My second rotation in fifth year was geriatrics. I’ll start off by saying how absolutely lovely the team was. I felt well supported throughout by the consultant, reg and HMO, who were proactive, kind and inclusive. It really felt like we were on the team as well, as we were contributing by writing notes, passing messages on to and from nurses and chatting with patients.

Medicine wise, I was in a rehab ward, which meant many patients were in after stays in the hospital, who were not well enough to live by themselves. Many came from home, but could not be discharged back to their home as well. There was much allied health input - including social workers, physiotherapists and dieticians, who met weekly with the medical staff in a multi disciplinary meeting in order to update or revise the goals of discharge.

The most common presentations in the geriatric space were mandated for us to study - and included falls, dementia, delirium and complex patients. I also came to realise that a lot of the complexity of discharge was around the sometimes conflicting desires of family members, who were sometimes estranged. This made for difficult interactions at times, and required a lot of social work input. Many times, the family would be supporting the medical team but the patient would be resistant to a decision, which had its own challenges. While it felt like we had someone on our side, it was also difficult to work around the ethical pillar of autonomy when trying to convince patients that a particular decision was the medically appropriate one.

Overall, I came to understand the complexities around geriatric care, much of which revolves around social and allied health issues, on top of medical issues. It is often sad to see patients remaining in the ward for so long, so helpless, but also so resilient as well.