Elderly medicine Rotation

 Published: 21/04/2023

Disclaimer: my advice comes from my experience of working in an Acute University Hospital Trust, however a lot of this advice can be used for other settings.

Preparation advice 

• Practice completing thorough social histories of the home environment e.g. equipment, indoor and outdoor mobility baseline and FRAT Score 
• Knowledge of factors contributing to falls, balance outcome measures and falls management resources e.g. Get Up and Go Booklet and balance groups in the community
• Awareness of the NICE Falls guidelines
• Knowledge of frailty and comprehensive geriatric assessment
• Fit for frailty guidelines from the British Society of Geriatrics 
• Frailty syndromes  (page 8 of the PDF)
• Knowledge of types of delirium and how delirium differs from dementia 
• Common conditions: falls, dementia, delirium, frailty and mobility reduction
• Knowledge of symptoms of fracture and Occult fracture guidelines (e.g. missed fractured neck of femurs)
• Awareness of pressure ulcers and pressure care (to enable referral to Occupational therapists for at-discharge pressure care equipment)

On the rotation

• Utilise a social history crib sheet to collect all the important relevant information e.g. continence, equipment and mobility. Occupational therapists are the best resource for learning how to take thorough social histories from
• Discharge planning from day one - this area tends to have a quick turnaround to reduce the risk of hospital-acquired diseases so early discharge planning is paramount 
• Work with your supervisor or seniors to learn about the trust-specific discharge options and discuss which would be appropriate for each patient until you are confident and competent 
• Learn from your peers and seniors 

Other resources

• CSP (2015) Get up and Go - a guide to staying steady English Version: https://www.csp.org.uk/publications/get-go-guide-staying-steady-english-version
• British Geriatrics Society (2022) World Guidelines for falls prevention and management in Older Adults: A Global Initiative https://www.bgs.org.uk/wfg
• Clinical Physio Balance On-demand webinar (also available on their membership site)
• Clinical Physio Patients that fall on-demand webinar (also available on their membership site)