Practitioner with Special Interest in Older People

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Practitioner with Special Interest in Older
People

• Dr Ian P Donald
• Consultant in Old Age Medicine
• Gloucestershire Royal Hospital

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Older People

• Arguments over title!

Fit, newly retired
1-3 LTCs Little disability
Frail older people
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Where are frail older people?

• Care Homes
• Community Hospitals
• DGHs hopefully not for too long!
• Intermediate care services
• Falls clinics

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What is frailty?

• Living with disability through multiple LTCs
• Diminished reserve causes vulnerability
• Disrupted homeostasis
• Those who require
• team approach
• comprehensive or holistic assessment

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What can a PwSI do?

• Specialist clinical assessment
• Leadership
• Education
• Clinical governance
• Service development

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What can a PwSI do?

• Clinical services
• CH wards
• Care Homes
• Day Hospital assessment services
• Intermediate care
• Improving Practice
• Models of service delivery
• Integrating care

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Training

• LOCAL
• Tap into training
• Mentorship
• Tailored to needs

• THEORETICAL
• Diploma courses
• University modules
• Reading materials

• PRACTICAL
• Working in a service
• Session attachment
• Within a team

• ONGOING
• AVOIDING ISOLATION

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Competences

• Identify those relevant for particular service
• Not necessarily at start work towards
• Demonstrate through assessment techniques

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Competency domains

• Comprehensive geriatric assessment
• Diagnosis of acute illness
• Management of major geriatric syndromes
• Diagnosis and management of common long-term
  conditions in older people
• Rehabilitation and multidisciplinary working
• Discharge planning
• Intermediate care and community liaison

• Care Home medicine
• End-of-life issues
• Falls and syncope assessment
• Continence assessment
• TIA and stroke assessment
• Orthogeriatric care
• Medicines management in older people
• Legal and ethical issues relating to care of
  older people