Geriatrics consult service boosts quality of life

This story appeared in the Internal Medicine Department’s 2022 Biennial Report, which was published earlier this year.

When aging adults are admitted to the hospital, they face a high-risk time.

Many older patients are living with chronic health and cognitive issues, in addition to the acute illness that brought them into the hospital.

Hospitalization is a time of care transitions, sometimes from independent community living to an institutional setting. Research shows such patients are at high risk of poor outcomes, said Jessie Jenkins, MD, assistant professor in UNMC’s geriatrics and hospital medicine divisions.

The situation calls for increased support for those patients — and the med center has a program to rally that care.

Through the UNMC Division of Geriatrics, Gerontology and Palliative Medicine, the med center offers inpatient consults by board certified geriatricians. Formed 1½ years ago, the consult service helps address the shortage of geriatricians in relation to the aging population.

Through the program, five physicians rotate on the service Mondays through Fridays year-round. Dr. Jenkins is on the team.

Presented with a case, the consulting physicians are faced with understanding the context of what brought the patients to the hospital. Then their task: how to improve the patient’s situation.

Dr. Jenkins said the service applies a philosophy around the four M’s of geriatrics: Mind, medication, mobility and “matters most.”

The consulting physicians will try to make sense of the complex interplay among such difficult issues as dementia, pill burden and falls. The concept behind “matters most” puts the patient’s highest priority front and center in considering how to respond to the other three areas.

The syndromes facing geriatric patients are frequently influenced by multiple factors, Dr. Jenkins said, so the physicians’ recommendations are always multi-faceted and specific to the individual.

Said Dr. Jenkins, “I don’t think I’ve ever gotten a consult where I don’t think that I’ve made a significant improvement in the patient’s quality of life when all is said and done.”