By Lesley K Bowker; James D Price, (Physician); Sarah C Smith, (Physician)
In an growing older inhabitants, geriatric drugs has develop into valuable to normal perform, and to emergency and normal inner drugs within the medical institution environment. illnesses are extra universal within the older individual, and will be quite tough to evaluate and to regard successfully in a box that has constrained facts, but makes up a considerable percentage of the paintings of so much clinicians. absolutely up-to-date, this moment variation of the Oxford instruction manual of Geriatric Medicine contains the entire details required to bring powerful geriatric care. counsel is given on quite a number key remedy components, indicating the place perform differs from that of more youthful adults or is ailing knowledgeable by means of facts, the place risks lurk for the green clinician, and at the many moral and scientific dilemmas universal in geriatric perform. This obtainable guide is vital studying for all junior medical professionals and expert trainees in geriatric drugs and common inner medication, and for all scientific and nursing employees who deal with older humans
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Extra resources for Oxford handbook of geriatric medicine
70) by a multidisciplinary team. However, more specialized services can be provided by individuals or teams that are missing some vital members (particularly medical or social work) and care is needed that important interventions (such as treatable illnesses or unclaimed beneﬁts) are not overlooked. The variety of different models makes it very hard to promote equity of access or research into the effectiveness and cost-effectiveness of the service. While it has been shown possible to provide almost all kinds of geriatric care in a community setting this does not necessarily mean that it is more effective, cost-efﬁcient, or even preferable for patient, family, and staff.
Other specialists, eg surgeons may hold outpatient clinics on site. Nurses and therapists are often very experienced in the care of older people, and are able and willing to work more independently from doctors. Nursing staff often lead the discharge planning process including multidisciplinary team (MDT) meetings. Staff turnover is often low, with a high proportion of committed, long-term staff. COMMUNITY HOSPITALS Community hospitals admissions Groups of patients being admitted include the following: Rehabilitation and discharge planning Often transferred from acute hospitals following surgery (elective or emergency) or acute medical problems.
Some projects concentrate on very speciﬁc groups (eg post-surgical fractured neck of femur in the >70 year olds) while others are more generic. Most regions have several complementary services. Examples of popular models are: • Discharge coordinating teams—nurse, therapy or social work teams that bridge the interface between hospital and community based services. They often act as gatekeepers for rehabilitation/community beds or supported discharge schemes • Hospital-at-home schemes—where intensive nursing and/or therapy input in the patients home can allow a patient to receive treatment without the need for admission to hospital or be discharged earlier • Front door teams—that recruit elderly patients from accident and emergency and assessment wards to improve assessment (eg provide an occupational therapy (OT)/physio assessment following a fall) and to make referrals to other services such as social workers, clinics, etc.