Stroke,PD.leg ulcers,CCF
 Local agreement regarding 64-75 age group
2.Patients with specific conditions
common in advanced age but not
exclusively

E.g. Geriatrician involvement in services for
Stroke,PD,Dementia,DM, and heart failure
provided for patients of a variety of ages
according to local expertise
3.Frail Older patients
presenting to other specialities

E.g. Pubic ramus and upper limb fractures
 Constipation or Pseudo-obstruction
 Falls with soft tissue injuries
 Electrolyte disturbance and renal failure
 Patients with medical problems presenting
to Old Age Psychiatry
4.Vulnerable Older Patients where
legal and Ethical issues are likely to
Arise

E.g. Cases known to POVA teams,
 Feeding Issues in Stroke or dementia
 Patients lacking capacity
Older Patients best looked
after by other specialities

Age related systems may lead to certain patient
groups failing to access appropriate care
 Non frail patient with single system disease should
be looked after by organ specialists with help if
necessary
 E.g.MI, GI bleeding, pneumonia, Diabetic
complications
Choose and Book

Each speciality divided into;

A. Clinic type- subdivision of speciality

B. Keywords- descriptors to aid search
Geriatric Medicine-Clinic
Types
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Geriatric Medicine
Cerebrovascular
Falls/Syncope
Movement disorders/PD
Heart failure
Memory/Cognitive decline
Day Hospital
Bone Clinic
Geriatric Medicine-Keywords

Anaemia
 Assessment
 Blackouts
 Cholinesterase inhibitors
 MDT Falls assessment
 OAP joint assessment
 Parkinsons Disease
Keywords -2

Stroke prevention
 Stroke risk factor management
 Syncope
 Tremor assessment
 Urgent TIA assessment
 Weight loss
 Rapid access community assessment
More keywords ?

Incontinence
 Gait disorders
 Cognitive impairment
 Dementia
 Osteoporosis
 Breathlessness
 Hypertension
Any Suggestions?