TEAM AND CATCHMENT AREA
Our department was founded in 1993, based on the recommendations of the Dublin Hospital Group (the Kennedy report) and The Years Ahead a blueprint for services for the elderly in Ireland.
The department was based up to June 21 1998 in the Meath and Adelaide hospitals and is now based in the William Stokes Unit, a purpose-built unit in the Tallaght Hospital. In conjunction with the departments of geriatric medicine of St James's Hospital and Naas Hospital, we provide specialist secondary and tertiary services for people over 65 in the areas of Southwest and South Central Dublin.Most recently, we have started a rehabilitation service with Peamount Hospital (Dr Rónán Collins, and from July 2007, Dr Tara Coughlan). Specialist services include those for stroke, dementia, falls and driving assessment (Dr Anne O'Driscoll), with Clinical Nurse Specialists developed in Stroke and Falls. A Stroke Unit was opened in 2009, and the first distance thrombolysis for stroke performed in 2010. In addition, a consultant physician in geriatric medicine has been appointed to the Acute Medical Unit in the Hospital
The assessment and rehabilitation beds, dedicated rehabilitation staff, Stroke Service, Charlie O'Toole Day Hospital, Visiting Sister, Centre for Mobility Enhancement and department offices are based in the William Stokes Unit at the Adelaide and Meath Hospital Dublin incorporating the National Children's Hospital, Tallaght, Dublin 24.
There is a weekly out-patients in geriatric medicine (Wednesday pm) and a daily stroke/rapid access TIA clinic (run alternate week by the geriatricians and neurologists).
Our core service is to provide rapid interdisciplinary assessment, treatment and rehabilitation of older people on a secondary and tertiary referral basis. In our in-patient unit, over two-thirds of our admissions are from the Accident and Emergency Department (ER) and over 85% return home.
Our out-patient service is notable for domiciliary assessment by a specialist assessment nurse. Within two working days of referral by the family doctor, the patient is assessed in their own home, screening phlebotomy performed, and transport arranged. At the clinic she arranges an electrocardiogram and chest X-ray. The benefits are: i) a more complete assessment, ii) a one-stop-shop approach with few (if any) repeat out-patient visits, iii) no waiting list. Clinics are on Wednesday afternoon (Prof O'Neill and Dr Collins). A falls service is currently has been developed for A/E referrals by Dr O'Driscoll.
Day hospital services are used when a patient requires at least two modalities of medical/rehabilitation treatment. Referral is from the out-patient clinic or from the in-patient beds. The Charlie O'Toole Day Hospital opened on May 8, 2001.
The Centre for Mobility Enhancement was founded in 1996 to aid in the assessment and rehabilitation of older drivers with medical problems or functional limitations.
The first acute Stroke Service in the Republic of Ireland was started on 1 July 1996 on a trial basis by Dr Patricia McCormack. Under the current direction of Dr Collins, all patients admitted to the hospital as a result of stroke or transient ischaemic attack will be offered admission to the stroke service. A TIA service has been available since 1995, and since January 2006 has been offering a rapid acess, rapid turn-around services to GPs and A/E in Tallaght, exclusively on the basis of using a pro-forma, which can be downloaded here or through the official hospital website, www.amnch.ie.
A falls and bone health service is under development.
Assessment for suitability for extended care is carried out on both an out-patient and in-patient basis.
Centre for Mobility Enhancement: no limitation - also no domiciliary assessment
The department is staffed by three consultant physicians, Professor Desmond O'Neill MD FRCPI, Dr Ronan Collins MD MRCP, and Dr Tara Coughlan MRCPI, with 3 sessions being provided by Dr O'Driscoll, two registrars (fellows), one senior house officer (resident) and two interns. The specialist nursing staff is led by clinical nurse managers and a specialist nurses in domiciliary assessment, stroke and falls.
The Age-Related Health Care team is supported by therpaists, including physiotherapy, occupational therapy, speech therapy (speech pathology), clinical nutrition and social work. We work closely with Old Age Psychiatry, directed by Dr Gregory Swanwick, MD MRCPI MRCPsych and Dr Siobhán Ní Bhriain MRCPI MRCPsych.
The Stroke Service consists of one one Specialist Registrar, one intern and part of one social worker, one occupational therapist, one speech therapist, one physiotherapist and support from clinical nutrition.
Administrative and secretarial support is provided by a departmental secretary.
Out-patient appointments (all patients must be referred by their family doctor):
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