Healthcare & Social Services Access to MCMOP Frail Elderly - PowerPoint PPT Presentation

Healthcare & Social Services Access to MCMOP Frail Elderly North Dublin POA At Home PHN Steering Senior SW for St Mary’s OP Clinical & Group for OP Hospital Social Care Day Hospital Other CCM MDT Community Community RANP Response Frail elderly Diagnostics MCMOP In NH & Geriatrician CGA Intervention RANP Acute, chronic CIT CCM illness CRT (CNS) End of life Imaging Acute Management Hospital Respite care Post dc follow up Home care Specialist Non-attendance Package OPD PCCT CSAR Palliative ED -GP - Social Care worker Safe guarding

Emergency Attendance of Nursing Home residents: DNC Outcome of Nursing Home residents at ED 2008 to 2016 ED Transfer and Admission rate per bed per year 2008 to 2016 Adm DC DID Transfer rate Admit rate MCMOP 10 10 0.48 8 0.45 7 0.43 281 9 210 0.40 0.40 8 0.38 0.37 187 0.35 0.35 264 12 181 13 10 0.29 248 0.27 0.26 169 187 0.24 172 0.21 0.21 0.21 0.19 0.18 398 379 350 326 296 240 224 229 197 Yr2008 Yr2009 Yr2010 Yr2011 Yr2012 Yr2013 Yr2014 Yr2015 Yr2016 Yr2008 Yr2009 Yr2010 Yr2011 Yr2012 Yr2013 Yr2014 Yr2015 Yr2016 Proportion of ED attendances requiring inpatient care (monthly vs yearly) 0.9 0.8 Presenting Complaint at Triage 0.7 Y2013 Y 2016 0.6 Unwell Adult 235 Unwell Adult 175 0.5 Fall 125 Fall 89 0.4 Shortness of Breath 91 Limb Problem 59 0.3 Limb Problem 72 Urinary Problem 53 0.2 Collapse 59 Shortness of Breath 47 0.1 Urinary Problem 42 Collapse 29 0 Oct-06 Feb-08 Jul-09 Nov-10 Apr-12 Aug-13 Dec-14 May-16 Sep-17 Proportion admit (mth) Proportion admit (yr)

“I want to stay home, sit in my chair to watch TV, look out the window” • 78 yo Man, He lived at home for 18 months Integration in Action sheltered accommodation, • Diabetes Mellitus, • Insulin requiring Frail Elderly (PHN) , At Home • heart failure, PHN * Senior SW for • recurrent cellulitis St Mary’s OP Clinical & Hospital • bilateral forefoot Social Care Day Hospital Other CCM amputee, MDT Community Community • recurrent falls, RANP 2 Response * • mild vascular 3 cognitive 7 impairment, 6 Frail elderly Diagnostics MCMOP • dietary non- In NH & 9 Geriatrician CGA Intervention compliance, RANP * Acute, chronic CIT* • medication non- CCM * illness CRT (CNS) adherence End of life * Imaging • NOT SAFE TO BE 5 1 AT HOME 4 8 Acute Management Hospital Respite care * Post dc follow up * Home care Non-attendance Package * OPD PCCT CSAR * ED -GP * - Social worker Safe guarding