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Home > About Us > About Us > Division of Advanced Internal Medicine > Geriatric Service (Care of the Older Adults)

Geriatric Service (Care of the Older Adults)

Geriatrics is the branch of medicine that deals with the problems and diseases of older adults and ageing. We work together in a team comprising Geriatricians, Geriatric nurse clinicians, medical social worker, physiotherapists, occupational therapists and speech therapists. The geriatric team cares for the most complex and frail elderly populations. At the same time, with aging population, we drive the necessary changes in the delivery system to promote optimum care for all older adults in the hospital.

 

We provide various services including geriatric evaluation, ongoing care coordination, a physician-directed multidisciplinary team and a holistic approach to patient care that involves clinical, psychosocial and functional assessment. All the patients who are referred to our service undergo full comprehensive geriatric assessment which includes their medical, function and psychosocial assessment.

 

Our expertise includes:

  • Managing common conditions that affect older persons including dementia, falls, urinary incontinence, malnutrition, osteoporosis, sensory impairment and depression.
  • Recognising effects of ageing and underlying illness on clinical health, physical and mental function.
  • To educate on the appropriate use of medications to avoid potential hazards and unintended consequences of multiple medications.
  • Coordinating care among other providers to help patients maintain functional independence and improve their overall quality of life.
  • Assisting families and other caregivers as they face decisions about declining capacity, independence and end-of-life decision making.



The ACE (Acute Care of the Elderly) Model of Care  

 

In recognition of the ageing population, the ACE model of care is implemented for the hospitalised patients who are aged 65 and above. When the older adults are admitted, a protocol of care initiatives will be initiated by the nurses which include measures such as reality orientation, adequate hydration and bowel management and early mobilisation with the intention to prevent delirium and functional decline.

 

Patients admitted to the Geriatric wards are encouraged to ambulate at least three times daily. An individualised ADL (Activities of Daily Living) Board will be updated by the rehabilitation therapists so that healthcare providers can engage the patients in activities as recommended and assist them in ambulation with the appropriate assistive aids. Elderly patients, especially those with cognitive impairment will be engaged in cognitive therapy for mental stimulation. The goal of this model is to preserve their function and independence.



Advanced Internal Medicine/ Geriatric Home Transitional Care Programme


The Advanced Internal Medicine/Geriatrics home transitional care programme is targeted at our patients who require continued care after being discharged from the hospital, which includes rehabilitation and adjustment together with their family members and/or caregivers.

 

For more information regarding the Advanced Internal Medicine/Geriatric Home Transitional Care Programme, please click here.

 

 

 

Clinics

 

Geriatric Assessment Clinic

 

This clinic provides a full comprehensive assessment to address the complex care needs of an elderly person. The person who will benefit most will include those:

  • Above 65 years old
  • Have complex health problems and atypical presentation e.g. functional decline, memory decline, weight loss, urinary incontinence and overall decline in personal well-being

During the first visit:

  • A Geriatric nurse will assess the older person through clinical, cognitive and vision assessments.
  • This will be followed by a full assessment and examination by a Geriatrician, including medication review and walking assessment.
  • If necessary, the Geriatrician will request investigations to be done and / or refer to the physiotherapist for formal assessment of walking and caregiver training.

Subsequent visits will depend on the nature and the complexity of the problems.

 


Falls and Balance Clinic

 

This is a multidisciplinary clinic led by a Geriatrician with the aim of preventing elderly patients from subsequent falls and fear of falling.

 

The person who will benefit most will include those

  • Above 65 years old, and
  • Had fallen before and/ or gait balance problems

At the first visit, all patients will undergo a full comprehensive geriatric assessment and counselling if necessary.

 

For more info on the Falls and Balance Clinic, please click here.

 

 

Memory Clinic

 

The aim of this comprehensive multidisciplinary clinic is to provide an assessment facility for patients with complaints of memory problem.

 

After the initial assessment, we also provide patients and carers with information on memory management and services for dementia.

 

 

Outpatient Palliative Care

 

For patients who are facing incurable advanced progressive illnesses, this clinic serves to maximise the quality of life for patients and their families by symptom control, management of the underlying disease condition and psychosocial support. The clinic also liases with community support and home medical services in supporting seamless care for the patient and their families.

 

For all the clinics: It is preferred that the older person be accompanied by a close relative or caregiver, who is familiar with the patient's daily activities. They should also bring either the full medication list or medications along, especially at the first visit.

 

Geriatric Clinic

 

 

Monday

Tuesday

Wednesday

Thursday

Friday

AM

A/ Prof Dr Reshma Merchant

A/Prof Dr Reshma Merchant

 

Dr Ng Shu Ee

 

 

Dr Santhosh Kumar Seetharaman

 

(Registrar Clinic)

 

Dr Santhosh Kumar Seetharaman

 

(Fall Clinic)

 

 

(Registrar Clinic)

 

 

 

 

PM

 

 

 

 

 

 

 

 

 

 

 

 

 

Dr Loo Swee Chin

(IACC*)

 

(Registrar Clinic)

 

*IACC: Integrated Advanced Care Clinic