QEH to have geriatric unit
Published on: Thursday, April 16, 2015
Kota Kinabalu: Queen Elizabeth Hospital I (QEH I) is setting up its Geriatric Unit, according to the Director, Dr Heric Corray. Geriatrics is the branch of medicine dealing with the health and care of old people."We are in the early stage and will definitely get it done as soon as possible because there is a great need for geriatric service in the State."For starters, we have put up a four-bedded geriatric ward at the hospital, and hope to increase the number to 12 beds at the existing premises by the end of the year.
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"Why we need that duration is because we need to train more nurses in geriatric nursing. "We intend to send them to Hospital Kuala Lumpur for an attachment in stages," he said when met at the 1st Sabah Orthogeriatric Care Update held at the hospital's auditorium. So far five nurses have been trained in this area in Kuala Lumpur and Seremban.Dr Corray also disclosed plans to have a geriatric ward by itself with a capacity of 20 beds (10 for male and 10 for female inpatients)."As it is, right now, we are sharing with the general medical ward at QEH I.
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"So we have identified Block C (former Chest Hospital atop the adjacent hill) for the necessary refurbishment. The proposed geriatric ward will be custom-made to specifically serve the needs of elderly patients, especially those with hip fractures."We have prepared the medical brief for submission to the Health Ministry through the State Health Department because we need funding for the purpose," he explained.
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Dr Peter Selestine, now a Consultant Geriatrician, is Head of the upcoming QEH I Geriatric Unit, having completed his Fellowship in Geriatric Medicine at the Tan Tock Seng Hospital, an acute tertiary care hospital in Singapore. A geriatrician is a physician who specialises in geriatrics (that is, the care of aged people).Dr Selestine concurred that there is a rising demand for geriatric care services globally, attributing this to the ageing population and increased life expectancy."When people live longer, they may need specialised care in the event of hip fractures, for example. Falls in the elderly (65 and above) is a major problem. Patients with hip fractures are also likely to have more comorbidities (additional disorders or diseases)," he pointed out.He lamented that there is no specialised service here (in Sabah) for falls yet, "so we plan to start that at our Geriatric Unit as we need to start from somewhere."Noting that Singapore is a pioneer of the unique Orthogeriatric Care Model, which works very well there, Dr Selestine said, in Malaysia, we are nowhere near there due to the shortage of geriatricians."So we are trying to pioneer this concept here whereby geriatricians and orthopaedicians work together to optimise elderly patients with hip fractures where we can get surgery done within 24 to 48 hours with a view to mobilising them (within 48 hours after surgery) so that they can go home fast." An orthopaedician is a doctor who deals with the treatment of injuries or diseases affecting bones, muscles, joints and ligaments.In contrast, the Consultant Geriatrician said previously, fractures in the elderly were treated conservatively with immobilisation and skin traction for six weeks. "However, it has been proven that conservative management for hip fractures does not work, with poor outcomes and increased complications."By immobilising the patient, we are predisposing them to complications like pneumonia, deep-vein thrombosis (blood clots in the leg veins, which may go to the lungs), urinary tract infection or bedsores," he contended. Saying that awareness about geriatric care hasn't caught on yet in Malaysia, Dr Selestine hoped more junior doctors will take up geriatrics as a speciality while young nurses will go into geriatric nursing as geriatrics is very much nursing-based. "When the numbers increase, we can improve the services. For now, we have to raise awareness about patients with high fall risk, among other aspects. Those with such risk should be assessed as a preventive measure." According to him, there are only about 25 geriatricians in the whole country for a population of 30 million. "Singapore started planning for geriatric care back in the 1990s because they could predict that they were going to have an ageing population. "Today, they are seeing the fruits of their labour. They have got a world-class hospital for geriatric care services and training," Dr Selestine said.The 1st Sabah Orthogeriatric Care Update which came with a seminar on orthogeriatrics for doctors and paramedics was jointly organised by Kota Kinabalu Orthopaedic Association, Sabah, QEH Department of Orthopaedic Surgery and QEH Geriatric Unit for continuing medical education (CME).Three experts from the Tan Tock Seng Hospital were guest speakers at the seminar to introduce the Orthogeriatric Model for Hip Fracture Patients in Singapore. Orthogeriatrics is defined as the care of elderly orthopaedic patients, most often following a fractured hip. Orthogeriatrics was developed as a sub-speciality to address the issue of poor outcomes of hip fracture patients by caring for them alongside orthopaedic surgeons and with the support of a specialist multidisciplinary team (comprising the orthopaedic surgeon, geriatrician, physiotherapist, occupational therapist, care manager and other allied health professionals).The trio are Associate Professor Dr Ganesan Naidu Rajamoney (Head & Senior Consultant, Department of Orthopaedic Surgery) who shared the Singapore Experience pertaining to its Integrated Hip Fracture Care Programme, and gave an Overview of Hip Fracture Management; Senior Consultant Dr Rani Ramason (Department of Geriatric Medicine) who presented a paper on Geriatric Co-Management in Hip Fracture Patients, and Hip Care Clinic; and Senior Integrated Care Manager, Josephine Jaipaul (Department of Orthopaedic Surgery) who discussed the Role of the Integrated Care Manager in Hip Fracture Management.Stay up-to-date by following Daily Express’s Telegram channel.
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