We see people with multiple health needs for Comprehensive Geriatric Assessment. This is either through a consultant-led clinic or as part of a multidisciplinary assessment service where people are seen by doctors, nursing staff, and therapists. This are held in the Western General’s ARC and Leith Community Treatment Centre’s OPRA
Our service sees patients who have:
- Dementia and memory problems
- Osteoporosis and thin bones
- Fallen or have mobility problems
- Parkinson’s disease and similar movement disorders
- Had a stroke or TIA
- Dizziness
- Weight loss
- Heart failure
Coming to Clinic
Most clinics are held at the Western General Hospital in either:
- The outpatients department of the Anne Fergusson Building (outpatients on the Lower Ground floor),
- Medical clinics in Leith Community Treatment Centre.
When you come to a clinic please bring with you an up-to-date list of your medications, including any herbal medicines or tablets you buy yourself from the chemists or other shops that do not need a prescription.
We often have nursing and medical students in the clinic who are here to learn about medical care for older people. We will invite patients to help us with teaching. This is always with your consent and does not affect the treatment you receive in the unit.
We may need to do a physical assessment, so wearing easily removable and comfortable clothing is helpful.
We will always ask for information about your GP and next of kin on arrival in our clinics, to keep our systems up-to-date.
Getting the most out of your appointment: Encouraging patient questions
While it should primarily be the responsibility of professionals to ensure that they are providing information that is accurate, relevant and understandable it can also be beneficial to support patients and service users in feeling comfortable to ask questions. As part of this patients need to feel that it is acceptable to ask questions, that the questions will be listened to and to know the types of questions they should ask.
There may be specific questions that a person wishes to ask about such as the impact of their condition on their ability to work or care for a family member, it is important that they feel comfortable and confident in asking questions and in being active partners in any decisions that are being made about their health or care.
One of the most common methods is called ‘Ask me three’, this method encourages patients to ask three questions which should provide them with the key information that they need to know about their condition and situation:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
Additionally, Choosing Wisely UK focusses on shared decision making using BRAN to encourage patients get the best from conversations with their healthcare professional by asking four questions.
- What are the Benefits?
- What are the Risks ?
- What are the Alternatives?
- What if I do Nothing?
This is a collaborative process in which doctors and healthcare professionals work together with patients to select tests, treatments and care management or support packages, based on clinical evidence and patients’ informed preferences and values.
ARC & OPRA
The Assessment and Rehabilitation Centre (ARC) and Older Persons Rehabilitation & Assessment service (OPRA) offer a service where elderly people with multiple health problems can see a specialist doctor, nursing staff, and therapists to provide a comprehensive assessment, intensive treatment, and hopefully prevent a hospital admission. The ARC is in the Western General Hospital and OPAH is in Leith Community Treatment Centre
A person can see the whole team or individual members of the team depending on their needs, and a visit may last several hours. We provide lunch, tea, coffee and snacks if necessary.
If you need to use hospital transport to get to and from your appointment, then this can be arranged using ambulance minibus.
Once here, you’ll firstly be booked in by the reception or nursing staff. Then you will have an assessment by a nurse. This will then be used by the doctor or therapists to see what treatment we can offer. This may mean further investigations, an occupational therapy home assessment or physiotherapy.
Physiotherapists provide assess and manage people at risk of falls, or those with mobility or balance problems. We provide group balance classes as well as individualised assessments and other forms of rehabilitation.
Occupational therapists assess people’s functional ability. This often focuses on how to help support them at home day to day and keep them as safe as possible. For example, occupational therapists can provide some aids, alarms, or recommend adaptations at home, and consider if regular carers are needed.
We may need to do a physical examination, so wearing easily removable and comfortable clothing is helpful.
We will always ask for information about your GP and next of kin on arrival in our clinics, to keep our systems up-to-date.
In addition, people can also visit the ARC if they need a blood transfusions and other therapies given through a drip.
We often have nursing and medical students in the clinic who are here to learn about medical care for older people. We will invite patients to help us with teaching. This is always with your consent and does not affect the treatment you receive in the unit.
We also have staff in the unit who are available to make a drink and have a chat whilst you’re with us
Parkinson’s Disease and Movement Disorders
NHS Lothian’s website has more information on it’s Parkinson’s Disease Movement Disorder services.
Proactive Care of Older People in Surgery (POPS) Team
The Proactive Care of Older People in surgery (POPS) team started in 2013 and has rapidly grown. It is recognised locally and nationally as being of high quality, innovative and effective at helping support elderly and more frail people through necessary procedure and operations.
Before their operation we assess people in clinic to improve and medical, functional, psychological and social issues, with the aim of reducing problems after their operation. We also always talk about the reason for needing and operation or procedure and what it is trying to achieve. Sometimes, people may feel that an operation is not worth it and they would rather not risk their health or quality of life.
We also see people while they are in hospital and work closely with your surgeon and anaesthetist to help ensure a safe and effective discharge home.
Your surgeon may ask that we see you, but the team always look out for when a more elderly person is referred for an operation to see if we can help.
The POPS secretary can be contacted at 0131 465 9000. Clinics are usually held in the Assessment and Rehabilitation Centre of the Western General Hospital.
