Geriatric Care Advances

Summary

This article explores a recent cross-sectional study examining inpatient geriatric medicine consultation patterns. Researchers analyzed data to understand how often and why older adults receive Comprehensive Geriatric Assessments (CGAs) during hospitalization. The findings highlight the need for expanded geriatric services to meet the demands of a growing aging population.

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** Main Story**

Okay, so I was just reading this interesting article from the Canadian Geriatrics Journal (March 5, 2025). It’s a cross-sectional study, and it basically looks at how inpatient geriatric medicine teams are being used. I think you’ll find it pretty relevant, given what we were discussing last week about optimizing our geriatric services.

Basically, they wanted to get a handle on how older folks in the hospital are actually using these specialized geriatric services. And, honestly, the findings really point to some key areas where we could definitely be doing better.

Diving into the Data

So, the researchers dug into health admin data from 2019, focusing on patients 65 and up who got a Comprehensive Geriatric Assessment, or CGA, while they were hospitalized. They were working with a pretty decent sample size – over 29,000 older adults. It turns out about 39% of them were classified as frail. But, here’s the kicker, only about 5.4% of all those patients actually received a CGA. Makes you wonder, doesn’t it?

The big reasons for requesting a CGA were:

• Getting assessed for inpatient geriatric rehab (that’s around 43% of requests).
• Delirium assessment and management (about 27%).
• Dementia assessment and management (roughly 24%).

And you know who was making most of these referrals? Hospitalists! They initiated almost half of them. Also, it’s worth noting, that the study found, not surprisingly, that frailty made it more likely you’d get a CGA. However, if you had a cancer diagnosis, your odds went down. Isn’t that strange?

So What Does This All Mean?

It really highlights how important those inpatient geriatric consultation teams are, especially for older adults in the hospital. But, it also shines a light on a pretty big gap. I mean, if only a small percentage of older adults are getting CGAs, clearly, we’ve got an access problem. And you know, with the aging population only getting bigger, that problem isn’t going away anytime soon.

Speaking of which, it reminds me of a conversation I had with a colleague at a conference last year. She was talking about how their hospital implemented a proactive geriatric screening program and saw a significant improvement in patient outcomes. Food for thought, right?

Meeting the Growing Needs

Because more and more people are getting older. The study’s authors really stress we need to figure out the best ways to deliver inpatient geriatric services. We’ve got to find ways to make them more accessible, more efficient, and keep them sustainable. We can’t just keep doing things the same way and expect better results. As the need for geriatric care keeps climbing, meeting the complex challenges of this vulnerable group will demand more research and innovation.

How Do We Widen Access?

There are different approaches we could take, of course to get these services to more people.

• One thing we could do is make routine screening for frailty and other geriatric syndromes standard practice for all older adults admitted to the hospital. That way, we’d catch more of the people who’d really benefit from a CGA.

• Plus, we need to educate the other healthcare providers, the ones who aren’t geriatric specialists, about how valuable these consultations are. Maybe then they’d refer patients earlier, and more appropriately. You know, it’s easy to get caught up in your own specialty and forget what other resources are available.

Streamlining the Process

Beyond just getting more people through the door, we’ve got to look at the consultation process itself. Can we make it better? More efficient?

This could mean:

• Developing standardized referral pathways.
• Making communication smoother between the consulting teams and the primary care providers.
• Making sure there’s proper follow-up to actually implement the recommendations that come out of the consultation.

It’s about closing the loop, isn’t it? If we don’t follow through, what’s the point of the assessment in the first place?

Keeping it Sustainable

To make sure these geriatric services can keep up with the demand, healthcare systems need to put some money into growing the geriatric workforce.

That means:

• Training more geriatricians, geriatric nurses, and other allied health pros who know their stuff when it comes to caring for older adults.
• And, yeah, it also means supporting research into new models of care, like telegeriatrics or collaborative care models. We can’t be afraid to try new things, especially when it comes to using technology to reach more people.

It’s all about finding ways to be more efficient and effective, so we can provide the best possible care for our aging population. Because, let’s face it, we’re all headed there eventually.