Contributor: Sangam Malani, Registrar in Elderly Medicine, London, Clinical Quality Trainee Representative
Origin/Affiliation: British Geriatrics Society, London
What I’ve always loved about Geriatric Medicine is the variety of work it offers. Be it in the nature of its setting, ward vs. clinic or, the nature of the work, acute vs. chronic. The stroke calls get your adrenaline going but so do the delirious old patients hell-bent upon leaving the ward. And, something as equally satisfying as de-escalating the said delirious patient without any sedatives, is the feeling that accompanies a successful complex discharge. Some of the most rewarding work I have done has been with this patient population. A memory that stands out to me is one where a patient with poor safety awareness and recurrent falls, consistently refused to go to a nursing home. On digging into his refusal, it appeared that this was a man with great pride who was fiercely independent previously, and being dependent on someone compromised his dignity. We, therefore, spoke to him and found a middle ground where he accepted going to Sheltered Accommodation. I still remember his sparkling eyes and the tears of joys that followed as he told me all about his new place and how they were going to personalize it for him. But most of all, I remember how he held on to my hand a little a bit longer as I was leaving his bedside and the catch in his voice as he said thank you. And that is what Geriatric Medicine is about - Listening. Listening to the multi-disciplinary team (MDT) looking after the patient, listening to the patient’s family, and listening to the patient and remembering, that after all, THEY are the most important member of the MDT. I get goosebumps some days going into work as I realise the privileged position, I am in. I feel honoured to be in a place to offer advice, support, and empathy to these patients, all whilst juggling complex decision making and ethical issues. But clinical medicine aside, the academic aspect to it is very stimulating too. Given the projected growth of the older population, we are afforded the opportunity to align our policies and health care system to the evolving needs of an ageing community and there is no better way to do this, than through research. Whilst previously, research hasn’t been inclusive of our older population, given the aging population, there is a real drive for this, making Geriatric Medicine an ever growing and exciting field. One that has proven itself, time and time again, to be the perfect amalgamation of medicine and holistic care.
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