Geriatric, Acute and Rehabilitation Medicine
The Geriatric, Acute and Rehabilitation Medicine (GARM) provides services for people aged over 65 with syndromes such as cognitive impairment, acute confusion, falls, declining mobility, frailty, incontinence and functional decline. These services include Acute Care of the Elderly, Delirium Care, Geriatric Evaluation and Management, Orthogeriatric Service, Stroke Rehabilitation Liaison, Vascular Geriatric Service, Consultation Liaison Service, Day Therapy Unit, Aged Care Assessment Team (ACAT) and Community Visiting Geriatric Assessments.
All external referrals should be sent via fax to Central Referrals Service on 1300 365 056. Enquiries only can be made by e-mail to centralreferralservice@health.wa.gov.au or by telephone to 1300 551 142. Hospital referrals for Outpatient services can also be made through the e-Referrals system.
Acute Care of the Elderly Unit (ACE – C16) provides Acute Medical care to people over 65 with syndromes including Cognitive Impairment, Acute confusion, Falls, Declining Mobility, Frailty and Functional Decline. “Comprehensive geriatric assessment” is undertaken utilising a multidisciplinary team to provide concurrent management of both acute medical problems and functional impairment. Once stable, patients may be discharged home or to rehabilitation units (eg Osborne Park Hospital). This model of care is used internationally and results in significant reductions in mortality, length of stay (LOS) and increases the likelihood of a person remaining in their own home 6 months after discharge. The ACE unit is located in ward C16. Current Consultants are Dr Elissa Campbell, Dr Brendan Foo, Dr Sook Ting Lee and Dr Sean Maher.
The Delirium Care Unit (DCU – C16) provides comprehensive geriatric assessment using a multidisciplinary team to provide assessment, management, and discharge planning for patients with acute delirium in a secure 10 bed setting. A consultation service for outlying patients with delirium is provided and ongoing review of these patients also occurs. Delirium care education is provided to hospital wards as well as to specific discipline meetings e.g. intern education. Currently, research is partnered with the Curtin University Health Innovation Research Institute (CHIRI). This model of care has been published – Wong M, Geddes J, Inderjeeth C. Innovations in Aged Care. AJA 2009. Delirium unit: Our experience. ACE unit consultants also provided DCU care.
Geriatric Evaluation and Management Unit (GEM – C17) provides comprehensive geriatric assessment using a multidisciplinary team to provide assessment, management, and discharge planning for patients requiring short stay rehabilitation for up to 10 days. The focus is to improve function and enable discharge readiness. The unit performs highly in benchmarking with other units in Australia for functional outcome and length of stay. Current consultant is Dr Kate Ingram.
The Orthogeriatric Service at SCGH consists of an Geriatrician (Dr Denise Glennon), Orthopaedic Nurse Practitioner (Ms Sharon Pickles) and an Advanced Trainee in Geriatric Medicine. We assist in the care of older patients admitted with orthopaedic conditions, such as hip fractures.
The service aims to:
- optimise the patient’s perioperative clinical condition to enable prompt surgical management and assist in the management of post-operative medical conditions and complications
- deliver early rehabilitation and multidisciplinary care
- co-ordinate and expedite discharge home or referral to rehabilitation services
All hip fracture patients are admitted under the joint care of Orthopaedic Surgery and Geriatric Medicine at SCGH. Patients are cared for according to the SCGH Hip Fracture Clinical Care Guidelines and Pathway. The aim of the guidelines / pathway is to ensure evidenced based best practice care is delivered to all hip fracture patients at SCGH.
Day Therapy Unit (DTU).
General Geriatric Medicine and Specialist Clinics (Falls, Fragile Bone, Memory and Continence) provide multidisciplinary team outpatient assessment and intervention for older people. The clinic appointments and community home visits carried out by the team focus on addressing issues of older age that can impact on independence and safety in daily living. Therapy interventions are provided both individually and in group programs. The DTU has been involved in the development and roll out of services and support for falls prevention on a regional and state-wide level.
Aged Care Assessment Team (ACAT) and Community Visiting Geriatric Assessments is a combined Commonwealth and State funded program for the assessment of the physical, functional, support, and medical care needs of older people in the community. The ACAT approves access to Australian Government services such as: Home care packages (levels 1-4), flexible care (transition care), residential permanent and respite care.
The Stroke Rehabilitation Liaison Service identifies stroke patients for early transfer to OPH for rehabilitation.
The Vascular Geriatric Service is based on the Orthogeriatrics model of care, to provide shared care to enhance perioperative care, and liaison to provide rapid access to rehabilitation and assist with complex discharge planning.
The Consultation Liaison Service provides consultation services to older people in other medical specialties for clinical opinions and assessment for rehabilitation and discharge planning including transitional care and residential care.