253 An Overview of the Current Status of Specialist Geriatric Services in Ireland

Abstract

Abstract Background The Royal College of Physicians of Ireland and the National Clinical Programme for Older People conducted a national survey of Specialist Geriatric Services (SGS) in 2014. The survey was repeated in 2018-2019 period to collect data on the resources available for the care of older people attending hospitals and associated communities in Ireland. Methods Participants were geriatrician leads or proxies in each hospital in Ireland. Questions based on the 2014 survey were updated to include frailty and dementia-delirium specific questions. Data were collected between September 2018 and April 2019 using an electronic survey. Comments from open-ended questions were analysed using qualitative analysis methods. Results In total, 20 fully complete and 18 incomplete responses were received. Most complete responses were from model 3 or 4 hospitals (n= 14/20). Less than half (47%) reported having a dedicated specialist geriatric ward in their institution. Half (50%) reported currently developing an integrated plan for services for frail older people with complex care needs. Barriers to managing frailty that were identified included limited access to funding and staffing. 82% reported that their group/area/unit/department engaged in case-finding for frailty. The most commonly used frailty-specific screening tools were the CFS (n=9), VIP (n=6), FRAIL scale (n=4), and PRISMA-7 (n=3). A National Frailty Education Programme governance structure was operational in 9/20 sites. Half (50%) reported that their hospital has an integrated pathway for people with dementia and/or delirium, although (82%) stated that their hospital does not formally screen all older people for cognitive impairment in the ED/AMAU, and does not formally screen people at risk for delirium on wards on a daily basis (100%). Conclusion Limited staffing and resources were reported for many aspects of SGS in Ireland. Although frailty and dementia-delirium are recognised as priority areas, there is need for standardised assessment and screening approaches.