CARE OF THE ELDERLY

There are 4 care of elderly inpatient wards at Ipswich hospital, each with 28 beds. Out of these wards, 2 are complex elderly wards, 1 is a short stay ward, and 1 is a stroke ward. In addition to these wards, there is 1 orthogeriatric ward (staffed with orthopaedic junior doctors).

The care of elderly teams at Ipswich and Colchester hospital are some of the largest departments in the hospital. During a patient’s stay, there is great emphasis on prompt diagnosis and multidisciplinary rehabilitation. Maintaining dignity and individual privacy is extremely important and experienced therapy staff work closely with the medical staff to achieve this.

Ipswich Hospital

The care of the elderly team at Ipswich Hospital is made up of 10 consultants (including 1 orthogeriatrics consultant and 3 stroke consultants). There are 2 permanent speciality doctors and 6 speciality nurses (frailty and Parkinson’s disease). There are also 3 higher speciality trainees and 14 junior doctors (GP trainees, IMT doctors and foundation doctors).

There are 3 community rehabilitation hospitals (Aldeburgh, Felixstowe and Bluebird Lodge). Higher Speciality trainees have a rotation based in these community hospitals.

Colchester Hospital

The care of the elderly team at Colchester Hospital is made up of a large multidisciplinary team. Comprehensive geriatric assessment and care is provided by consultants and junior doctors supported by a team of dedicated and experienced specialist nurses and therapists, with input from borough-based social care practitioners.

There are 4 care of the elderly wards (28 to 36 beds on each ward). A typical day consists of a morning board round with the multidisciplinary team, to enable early discharge planning and rehabilitation plans. This is then followed by a ward round. New or unwell patients are reviewed by a consultant and the remaining patients are reviewed by junior doctors. Higher speciality trainees will usually review the care of the elderly outliers and any new referrals.

Training Opportunities

Care of the elderly medicine benefits from a wide variety of pathology which allows trainees to gain experience in managing a broad range of conditions. These include frailty, multimorbidity, polypharmacy, falls, dementia, delirium and end of life care. Care of the elderly is not only about prescribing medications and treating illnesses, but it is also about assessing patient’s needs, making them comfortable and keeping their relatives up to date.

Alongside the inpatient setting, there are a large variety of outpatient clinics that trainees are encouraged to attend. These include Parkinson’s disease, memory clinic, movement disorders. Higher speciality trainees will have clinics scheduled into their rota with the expectation to lead clinics. Internal medical trainees (IMT) will also have scheduled clinic time in their rota. They will have the opportunity to review patients with the support of consultants.

There is a daily rapid assessment TIA clinic which provides opportunities for trainees to review and manage patients who have been referred by the emergency department and GPs. There is also a frailty assessment base clinic which enables trainees to review and manage acute pathology with the aim to prevent admissions, where possible.

There is weekly lunchtime care of the elderly teaching, Each trainee takes it in turns to present at these teaching sessions. This departmental teaching covers the important topics relating to care of the elderly.

There are monthly M&Ms to ensure patient safety is at the center of the department. Quality improvement projects are also encouraged. Trainees are encouraged to support the teaching of medical students working in the department, predominantly those in 3rd to 5th year of training.