Comprehensive Health Screening for Older Persons (Comprehensive Geriatric Assessment)

The process of ageing is associated with changes in the body both internally and externally. While the external, physical attributes associated with ageing are often easily visible (e.g. loss of hair, skin changes, increased body fat) there are more subtle changes within the different organ systems that are significant but not easily observable. These internal changes are often associated with an increased risk of chronic diseases, and also result in atypical presentations when older persons fall ill.

Studies have shown that comprehensive geriatric assessment, coupled with appropriate management strategies can result in a reduction in the risk of disability and lead to improved health and quality of life.

Our clinic provides a comprehensive assessment of older persons that aims to facilitate the early detection of problems and the discovery of risk factors that are amenable to intervention and life-style changes.

Management of Chronic Diseases

Chronic diseases such as diabetes mellitus, hypertension, ischaemic heart disease and strokes are more likely to occur with increasing age. Many of the patients with these diseases are often unaware that they are suffering from these chronic illnesses, and remain unaware until complications strike. Furthermore, these disorders often co-exist and result in the use of multiple medications that may interact with each other.

Age-link aims to provide evidence-based care of chronic diseases, keeping in mind the decreased physiological reserves that are associated with ageing and the increased risk of adverse drug reactions and drug-drug interactions that are more common in older persons requiring multiple medications. In addition, our doctor is happy to assist in the coordination of care when patients suffer from multiple conditions that are already being managed by multiple different specialists.

Management of Geriatric Syndromes

Physiological changes associated with ageing, coupled with the frequent co-existence of multiple co-morbid chronic diseases result in atypical presentations of illnesses in older persons. These atypical presentations are often referred to as "Geriatric Syndromes" and include the following:

- Delirium (Acute Confusional States)
- Dementia
- Depression
- Frailty
- Osteoporosis
- Polypharmacy
- Walking difficulties and frequent falls

At Age-Link, management of these geriatric syndromes usually involve a thorough medical evaluation that includes the exclusion of reversible elements and the implementation of therapy strategies that may include medication review, counseling, patient and carer education and other non-pharmacological interventions.

Management of the Acutely-ill Older Person

In Singapore, as in the case of other developed countries, individuals aged 65 and above are far more likely to require hospitalization for acute illnesses than younger individuals. Acutely ill older persons tend to present in atypical fashions and there is a greater tendency for their illnesses to be detected late, and to be associated with complications. Geriatricians are trained to recognize atypical presentations of acute illnesses in older persons, and to minimize the risk of developing complications relating to acute ailments. Our clinic takes a holistic approach to the diagnosis and management of acute ailments in older persons. This includes all phases of care from diagnosis to acute management and post illness rehabilitation.

Geriatric Rehabilitation

Older persons who suffer from specific conditions e.g. fractures, strokes or chronic pain syndromes often develop decline in their mobility and functional abilities. In addition, decreased physiological reserves in older persons often translate into a state of deconditioning after an acute illness. This is associated with impaired stamina and an increased risk of complications such as falls, impaired mobility and incontinence.

Our doctor works with a multi-disciplinary team that includes other specialists, physiotherapists, occupational therapists and speech therapists to plan a comprehensive rehabilitation programme that is goal oriented and suited to the individual needs of our patients.

Care-giver Training

Caring for a frail older person is often stressful and carries many challenges, especially in the case of older persons who have suffered sudden or progressive decline in their ability to think and care for themselves.

Our staff members are experienced in the care of older persons and will assist in the provision of teaching and support for family members and carers of older individuals with special needs. Special areas of need may include guidance on how to prevent falls, advice on feeding techniques, precautions against the development of pressure sores and management strategies for persons with difficult behaviours.

Home-based Care

Some older persons may become frail and home-bound as a consequence of progression of their ailments. At Age-Link, our doctor and staff will endeavor to provide appropriate support and care for our frail home-bound patients so as to ensure a seamless continuation of care when the need for home based medical services arises. In certain instances, when the patients' conditions dictate the need for a higher level of care that can only be provided in a hospital setting (e.g. when multiple investigations and a high level of continuous observation and nursing care are required), our staff members will be pleased to help coordinate the transfer of care to the hospital and to continue the provision of care in the in-patient setting.

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