
WHERE TO GET HELP: ACCESS TO HOSPITALS
Most geriatricians and psychogeriatricians keep a few beds available for respite and holiday admissions. A respite admission is one where it is the carer who mainly benefits from the break of looking after a very disabled elderly person. Such beds should not be seen as crisis beds, for in those circumstances there is usually a medical problem underlying the crisis and the person is better in an acute bed. The respite beds are for the very medically stable clients, often admitted on a regular basis or rota system. Holiday beds fulfill the same function allowing carers a definite break once or twice a year. Again these beds are very scarce and get booked up very quickly. Access is usually via the GP, and hence the GP must be approached early so that the communication with the geriatrician can take place.
Apart from inpatient beds, the units specializing in the elderly will offer other services. These may range from the conventional outpatient clinic to more specialist clinics such as those dealing with incontinence and confusion (memory clinics). Some of these clinics offer open access and accept direct referrals from members of the public. Most however require a letter from a GP. This illustrates how important it is that the GP is aware of all the services available in his/her district.
Most units caring for the elderly will have access to a Day Hospital. These can have a medical or psychiatric bias but essentially they are units that treat the elderly on a day-patient basis with the emphasis on treatment and rehabilitation. On average a person attends twice a week for about a month or two and is then discharged. The whole multidisciplinary team works there specializing in diagnosis, treatment and rehabilitation. Because the person arrives in the morning (usually by ambulance) and stays for the day (including meals) there is a much longer period of time available for sorting out problems than is the case in outpatients and yet the person has the security of returning to their own home in the afternoon.
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GENERAL HEALTH
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