Exactly what you are asking the geriatrician to do – ask your registrar or consultant if unsure. Common reasons include: approval for ACAT assessment, prolonged delirium, capacity assessment, diagnosis and management of cognitive impairment.
The patient’s baseline level of function/independence/cognitive function. You may need to gather collateral history from family, etc.
Goals of care for the patient, including resuscitation status.
Is the patient known to a geriatrician? When were they last seen? If possible, you should obtain any relevant letters from the geriatrician’s rooms/clinic prior to calling for the consult.
The baseline level of cognitive function. (A cognitive history from family and results of recent cognitive screens i.e. MMSE/ MoCA/RUDAS/ACE-III.)
Medication history – engage your helpful pharmacist or call local pharmacy yourself. (NB: sleeping tablets are often taken and not reported.)
Social history, including alcohol intake.
Functional background, including personal and instrumental activities of daily living.
A cognitive screening test (commonly used tests include MMSE, MoCA, RUDAS).
Occupational therapy, physiotherapy and social work assessments.
If the patient is delirious: workup to exclude reversible cause such as infection – bloods, CXR, UA/MSU and blood cultures, consider delirium pathway including regular CAM (see reference).
Discuss with registrar regarding need for a cerebral imaging if not previously performed – useful in assessment for reversible causes of cognitive impairment or initial diagnosis.
Not having arranged allied health assessments prior to requesting the consult – this is likely to be the first thing the geriatrics registrar asks you to do, especially if the request is for an ACAT assessment.
They are likely only to consider taking over care if the patient has multiple complex medical or social issues that require specific geriatric input.
Not chasing collateral history from family members/carers – is the current level of function different from baseline or are they at their usual level?
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