Short-term geriatric assessment units: 30 years later
1 Research Centre, Institut universitaire de gériatrie de Montréal, 4565 Chemin Queen-Mary, Montréal (QC), H3W 1W5, Canada
2 Service de gériatrie, Hôpital St-Luc, Centre hospitalier de l'Université de Montréal, 1058 rue St-Denis, Montréal (QC), H2X 3J4, Canada
3 Direction de santé publique et d'évaluation, Agence de la santé et des services sociaux de Lanaudière, 245 rue du Curé-Majeau, Joliette (QC), J6E 8S8, Canada (at the time of the study)
4 Department of Health Administration, School of Public Health, Université de Montréal, Pavillon Mont-Royal, 1430 boul. Mont-Royal, Montréal (QC), H2V 4P3, Canada
5 Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto (ON), M5G 1V7, Canada
BMC Geriatrics 2010, 10:41 doi:10.1186/1471-2318-10-41Published: 22 June 2010
The increasing number of hospitalized elderly persons has greatly challenged decision makers to reorganize services so as to meet the needs of this clientele. Established progressively over the last 30 years, the short-term Geriatric Assessment Unit (GAU) is a specialized care program, now implemented in all the general hospital centres in Quebec. Within the scope of a broader reflection upon the appropriate care delivery for elderly patients in our demographic context, there is a need to revisit the role of GAU within the hospital and the continuum of care. The objective of this project is to describe the range of activities offered by Quebec GAU and the resources available to them.
In 2004, 64 managers of 71 GAU answered a mail questionnaire which included 119 items covering their unit's operation and resources in 2002-2003. The clinical and administrative characteristics of the clientele admitted during this period were obtained from the provincial database Med-Echo. The results were presented according to the geographical location of GAU, their size, their university academic affiliation, the composition of their medical staff, and their clinical care profile.
Overall, GAU programs admitted 9% of all patients aged 65 years and older in the surveyed year. GAU patients presented one or more geriatric syndromes, including dementia. Based on their clientele, three distinct clinical care profiles of GAU were identified. Only 19% of GAU were focused on geriatric assessment and acute care management; 23% mainly offered rehabilitation care, and the others offered a mix of both types. Thus, there was a significant heterogeneity in GAU's operation.
The GAU is at the cutting edge of geriatric services in hospital centres. Given the scarcity of these resources, it would be appropriate to better target the clientele that may benefit from them. Standardizing and promoting GAU's primary role in acute care must be reinforced. In order to meet the needs of the frail elderly not admitted in GAU, alternative care models centered on prevention of functional decline must be applied throughout all hospital wards.