Provide diagnosis, treatment and rehab of illness in older people.
The Complex Assessment and Liaison (CALS) service
The CALS service operates in the emergency zone, Level 0, Brunel building. It consists of consultant geriatricians (Dr Neubauer, Dr McCracken and Dr Richards), Advanced Nurse Practitioners, OTs, Physiotherapists, social workers and case managers. The team has developed strong links with the community to promote seamless care for the patient between primary and secondary services.
These patients will have a comprehensive geriatric assessment (CGA) which will address not only their initial medical presentation, but their co-morbidities, rehabilitation, psychological and social needs.
The team aims to improve the identification of patients with frailty syndromes such as, delirium, dementia, falls and incontinence and enable these problems to be addressed, improve sign posting to appropriate services, improve patient quality of life and ensure more patient centred and timely discharge planning.
The CALS team also cover some ward beds on Level 1, Brunel building for specific patients identified by the team as being able to be rapidly discharged with intensive input. They also provide advice to GPs via a “Geriatrician of the day” hotline.
Patients admitted with fractures
Medicine Older People is very active in the care of older patients admitted with fractures, particularly hip fractures.
Dr Harding's clinical work is now focussed on the trauma wards on Level 2, Brunel building and Level 5, Brunel building and all hip fracture patients are now admitted under shared care with the Orthopaedic Surgeons.
Dr Harding, Dr Walsh and Dr Srivastava now provide a daily consultant ward round (Monday to Friday) to assess and manage the medical needs of these patients, lead their multidisciplinary rehabilitation and contribute to planning discharges.
The Medicine for Older People department teaches forth year University of Bristol students for over forty-four weeks a year. Twice yearly exams take place in the Learning and Research, Southmead Hospital Bristol. The Department is also involved with teaching and assessing second, third and fifth year students.