Geriatric Medicine

In March 2022, the Department of Geriatric Medicine of Dongguan People's Hospital was officially opened. It is the first clinical department among the city's tertiary hospitals dedicated specifically to the care of older people. It provides one-stop diagnostic and treatment services for older adults and has attracted keen public attention.

The Department of Geriatric Medicine is located on Level 3 of the Multipurpose Building (综合楼) at the Honglou Campus of Dongguan People's Hospital. The department currently has 39 beds in use. It is a comprehensive department integrating medical care, health care, research and teaching, with strong technical capacity. It currently has more than 20 medical and nursing professionals, including 3 chief physicians, 3 associate chief physicians, 1 attending physician and 1 resident physician (Chinese professional-title system), as well as 1 master's degree supervisor and 3 master's degree holders. It operates a special-need medical centre (特需医疗中心), geriatric wards and a geriatric outpatient clinic. The environment is clean, comfortable, spacious and bright. Wards are two-person rooms or single rooms, with private toilets, bathing and other facilities, and an activity room is provided for recreation.

The department is mainly engaged in the clinical diagnosis, treatment, prevention and rehabilitation of diseases of old age, provides high-quality medical and health-care services, conducts basic and clinical research on geriatric diseases and trains high-level professionals in geriatric medicine. The wards are comfortable, with complete facilities and comprehensive supporting services. The department has a complete central monitoring system and has recently purchased a batch of intelligent rehabilitation training equipment and various diagnostic and treatment devices, such as non-invasive ventilators, headache treatment devices, vibration sputum-expulsion devices, lower-limb pneumatic pressure-wave therapy devices and cognitive function training kits.

The medical team has mastered the diagnostic and treatment techniques for age-related diseases, and has established geriatric neurology, geriatric cardiovascular, geriatric respiratory and geriatric nephrology groups. It has extensive experience in managing common geriatric conditions such as cerebrovascular disease, dementia, hypertension, hyperlipidaemia, coronary heart disease, osteoporosis, pulmonary infection, chronic obstructive pulmonary disease (COPD), senile dementia and Parkinson's disease, and provides continuous follow-up management for patients after discharge.

While attaching importance to the quality of medical care, the department also attaches importance to personnel training and research. As a postgraduate enrolment base, it currently enrols master's degree students in geriatric medicine from Guangdong Medical University. It has received the Dongguan Science and Technology Progress Award (second prize) twice and the third prize once. The research projects currently under way include three items: a key project of Dongguan social science and technology development, a project of the Guangdong Provincial Health and Family Planning Commission, and a project on optimising teaching in standardised residency training. It has published more than 30 papers in SCI journals, in the journal series of Chinese medicine associations (中医学会系列杂志), in science and technology core journals (科技核心) and elsewhere, holds 1 invention patent, and has produced 5 professional books with its staff as editor-in-chief or associate editor-in-chief.

Development goals and positioning of the department 1. Proceeding from the characteristics of the older people admitted to the department — "many disease entities, severe conditions, poor physical constitution, weak nutritional status and strong dependency" — explore and establish a composite prevention and treatment system for geriatric diseases, and improve the survival and quality of life of admitted older residents; provide advanced life support for critically ill patients and prolong their survival. 2. Establish disease risk assessment, nutritional risk assessment and daily living ability assessment systems adapted to the older population, to guide admitted older people in convalescent care and health maintenance. 3. Train composite medical and nursing personnel for geriatric disease management, and promote the building and development of the discipline of geriatric medicine.

Services provided by the department 1. Comprehensive geriatric assessment. Because older people often have geriatric syndromes — such as falls, dementia, urinary incontinence, syncope, delirium, insomnia, pain, depression, frailty syndrome and polypharmacy — the geriatric medicine division carries out a number of comprehensive geriatric assessments, such as assessment of cognitive function, assessment with depression scales, assessment of delirium, assessment of falls and nutritional assessment in older adults, and has carried out research related to geriatric frailty. 2. Diagnosis and treatment of common geriatric diseases. The medical and nursing team of the geriatric ward is composed of staff who have long been engaged in health care for cadres. They are experienced, technically solid and advanced in their approach, with a strong sense of responsibility and great enthusiasm for their work; in their work they highlight the characteristics of the geriatric specialty and improve patient satisfaction. For patients whose conditions involve several disciplines, [the department] provides clinical diagnosis, treatment and nursing care, preventive guidance and safety prevention for geriatric cardiovascular diseases, geriatric respiratory diseases, geriatric digestive diseases, geriatric endocrine diseases, geriatric neurological diseases, osteoporosis and geriatric bone and joint diseases — for example senile constipation, geriatric malnutrition, geriatric frailty, senile dementia, geriatric pain, vertigo, geriatric delirium and geriatric sleep disorders. 3. Multidisciplinary team diagnosis and treatment model. The department breaks away from the single-disease model of diagnosis and treatment and adopts a patient-centred service concept with comorbidity management and polypharmacy management at its core, emphasising a multidisciplinary collaborative diagnosis and treatment model and forming the specialty features of chronic disease management in older people, emergency care and maintenance of function in older people. It concentrates on comprehensive treatment in the acute phase in older adults, which, according to the department, has effectively improved the self-care ability and quality of life of older patients, reduced the average length of stay of patients and helped patients return to their families and to society as early as possible. 4. Health education. Our department conducts popular science education on health knowledge with the prevention of chronic diseases in older people as its theme, further enhancing older people's understanding of diseases and their awareness of prevention. From time to time it holds various health lectures and free clinic activities, stimulating older people's awareness of self-care — of caring for themselves and caring for their health. Safeguarding the health of older people is the eternal pursuit of all the staff of our department. 5. Nursing team. Under the leadership and guidance of the hospital and the nursing department, the department's nursing team takes "the patient as the centre" and, with the warm service of the "five hearts" — loving care, patience, attentiveness, enthusiasm and reassurance — as its tenet, actively develops high-quality nursing services. It provides nursing care that is efficient, convenient, prompt, humanised, of high quality throughout the whole process and seamless. The geriatric nursing team is professional and experienced, and carries out nursing work to prevent aspiration, pressure ulcers, falls and accidental removal of tubes and catheters.

Which patients are suitable for the geriatric medicine outpatient clinic? 1. Older patients who have several chronic diseases at the same time, take several medicines and need to have their medication simplified, an individualised treatment plan drawn up and comprehensive treatment provided. 2. Older people who have too many symptoms or whose symptoms are atypical, who do not know which department to attend and hope to receive a doctor's guidance. 3. Older people who are concerned about their own health and quality of life and who, in health maintenance, prevention and assessment of their own functional status, wish to detect functional decline early and hope to receive a doctor's guidance for early intervention.

"Honour the aged of your own family, and extend it to the aged of other families". All the medical and nursing staff of the department will do all they can to give back to society and will continue wholeheartedly to provide high-quality medical and nursing services for older friends, safeguarding the health of older friends.