From the Guidelines
As a junior doctor in a geriatric ward, you can learn to apply the "Geriatric 5Ms" framework, which consists of managing the patient's mind, mobility, medications, what matters most to the patient, and multicomplexity, to provide comprehensive care to older adults. This framework is essential in evaluating and managing the complex healthcare needs of older adults, as highlighted in a recent study published in the Mayo Clinic Proceedings 1.
The study emphasizes the importance of considering the cognitive and psychological domains of a patient's health, evaluating mobility and fall risk, reviewing and reconciling medications, particularly high-risk medications, and assessing multicomplexity, which refers to the intersection of multiple chronic conditions and social determinants of health that influence the patient's healthcare management.
Key skills you can acquire in a geriatric ward include:
- Conducting comprehensive geriatric assessments to identify medical, psychosocial, cognitive, physical, and functional needs of older adults
- Developing expertise in medication management, including recognizing polypharmacy issues and adjusting dosages for age-related pharmacokinetic changes
- Managing common geriatric syndromes such as falls, delirium, dementia, and incontinence
- Improving communication skills with patients who may have sensory or cognitive impairments
- Engaging in ethical discussions around end-of-life care, capacity assessment, and advanced care planning
- Collaborating with multidisciplinary teams to provide holistic care that addresses the complex interplay between medical, functional, psychological, and social factors affecting elderly patients, as recommended by a recent study 1.
By applying the Geriatric 5Ms framework and acquiring these skills, you can provide high-quality care that improves functional status, quality of life, and mortality outcomes for older adults, which is critical given the predicted shortage of geriatricians and the growing population of older adults 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Learning Opportunities in a Geriatry Ward
As a junior doctor in a geriatry ward, there are several learning opportunities available. Some of the key areas of learning include:
- Patient deterioration recognition and management: Junior doctors can learn to recognize and manage patient deterioration in an acute ward setting, which is critical in a geriatry ward where patients are often frail and vulnerable 2.
- Geriatric syndromes: Junior doctors can learn about various geriatric syndromes such as dementia, delirium, and falls, and how to manage them effectively.
- Medication management: Junior doctors can learn about the safe use of medications in older adults, including the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer's disease 3, 4, 5, 6.
- Interdisciplinary team work: Junior doctors can learn to work effectively with other healthcare professionals, such as nurses, physiotherapists, and occupational therapists, to provide comprehensive care to older adults.
- Communication skills: Junior doctors can learn effective communication skills to interact with older adults, their families, and other healthcare professionals.
Clinical Skills
Some of the clinical skills that junior doctors can learn in a geriatry ward include:
- Assessing and managing cognitive impairment: Junior doctors can learn to assess and manage cognitive impairment in older adults, including the use of cognitive screening tools and the diagnosis of dementia.
- Managing chronic diseases: Junior doctors can learn to manage chronic diseases such as diabetes, hypertension, and heart failure in older adults.
- Wound care: Junior doctors can learn about wound care and management in older adults, including the prevention and treatment of pressure ulcers.
- Palliative care: Junior doctors can learn about palliative care and how to provide end-of-life care to older adults.
Non-Technical Skills
Some of the non-technical skills that junior doctors can learn in a geriatry ward include:
- Time management: Junior doctors can learn to prioritize tasks and manage their time effectively in a busy geriatry ward.
- Leadership: Junior doctors can learn leadership skills and how to lead a team of healthcare professionals to provide effective care to older adults.
- Communication: Junior doctors can learn effective communication skills to interact with older adults, their families, and other healthcare professionals.
- Teamwork: Junior doctors can learn to work effectively with other healthcare professionals to provide comprehensive care to older adults.