Division Description
Clinical Programs and their Locations
Education
Research
Faculty
Division Description
Overview
The Division of Geriatric Medicine is currently comprised
of 8 physicians based at the QEII HSC, 3 QEII based cross appointments
(Neurology, Psychology, Family Medicine), 3 physicians based at
the Saint John Regional Hospital and 2 physicians based in PEI (one
with Veterans' Affairs Canada). The Division of Geriatric Medicine
provides services through its participation in the Centre for Health
Care of the Elderly (CHCE). CHCE is a multi-service, interdisciplinary
program based primarily in the Camp Hill Veterans' Memorial Building
(CHVMB) of the Queen Elizabeth II Health Sciences Centre. The cornerstone
of our care is interdisciplinary comprehensive geriatric assessment
and treatment of frail older persons. This model of care provides
a suitable training ground for a wide variety of disciplines, and
the care, in turn, is enhanced by the educational focus. Likewise,
both patient care and education are enriched by the prominent role
of research, centred in the Geriatric Medicine Research Unit.
The Acting Director of the CHCE is Laurie Mallery,
who is also Acting Head of the Division of Geriatric Medicine. In
addition to eight internist-geriatricians, several other physicians
and numerous research associates, assistants and support staff,
the disciplines involved in CHCE services include nursing, social
work, physiotherapy, occupational therapy, psychology, pharmacy,
dietary, spiritual care and recreation therapy. There are strong
and important links with the Department of Family Medicine and the
Department of Psychiatry. This representation enables CHCE to function
as an interdisciplinary program for the delivery of health care
to the elderly. There are two full-time Nurse Practitioners and
one Geriatric Assessor who assist with all areas of the program.
Clinical Care
The Division provides secondary and tertiary care to frail elderly
patients throughout Nova Scotia and the Atlantic Provinces. The
Division provides expertise in the assessment, care and ongoing
management of conditions affecting the frail elderly and their families/caregivers.
The Division is the centre of training in geriatric medicine in
the Atlantic Provinces and is recognized at local, national and
international levels for its research activities.
Clinical activities take place both within the QEII HSC as well
as outside the hospital either within the Capital Health District
or in various regions of the province.
Services within the QEII HSC:
- Geriatric Assessment Unit (GAU) - 10 inpatient
beds with referrals from family physicians in the community
and the emergency room. Care is supervised by family and geriatric
medicine residents and geriatricians.
- Geriatric Restorative Unit (GRU) - 27 inpatient beds
which predominantly accepts referrals from other inpatient services.
Primary care is delivered by family physicians with geriatricians
acting in a consultation/supervisory capacity.
- Progressive Care Unit (PCU) - 9 inpatient beds which
predominantly accepts referrals from other inpatient services.
Primary care is delivered by family physicians with geriatricians
acting in a consultation/supervisory capacity.
- Geriatric Consultation Service - a consultation service
provided to all sites within the QEII HSC. Part of this activity
consists of assessments for the GRU/PCU.
- Geriatric Day Hospital (GDH) - an outpatient multi-disciplinary
assessment and rehabilitation unit with care provided both by
family physicians and geriatricians.
- Geriatric Ambulatory Care (GAC) - outpatient consultation
clinics conducted by geriatricians, geriatric and internal medicine
trainees and nursing staff with significant emphasis on the
assessment and management of memory disability.
- PATH (Palliative and Therapeutic Harmonization Clinic) - The Palliative and Therapeutic Harmonization (PATH) clinic and consultation service is for older people with multiple and serious health conditions. Through a process that gives thoughtful attention to frailty as a marker of health, the staff at PATH guide patients, caregivers, and families through the process of making medical decisions that will protect the patient’s best interests and quality of life.
Services Outside the QEII HSC:
- Home Visits - conducted by geriatrics and providing
an optimum opportunity to directly assess difficulties for elderly
patients within the home.
- Nursing Home Visits - currently provided by geriatricians
to nursing homes in the Halifax area. This service is provided
with the approval of the patient's family physician. The benefits
include an enhancement of care for individual patients and a
reduction in acute hospital admissions through the emergency
room.
- Satellite Clinics - currently conducted in Antigonish,
Lunenburg, Digby, Annapolis Royal, Middleton, and Berwick by
geriatricians with plans to expand to other centres pending
increases in manpower.
Education
The Division is very involved in both undergraduate and postgraduate
education. With the revised COPS curriculum the undergraduate exposure
to geriatric medicine has increased from four half-day sessions
to a three-week rotation. January 2001 saw the first 3-week rotation
dedicated to teaching students how to care for the elderly. Evaluations
were very positive.
The postgraduate training program is accredited
with the Royal College of Physicians and Surgeons of Canada. Dr.
Dan Carver is the program director. The program has been a major
resource in the training of geriatricians for the division and for
other centres throughout Atlantic Canada. Trainees work with all
of the attending staff geriatricians throughout the difference services
and also have rotations through the Saint John Campus.
Dr. Carver in collaboration with Dr. Barry Clarke
(Department of Family Medicine) is also responsible for a 6 month
to one-year program providing a Certificate of Health Care of the
Elderly. This is an accredited program primarily directed at post-CCFP
family physicians.
Research
Research within CHCE is primarily focused on two main
areas, dementia and frailty in the elderly. All members of the division
contribute to this endeavor. The Geriatric Medicine Research Unit,
established by Dr. Kenneth Rockwood, has gained national and international
stature.
Contact Information
Dr. Laurie Mallery, M.D., FRCPC
Head, Division of Geriatric Medicine
Camp Hill Veterans' Memorial Building
5955 Veterans' Memorial Lane, Room 2650
Halifax, NS B3H 2E1
Tel: (902) 473-8603
Fax: (902) 473-4867
