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maltatoday | SUNDAY • 5 FEBRUARY 2023 2 CARE IN THE SOCIETY Specialised services for the elderly, all under one roof at St Vincent de Paul THE specialised and targeted services which the geriatric day hospital at St Vin- cent de Paul provides, through its mul- ti-disciplinary team of professionals and health care workers, in collaboration with Mater Dei specialists, are not only for the benefit of its residents but also for all the elderly who live in care homes and others who live in the community. This invest- ment is part of ongoing and planned pro- jects to transform St Vincent de Paul into a centre of excellence. The geriatric day hospital offers several consultation clinics which offer integrated care to patients under the same roof, thus serving to reduce pressure on the general hospital, by reducing the number of vis- its and admissions, as well as serve as an out-patient clinic. It also has several bed wards which of- fer intermediate care to those elderly who temporarily need a few days under obser- vation before returning home. The centre has also an electronic patient record so that medical staff can easily access records and communicate with other professionals working in the same environment. In this article we're focusing on just six of our clinics - the physiotherapy and the hydrotherapy services, the geriatric out- patients, audiometry clinic, ophthalmic clinic, the video fluoroscopy clinic and the vascular clinic – why are these services im- portant, what do they consist of and how can they be accessed? Geriatrics outpatient The Geriatric Outpatient at St Vincent de Paul Geriatric Day Hospital is based on the concept of later life as a natural part of an individual's lifecycle. Sessions are intended for those persons over the age of 65 and in need of a clinical assessment for various ail- ments. With advancing years, a person may bear multiple pathologies, not all of which will be symptomatic and present on a background of biological ageing. This often gives rise to the problem that the person would attribute such problems to 'old age' and hence may present and be diagnosed late for a potentially treatable disorder. A major innovation, ascribed primarily to Geriatric medicine, is the inter-disciplinary approach to the clinical assessment of the client. A functional assessment (physical, psychological, social) is an essential and integral part of geriatric practice and is carried out by the multidisciplinary team led by a Consultant Geriatrician. The cli- ent's status is evaluated, by the medical, allied health professionals and nurses and a management plan established for the cli- ent. The client is given periodic follow-up appointments to determine whether health goals are being achieved or require adjust- ments. Particular attention is also given to the older person's psychosocial needs by professionals trained in the principles of geriatrics. The philosophy underlying this concept is that practitioners would encour- age and capitalise on the person's ability to make compensations or use alternative re- sources and aides, thereby enhancing the gains to their possible maximum and min- imising the losses. In many cases, cure is unlikely, but patients would receive help to maintain their health and protect their au- tonomy and independence, to the greatest extent possible. The service can be accessed through a Primary Care Physician or the Family Doc- tor by filling in a ticket of referral and sent to the SVP Geriatric Day Hospital, Triq Florence Nightingale, Luqa LQA 3303 or online by following this link https://cpas. gov.mt/tor Ophthalmic The national ophthalmic screening pro- gramme is a new service, which will start operating this year and which will be of- fered to all elderly residents living in the Maltese Islands. All persons aged 65 plus will be invited to participate in the programme, excluding those who are already being monitored at Mater Dei Hospital. Administrative support personnel will be scheduling appointments and send letters and/smses to eligible clients. This is a very important services as it will check for signs of reduced vision, high eye pressure and problem with the retina. Sessions will be held mainly in the after- noon and weekends. Nurses at day clinic will be trained for this purpose. Videofluoroscopy Dysphagia is a swallowing disorder which can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause. Despite its enormous impact on the functional capacity, health, and quali- ty of life of the patients who suffer from it, dysphagia is underestimated and under- diagnosed as a cause of major respiratory complications in elderly patients. The pro- ce-dure is a video fluoroscopic evaluation of the functional anatomy and physiology of swallowing that permits visualisation of bolus flow from the oral cavity down to the stomach in real time. Patients who have clinical signs of dys- phagia, for example coughing on fluids or foods, pain during swallowing, food pock- eting in the mouth, etc. can consult their physician or speech language pathologist and, if indicated they will be referred. All referrals are vetted, and an appointment will be scheduled accordingly. The procedure can last up to one hour. Findings will be discussed with the patient and relevant recommendations will be giv- en. A final report with a treatment plan will be forwarded to the referring clinicians and any other specialists that may need to ex- amine the patient as per findings. Geriatrics outpatient Ophthalmic Videofluoroscopy