How to make the most of your care of older adults placementBMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4911 (Published 09 August 2019) Cite this as: BMJ 2019;366:l4911
- Gloria Onwuneme, foundation year one doctor1,
- Rebecca Kingston, foundation year two doctor2
- 1Lincoln County Hospital, Lincolnshire
- 2Southmead Hospital, Bristol
- , @GloriaNOnwuneme
Before a placement in care of older adults, many students worry that they will not be able to identify a clear presenting condition when speaking to an older adult with multiple comorbidities. They might also be anxious about witnessing end of life discussions, eliciting information from a confused patient, or examining a patient who has limited mobility.1 A care of older adults placement will give you the space to practise these aspects of older adult medicine and to spend time speaking with older adults. Students will also gain an appreciation of the psychosocial elements of a person’s life that affect, and are affected by, aging.
As the proportion of older adults is continuously rising in the UK population,2 being competent in skills specific to older adults will be useful across almost all care settings, during and beyond medical school. The skills and tips covered in this article will be particularly useful in your primary care and emergency placements, as well as in wards and services that specifically provide for older adults.
Core skills for caring for older adults
Box 1 lists some of the skills you can practise and observe on your placement.
Skills to practise and observe in care of older adults
Taking a detailed social history
Taking a collateral history
Taking focused histories (falls, cognition/mental health)
Communicating with patients with impaired cognition
Taking blood and inserting a cannula
Measuring lying and standing blood pressure
Performing a drugs review
Observing and practising making a problems list
Observing how to assess capacity
Observing a discussion about cardiopulmonary resuscitation or level of treatment
Taking a history
Be sensitive to physical and cognitive factors that might limit patient participation in a consultation or an examination, such as impaired mobility or marked confusion.
Older adults’ social histories …