Aged Care

 

Medical Students in Aged Care at POW

All POWCS medical students undertake 4 weeks in the Aged Care Department during Phase 2 as part of the Integrated Clinical Studies - B semester. This is a busy Department where you will see a lot of the important medical issues that affect our aging population. Students will be allocated to an Acute Geriatric team as well as have outpatient and community experiences.

 

Educational Activities

·         Weekly RMO/intern teaching – usually Thursday 2-3pm

·         Weekly inter-disciplinary teaching Thursday 1-2pm

·         Journal club alt Mondays during term time 5-6pm

·         Palliative care teaching- attendance welcome alt Tuesday pm 2-3pm(registrars only)

·         Grand Rounds on a Wednesday morning at 8am.

·         Interns and RMOs also have protected teaching time for two hours a week.

 

Aged Care Services at Prince of Wales Hospital

Acute Aged Care & GMAU Parkes 6

The Acute Geriatric service is located on Parkes 6. There may be additional outlying patients. There are four acute geriatric teams including the MAU team. The aged care teams include nursing and other allied health staff (physiotherapists, occupational therapists, speech therapists, pharmacists, podiatrist, dietician and neuropsychologist).

Each morning there is a 30 minute whiteboard meeting from 8.45am on Parkes 6 (9.00am on Wednesday) highlighting active and immediate plans for patients . A weekly case conference allows for more in-depth discussion of patient planning and care.

Eight ward beds (M1-M8) are designated a Geriatric medical admission unit (GMAU). GMAU has dedicated medical, nursing and allied health staff.  It is a rapid geriatric assessment unit with a 48-hour length of stay, after which patients can either be discharged from hospital/acute care or admitted to the Acute Aged Care Service.

The AACE (Acute Aged Care Extension) on Parkes 5

This is a 6 bedded unit located on the 5th floor of the Parkes building is designed to deal with the behaviourally challenging aged care patients who are physiologically stable but still have ongoing issues withbehaviour that requires management in a secure facility.

Aged Care Rehabilitation Parkes 5

There should be clear goals documented for rehabilitation.  Cognitive impairment or dementia in itself does not an exclude a patient from consideration for rehabilitation and many patients with cognitive deficits benefit from rehabilitation.  However, the medical records should reflect genuine signs of improvement shown during the in-patient stay before requesting rehabilitation and the Allied health team members should agree with the suitability for rehab.

Orthogeriatric Liaison Service

Given the number of older people with complex problems and acute fractures underorthopaediccare, the input here isformalisedand occurs on a regular basis. The purpose of the service is twofold. To ensure that all older fracture patients have an appropriate level of geriatric medicine review, assessment of the cause(s) of their fracture and consideration of bone health. In addition, patients are assessed with respect to their rehabilitation potential and whether they would benefit from a discharge with PACS or require a further period of in-patient rehabilitation.

Consults/ Ward Referral

The registrar of the team on call for the day will see consults that day and discuss management with their consultant.

Post Acute Care Services (PACS)

PACS is a hospital outreach service that delivers care at home – IV antibiotic therapy, warfarinisation/ dewarfarinisation, rehabilitation and transfusion. The Registrar working in PACS is an integral part of the multidisciplinary team caring for all of these patient types, referred from a variety of inpatient wards and Specialists, the ED, and GPs.  Therefore, this work will involve assessing patients at home or in the ED, participating in daily task oriented meetings and weekly case conferences with the multidisciplinary team.  Some of the work involves the medical supervision of these patients prior to discharge, such as on the Orthogeriatric service.  PACS is based in the McNevin Dickson Building.

Out-patient services

The department has an expanding range of outpatient services all of which have educational value for junior staff and students. Junior staff is encouraged to gain outpatient experience and should discuss with the relevant specialist if they wish to attend a clinic.

·         Falls clinic(Rehab Registrar and PACS Registrar attend)

·         Cognitive Disorders Clinic(AACE Reg attends)

·         Caplan general geriatric Medicine clinic (Caplan Reg and PACS Reg attends)

·         Sim general geriatric clinic

 

Research

Evidence based quality services for older people need to be supported by an active research program. Research can be anything from the basic sciences to the evaluation of new approaches to care. The Department of Geriatric Medicine has a strong research focus with an active Ageing Research Centre.  Junior staff are encouraged to consider small research projects to undertake during their term in Geriatric Medicine. If interested in undertaking research – juniors are encouraged to talk to a relevant member of staff for guidance and supervision. Within the department, there is staff with a variety of research interests and with links both to UNSW and theneighbouring NEURA.

Medical Student Coordinator: Dr Catherine McVeigh