Let’s start again. Tell me your story. What Matters To You?

Like many healthcare organisations, mine has a mantra around putting the patient first, a statement so blindingly obvious that it shouldn’t really need saying, I thought. Are you person centred? Do you make the patient your first priority and take their preferences into account? I always thought I did. I’m a geriatrician you know. IContinue reading “Let’s start again. Tell me your story. What Matters To You?”

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What do geriatricians actually do?

It’s a question that I’ve come to think about again as use and abuse of the Clinical Frailty Score proliferates, but now in the context of a pandemic, where there are concerns about the availability of critical care beds, and a need for rationing but an admirable desire not to be ageist.It’s a question thatContinue reading “What do geriatricians actually do?”

How to take a history of memory problems

A good collateral history of cognitive decline is a crucial part of assessing cognition and you may even be able to make a diagnosis with this information. Here’s what to cover… Remember to think about previous level of executive function so ask about occupation and educational attainment. Remember also that some people may never haveContinue reading “How to take a history of memory problems”

How to take a Collateral History

Many of you may have been tasked with the request to “take a collateral.” What does this mean? The heart of acute geriatrics is about gaps in function, and sometimes the patient isn’t able to tell us so we need to find out from somewhere else. What is your patient like normally? How are theyContinue reading “How to take a Collateral History”

Don’t treat junior doctors the way you wished you had been treated

  My first consultant was a charming white haired Irish man who was one of those doctors that seemed to make patients better with his very presence. When people talk of a “good bedside manner” I think he was the kind of doctor they refer to. He was not shy in praising us, his juniorContinue reading “Don’t treat junior doctors the way you wished you had been treated”

We’re just begging you not to make it any worse

In the last year, two junior doctor friends of mine, who I had rather hoped might join me in geriatric medicine quit their jobs. Dramatically. Handed their notice in and everything. I had worked with both of them before and know them to be bright and hard working and caring. So why have they quit?Continue reading “We’re just begging you not to make it any worse”

Twenty (One) Tips for junior doctors working with older people

Be good to older people. Many of your patients will be frail and vulnerable. Much of society may view them as a burden. You should not. These are mothers, fathers, husbands and wives. They have been on this planet two or three times as long as you have and many of them will have richContinue reading “Twenty (One) Tips for junior doctors working with older people”