A Day in the Life: Siobhán Ryan, ANP Frailty – ICPOP North Tipp

My name is Siobhán Ryan, and I work with the Integrated Care Programme for Older Persons (ICPOP) in North Tipperary. I joined the team in September 2022 as a Candidate Advanced Nurse Practitioner (ANP) in frailty. Since then, I have completed a Master’s in Advanced Nursing Practice at the University of Limerick and became a registered ANP in 2024.

I have several years’ experience caring for older adults, with a special interest in Parkinson’s disease, a condition that affects movement and can cause tremors, stiffness, and balance problems. Before joining ICPOP, I worked as a Clinical Nurse Specialist in Parkinson’s at St Vincent’s University Hospital, Dublin.

About ICPOP

ICPOP is a national HSE programme that helps older people stay healthy and independent in their own homes and communities. We provide Comprehensive Geriatric Assessments (CGA) to understand each person’s needs and support them with joined-up health and social care. Our goal is to reduce hospital admissions and provide care earlier, in the community.

What I enjoy most about my work

I truly enjoy working with older adults and believe our role in the community is very important. Most people who attend our service are not seriously ill - our focus is on prevention and early support. We aim to help patients remain independent in their own homes for as long as possible. They enjoy coming to us, especially as we are based in a modern, purpose-built facility designed specifically for the needs of older adults. The building is bright, spacious, and well-equipped, with ample parking, which helps create a relaxed and welcoming atmosphere for appointments.

I’m fortunate to be part of an excellent multidisciplinary team (MDT), which includes a Consultant, another ANP in Gerontology, Registrar, an Operational Team Lead, Case Manager, Clinical Nurse Specialist, Multitask Attendant, Occupational Therapist, Physiotherapist, Speech and Language Therapists, and administrative support. We work closely together with a shared goal - to keep our patients out of hospital and support their independence.

That said, being the only Cork native in a Tipperary unit in the build-up to this year’s All-Ireland Hurling Final was very interesting.

Role of an ANP in ICPOP

As ANPs, we carry out detailed assessments, develop personalised care plans, and support patients throughout their time with us. Our work helps avoid hospital stays, supports early discharge, and improves patient experience.

In our unit, I focus on Parkinson’s and dementia, while Sheila specialises in syncope (fainting or sudden loss of consciousness) and bone health.

I was lucky to work alongside Sheila, a registered ANP, during my Candidacy training, and having her support was invaluable.

A typical Day

No two days in ICPOP are the same. When a new patient attends, either myself or another nurse on the team carries out a Comprehensive Geriatric Assessment (CGA). This looks at how they’re managing at home, including their social circumstances, mobility, bone health, memory, mood, and ability to speak or swallow. As an ANP, I also do a full physical check-up.

We review medications to make sure they’re safe and still needed. Sometimes we stop ones that are no longer needed - this is called deprescribing. Some medicines can increase the risk of falls or affect memory, especially in older adults.

A CGA can take two to three hours. Once complete, we decide which team members the patient should see and arrange follow-up appointments.

Feedback from patients has been very positive - they appreciate that the consultations are not rushed and that their concerns are genuinely heard. Most patients take part in a six-week programme, during which they can meet with all relevant MDT members.

Patients often tell us they appreciate the time we spend with them and that their concerns are listened to. When it’s time to finish the programme, many are reluctant to leave - it can feel a bit like a breakup.

Vestibular Assessments in ICPOP

We’ve been fortunate to have a physiotherapist with a specialist interest in vestibular physiotherapy, which helps with vertigo – a condition that causes dizziness and balance problems. With funding from the Spark Innovation Programme, we trained nurses in the Mid West to assess and treat during clinic visits. More complex cases are referred to our physiotherapist for further care. This has been a great addition to our service, especially since many of our patients come to us after having a fall.

Challenges Faced in ICPOP

One of our biggest challenges is ensuring patients can travel to our ICPOP unit. We’re based in Thurles but support people across North Tipperary. Many rely on family to get to appointments, and attending a six-week programme isn’t always possible.

In future, we hope to set up outreach clinics and secure dedicated transport to help patients attend.

If you or someone you care for is interested in ICPOP, please speak to your GP or Consultant. ICPOP hubs are available in Clare, Limerick, and North Tipperary. We are here to help and look forward to making a positive difference in more people’s lives.

Contact tel. nos. for ICPOP in HSE Mid West

Limerick: 061 483968

Clare: 065 686 3841

North Tipperary: 0504 27860