I cannot believe 2019 is almost at an end! This year has just flown by! I just had an incredible rotation in Geriatrics. It consisted of 2 weeks on consults and 2 weeks managing patients on the Geriatrics wards or off-service units. There were also two 1/2 weekends on consults.
Geriatrics was challenging in many ways:
- Patients often have complex medical histories
- Patients often have varying degrees of neurocognitive disorder (dementia)
- Patients are often frail and at risk of falls
- Patients may have delirium which can be difficult to tease apart from possible underlying neurocognitive disorder
- Patients are dealing with many challenges such as incontinence which can be demoralizing for them. For some patients, continence may be their last act of independent functioning.
- Patients are often on multiple medications (polypharmacy) whose side effects can put patients at further risk of falls or delirium.
- Patients are faced with what we often write in the charts as “disposition”. Where will they be going next after being discharged from hospital? They are often too frail or dependent to go back home therefore may be facing the reality of moving to a residence or nursing home. There can be complex family dynamics as the details of this transition is worked out.
Despite the complexity of geriatrics, I found this to be a truly rewarding rotation as I developed close bonds with my patients and got to know some of them very well. I was really touched by some of the conversations I had with my patients and how much I learned from them. I worked with a fantastic interdisciplinary team and found the geriatric physicians to be extremely compassionate. I also developed clinical skills that will be very useful in my future practice as a family doctor.
I am now on my last rotation of clerkship! It is an elective in Allergy and Immunology and has been an extremely fascinating rotation so far! More details to come!
Featured image courtesy of Emory University School of Medicine