Multi-disciplinary team approach taken to help elderly patients

PUBLISHED : Sunday, 18 September, 2016, 12:18am
UPDATED : Sunday, 18 September, 2016, 5:34pm

I refer to the report (“ ‘Silver tsunami’ threat to public hospitals”, September 12), in which the Hospital Authority has been briefly quoted as providing medical care to the “elderly in care homes to enhance community care. An online platform was also launched in 2013 to provide care tips to chronically ill elderly patients and their caregivers.”

We would like to elaborate on the efforts of public hospitals to cope with the challenge of the ever-increasing demand on public hospital services by an ageing population.

To guide the future development and delivery of health care services for older people through a systematic approach, the Hospital Authority has formulated a strategic service framework for elderly patients.

Strategies have been put in place with the aim of providing an appropriate level of care according to patients’ needs. A wide spectrum of medical services, from inpatient, outpatient, day hospital, community to infirmary services are delivered through a multidisciplinary team approach to the elderly.

In particular, for elderly patients who are at high risk of hospital readmission, the measures include comprehensive needs assessment for the formulation of an individualised care plan and a discharge plan, as well as provision of post-discharge support services.

The authority has also commissioned NGOs to provide transitional rehabilitation, home and personal care support services for high-risk elderly patients according to individual needs, as well as carer training to enable patients to remain in the home of their choice for as long as possible.

For frail residents in residential care homes for the elderly with complex health problems and poor mobility status, the authority’s community geriatric assessment teams have been providing medical and nursing care on a regular basis to enhance continuity of care in the community.

To provide support to high-risk elderly patients discharged from Hospital Authority hospitals, the authority’s community health call centre has made proactive outbound calls after patients’ discharge to assess and identify their health problems, provide advice on disease management and care support, and arrange referrals to appropriate services when necessary.

Last, but not least, ongoing enhancement has been introduced to the one-stop online information platform, “Smart Elders” launched in 2013, providing comprehensive disease information and practical tips on self-care for chronically ill elderly patients and their carers.

I assure your readers that the challenge of an ageing population has always been high on the authority’s agenda in the strategic planning and current provision of public hospital services.

Dr Christina Maw, chief manager (primary and community services), Hospital Authority