Care for the elderly

All hospitals in the IRIS Network (with the exception of the Children’s Hospital) offer a geriatric service. This wide-ranging availability is essential to geriatric care, as it must be delivered locally.

The IRIS geriatric public network is the largest in the Brussels region, with around 300 acute geriatric beds (out of a thousand available country wide), in addition to which, through our cooperation agreements, there are another 168 sub-acute geriatric beds, 76 psychogeriatric beds and 6 oncogeriatric beds.

In 2007, our hospitals were approved by the PSG (Geriatric Patient Care Programme). In recent years, PSG implementation has brought new momentum to practice in the field of care, designed to meet the needs and problems of the elderly and frail. Due to this Programme, all elderly and frail patients now benefit from a global approach aimed at ensuring good collaboration and strong communication among the different health care providers at home and attending physicians.

The PSG is based on five principles:

• In-patient care. This treats patients, suffering from acute conditions (infections, heart, lung, digestive and neurological problems, etc) or who need an assessment that cannot be done on an out-patient basis. The aim of hospitalisation is to treat patients and to help them recover their independence, so that they are able to return to their normal living environment. The team is composed of doctors, nurses, physiotherapists, speech therapists, neuropsychologists, dieticians, social workers and care assistants.
• Geriatric consultation. This is designed for elderly people in complex situations with a combination of medical, psychological and social problems. The end objective is to reach a diagnosis and to suggest and/or adapt treatment accordingly.
• Geriatric out-patient care. This provides GPs and elderly patients with diagnostic assessments, treatment and rehabilitation on an out-patient basis. Personalised care is provided.
• Internal liaison team. This team carries out geriatric evaluations of all frail, elderly patients, identified by the ISAR scale and admitted to a hospital department other than Geriatrics. A report, also sent to the GP, is given to the health care teams concerned with proposals for action to address geriatric syndromes such as nutrition, incontinence, fall prevention, etc.
• External liaison. This places the expertise of the hospital geriatric team at the disposal of attending physicians and home carers or care assistants in rest homes and nursing homes, in order to ensure optimum continuity of care.

To provide the best possible care for our elderly patients, IRIS Network hospitals have developed functional links with geriatric and psychogeriatric rehabilitation centres, including the Brussels CPAS Pacheco Institute and the CPAS Geriatric Rehabilitation Hospital at Woluwe-Saint-Lambert. In addition, many rest homes, nursing homes, day-care centres and GP associations have entered into cooperative agreements with the different IRIS Network PSGs.

Finally, a number of oncogeriatric projects are being developed, including a cooperative agreement between the Jules Bordet Institute and the PSG of the neighbouring Saint-Pierre Hospital.

Working together to prevent fractures

Among the IRIS Network projects under development is a multi-site, added value project to put in place multidisciplinary coordinators for the care management of elderly patients with low energy fractures. This project will require the collaboration of geriatricians via our out-patient care services and internal liaison team in the screening and management of patients with osteoporosis who have suffered falls.

In the past, few patients who suffered spontaneous fractures received follow-up care to prevent the risk of a fall or to investigate the possibility of osteoporosis and, where necessary, offer treatment for this.