We look forward to working with you in providing the best clinical assessment, diagnosis and management of your patients aged 65 or above who have:
Three or more medical co-morbidities, such as IHD, HTN, AF, CCF, COPD, Type 1 or Type 2 respiratory failure, Chronic Renal Failure, OSTEOARTHRITIS, OSTEOPOROSIS, TIA, CVA/stroke, Type 2 diabetes mellitus, thyroid disease. With or without Dementia or Cognitive Impairment:
Geriatric Syndrome including delirium, falls, impaired balance, impaired mobility, impaired functional capacity, dizziness, urinary incontinence.
Behavioural and Psychological symptoms due to dementia (BPSD).
We will also assist you in developing care plans for your patients attending clinics and those in nursing homes such as addressing to advanced care directives, palliative care management, polypharmacy and deprescribing.
Please contact us on (02) 8313 9064 for above to make an appointment and/or complete the form below.
For CGA referrals, the general practitioner (GP) is required to ask for comprehensive geriatric assessment for chronic, complex and multiple medical co-morbidity.
Each referral has a valid duration of 12 months. This period begins from the date that the specialist first attends the patient, not from the date the referral is issued by the GP.
Bulk Billing: Medicare card holders will be bulk billed for initial comprehensive geriatric assessment and review. Thereafter majority of patients can be followed up by the GP, unless otherwise specified by the practitioner or specialist.
DVA: DVA health card holders are accepted. Payment fee will be that which is covered by the medical benefits schedule.
Health Fund: Medicare and AMA rates with no gap payment
Private patients: Predetermined fee by the specialist at AMA rate
SPRINT TRAIL:Following the press release on 11th September, 2015 based on the initial results of the LANDMARK STUDY – SPRINT TRAIL (Systolic Blood Pressure Intervention Trail) – the slides have also been released this month now. Sprint trail was a two-arm, multicentre randomised clinical trail designed to answer the question whether intensive management of high blood pressure below currently recommended blood pressure target significantly reduces the risk of cardio-vascular disease and lower the risk of death in a group of people of 50 or above years of age.
IT WAS FOUND THAT MORE INTENSIVE BLOOD PRESSURE CONTROL (i.e. below 120 mm Hg) RESULTED IN ABOUT ONE THIRD REDUCTION IN PRIMARY CARDIOVASCULAR EVENTS AND 25% REDUCTION IN ALL-CAUSE MORTALITY.
Comparing to ACCORD TRAIL which also compared the SBP Goals of less than 140 mm Hg and less than 120 mm Hg, SPRINT was double the size, with a higher-risk population with an older average. People with diabetes mellitus and previous stroke were excluded in SPRINT.
As always the interpretation and implementation of these results including of such Landmark Study in your clinical practice should always be based on a number of individual factors and more so in aged care patients though I was very pleased that people above 75 years of age were included.
ALCOHOL AND MEMORY: Numerous studies suggest that mild to moderate alcohol intake is protective against Cardiovascular events. But a study published in Neurology in January 2014 found that middle-aged men who drink 2.5 drinks daily are more likely to have faster decline in cognition and more so in memory over 10 years period.
RECENTLY PUBLISHED ARTICLES OF INTEREST IN GERIATRIC MEDICINE
Towards Evidence-based End of Life Care: Perspective; Scott D Halpern: New England Journal of Medicine: 373: 21: 2001-2001
Why Should We Care, and Is It a Missed Quality Indicator? XinQi Dong J Am Geriatr Soc. 2015;63(8):1686-1692. A very interesting article on elder abuse was published recently in Journal of American Geriatric Society.
Unfortunately elder abuse (which includes psychological, physical, sexual abuse; neglect (caregiver and self-neglect); and financial exploitation) is not uncommon. It is a very difficult, serious & sometimes even fatal, costly, yet understudied condition. Screening for elder abuse is complex; the intended benefits should be balanced against potential harms. In this article, some practical suggestions are provided to healthcare professionals to detect and treat cases of elder abuse.