260Profile of a North Dublin Community Outreach Service

  • Moola R
  • McCabe B
  • Martin A
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Abstract

Background: Irish healthcare in recent years has begun to focus on integration of specialist services throughout the Integrated Care Programmes. A Specialist Geriatric Nursing Home Outreach Service has been in place in our centre for frail older persons in long term care facilities with the aim of improved care and appropriate use of acute hospital services. We audited our activity to look at the profile of our service users and the interventions required, to evaluate performance and to identify gaps in service or directions for future care. Methods: Data was collected on consecutive patients referred to the Specialist Geriatric Nursing Home Outreach Service between July 2015 and November 2016. The service consists of a Consultant Geriatrician, Gerontology CNS, and an Occupational Therapist. Results: 132 referrals (67.4% female) were received from 22 nursing homes. Average patient age was 84 at time of review with an average Barthel Index of 10.1 and MMSE of 14.6. The most common reasons for referral were Behavioural and Psychological Symptoms of Dementia (22.7%), functional decline (15.9%), falls (15.9%), low mood (15.1%), weight loss (12.1%) and cognitive decline (9.8%). 43% of patients required one visit, with 41.6% requiring two (average 1.8). The most common underlying comorbidity was dementia - 84 patients (63.6%). The most frequent interventions were: medication review and amendment (62.1%), physio referral (19.6%), referral to activities (16.7%) and blood tests (15.1%). No intervention was needed for 19 patients (14.4%). Conclusions: Specialist Geriatric Outreach Services encompass multiple areas of geriatric care. Based on referrals, nursing homes and their medical providers require support predominantly in the area of dementia care and in particular Behavioural and Psychological Symptoms of Dementia. Additional access to full MDT and diagnostic supports would also be a priority.

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Moola, R., McCabe, B., & Martin, A. (2017). 260Profile of a North Dublin Community Outreach Service. Age and Ageing, 46(Suppl_3), iii13–iii59. https://doi.org/10.1093/ageing/afx144.238

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