1. Which Patients should be under the care of Geriatricians? D.M.Beaumont

2. Rationale Query from member as to whether guidance exists Choose and Book Need for publishable descriptors to assist lay people and Health professionals understand scope of speciality

3. Suggested Categories 1.Frailty related health problems 2.Patients with specific conditions common in advanced age but not exclusively 3.Frail older patients who present to other specialities but need input from Geriatricians 4. Vulnerable older patients where ethical and legal issues are likely to arise

4. 1.Frailty related health problems Acute presentations with loss of function e.g. delirium, deteriorating self care, falls, found on floor admissions,sudden incontinence Care home residents,EMI home residents Patients with chronic disease affecting functional status,e.g. Stroke,PD.leg ulcers,CCF Local agreement regarding 64-75 age group

5. 2.Patients with specific conditions common in advanced age but not exclusively E.g. Geriatrician involvement in services for Stroke,PD,Dementia,DM, and heart failure provided for patients of a variety of ages according to local expertise

6. 3.Frail Older patients presenting to other specialities E.g. Pubic ramus and upper limb fractures Constipation or Pseudo-obstruction Falls with soft tissue injuries Electrolyte disturbance and renal failure Patients with medical problems presenting to Old Age Psychiatry

7. 4.Vulnerable Older Patients where legal and Ethical issues are likely to Arise E.g. Cases known to POVA teams, Feeding Issues in Stroke or dementia Patients lacking capacity

8. Older Patients best looked after by other specialities Age related systems may lead to certain patient groups failing to access appropriate care Non frail patient with single system disease should be looked after by organ specialists with help if necessary E.g.MI, GI bleeding, pneumonia, Diabetic complications

9. Choose and Book Each speciality divided into; A. Clinic type- subdivision of speciality B. Keywords- descriptors to aid search

10. Geriatric Medicine-Clinic Types Geriatric Medicine Cerebrovascular Falls/Syncope Movement disorders/PD Heart failure Memory/Cognitive decline Day Hospital Bone Clinic

11. Geriatric Medicine-Keywords Anaemia Assessment Blackouts Cholinesterase inhibitors MDT Falls assessment OAP joint assessment Parkinsons Disease

12. Keywords -2 Stroke prevention Stroke risk factor management Syncope Tremor assessment Urgent TIA assessment Weight loss Rapid access community assessment

13. More keywords ? Incontinence Gait disorders Cognitive impairment Dementia Osteoporosis Breathlessness Hypertension

14. Any Suggestions?