Geriatric Evaluation and Management In The Home

Geriatric Evaluation and Management in the Home (GEMITH) delivers comprehensive geriatric assessment and goal-directed care where it is most accurate and most effective – in the older person’s own home.

A ward is a poor place to assess function. It removes many of the cues an older person relies on and introduces risks a hospital cannot fully engineer away – delirium in unfamiliar surroundings, deconditioning from days in bed, and falls on unfamiliar ground. Assessing someone in their own kitchen, on their own stairs and in their own bathroom produces a truer picture of what they can do and what would need to change for them to remain independent.

Our multidisciplinary team – comprising nursing, physiotherapy, occupational therapy, pharmacy and social work, under the oversight of a geriatrician – completes a comprehensive assessment across medical, functional, cognitive, medication and psychosocial domains. From there, we negotiate goals with the patient and their family, deliver the therapy and medical management needed to reach them, and review progress against those goals. Medication review at home, against what is actually in the cupboard, routinely finds what a ward reconciliation can miss.

Patients remain admitted to your service under your governance, with 24/7 clinical support and a defined pathway back to a bed if their condition deteriorates. Episodes are reported against the GEM care type.

Because the assessment happens in context, the decision about what comes next is better informed – including whether residential care is genuinely needed or whether the right supports at home would be enough. That is a decision worth getting right, and one that is very difficult to make from a ward bed.