Geriatric Services

The General Geriatrics clinic focuses on comprehensive geriatric assessments. 

The clinics are also used to review specific geriatric syndromes, such as:

• problems with walking and falls
• cognitive impairment
• polypharmacy (taking multiple medications)
• bowel/bladder difficulties
• functional decline
• frailty.

What to expect

• Patients should expect to visit the clinic and see a specialist 1-2 times (more may be required for complex cases), so a detailed assessment can be completed
• Blood or imaging tests may be required as part of the assessment. Certain cases may be referred to a neuropsychologist for more expert assessments
• The assessments will aim to include support persons to ensure a complete picture is built
• Finally a diagnosis and management plan will be produced and discussed with patients, carers and support persons.
• The diagnosis and management plan will be communicated to your GP and, if needed, to other support persons with your permission.

The memory clinic is a specialist assessment service that can assist patients, families and carers and GPs to understand cognitive changes and provide guidance on the steps going forward.

Early assessment of changes to thinking, communication, memory and behaviour is important to identify and initiate appropriate and personalised management strategies. 

This allows for someone living with cognitive changes and their supported members, to proactively engage with their changes and cope, if not thrive at home for as long as possible. 

Clinic services

• Diagnosis
• Non-pharmacologic management strategies
• Pharmacologic treatment options
• Information on resources
• Information on future planning and support for carers
• Cognitive supportive strategies

What to expect

• Patients should expect to visit the memory clinic and see a specialist 1-2 times (more may be required for complex cases), so a detailed assessment can be completed
• Blood or imaging tests may be required as part of the assessment
• The assessments will aim to include support persons to ensure a complete picture is built
• A personalised and comprehensive management plan will be produced and discussed with patients, carers and support persons.
• The management plan will be communicated to your GP and, if needed, to other support persons with your permission.

GITH is a 6 – 10 day hospital avoidance or substitution program, that operates as a comprehensive inpatient service based in the community. 

GITH is staffed by clinicians who specialise in Geriatric care and provide a holistic multidisciplinary approach. 

Patients admitted to GITH will be classified as an inpatient of the Royal Adelaide Hospital, and can receive up to three home visits per day from members of our team in their home, dependent on individual goals and clinical need. 

GITH patients also have access to 24-hour telephone support.

Referrals to GITH are considered for patients who:

• are over 65 years or older, or 50 years for Aboriginal and Torres Strait Islander (ATSI) who reside in the CALHN catchment (Adelaide metropolitan area)
• have potential for improvement in health and function within the duration of GITH (6-10 days)
• require a multidisciplinary approach
• have access to a telephone at home
• have a safe home environment for staff to visit.

MCGS is a multi-disciplinary team consisting of nurses, social workers, occupational therapists, physiotherapists, pharmacists, geriatricians and a registrar. 

Clients accepted to MCGS are generally complex, are considered most at risk in the community with little to no other support services.

Clients referred to MCGS often have a combination of the following scenarios:

• no formal cognitive diagnosis
• limited or no informal support
• no formal services
• resistant to support services
• live alone
• complex social situation
• suspicion of elder abuse
• risk to self or others
• BPSD
• frequent presenter to the hospital system
• failure to attend OPD
• no EPOA or ACD
• falls or reduced mobility
• insecure accommodation.

Clients who are not considered for our service include:

• have, or can access, existing formal or informal supports
• have a formal diagnosis concerning cognition
• can, or do attend OPD appointments.

If another service in the community can meet the needs of out of scope clients, they do not need to be assessed by MCGS, however they can advise and redirect to other community healthcare systems in place.

Referrals categorised as urgent will be reviewed within 2 business days. 

Those that are less urgent but need a holistic multidisciplinary geriatric assessment (including cognitive investigation and linking to support services via RAS/ ACAT/SACAT) will be waitlisted by priority.

IC RACF in-reach is an outpatient service supporting RACF patients to receive support in place and avoid transfer to hospital when appropriate.

Main services include:

• assisting with transition from hospital to RACF with outreach support
• utilising other out of hospital services as required
• providing the facility with confidence and support when accepting a new resident, particularly with Behavioural Psychological symptoms of Dementia (BPSD).