1. Geriatric Medicine Taster Evening “Acute Geriatrics” Dr Sally Jones Birmingham Heartlands Hospital

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3. What is Acute Geriatrics Acutely ill frail elderly patients Different models in different hospitals: – In A&E – In CDU – In AMU – Dedicated ‘frail elderly assessment units’ – Rapid access clinics – “Interface Geriatrics”

4. Why Acute Geriatrics The biggest “elderly care department” in the hospital is A&E Majority of older patients do not end up on specialist elderly care wards Geriatricians should be where the patients are Teaching/training of non elderly care staff Appropriate decisions right from the outset Facilitate earlier access to CGA

5. My Job A&E – “Front Door Geriatrician” Ward – Elderly Care Assessment Unit/short stay Clinics: – Rapid Access Elderly Care – Parkinson’s Disease Also: – Teaching in ED for junior doctors and ACP’s – Service development... ‘Front door’ elderly care Emergency pathways – in conjunction with ED and Acute Med Real chance to influence medical politics locally & regionally Geriatrician’s are now being listened to by many people!

6. Day in the life... First thing...a visit to CDU with OT and physio – Several frail patients observed there overnight – faints/falls, and a safeguarding problem. Who can go home? Mid morning...onto A&E – Fantastic range of medical issues to keep me busy! Older patients with postural hypotension, hypercalaemia, pancytopenia, deteriorating dementia, end of life – “can she go back to Nursing Home?” Discussions with families, GPs, SW...and on the job teaching for A&E junior docs. Lunchtime – Coffee with manager and A&E consultants about ideas & problems Early to mid afternoon...Rapid Access Clinic – 2 new patients sent from GP, one with Hb of 6, another with worsening heart failure. 4 patients I’d discharged home from A&E but brought back for review...3 better (very rewarding & good continuity), 1 needs more Ix Late afternoon – Big cup of tea in my office preparing teaching session on falls for the ACPs in A&E, and on delirium for the A&E middle grades.

7. Questions? Thank you