An Acute Geriatric Care Model to Meet Population Needs

Abstract

The purpose of this paper is to propose an enhancement of future acute geriatric care to meet the needs of an ageing population. Elderly patients should have access to the particular skills & experience of a physician trained in geriatric medicine and special services of a multi-disciplinary team. More physicians and nurses should be trained to meet the rising need. Early access to geriatric care in the acute phase could help reduce morbidity and optimize use of hospital resources. For an effective, efficient service and continuity of care, a structural and functional geriatric service is essential. The service should be led by geriatricians and supported by a multi-disciplinary team. There should be dedicated geriatric wards for the acutely hospitalized high risk frail elderly patients. A targeted approach to providing acute geriatric care (e.g. RCHE residents, elders presenting with falls, stroke, confusion, etc) is desirable Implementation of the proposed acute geriatric care model would be cost-neutral to start with, by striking a balance between geriatric commitments and non-geriatric commitments of geriatricians. There is potential for cost saving in terms of optimal use of hospital resources; improving flow between the acute, rehabilitation, reducing disability; and reducing institutionalization. These are some of the issues that must be confronted if we are to improve our present medical care of biologically aged patients and successfully negotiate the coming demographic changes. Or else, more and more patients might be hived off into residential care homes where they will spend their days in precisely the way that Marjory Warren in the 1940’s found patients in the chronic sick wards and which stimulated her to advocate the development of the specialty of geriatric medicine.