It's often called the silver tsunami - the aging population that many countries are facing. At Australia's biggest trauma hospital, doctors have noticed a significant jump in the number of older people being admitted after falls. Worried that many were suffering poor outcomes, they've come up with a solution - a special geriatric trauma service. For this special report, our reporter Natalie Whiting joined the geriatricians on their rounds.
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00:00 Communication is key for a geriatrician.
00:07 Is that on?
00:09 But it's not always easy.
00:11 Is that working?
00:13 Hang on, there we go.
00:15 Does that work better?
00:17 Yeah, I can hear you.
00:18 This device connects to Douglas Hill's hearing aid.
00:21 I'm a geriatrician, so I'm a specialist doctor who looks after older people.
00:26 Mr Hill is among a growing number of older people coming to Australia's busiest trauma hospital
00:32 after a fall from standing height.
00:35 When you get on the floor and you can't get up,
00:38 and you lay there for a couple of hours,
00:42 and you don't know where your phone is, you can't reach it, you can't get to it,
00:47 it's a pain in the arse.
00:49 His recent bouts of blacking out and collapsing have been caused by heart problems
00:55 and tomorrow he'll have a pacemaker fitted.
00:57 And hopefully that means you won't fall over anymore.
01:00 Yeah.
01:01 He's taking the news well.
01:04 I'll tell you one thing.
01:05 Yes.
01:06 I had a mate who said to me once,
01:08 twice a baby and once a man.
01:11 That's right.
01:13 And not bloody wrong, either.
01:16 Dr Margot Lodge leads a new team called the Geriatric Trauma Service.
01:22 It was introduced 12 months ago.
01:24 There is this recognition that we can work alongside other medical specialists
01:30 and surgical specialists to provide care for this group of patients
01:35 who have very specific and complex care needs.
01:39 People over 65 now account for one in three major trauma admissions to the Alfred Hospital.
01:46 I might be good at actually treating the injuries and the complications related to the injuries,
01:51 but all the other comorbidities, how this overlays on the injuries,
01:54 you need the expertise of the geriatrician.
01:57 An increase in admissions for falls from standing height prompted the introduction of the new team.
02:03 They have a plethora of complications which includes the medical comorbidities
02:07 plus the secondary injury that has been caused by the fall
02:10 and then associated with that there's a vicious loop of complications that come in after that.
02:15 Falls are the number one cause of hospitalisation and deaths from injury in Australia by a long way.
02:23 They account for more than 40% of both.
02:26 People aged over 65 are the most likely to end up here after a fall
02:32 and the risk continues to increase with age.
02:36 How are you?
02:39 Now that I met you, you were one of the doctors here, I'm feeling top of the world.
02:44 Duncan Bartholomew couldn't say that a few days ago.
02:47 You were pretty crook last week.
02:50 He's been here for a month after falling from a ladder while gardening.
02:54 He had other complications and then came down with delirium,
02:59 which is common among older people who have long hospital stays.
03:03 Patients can become very agitated, likewise they can become extremely sedated
03:07 and almost look like they're in a coma
03:09 and so there's a huge range of different management plans that need to be instituted
03:14 to look after this very unwell patient.
03:17 He knows it's a dream, but he can't get out of it.
03:23 It's the first time I'd experienced something like that and I'm a nurse,
03:26 but I had never seen that kind of delirium before.
03:30 Preventing or quickly treating complications is a focus for the team.
03:35 We take the pressure off the trauma junior doctors because we manage all of that
03:39 and we educate them as we're going.
03:41 Other hospitals are watching what's happening here.
03:44 It's just a question of getting the money and the training,
03:48 but we actually need more resources and more people that are trained
03:53 in looking after older and more complex patients.
03:56 Geriatricians are working in more areas, including emergency, oncology and orthopaedics.
04:04 Wherever we have older people with multiple comorbidities,
04:08 we need geriatricians working alongside the single organ specialists.
04:16 Finally back home, Duncan Bartholomew credits the support of his family for getting him through.
04:22 I'm feeling better and getting more confident as the days go by.
04:29 Home is where I belong.
04:31 [BLANK_AUDIO]