The Geriatric Medicine rotation involves a variety of learning experiences in various clinical settings. Educational sessions involve didactic teaching, a practical/evidence based critical appraisal of a clinical question, and bedside teaching. The resident is involved on a daily basis with members of the interdisciplinary health care team. The importance of interdisciplinary care stems from the literature. Comprehensive Geriatric Assessment with an interdisciplinary team approach has been shown to decrease nursing home placement, increase quality of life, improve cognition, improve functional status, reduce hospital readmission, and decrease mortality (Stuck, 1993; Rubenstein, 1991).
During the Geriatric Medicine rotation, residents learn how to perform a CGA in order to diagnose and manage common geriatric syndromes seen in this population (delirium, dementia, depression, polypharmacy, urinary incontinence, decreased functional abilities and falls). The settings for the rotation differs depending on the base hospital. All learners regardless of site will have opportunities in a variety of outpatient settings.
The geriatric rehabilitation unit is a 30-bed unit located at Parkwood hospital. It accepts patients from a variety of regional and local settings that include home, LTC, residential care, and acute care. The geriatric resident will participate as a member of the interdisciplinary team in the assessment, treatment and discharge planning of frail elderly patients. The resident will also complete geriatric consultations, on an as needed basis, for the in patients and residents at Parkwood hospital.
The Consultation Liaison Service is an acute care combined geriatric medicine and geriatric psychiatry consultation service that operates at each acute care site of LHSC. The team is composed of NPs, geriatricians and a psychiatrist. During this rotation, in conjunction with other team members, the resident will complete comprehensive geriatric and psycho-geriatric assessments on medically and cognitively frail elderly inpatients.