Masterclass in Practical Geriatrics, Module 2-Cognitive impairment- Delirium and Dementia

This module will give you practical skills to identify and provide proactive frailty care to older people living in the community, manage patients with frailty in acute setting and ensure prompt and safe discharges from hospital. You will learn how to reverse frailty and give your patients better and longer quality of life. You will be confident in using Rockwood frailty scale, explaining frailty to patients and their families and teaching frailty to your colleagues/team.

This final module of the Masterclass puts it all together for you, using a heart failure as an example you will be guided how to use CGA tool to achieve the best results for your patient. Most importantly this module talks about service development, how to build a successful business in geriatric care and discusses leadership skills which are necessary to succeed as a service developer and business partner.

This module is using a real patient scenario, an elderly lady with 13 pills and 4 injections of insulin a day is having recurrent falls. How to stop her from falling and prevent a hip fracture? You will be taken through a methodical, step by step pathway of deprescribing, using evidence based medicine applicable to the care of older adults. A number of deprescribing tools as well as clinical judgement will be used in this process, which will lead to major improvements to patient’s quality of life.

After completing this module you will be confident in assessing patients with falls and making falls and fracture prevention plans. You will be taught practical skills of managing vitamin D deficiency in different patient groups, know when to send your patient on a bisphosphonate holiday and learn how to do Dix-Hallpike and many other practical tests yourself. This module is packed with tips you can use to explain falls related issues to families and tools for you to use in your everyday practice.

This module will teach you how to recognise a patient approaching the end of their life in different healthcare settings. By the end of this module you will become confident in using practical prognostication tools, and will learn how to use these in family discussions, deprescribing and personalised future care planning. You will become confident in hospital admission avoidance planning. You also will be taught how to control/treat most common symptoms in the end of life, such as breathlessness, anxiety, nausea, constipation and others.

Cardiovascular geriatrics is an extensive topic. This module narrows it down to commonly seen cardiac pathologies in day to day care of older people. These are Atrial fibrillation, Heart failure, Hypertension and Stroke. The module will teach you the challenging practice of balancing risks and benefits of cardiac treatments in frail elderly. By the end of this module you will be confident to recognise and deal with challenging situations in the care of older cardiac patient, treat most commonly seen acute presentations and work together with cardiology team to get the safest outcomes for your patients. This module is applicable to doctors, nurses, physician associates and pharmacists working with older cardiac patients.

As population is ageing so do patients undergoing surgery This module will introduce you to the fundamental principles of pre-operative assessment, how to recognise frailty and when to consider pre-op comprehensive geriatric assessment (CGA)? What pre-op CGA looks like? As anaemia is one of the commonest pathologies seen in surgical population, the module will give you a comprehensive overview of Iron deficiency anaemias and how to diagnose and treat them pre-op Validated medical tools are used extensively within healthcare to guide treatments and prognoses, this module put together over two dozen of well researched tools, to help you to guide the care of your patients pre-operatively This module is applicable to doctors, nurses, surgical trainee doctors and surgeons

The aim of this module is to equip non-psychiatry clinicians with essential knowledge and skills to diagnose and initiate mental health treatments in the elderly in a variety of healthcare settings, while seeking/waiting for specialist help. Mental health decline is prevalent in older adults because of amalgamation of many risk factors, loneliness, polypharmacy, bereavement, living longer with chronic disease. Majority of people present with physical manifestations of their mental health problems leading to delay in diagnoses and treatment. Besides the problem is so widespread amongst elderly, that even when suspected, it will take many months, if not years, to get a specialist psychiatric help.

This module contains fascinating collection of 9 diagnostically challenging cases for you to solve. It is interactive, clinical case is presented you will then be asked to stop the video and guess the diagnoses and construct a treatment plan. I will then continue giving you more information so you will have several opportunities to guess the diagnoses before it is finally revealed. I will share my experience and clinical pearls for each case.