[Essential questions concerning the realization of a geriatric department in a general hospital]

In this article a number of questions are dealt with, that must be answered before starting a GAAZ: e.g. determining the target group of patients, the philosophy, the work methods and the internal and external organization. The patient-group of a GAAZ consists of all aged patients, for whom the normal network of care is threatened by an acute event (emergency care) or by an impending health situation that must be assessed, and for whom the total equilibrium (primarily somatic, but very often also social and psychological) is in danger. The GAAZ is primarily directed towards temporary treatment and screening. It is a hospital department, in which a holistic approach is the central goal. At least 20 beds seem necessary for a GAAZ as an independent department. Preferably the geriatrician will be employed by the hospital. A lot of attention should be paid to consultation with other specialists, to good relations with the caretakers of the elderly outside the hospital, especially general physicians, district nurses, home help, nursing homes, homes for the aged, and to selection, instruction, deliberation, training and supervision of the nursing and attending staff of the GAAZ. Because it is extremely important that the GAAZ does not get 'clogged up' with chronic patients, considerable attention should be paid to the relocation after dismissal and to a strict selection of the 'right' patients.