Referral to specialized geriatric services. Which elderly people living in the community are likely to benefit?
OBJECTIVE
As the Canadian population ages, family physicians encounter increasing numbers of elderly people with medical, functional, psychological, and social difficulties. In the past two decades, most regions of Canada have developed systems of specialized geriatric services, available on a consultative basis, to assist family physicians evaluating and managing elderly patients with these difficulties. For many family physicians, however, it is often unclear which of their elderly patients are likely to benefit from referral to these geriatric services.


OBJECTIVE
Using an interdisciplinary approach, specialized geriatric services seek to optimize health, maximize function, promote independence, and prevent or delay institutionalization of elderly people. Yet not all elderly people benefit from referral to specialized geriatric services. This article offers a clear and clinically practical framework to help family physicians identify elderly patients in their practices who are likely to benefit from referral to specialized geriatric services.


METHODS
By synthesizing previous work on the concept of frail elderly persons into a 2 x 2 matrix, the level and intensity of geriatric intervention most appropriate for different segments of the elderly population is clarified.


CONCLUSIONS
Using the simple approach described in this article, family physicians should be able to use available geriatric resources easily and efficiently to optimize the health and function of their elderly patients.
Man-Son-Hing
M
M
Geriatric Assessment Unit, Ottawa Civic Hospital, ON.
Power
B
B
Byszewski
A
A
Dalziel
W B
WB
D000203:Activities of Daily Living; D002170:Canada; D003663:Decision Trees; D005194:Family Practice; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006801:Humans; D010348:Patient Care Team; D018579:Patient Selection; D012017:Referral and Consultation