Geriatric Medicine

Geriatric Medicine is a medical specialty that focuses on providing care for older adults with complex medical, physical or psychosocial problems, particularly the older frail persons. Holistic care is coordinated and delivered through a multidisciplinary team comprising geriatricians, nurses, physio- and occupational therapists, speech therapists, dietitians and medical social workers. We work closely with community and primary care partners to address the unique needs of our older patients. Care is also delivered across the continuum from the inpatient to outpatient settings.

Inpatient Service

Geriatric inpatient services for hospitalized older adults in Sengkang General Hospital include the following:

Geriatric Assessment and INtervention (GAIN) unit is a specialty unit designed to deliver intensive geriatric and nursing care for hospitalized elderly patients with complex delirium or behavioural and psychological symptoms of dementia. The multidisciplinary team of geriatricians, nurses and allied health members will work with the patient and caregiver in the management of the acute illness, rehabilitation, and post-discharge care plans.

The Orthogeriatric Service looks after older patients with fragility hip fractures. The geriatrician works closely with the Orthopedic surgeons, anesthetists, allied health members and nurses to optimise patients with hip fractures for surgery and provide care during the perioperative period. We also advise family on discharge planning and osteoporosis management.

The Geriatric Perioperative Service (GPS) aims to optimise perioperative care for at-risk older adults who are being prepared for surgery. Older adults, especially those with underlying cognitive impairment, are more susceptible to perioperative delirium. Prevention measures and early detection of perioperative delirium can help to reduce complications and improve outcomes.

Geriatric Resources for Assessment and Care of hospitalized Elderly (GRACE) is a mobile nurse-led initiative to support general wards in the care of older adults with behaviour disturbance due to delirium and/or dementia, as well as falls. Patients will be reviewed daily by the geriatric specialty nurse and geriatrician to monitor their recovery progress.

We also review inpatient referrals for geriatric syndromes which include delirium, dementia, falls, immobility, incontinence and functional decline.

Geriatric Medicine Clinics

Department of Geriatric Medicine runs 3 different specialty clinics which include the Geriatric Assessment Clinic, Memory Clinic and Falls Clinic.

Geriatric Assessment Clinic

The Geriatric Assessment Clinic provides care for frail older adults with complex medical problems such as progressive decline in functional ability affecting self-care, mobility limitations, poor oral intake, and incontinence. Patients will receive comprehensive medical and functional evaluation, with an individualized care plan to address unique needs that have been identified. The team will coordinate the delivery of comprehensive care for older adults and their caregivers challenged with multiple geriatric syndromes, and facilitate the link-up with appropriate community services.

Memory Clinic

The sub-specialty Memory Clinic provides assessment and management for patients experiencing symptoms of cognitive decline. The patient will be attended to by our cognition nurse, along with a geriatrician with sub-specialty in cognitive disorders or psychogeriatrician, for a comprehensive assessment which will include an interview with the patient’s caregiver. The patient may be referred to our neuropsychologist for more extensive cognitive tests if indicated. The multidisciplinary team will work closely with the family to equip caregivers with the knowledge and skills for looking after a person with dementia, and assist to link the patient with appropriate community services. Mindfully Me is a group-based programme focusing on cognitive stimulation for patients with mild-to-moderate dementia.

Falls Clinic

The sub-specialty Falls Clinic caters to older adults with a history of frequent falls, or have problems with balance and stability. The patient will be assessed and managed by a multidisciplinary team of geriatric nurses, geriatricians with sub-specialty in falls and balance disorders, physiotherapists and occupational therapists. The assessment will seek to identify factors contributing to the patient’s fall risk, which will be managed to reduce future falls. Our therapists will work with patients to help them regain strength, mobility and balance, including training in the use of appropriate walking aids. The Fall Exercise Group allows participants to grow stronger and steadier together with the aim to prevent falls. It also includes an educational session on tips on fall prevention.

Peri-Operative Geriatric Assessment

We provide peri-operative assessment to optimize the frail older adult’s medical and functional status prior to elective surgery. Patients may be referred to our clinic by their managing surgeons.

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FAQs

What is geriatric medicine and what conditions can it treat?

Geriatric medicine is a medical specialty that focuses on the health and well-being of older adults. Conditions commonly managed under Geriatric Medicine include dementia, delirium, falls, osteoporosis, urine incontinence, malnutrition, and frailty. The specialty works closely with a multidisciplinary team, patient’s families and caregivers to deliver holistic care.

An important part of a geriatrician’s role is the prevention of disease and problems related to the ageing process.

When would be the right time to consult a geriatric doctor?

If you or your elderly loved ones are experiencing any of the following issues, you may wish to consult a geriatric specialist:

Incontinence
Declining memory, dementia and mood problems
Issues associated with polypharmacy (e.g. too many medications that may be difficult to take or may cause side effects)
Nutritional problems, difficulties with eating, or weight loss
Problems with walking due to weakness, joint problems or unsteadiness, often leading to falls, or difficulties with daily activities such as bathing, dressing, feeding, and grooming

We also care for elderly patients who have pre-existing and chronic diseases.

Is it ok that my dad still drives?

Many older adults will have to give up driving at some point. Seniors who are cognitively intact but have physical problems such as poor mobility, impaired vision or medication side effects will often retire from driving when they feel unsafe. Patients with dementia or memory loss do not have this insight. At SKH, our team of geriatricians can evaluate memory and make recommendations about driving safety. We will facilitate referrals for on-road driving assessment as appropriate. We understand that this can be of great concern for loved ones and often a difficult issue to deal with; we will be sure you have the help and support from our team to help you and your loved one make a decision.

My mum refuses to stay with me or my siblings and wants to be independent. We on the other hand are worried about her well-being. Is it safe for her to live alone?

Most older adults have a strong desire to continue to live independently and are willing to risk their safety for this. However, most children put a higher value on safety and want to intervene with help in the home or a suggested move. At SKH, our team of geriatricians can help evaluate a person’s functional status and memory to help recommend when and if additional help is needed or an alternative living situation should be considered.

Our Care Team

Our dedicated geriatiricans will ensure a rigorous process of diagnosis, as well as a complete treatment plan, follow-up care, and rehabilitation for you or your elderly loved ones. Our team of geriatricians aim to slow down the progress of any existing conditions where possible, alleviate pain, and help you or your loved ones live fulfilling lives by managing your health appropriately.