The topic content is divided into the information types below
18. CGA in primary care settings: end of life care issues
End of life care refers specifically to the last few days or hours of life, when maintenance of comfort and dignity, and avoidance of pain and distress take priority. Many of the principles of care at the end of life are shared with CGA.
NICE Guidance: Emergency and acute medical care in over 16s
This NICE quality standard, published in September 2018, covers the organisation and delivery of emergency and acute medical care in the community and in hospital.
HoW-CGA - Introduction to the service level toolkit
You are an anaesthetist, a surgeon, an oncology specialist, or other acute care physician. Team members’ training may not have focused on the needs of older people and may lack confidence and expertise in managing older people.
HoW-CGA Chapter 1: Using data to identify problem and convince others about the solution
The first challenge on your improvement journey is to identify whether there are areas of the care you provide for frail older patients that could be improved, and then convincing others that the solution to the problem is the right one.
How-CGA Chapter 2: Self-assessment
You may already have a good idea about the service outcomes you wish to improve. Evidence suggests that integrating assessment and management of frail older patients into your service is more effective than having a consultation geriatric service at arm’s length.
HoW-CGA Chapter 3: Team approach to change
Designing solutions and delivering change is more effective when delivered by a core team of people who invest in engaging with a network of stakeholders. You may wish to start thinking about the advocates of improving care for frail older people in your service early.
HoW-CGA Chapter 4: Barriers to implementation
The overarching message about successful improvement shows how social relationships in organisations are key for embedding the technical features of change. A lot of time and energy in leading organisational change will require you to uncover and mitigate barriers.
Hospital Wide Comprehensive Geriatric Assessment (HoW CGA) - History of the project
The aim of the Hospital Wide Comprehensive Geriatric Assessment (HoW CGA) project was to inform NHS managers, clinicians, patients and the public about how best to organise hospital services for frail older people.
Hospital Wide Comprehensive Geriatric Assessment (HoW-CGA): Overview
The aim of this project was to provide high quality evidence on delivering hospital-wide Comprehensive Geriatric Assessment (CGA). Comprehensive Geriatric Assessment (CGA) improves outcomes for frail older people, particularly on specialised wards.
Tools for Clinical History-Taking
A list of validated tools which may be useful in augmenting clinical history-taking as part of comprehensive geriatric assessment, or as screening tools to trigger the need for an in-depth assessment.
Although much progress has been made in defining best practice, setting standards for delivery and improving the processes of care, there is still variability; there is no consistent delivery or outcomes.
Think frailty and delirium - the Scottish approach
Ten per cent of patients admitted to hospital as an emergency stay more than two weeks, using 55 per cent of all hospital bed days, and 80 per cent of that group are aged over 65 years. The average age of a hospital inpatient is over 80.
Frailty means patients with what appear to be straightforward symptoms may be masking a more serious underlying problem. How to recognise frailty in a routine situation, emergency situation, or in an outpatient surgical setting, including a range of established tests you can use.
Integrated care for older people
Ian Philp of the South Warwickshire NHS Foundation Trust examines a model of integrated car which has seen reduced admissions of older people for acute hospital care and a significant fall in deaths of older people in hospital.