Medical Q&As

Geriatric assessment - procedure?

My 73-year-old mother had a mastectomy in 2001 and a complicated gall bladder removal last October. After both spells in hospital she experienced stiffness in her back and hips. A few weeks ago, she slipped on a step and now has severe pain from her hips down both legs. Movement is difficult and she has taken to her bed. She lives alone by choice. I would like her to have a general geriatric assessment, a proper diagnosis of her condition and a care management plan to get her mobile again. I have found her GP to be less than satisfactory in this regard. Where could I go to have a proper assessment and diagnosis made? What procedure I should follow?

It would be appropriate for your mother to be assessed by a geriatrician who could make a comprehensive assessment of your motherís current difficulties and formulate a treatment plan for her. Geriatric assessment and care is based on a team model and most geriatricians in Ireland work with a healthcare team consisting of doctors, nurses, chartered physiotherapists, occupational therapists and social workers. The first step in this process of assessment is for the GP to request such an assessment, which generates a home visit from one of the nurses on the team. The nurse usually visits and assesses the elderly person at home and then makes the arrangements for the person to be collected subsequently and brought to the outpatientís department for a more comprehensive assessment. The nurse usually takes some blood samples from the person on this preliminary visit in order that the team has some basic blood test results when the person first visits the outpatientís department. That visit usually takes up most of the working day and can involve input from several members of the geriatric team. It is the intention of such teams to try to provide a ďone stop shopĒ where as much work as possible can be done on the one visit thereby obviating the need for frequent returns to the hospital. This comprehensive assessment defines the personís global needs and a treatment plan is then formulated. I note your comments about your motherís GP but I cannot see how the doctor would not approve of and support the request contained in your question. The little vignette you have portrayed of your motherís predicament is exactly the sort of case that would merit from geriatric assessment. Your next step should be to contact your motherís GP and outline your request as succinctly as you have done in your question.