In Practice
Aged Care Views Dr Ken Cullen is finding it hard to retire gracefully. Except for the paperwork, he enjoys the two aged care facilities he looks after. What trends has he noticed over 40 years? “Facilities have evolved from big old homes to purpose-built hotel-like accommodation with physios, OTs, visiting speech pathologists, dieticians, podiatrists, opticians, etc. Despite all this, there are still unhappy residents and families. The demands on carers are high and people going into aged care are a lot sicker than they were,� he said. i8IFO * GJSTU TUBSUFE BU UIF 34- DPNQMFY UIFSF XFSF B MPU PG PME veterans with only simple medical problems who couldn’t manage on their own – almost like a boarding house where people could still get on a bus and go out.� /PU BOZNPSF )F DBO CF BU IJT CFE 34- BHFE DBSF GBDJMJUZ "$' in Menora from 8am until 5pm – a long trying day he admits but mentions spending extra time with patients and talking to relatives. “I look at medications I can cut out because I get sick of writing prescriptions and you often wonder if you are doing more harm than good – but I don’t have any particular philosophy. I am guided by family wishes – that might mean full-on care or, in many cases, just keep comfortable.� “I don’t get involved in the politics of it all but just do the job. I’ve always felt that regular visiting would help. Mental health provides a wonderful service with visiting psychiatrists but a geriatrician to provide management advice and at the same time educate me, would be great.� His wish list to stay in the game is less paperwork, relevant CPD, help with issues around medications, perhaps a specialist to come in and do some things, and nursing staff who can be relied on. He wondered how many people are sent off in an ambulance from an aged care facility because they couldn’t get a GP to go there. While the hard-to-get locum and Silver Chain offer some services, often informal arrangements between the GP and experienced nurses allow things to be started prior to the doctor’s visit. Then again, he suspects an available GP might only stop half the hospital visits that follow falls in the elderly. Two new things might interest Ken. The first is an attempt to cut down on ACF scripts. Legislation is coming this year to allow a standard Medication Chart in ACFs, a system already trialled interstate in August as the National Residential Medication Chart /3.$ CZ UIF "VTUSBMJBO $PNNJTTJPO PO 4BGFUZ and Quality in Health Care. The chart is to be used to authorise supply BOE DMBJNJOH PG 1#4 31#4 ESVHT GPS QBUJFOUT JO "$'T o OP XSJUUFO TDSJQU JT SFRVJSFE FYDFQU "VUIPSJUZ TDSJQUT BOE TDIFEVMFE ESVHT 4FF XXX DQB DPN BV BOE XXX TBGFUZBOERVBMJUZ HPW BV Dr Kathleen Potter (March edition Medical Forum) now has funding to extend her research nationally from WA, having safely reduced medications by 40% in her initial trial of ACF patients, with the assistance of their GP and a co-researcher geriatrician. O
By Dr Rob McEvoy
You can now prescribe exercise! As part of our commitment to health of Western Australia the team at Obesity Surgery WA, is now offering exercise programmes at no cost. To enrol, we need a referral to our practice for exercise. Everyone gets a health review to check their suitability and will get a personal plan or get to join one of our group sessions. The service is open to anyone who needs a little help to get fitter, even if they are not considering surgery. < Mr Harsha Chandraratna Surgeon Jo Climo > Clinical Nurse & Exercise Co-ordinator
Obesity Surgery WA (08) 9332 0066 SUBIACO
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