Our physicians, geriatric nurse practitioner and social workers offer a variety of clinical services to older patients, including comprehensive geriatric assessment; in-hospital consultation; comprehensive long-term care; end-of-life symptom control; coordination of determination of competency; medication education and compliance, wound care program; falls analysis and prevention; functional assessment; advance directives counseling; long-term care information; patient; family and caregiver counseling; community resource information; screening for dementia and depression; education on dementia and related issues; research on early detection and treatment of memory problems; and house calls.
Comprehensive Geriatric Assessment
Geriatric professionals at the Senior Care Clinic at Baylor College of Medicine offer a unique, comprehensive assessment of older persons in an outpatient setting. The assessment is especially valuable to those whose physical, functional or emotional status has become challenged. Patients are evaluated by a multidisciplinary team including geriatricians, a geriatric nurse practitioner, a geriatric social worker and fellows in geriatric medicine. Recommendations for ongoing care are provided based on their findings. The assessment is available on a consultation basis or as a first step in ongoing primary care.
Senior Care Clinic practitioners deliver the primary medical care for established patients who need hospitalization or evaluation at Baylor St. Luke's Medical Center or Houston Methodist Hospital. The team also routinely provides consultative services for established patients who are admitted to the hospital for surgical or other specialty services. Inpatient geriatric consultations are performed, at the request of other physicians, for any older patient who may have multiple medical conditions, dementia, functional impairments or wound care needs. The team frequently assists other physicians with complicated placement and psychosocial concerns, palliative care needs and end-of-life issues.
Palliative and End-of-Life Care
Working as a team, our geriatric staff coordinates medical, social and hospice services for patients and families facing terminal illnesses. Pain management and control of other symptoms is a priority in ensuring optimal patient comfort. Assistance is provided in establishing advance directives, selective resuscitation status and designating a power of attorney. Care plans are individualized to the needs of the patient and family, with a focus on maximizing quality of life and comfort.
Social Work Consultation
Our social workers provide screenings for dementia and depression, and assess both functional and psychosocial needs. Education for patients and families regarding memory loss, behavioral management and community resources is available. Information regarding long-term care options, financial matters and advance directives is an integral part of the social work assessment. Psychotherapy for patients, families and caregivers is also available.
House calls are offered to select patients in the geographic area who are no longer able to seek medical care in the office or clinic setting because of physical or emotional limitations. Care is tailored for this setting, with the understanding that diagnostic testing is more limited in homes, and homebound patients and their families face unique challenges. House calls may be used temporarily, until someone is again able to return to the outpatient clinic, or it may be used as a permanent way to receive healthcare.
Senior Care Clinic clinicians, who are members of the Section of Geriatrics at Baylor College of Medicine, have developed an in-depth research program in the areas of memory and mood. Protocols include early detection of memory loss and function using novel techniques. Additionally, some persons may be eligible for experimental medication trials targeting memory.