Geriatrics - Palliative Care Department
Overview
Aging is an inevitable law in every person's life cycle. In addition to physiological aging that alters the structure and function of many organ systems, older adults often suffer multiple diseases simultaneously, making the treatment of common conditions more complex. Therefore, this group requires specialized, individualized medical care to maintain health and longevity.
The Geriatrics – Palliative Care Department of the University of Medicine and Pharmacy Hospital in Ho Chi Minh City is one of the first units to implement medical care models dedicated to the elderly and particularly chronic patients in the final stage, not only focusing on treatment but also integrating multiple care therapies to improve patients' physical and mental health.
Given the department's unique nature, the multidisciplinary team of physicians, nurses, pharmacists, social workers and psychologists … who work here always share with patients throughout each treatment stage. In addition to pharmacological therapies, being listened to and understood is the “spiritual medicine” that provides comprehensive care centered on patients and their families.
Strength
1. New techniques that have/are being/will be implemented
Cognitive assessment protocol for hospitalized elderly patients.
Fall prevention protocol for the elderly.
Interdisciplinary collaboration practice protocol, patient‑centered care.
Comprehensive geriatric assessment for elderly inpatients at the Department.
2. Evaluation of the department's position compared to other specialties at peer hospitals regarding scope of specialized, high‑tech and deep expertise
One of four multi‑specialty hospitals in Ho Chi Minh City with a Geriatrics Department.
One of three multi‑specialty hospitals with an inpatient palliative care unit in Ho Chi Minh City.
The only model nationwide that combines Geriatrics and Palliative Care; integrates the Hospital with the University (University Medical and Pharmacy Hospital of Ho Chi Minh City and University Medical Center Ho Chi Minh City); combines the Geriatrics Department, Palliative Care Department, and Geriatrics – Palliative Care Department.
The only model implementing pre‑operative geriatric assessment, comprehensive geriatric assessment, frailty assessment for the elderly, palliative care, comprehensive elderly care with an interdisciplinary team (Medicine/Psychology/Social/Spiritual).
3. Treatment protocols
Low back pain treatment in the elderly
Guidelines for diagnosis and medical treatment of neutropenic fever in palliative care
Protocol guiding discussion for decision‑making on do‑not‑resuscitate wishes
Protocol for diagnosis and medical treatment of spinal cord compression in Palliative Care
Pain management protocol in Palliative Care
Guidelines for diagnosis and treatment of opioid toxicity in Palliative Care
Guidelines for diagnosis and treatment of hypercalcemia in Palliative Care
Protocol for acute pain management in Palliative Care
The Department always emphasizes the importance of high‑quality human resources that meet ethical and academic standards in fulfilling its mission:
Providing inpatient and outpatient medical services for the elderly (≥60 years).
Providing inpatient and outpatient medical services for patients requiring palliative care (cancer, life‑threatening serious illnesses, severe chronic diseases especially in the end‑stage). Specifically in Geriatrics, patients are diagnosed and treated for internal diseases, multimorbidity, polypharmacy in an inpatient setting at the Department and receive outpatient care at the Geriatrics clinic.
Elderly inpatients at the Geriatrics Department receive a comprehensive geriatric assessment, including:
Fall‑risk assessment to implement appropriate prevention measures.
Consultation, prevention and care of ulcers to provide suitable treatment according to the severity of the lesion and disease condition.
Assessment of cognitive decline and dementia for screening, prevention and early, appropriate interventions.
Nutritional assessment.
Functional activity assessment, frailty status, life‑expectancy evaluation, and discussion of care goals.
Discussion of treatment plans aligned with care objectives.
End‑of‑life care for the elderly, controlling terminal stage symptoms.
Pre‑ and postoperative internal disease control assessment for all elderly patients undergoing surgery to minimize peri‑operative complications and promote good postoperative recovery.
In the field of Palliative Care, hospitalized patients receive:
Pain assessment and timely pain control.
Assessment and appropriate treatment of other symptoms requiring palliation such as dyspnea, nausea/vomiting, bleeding, malignant wounds, pressure injuries, edema, ascites, thromboembolism,…
Provision of correctly indicated opioid therapy for cases of pain or dyspnea due to cancer or end‑stage chronic illnesses.
Discussion with patients and families about care goals, future medical care plans, leading to a palliative care plan, and shared decision‑making on appropriate medical interventions for each disease stage.
In addition to effectively treating physical issues, palliative care activities also include psychological, social, and spiritual support for patients, caregivers, and families through collaboration with social work staff and clinical psychology counseling units to optimally support patients, helping them improve quality of life and better adhere to treatment measures.
After discharge, medical staff will guide patients to continue using effective and safe analgesics at home, regularly call to check on the patient and family, especially for patients with limited life expectancy who wish to be discharged and receive home care, while providing a support phone number for patients when needed and offering outpatient follow‑up after hospitalization.
Training & Research
The Geriatrics – Palliative Care Department always focuses on parallel development of training and scientific research, viewing this as an important foundation to improve diagnostic quality and patient service
Alongside its goal of being a specialized medical treatment center for elderly patients and those with life‑threatening serious illnesses, the Geriatrics – Palliative Care Department also serves as a training and practice base for undergraduate and postgraduate students in Geriatrics, Palliative Care, Family Medicine, Nursing, Medical Technology… at the University Medical Center Ho Chi Minh City. Foreign experts who have collaborated in teaching at the department include:
Assoc. Prof. Dr. Eric L. Krakauer – Director of International Programs, Palliative Care Center, Harvard University.
Dr. Ronald W. Sand – Senior consultant for International Programs, Palliative Care Center, Harvard Medical School and Massachusetts General Hospital.
Dr. Roger Strong – Former practicing nurse, End‑of‑Life Care Center, San Diego.
In addition to treatment, teaching, and scientific research, the Geriatrics – Palliative Care Department also contributes to community health care and medical education by annually organizing events such as “Elderly Day”, “World Palliative Care Day”, “World Dementia Day” with wide public participation. Consequently, the dissemination of basic medical knowledge to the public has been strengthened and achieved significant effectiveness.
The department is also a place for practicing social work and psychology in medicine for students of related fields. Not stopping there, the Geriatrics – Palliative Care Department is also a place for clinical teaching cooperation and scientific research with many prestigious universities worldwide: Harvard University, University of California San Francisco,…
Equipments
To effectively meet treatment and patient care needs, in the future the Geriatrics – Palliative Care Department will focus on fully equipping facilities with advanced equipment such as: inpatient treatment rooms, intensive care unit for critically ill patients (Level I), private rooms supporting end‑of‑life patients, operating rooms, rehabilitation training rooms for the elderly after acute phase, functional rehabilitation rooms, exercise rooms for the elderly focusing on mobility, occupational and speech therapy, and multifunctional rooms serving families and staff...
Staff
The Geriatrics Department – Palliative Care is characterized by an interdisciplinary staff team of doctors, nurses, pharmacists, professional caregivers, ... with many years of experience and specialized training in geriatrics and palliative care.
In the future, the department will also be supported by social work personnel, psychologists, spiritual support experts, ... to create a multidisciplinary team providing comprehensive care for patients and families.