Dr Alexandra Wu
, a physician experienced in health and illness in the elderly, has joined The Physicians’ Clinic within its Acute and General Medicine specialty.
Dr Wu is consultant in Health Services for Elderly People at the Royal Free Hospital in London, where she provides acute care for patients aged 80 and older. “The department is very busy and I see approximately 3,000 emergency acute medical admissions each year. A multidisciplinary ward round takes place each day and we assess each patient and discuss all aspects of their health needs. Getting people home again is a priority but we need to make sure frail patients are going to be safe when they get home,” she says.
The medical needs of elderly patients made news headlines recently, with the announcement that the rate of admission to A&E for people over 70 has risen by 93% over the last 5 years. Dr Wu agrees with other experts that this trend needs to be addressed.
“Continual assessment is crucial; elderly patients can deteriorate very quickly and can become very ill as a result of problem that could have been treated promptly if it had been recognized. Keeping elderly patients out of hospital whenever possible is one of my main goals.”
Dr Wu also believes strongly in treating the whole patient, not their individual medical problems. “It is common for an elderly patient to have one acute problem and several chronic problems. We would aim to treat their severe angina successfully but we also check their functional status and home environment and assess if they have impaired mobility, risk of falling, diabetes, incontinence or memory problems. ”
This holistic approach can help patients maintain a better quality of life and to keep their independence as far as possible. “Patients with several health conditions may find it difficult to cope with the complex routine of taking medication; we can arrange for medicines to be reviewed to make this simpler without compromising the effectiveness of their treatment.”
Liaison and multidisciplinary teamwork
Being a specialist in illness in the elderly involves a great deal of liaison with other health professionals. “We work a lot with our colleagues in A&E and specialists consultants but we also involve the patient’s GP and those responsible for their care at home. At The Physicians’ Clinic, having 40+ physicians across 12 specialties will also make a holistic approach much easier. As within the NHS, I manage each case centrally, so that the patient knows that the responsibility for providing and coordinating their care rests with me.”
Enabling patients to recover at home
One of Dr Wu’s roles at The Royal Free is to lead the PACE programme – which stands for post acute care enablement. “What this means is that we identify elderly patients who may still be quite ill but who are able to recover better at home if they have the correct medical support in place.”
“Our teams of senior nurses work in the community, seeing patients everyday and we run what could be described as virtual wards. Instead of being in a hospital bed within a real ward, patients are in their own home but with the same level of medical support. Patients are delighted that they can get home and the rate of readmission to hospital for these elderly patients has dropped from about 20% to only 3.5%.”
Care for elderly patients at The Physicians’ Clinic
Dr Wu’s expertise in health and illness in the elderly will complement the already strong team of acute care consultants. “My clinics here will be for outpatients and will be based on the holistic approach that I have found works so well.”