Access to geriatric medicine occurs in a number of different settings, discussed further in services delivered.
People can be referred by their GP to a geriatric medicine service, and may be seen:
- in a traditional hospital outpatient setting
- in a ‘rapid access’ clinic, which often takes place in a day hospital environment
- in their own home if local consultants are also community based.
In addition to general clinics, geriatricians often lead clinics in subspecialties such as transient ischaemic attack (TIA) and stroke, falls, and Parkinson’s disease.
Many people will access specialist input as a consequence of attendance to an acute hospital. This could be assessment by a ‘front door’ interface geriatrics team based within the emergency department or medical admissions unit, admission under a consultant in geriatric medicine on a specialist ward, or review by a geriatrician after admission to a different medical specialty.
When someone is admitted to hospital under a different specialty, there should be a referral process in place to allow specialist geriatric assessment to take place on request. This could then result in the next stage of the person’s care taking place in a different setting (particularly if rehabilitation or reablement is needed), and provided by a multidisciplinary team, often led by a geriatrician. Another approach taken by some specialties is to provide a service run jointly with geriatricians, for example in the orthopaedic, general surgery, urology or oncology setting. This allows access to comprehensive geriatric assessment during treatment for other conditions, and helps to ensure such services are age-attuned.