Older Person’s Health

As populations age, the health and wellbeing of older adults has become an increasingly central aspect of general practice. Older patients often present with complex, multifactorial issues, including multimorbidity, polypharmacy, frailty, cognitive impairment, sensory loss and social isolation. GPs play a vital role in providing person-centred care that supports independence, dignity, and quality of life for patients in their later years.

Many older patients value maintaining autonomy and function as highly as the treatment of specific diseases. Early identification of frailty, , memory issues, and safeguarding concerns is key to effective preventive care and appropriate intervention.

This part of the curriculum aims to equip GP trainees with the knowledge, skills, and confidence to manage the health needs of older adults in an evidence-informed, and respectful manner-supporting healthy ageing and enabling older people to live well for as long as possible.

• OP1. Conduct thorough assessments of older adults to aid diagnosis and management.
• OP2. Understand the epidemiology, prognosis, diagnosis and management of common age-related conditions, including frailty, falls, dementia and bone health.
• OP3. Diagnose and manage cancer in older adults, recognising common red flag symptoms, prioritising referrals, and addressing the unique challenges associated with diagnosis in this population.
• OP4. Implement appropriate management plans that take into account the unique needs of older adults.
• OP5. Provide evidence-based care for older adults while considering the limitations of research in this population.
• OP6. Demonstrate self-awareness and a commitment to providing equitable and age-appropriate care respecting patient autonomy and independence.
• OP7. Develop strategies for health promotion and the prevention of common health conditions in older adults.
• OP8. Optimise medication management in older patients by considering individual factors affecting medication adherence, potential side effects, drug interactions, polypharmacy and age-related changes in pharmacokinetics to minimise adverse events.
• OP9. Communicate effectively with older patients and their families, ensuring their involvement in decision-making and addressing their concerns.
• OP10. Provide holistic care that integrates physical, psychological, social, and ethical considerations in supporting the well-being of older adults.
• OP11. Deliver culturally sensitive and non-judgmental care, respecting individual beliefs, preferences, and diverse backgrounds.
• OP12. Coordinate comprehensive care for older adults, ensuring access to appropriate services, managing chronic conditions, and utilising a team-based approach in the community.
• OP13. Analyse how social determinants of health impact older adults and identify healthcare inequalities.
• OP14. Demonstrate an understanding of the importance of addressing sexual health and intimacy in older adults, including the ability to initiate sensitive conversations during consultations, in recognition of the ongoing sexual activity and needs of older patients.
• OP15. Provide person-centred care to older adults in residential settings, ensuring regular clinical review, effective communication with care staff and families, and appropriate involvement of the wider healthcare team, supporting dignity, autonomy, and quality of life through proactive management, medication review, and advance care planning.
• OP16. Recognise signs of neglect and abuse in older adults to inform appropriate safeguarding and care planning.
• OP17. Recognise and address the unique mental health needs of older adults, understanding the impact of psychiatric disorders on individuals, families, and carers.
• OP18. Adhere to legal and ethical principles in the care of older adults, including on issues related to capacity, consent, advanced care planning and end-of-life care.

For each problem or disease, consider the following areas within the general context of primary care:  

• The natural history of the condition, including whether acute or chronic
• The incidence and prevalence, including in different demographic groups
• Typical and atypical presentations
• Recognition of normal variations throughout life
• Risk factors, including lifestyle, socio-economic and genetic factors
• Diagnostic features and differential diagnosis
• Recognition of ‘alarm’ or ‘red flag’ features
• Appropriate and relevant investigations
• Interpretation of test results
• Management, including initial and continuing care, chronic disease monitoring and emergency care
• Patient and carer information and education
• Prognosis

Signs, Symptoms & Presentations

• Behavioural and Psychological symptoms of Dementia
• Cognitive Impairment
• Confusion
• Constipation
• Deconditioning
• Dizziness
• Falls
• Fractures
• Gait disturbance
• Incontinence
• Joint Pain
• Loneliness
• Low Mood
• Lower Urinary Tract Symptoms
• Memory Loss
• Social Isolation
• Speech Disturbance
• Visual Disturbance
• Weight Loss

Common and Important Conditions

• Atrial Fibrillation
• Basal Cell Carcinoma
• Benign Skin Lesions of Ageing
• Chronic Kidney Disease
• Chronic Obstructive Pulmonary Disease
• Dehydration
• Delirium
• Dementia
• Faecal Incontinence
• Heart Failure
• Hypertension
• Hypotension
• Mild Cognitive Impairment
• Osteoarthritis
• Osteoporosis
• Parkinson’s Disease
• Polymyalgia Rheumatica
• Premalignant Skin lesions
• Prostatic Issues
• Recurrent UTIs
• Squamous Cell Carcinoma
• Stroke
• Ulcers
• Urinary Incontinence

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed 

Blended Learning Resources (Education Platform)

Residential Care Medicine - a focus on Frailty

Dying, Death and Bereavement

Useful Websites

Alzheimer’s Society of Ireland

NHS Frailty Toolkit

STEADI – older adults fall prevention

Drugs that cause falls

Enduring Power of Attorney – Decision Support Service

Workplace Based Learning

Workplace-based learning provides invaluable, real-life experience in caring for older adults across a range of settings, including general practice, nursing homes, hospital wards, integrated care settings such as memory clinics, integrated care of older people, falls clinics and home visits. Trainees should develop essential skills in assessing complex, often interrelated problems such as frailty, polypharmacy, memory loss, falls, and functional decline. Exposure to the social and emotional aspects of ageing; including carer support, loneliness, and safeguarding, enhances trainees' holistic understanding of older adults’ needs. These experiences build confidence in delivering person-centred care and support the development of clinical judgement in managing uncertainty and complexity.

Day Release

Day release teaching offers a valuable opportunity to explore the complexities of caring for older adults in a supportive, reflective setting. Sessions can focus on key topics such as frailty, polypharmacy, dementia, falls, functional decline, and end of life care. Case-based discussions allow trainees to navigate real-world clinical dilemmas, consider ethical and communication challenges, and reflect on the balance between medical intervention and quality of life. Teaching can also cover the roles of multidisciplinary teams, social supports, and community services in supporting older patients. Interactive formats, including role play and case simulation, help build confidence in addressing sensitive issues such as capacity, advance care planning, and carer support.

Registrar Tutorials

Registrar tutorials provide an excellent space to explore the unique challenges and rewards of caring for older adults in general practice. These sessions can focus on practical topics such as managing multimorbidity, conducting comprehensive geriatric assessments, deprescribing safely, and recognising frailty or early cognitive decline. Tutorials offer a chance to review complex cases, discuss ethical dilemmas (e.g., capacity and consent), and reflect on how to balance clinical priorities with patients' values and goals. Interactive discussions around real-life scenarios (such as falls, functional decline, or palliative planning) help trainees build confidence in navigating nuanced, often multi-layered consultations. These tutorials also support the development of holistic, compassionate, and coordinated care approaches that are central to effective primary care for older adults.

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

 EPA 13: Patient Advocacy

When supporting an older person experiencing neglect in a residential care setting, trainees demonstrate EPA 13 by advocating for the patient’s safety, engaging safeguarding protocols, and working collaboratively with social services and care staff. Reflection could cover recognising abuse, ethical responsibilities, and clear documentation.

Core Knowledge Test (CKT)

• Management of an older adult at risk of falls

• Assessment of an elderly patient with acute confusion

• Deprescribing in polypharmacy

Clinical Competency Test (CCT)

• A patient is worried about their memory and would like to discuss this with you.
• A patient had a fall last week.
• You are asked to review a patient’s medications to see if they can be optimised.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.