Department of Geriatric Medicine
Geriatrics is a highly challenging speciality. ‘One hat doesn’t fit all’ is especially applicable here. Every patient and his/her problems are quite unique and will need a personalised treatment plan. Quick-fix doesn’t have much application in this field of medicine.
Despite this speciality being so complex, we try to make it interesting and easier for our patients, their families, and ourselves.
This department is led by Dr. Sathishkumar Mohanakrishnan. He was trained in the United Kingdom and was working as a Consultant Geriatrician in N.H.S., U.K. He is also a life member of Indian Academy of Geriatrics, Former member of British Geriatric Society, Member of Royal College of Physicians, London, and Member of National Osteoporosis Society, U.K.
House Call
Wednesdays- ‘House Call’- For frail elderly living in Coimbatore. At present, this service is NOT for emergencies. The patient or his/her next of kin is expected to complete a Pre-visit Questionnaire (PG) form before the actual visit.
Geriatric Health Check
This is similar to Master Health Check, but more focus is on Geriatrics. The patient or his/her next of kin is expected to complete a Pre-visit Questionnaire (PG) form before the actual visit.
Patients are required to come on an empty stomach (i.e. overnight fasting state) and also requested to bring in their medication box (not just the prescription). It is important for our Geriatric team to know exactly the medications that one takes. If possible, try to recall the medications that were recently stopped (i.e. in the last 6 months).
Inter-active sessions
It is always important to know the end-users need. Keeping this in mind, we conduct regular inter-active sessions with the general public. Typically, our geriatric team will do a short presentation on various interesting topics such as Dementia, Falls, Osteoporosis, Stroke prevention etc. Following this, the audience (elderly and their family) are encouraged to ask questions and give their valuable suggestions. For the convenience of the public, such sessions are conducted in their own vicinity.
Those interested are requested to email the department of geriatric medicine for facilitating such events in their locality.
Comprehensive Geriatric Assessment
The concept of C.G.A. (Comprehensive Geriatric Assessment) is getting more and more popular. Patients and their families (and their referring doctors) love it. This C.G.A. consists of 5M– namely, Mind, Mobility, Medication, Multi-complexity, and Matters Most.
Mind– Certain issues are dealt here- Delirium, Dementia, Depression and other behavioural problems
Mobility– Background information of patient’s level of functioning will help us to make an action plan for their rehabilitation
Medication– Poly pharmacy is a serious threat to the elderly. We try our best to minimise the number of drugs, review the duration of a particular drug, assess the risk vs benefit ratio for each drug, and always have this golden rule for commencing any new drug-‘Start low and go slow’.
Multi-complexity– Most of the Non Communicable Diseases are chronic and unfortunately they don’t have a cure. This means, as we grow older and older, there can be a cumulative insult to our body’s homeostatic mechanisms. Interestingly, treating one aggressively can severely compromise the other system(s). Maintaining the balance is the key. Tight control of common disease entities like diabetes, hypertension in the elderly can be extremely dangerous. Various governing bodies have recognised this challenge and had recommended a soft approach (e.g. The HbA1c target is different for a middle-aged person and an elderly person).
Matters Most– At the end of the day, the patient should be given the ‘autonomy’ to choose what he/she wants. There are so many incidental findings in the elderly, and not everything warrants detailed evaluation. It is important to find out from the concerned patient on his/her wishes and if he/she has made any ‘Advanced Directive’ or ‘Advanced Care Plan’.
After all, we treat the patient rather than just his/her illness.
Departments
