Which Patients should be under Which Patients should be under the care of Geriatricians?the care of Geriatricians?

D.M.Beaumont

RationaleRationale

Query from member as to whether guidance exists

Choose and BookNeed for publishable descriptors to assist

lay people and Health professionals understand scope of speciality

Suggested CategoriesSuggested Categories

1.Frailty related health problems2.Patients with specific conditions common

in advanced age but not exclusively3.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 1.Frailty related health problemsproblems

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 2.Patients with specific conditions common in advanced age but not common in advanced age but not

exclusivelyexclusively

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 3.Frail Older patients presenting to other specialitiespresenting to other specialities

E.g. Pubic ramus and upper limb fracturesConstipation or Pseudo-obstructionFalls with soft tissue injuriesElectrolyte disturbance and renal failurePatients with medical problems presenting

to Old Age Psychiatry

4.Vulnerable Older Patients where 4.Vulnerable Older Patients where legal and Ethical issues are likely to legal and Ethical issues are likely to

AriseArise

E.g. Cases known to POVA teams,Feeding Issues in Stroke or dementiaPatients lacking capacity

Older Patients best looked Older Patients best looked after by other specialitiesafter 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 BookChoose and Book

Each speciality divided into;

A. Clinic type- subdivision of speciality

B. Keywords- descriptors to aid search

Geriatric Medicine-Clinic Geriatric Medicine-Clinic TypesTypes

Geriatric Medicine Cerebrovascular Falls/Syncope Movement disorders/PD Heart failure Memory/Cognitive decline Day Hospital Bone Clinic

Geriatric Medicine-KeywordsGeriatric Medicine-Keywords

AnaemiaAssessmentBlackoutsCholinesterase inhibitorsMDT Falls assessmentOAP joint assessmentParkinsons Disease

Keywords -2Keywords -2

Stroke preventionStroke risk factor managementSyncopeTremor assessmentUrgent TIA assessmentWeight lossRapid access community assessment

More keywords ?More keywords ?

Incontinence Gait disordersCognitive impairment DementiaOsteoporosisBreathlessnessHypertension

Any Suggestions?Any Suggestions?