The Portal of Geriatrics Online Education

University of North Carolina at Chapel Hill School of Medicine

Is this a Reynold's grantee: 
Yes

Powerpoint: Medicare, Medicaid and Discharge Planning

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
1
Abstract: 

This is a Powerpoint presentation designed to provide the backbone for a talk to primary care or specialty residents responsible for discharging hospitalized Medicare patients to another level of care. It reviews the available post-acute options (LTACH, AIR, SNF, LTC, home health) and provides just the information on Medicare and Medicaid that are critical to understanding the patient’s options. The presentation includes Medicare financial information and criteria for coverage specific to 2014, and Medicaid information specific to NC, so some modification and updating may be necessary for use in other venues or later years. The presentation can be accomplished in 45 minutes leaving room for questions in a one-hour time block. A decision-tree diagram is included as a handout that can be provided with the talk and provides a succinct summary for future reference.

Educational objectives: 

1. Review a few key elements of Medicare and Medicaid eligibility and benefits

2. Distinguish between Inpatient and Observation status for Medicare patients

3. Be able to clearly state a patient’s discharge needs

4. Know the various discharge options and the key differences between them

5. Apply the criteria for Medicare coverage of various discharge options

Date posted: 
Fri, 10/03/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 10/03/2014
Contact Person/Corresponding Author:



Suggested Citation:
Powerpoint: Medicare, Medicaid and Discharge Planning. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/1226

First Think Delirium! An effective way to teach residents and fellows about delirium

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
2
Abstract: 

Three twenty-minute standardized patient encounters that are designed for learners of all levels and backgrounds to teach the Confusion Assessment Method and the diagnosis, evaluation, and management of delirium. Standardized cases include the following:

  • Older man with hypoactive delirium after taking Tylenol PM

  • Older woman with delirium in the setting of possible alcohol withdrawal

  • Older woman with terminal cancer presenting with delirium

Each case is designed to require the learner to interact with the patient's family member to obtain information about the acuity of the mental status change. There are no physical exams included but these could be added if desired. Feedback to the learners is provided by faculty facilitators who are geriatricians or specialty faculty who have been trained by geriatricians.

Submission includes standardized patient training materials, facilitator training materials, and PowerPoint materials for a didactic pre- and post-session. Finally, pre- and post-surveys to evaluate the learners and the workshop are included.

Educational objectives: 
  1. To evaluate all older adults for delirium using the Confusion Assessment Method Use.
  2. To interview an older adult's family member to obtain baseline health information, including activities of daily living and cognitive status.
  3. To manage delirium without using physical or chemical restraints.
  4. To consider alcohol withdrawal in an older adult presenting with altered mental status.
  5. To discuss goals of care with a patient's family member when the patient lacks capacity.
  6. To consider an adverse medication event as a cause of an older adult's altered mental status.
Additional information/Special implementation requirements or guidelines: 

This workshop may be modified for use by learners from different specialty backgrounds. At our institution, the workshop has been modified for Physical Medicine and Rehabilitation learners. In addition to changes in the patient conditions, patient presentation was changed to the Acute Inpatient Rehabilitation service or the Orthopedic Unit, two places were these learners see patients. The SP/CI pairs were re-trained prior to the workshop when changes were made. As a result, our SP/CI pairs received more training than the recommended two hours. We believe two hours is sufficient to train the SP/CI pairs as long as no changes are made between workshops. We highly recommend that the training sessions be led by a clinical content expert and an educator with experience in training standardized patients.

Finally, due to scheduling conflicts, we were unable to use the same actor pair for the same case with each workshop. Each case was portrayed by at least two actors, which highlighted the fact that some actors perform better than others. We highly recommend that the clinical content expert review the actors' portrayal of the cases before the workshop to ensure accuracy.

This workshop also requires training of faculty facilitators. Learners need feedback from faculty facilitators regarding their evaluation and management. Faculty facilitators must undergo a thorough, standardized training in order to function as effective teachers in this workshop setting. Our faculty facilitators, all of whom had already participated in a faculty development retreat on Geriatric Medicine topics, completed a 1 hour training session led by a geriatrician prior to the workshop. Again, we highly recommend that the facilitators undergo training led by a clinical content expert and receive additional information and training as needed depending on their clinical experience and background.

We recommend that the session occur in a clinical skills lab or an environment that simulates a clinical setting.

This entire workshop takes about 2 to 3 hours to complete when the full didactic session, pre- and post- tests, and program evaluation are included.

Publications from, presentations from, and/or citations to this product: 

Wilson LA, Roberts E, Waller N, Biese K, Caprio A, Busby-Whitehead J.  “Three Standardized Patient Cases to Teach the Confusion Assessment Method to Diagnose Delirium."  MedEdPORTAL Publications.  Mar 2013.  Available from: www.mededportal.org/publication/9393.

Wilson LA, Roberts E, Hollar D, Waller N, Biese K, Busby-Whitehead J. “An Innovative Approach to Teaching Delirium Using Standardized Patients.”  Journal of American Geriatrics Society.  2013, Volume 61, Issue Supplement s1, S43, Abstract A75.  Full text published first online on April 3, 2013.

Wilson LA, Roberts E, Caprio A, Winzelberg G, Busby-Whitehead J. “An Innovative Approach to Teaching Delirium Using Standardized Patients.” Journal of American Geriatrics Society.  2012, Volume 60, Issue Supplement s4, S209-S210, Abstract D66.  Full text published first online on April 4, 2012.

Wilson LA, Waller N, Biese K, Roberts E, Busby-Whitehead J. “First Think Delirium!  An effective way to teach residents and fellows about delirium.” Annual Scientific Meeting, American Geriatrics Society, Grapevine, Texas.  May 4, 2013.  (Presentation, Invited). (1.5 hours, 50 attendees).

Wilson LA, Roberts E, Hollar D, Waller N, Biese K, Busby-Whitehead J. “An Innovative Approach to Teaching Delirium Using Standardized Patients.”  Annual Scientific Meeting, American Geriatrics Society, Grapevine, Texas.  May 3, 2013. (Poster, Solicited).

Wilson LA, Roberts E, Hollar D, Waller N, Biese K, Busby-Whitehead J. “An Innovative Approach to Teaching Delirium Using Standardized Patients.”, Council on Emergency Medicine Residency Directors Academic Assembly 2013. Denver, Colorado. March 7, 2013. (Poster, Solicited).

Wilson LA, Waller N, Adams S, Iwata I, Biese K, Vanderberg E.  “Using Standardized Patients and Collateral Informants in Geriatric Medicine Education.”  The Donald W. Reynolds Foundation 2012 Reynolds Grantee 19th Annual Meeting, St. Louis, Missouri.  October 22, 2012.  (Didactic Oral Presentation/Workshop, Solicited). (1 hour, 10 faculty members).

Wilson LA, Roberts E, Hollar D, Waller N, Biese K, Busby-Whitehead J. “An Innovative Approach to Teaching Delirium Using Standardized Patients.” The John A. Hartford Foundation Interdisciplinary Scholars Communications Conference, Chicago, Illinois, July 10, 2012. (Poster, Solicited).

Wilson LA, Roberts E, Caprio A, Winzelberg G, Busby-Whitehead J. “An Innovative Approach to Teaching Delirium Using Standardized Patients.” Annual Scientific Meeting, American Geriatrics Society, Seattle, Washington, May 4, 2012. (Poster, Solicited).

Wilson LA, Caprio A, Roberts E.  “Training Subspecialty Faculty With Simulated Patients: Teaching General Skill Sets to Faculty.”  Gerolina, Kiawah Island, SC.  December 2, 2011. (Didactic Oral Presentation/Workshop, Solicited). (1 hour, 12 faculty members).

Date posted: 
Tue, 07/02/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 09/20/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . First Think Delirium! An effective way to teach residents and fellows about delirium. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/1226

Precise Evaluation of the Geriatric Patient in the Emergency Department

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
2
Abstract: 

Background: The number of Emergency Department (ED) visits by patients over age 65 is increasing rapidly. Common chief complaints, such as abdominal pain, often are associated with atypical presentations and significant morbidity and mortality. Hence, it is important for Emergency Medicine (EM) physicians to have both a high suspicion for disease and an in-depth knowledge base when treating these patients. However, the unique presentations of disease in older patients are rarely focused on during EM residency training. The authors created an innovative, interactive small group activity with five cases of older patients presenting to the ED, focusing on fundamental disease processes and presentations, for training EM residents.

Methods: EM residents are divided into teams and challenged to provide the most efficient, cost-effective care in five cases. Using play money, the residents are given limited funds to perform specific exam components and order laboratory studies and imaging. After teams complete the cases, a debriefing is performed in a large group to discuss learning points, highlighting diagnoses and treatments specific to geriatric patients. This activity was developed for EM residents but has since been adapted for use with medical students and residents and faculty from other specialties, including Internal Medicine and Surgery.

Results: EM residents were very receptive to this exercise. On evaluations, they appreciated the interactive learning and case-based teaching. On a scale from 1-5, with 5 being the highest score, residents rated the overall quality of the session and teaching effectiveness as 4.6 and 4.3, respectively. Comments included: “awesome case format” and “very clinically applicable”.

Conclusions: A case-based, interactive small group exercise is an innovative way to educate EM residents about emergencies and atypical presentations in geriatric patients. These cases also can be adapted for residents in other specialties as well as for faculty and medical students.

Educational objectives: 

On completion, the learner will:

  • Understand Geriatric Emergency Medicine as its own subspecialty, with unique and evolving knowledge base and skills

  • Be wary of "under-triaging" geriatric patients, especially trauma patients

  • Identify acute abdominal pain in geriatric patients as often life threatening

  • Utilize the Mini Cog and ICU CAM

  • Identify delirium and understand that it requires further evaluation for an underlying cause

  • Treat pain appropriately in older patients

  • Treat agitation appropriately in older patients

  • Prepare for care transitions
Additional information/Special implementation requirements or guidelines: 

This is an interactive, case-based didactic on the evaluation of older patients in the Emergency Department (ED). This product consists of five cases of common chief complaints in the ED, as well as a lecture to describe the importance of Geriatric Emergency Medicine (EM) and highlight the keypoints of each case. The didactic is intended to begin with the Power Point lecture as a large group. Then, learners will break out in smaller teams to complete the "Precise Evaluation of Older Patients in the ED Game." Each team is provided with the packet of cases and play money, which can better demonstrate cost. The teams will work through the differential diagnoses on each case and selectively order tests to identify the correct diagnosis. Teams must keep track of the tests ordered on each case as well as total money spent. Either facilitators or one member of each team can provide results to the team from the appropriate answer key for each case. Teams then return to the large group to debrief and discuss each case. The lecture provides key learning points on each case specifically related to Geriatric EM, including atypical presentations and management. The winning team can be rewarded for spending the least while arriving at the correct diagnoses. The workshop in its entirety takes about 2 hours; however, less cases can be used for a shorter didactic. In addition, more cases can easily be added to this exercise to discuss other dieases processes. This curriculum has been used with EM residents as well as residents and faculty from other specialties and medical students.

Publications from, presentations from, and/or citations to this product: 

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Geriatric Abdominal Pain Game.”  Society of Academic Emergency Medicine 2013. Atlanta, Geargia. May 16, 2013. (Poster, Solicited).

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Material and Methods Swap: Geriatric Abdominal Pain Game.” American Geriatrics Society 2013. Grapevine, Texas. May 5, 2013. (Oral Presentation, Invited).

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Geriatric Abdominal Pain Game.”  American Geriatrics Society 2013. Grapevine, Texas. Denver, Colorado. May 3, 2013. (Poster, Solicited).

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Educational Soundbites: Geriatric Abdominal Pain Game.” Council on Emergency Medicine Residency Directors Academic Assembly 2013. Denver, Colorado. March 7, 2013. (Oral Presentation, Invited). (1 hour, 200 faculty members)

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Geriatric Abdominal Pain Game.” Council on Emergency Medicine Residency Directors Academic Assembly 2013. Denver, Colorado. March 7, 2013. (Poster, Solicited).

Date posted: 
Thu, 09/05/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 09/05/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Precise Evaluation of the Geriatric Patient in the Emergency Department. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/1226

Alliance for Geriatric Education in Specialties Curriculum

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Intended Learner Audiences: 
Specialty Faculty
Product Information
Estimated time to complete: 
999
Abstract: 

The Alliance for Geriatrics Education in Specialties (AGES) consists of 8 interactive core curriculum modules: iatrogenic injury, delirium, dementia, polypharmacy, transitions of care, basics of geriatrics assessment and levels of care, physiology of aging, palliative care communication and medications. These 8 modules have been designed to teach specialty faculty, at all levels of their career, how to increase effectiveness and quality of care for their older adult patients. In 2009, the University of North Carolina School of Medicine at Chapel Hill conducted a needs assessment to evaluate the potential for improvement of UNC Healthcare System specialty/subspecialty faculty regarding geriatrics care through training. Based on the assessment results, the AGES curriculum was developed, implemented, evaluated, and now available for use through POGOe. The AGES curriculum can be taught as an entire course or each module can be taught as a separate training session. The UNC Healthcare System is currently using all 8 modules for training its non-geriatrician specialty faculty. Each of the 8 module PowerPoint presentations will take approximately 60 minutes per training session. *This curriculum may also be applicable to internists and family medicine practitioners.

Educational objectives: 

Objectives by Module

Module 1:    The Physiology of Aging

•          Learners will be able to describe the normal changes that occur with aging

•          Learners will be able to identify the common age-related changes that occur in the following systems: cardiovascular, respiratory, renal, hematology/immune, gastrointestinal, endocrine, neurologic, musculoskeletal, and reproductive

 

Module 2:    Dementia

•          Learners will be able to define dementia

•          Learners will be able to name risk factors/causes for dementia

•          Learners will be able to discuss why delirium and depression are predictors/red flags for dementia

•          Learners will be able to discuss assessment tools/strategies for identifying dementia

•          Learners will be able to name at least 5 types of dementia

•          Learners will be able to discuss the treatment options for dementia

 

Module 3:    Delirium

•          Learners will be able to define delirium and describe its cardinal features and underlying pathophysiology

•          Learners will be able to recognize that delirium is common, under-diagnosed, and associated with significant morbidity and mortality

•          Learners will be able to, regarding delirium, identify ways to: 

»      prevent

»      diagnose

»      evaluate

»      manage

•          Learners will be able to teach key concepts in < 1 minute

•          Learners will be able to define delirium and describe its cardinal features and underlying pathophysiology

 

Module 4:    Transitions of Care

•          Learners will be able to define transitional care

•          Learners will be able to identify barriers to providing improved transitional care to patients

 

Module 5:    Basics of Geriatric Assessment & Levels of Care

•          Learners will be able to illustrate the importance of physical, cognitive, and psychosocial assessments for older adults

•          Learners will be able to describe Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)

•          Learners will be able to demonstrate gait assessment and falls risk assessment with an older adult

•          Learners will be able to demonstrate cognitive and depression screening with an older adult

 

Module 6:    Iatrogenic Injury

•          Learners will be able to list the most common types of iatrogenic injuries

•          Learners will be able to identify the most common cause of nosocomial fever in the hospital

•          Learners will be able to identify the reasons for use of restraints and how to avoid using them

•          Learners will be able to list the appropriate use of urinary catheters

 

Module 7:    Palliative Care Communications

•          Learners will be able to address Palliative Care misconceptions: What, Why, Where, Who

•          Learners will be able to review outcomes of Palliative Care

•          Learners will be able to present general communication strategies

•          Learners will be able to discuss pain assessment and management principles for older adults

 

Module 8:    Polypharmacy

•          Learners will be able to identify risk factors for Adverse Drug Events (ADEs) in older adults

•          Learners will be able to identify the physiologic changes associated with normal aging that influence pharmacokinetics and pharmacodynamics

•          Learners will be able to recognize ADEs when an older adult presents with a new clinical condition or complaint

•          Learners will be able to avoid potentially harmful medications for older adults

•          Learners will be able to utilize strategies for shortening medication lists and carefully introducing new medications

 

Date posted: 
Wed, 08/29/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/29/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , and . Alliance for Geriatric Education in Specialties Curriculum. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1226

High fidelity simulations to teach key concepts in emergency department care of the elderly

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
999
Abstract: 

"High fidelity simulations to teach key concepts in emergency department (ED) care of the elderly" is a series of seven high fidelity simulations designed to instruct ED medical residents as well as other providers who care for the elderly in the ED key concepts of geriatric care. The cases include gastrointestinal bleeding, myocardial infarction, altered mental status, toxicology, sepsis, abdominal aortic aneurysm, and mesenteric ischemia. Core concepts taught include medication interactions, transitions of care, delirium, suicide risks and depression in the elderly, atypical presentations of disease in the elderly, and iatrogenic injuries. The cases have been successfully deployed in an ED resident training program with resulting care improvements for the elderly.  

Educational objectives: 
  • To increase emergency medicine care givers' knowledge of geriatric principals of care
  • To promote safe delivery of care for geriatric patients in emergency departments
  • To encourage emergency medicine care givers to consider the particular aspects of geriatric medicine when caring for elderly patients in the ED
  • To encourage collaboration and enhanced communication in caring for critically ill elderly patients
  • Each simulation scenario has its own specific learning objectives and topics to discuss during debriefing.
Publications from, presentations from, and/or citations to this product: 
  • Biese K, Roberts E, LaMantia M, Zamora Z, Shofer F, Snyder G, Patel A,Hollar D, Kizer JS, Busby-Whitehead J. Impact of a Geriatric Curriculum on Emergency Medicine Resident Attitudes, Knowledge, and Decision Making. Journal of Academic Emergency Medicine, in press
  • Presidential Poster "Best Poster" Award in Emergency Medicine American Geriatrics Society Annual Meeting 2011
  • Biese K, Roberts E, LaMantia M, Zamora Z, Shofer F, Snyder G, Patel A,Hollar D, Kizer JS, Busby-Whitehead J. Impact of a Geriatric Curriculum on Emergency Medicine Resident Attitudes, Knowledge, and Decision Making. Society Academic Emergency Medicine National Annual Assembly. Oral Presentation. Boston, MA June 3rd, 2011
Date posted: 
Mon, 10/10/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/10/2011
Contact Person/Corresponding Author:



Suggested Citation:
, , , , and . High fidelity simulations to teach key concepts in emergency department care of the elderly. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/1226

Caring for Elderly Patients in the Emergency Department: An interactive lecture series

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
999
Abstract: 

Caring for Elderly Patients in the Emergency Department: An interactive lecture series is a series of six lectures with multiple choice questions designed to introduce Emergency Medicine (EM) care givers to key concepts in caring for elderly patients.  The lectures address key concepts in elderly trauma, acute abdominal pain, iatrogenic injuries, altered mental status, medication management, and transitions of care and were designed by physicians in The Department of Emergency Medicine and the Division of Geriatric Medicine at the University of North Carolina at Chapel Hill (UNC).  The multiple choice questions can be used to asses the learners retention after the lecture series, or to test their knowledge base prior to delivering the lectures.  This curriculum was successfully delivered to the EM residents at UNC with resulting improvements in care delivery to elderly Emergency Department patients at our institution.

Educational objectives: 
  • To increase emergency medicine care givers knowledge of geriatric principals of care
  • To promote safe delivery of care for geriatric patients in emergency departments
  • To encourage emergency medicine care givers to continue to expand their knowledge base and educate colleagues in geriatric care
  • Each interactive lecture has specific objectives.
Publications from, presentations from, and/or citations to this product: 

  • Biese K, Roberts E, LaMantia M, Zamora Z, Shofer F, Snyder G, Patel A,Hollar D, Kizer JS, Busby-Whitehead J. Impact of a Geriatric Curriculum on Emergency Medicine Resident Attitudes, Knowledge, and Decision Making. Journal of Academic Emergency Medicine 2011; 18: S92-96.

  • Presidential Poster "Best Poster" Award in Emergency Medicine American Geriatrics Society Annual Meeting 2011

  • Biese K, Roberts E, LaMantia M, Zamora Z, Shofer F, Snyder G, Patel A,Hollar D, Kizer JS, Busby-Whitehead J. Impact of a Geriatric Curriculum on Emergency Medicine Resident Attitudes, Knowledge, and Decision Making. Society Academic Emergency Medicine National Annual Assembly. Oral Presentation. Boston, MA June 3rd, 2011

Date posted: 
Fri, 04/27/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 04/27/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Caring for Elderly Patients in the Emergency Department: An interactive lecture series. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1226

Carolina Opinions on Care of Older Adults (COCOA)

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Abstract: 

The Carolina Opinions on Care of Older Adults (COCOA) is an instrument that was developed to gather more detailed information regarding medical and health professional students' perceived attitudes and opinions on working with the elderly, and to assess the compatibility of a career choice in geriatrics.

Additional information/Special implementation requirements or guidelines: 

This instrument is usually used to assess the students in Year 1 and again in year 4.

Each COCOA item is scored on a 1-5 Likert-type agreement scale (see attached COCOA items with wording for 1-5 response choices).
 
Single item responses can be compared across survey respondents over time with multiple administrations using a pretest-posttest format. Comparisons across comparison or alternative treatment/intervention groups can be conducted on single items as well.
 
The COCOA items can be summed to produce a composite score for the entire instrument or for subscale combinations of items. However, if this procedure is taken, the following items must be reverse-scored to preserve common orientation of attitudes across items:
 
Items 1, 5, 7, 8, 9, 11, 12, 13, 18, 24, 25, 26, 27, 29, 30, 32, 33, 34, 36, 37, 39, 40, and 42 are reverse-scored (see attached table of COCOA items).
 
Potential subscales (for the reduced 24-item COCOA instrument) are as follows:
 

  1. Geriatrics as a Career (Items 2, 4, 10, 16, 21, 31, 38, 41 in Factor 1 on Table 1)
  2. Cost Effectiveness of Caring for Older Adults (Items 11, 13, 24, 25, 27, 32, 33 in Factor 2 on Table 1)
  3. Value of Older Adults (Items 15, 17, and 20 in Factor 4 on Table 1)
  4. Experience in Caring for Older Adults (Items 6 and 19 in Factor 5 on Table 1)
  5. Perception of Older Adults being Helpless (Items 1, 5, 18, and 39 in Factor 6 on Table 1)

 A study was performed on the effectiveness of this instrument. The objective of this study was to test the reliability and validity of the Carolina Opinions on Care of Older Adults (COCOA) survey compared with the Geriatric Assessment Survey (GAS). Participants were first year medical students (n=160). A Linear Structural Relations (LISREL) measurement model for COCOA had a moderately strong fit that was significantly better than the null model (GFI = 0.81, TLI = 0.90) and the GAS (GFI = 0.76). A reduced, 24-item COCOA performed well (GFI = 0.90, TLI = 1.00) with R2  = 0.595 on five factors. The COCOA and GAS represent complementary instruments for assessing attitudes toward older adults.

The Factor Loadings for all 42 items are included in the attached table.

Publications from, presentations from, and/or citations to this product: 

Hollar, D; Roberts, E; Busby-Whitehead, J. “COCOA: A New Validated Instrument to Assess Medical Students’ Attitudes towards Older Adults”. Educational Gerontology. In Press.

Date posted: 
Tue, 12/07/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 12/07/2010
Contact Person/Corresponding Author:



Suggested Citation:
, and . Carolina Opinions on Care of Older Adults (COCOA). POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/1226

Treatment Options for Dementia

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Abstract: 

This presentation is a PowerPoint on treating dementia in older adults. It includes an evidence-based review on the treatment option for an older patient with dementia targeted at medical students and residents.

Educational objectives: 

To understand the different treatment option for dementia. Learners should be able to: - to understand the evidence behind different treatment options for dementia - to be able to discuss with families possible benefits of various treatments - to understand the limitations in some cases of pharmacological treatment

Additional information/Special implementation requirements or guidelines: 

This lecture was taught to combined 3rd and 4th year medical students, interns and residents during inpatient attending rounds and core lectures for residents.

Date posted: 
Tue, 01/30/2007
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sat, 10/17/2009
Contact Person/Corresponding Author:



Suggested Citation:
Treatment Options for Dementia. POGOe - Portal of Geriatrics Online Education; 2007 Available from: https://pogoe.org/taxonomy/term/1226

Dementia: Diagnosis and Treatment

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Abstract: 

This presentation is a PowerPoint on dementia in older adults. It includes an evidence-based review on the evaluation and management of an older patient with dementia targeted at medical students and residents.

Educational objectives: 

To understand the different types of dementia in older patients. To explore the different treatment options for dementia. Learners should be able to: - List the different categories of dementia - Understand the different clinical features of each type of dementia - Develop and appropriate treatment plan for a patient with cognitive impairment

Additional information/Special implementation requirements or guidelines: 

This lecture has been taught to combined 3rd and 4th year medical students, interns and residents during inpatient attending rounds and core lectures for residents.

Date posted: 
Fri, 08/28/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 08/28/2009
Contact Person/Corresponding Author:



Suggested Citation:
Dementia: Diagnosis and Treatment. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1226

Care of the Hip Fracture Patient

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Abstract: 

An evidence-based review of the hip fracture patient, the problems, conservative management and advanced directives.

Educational objectives: 

Learners will obtain general background information on hip fractures, preoperative assessment and cardiac risk stratification, perioperative beta blockade, and other perioperative management options. Learners will also review other complications following surgery, prevention of future fractures and discharge planning.

Learners should be able to:

  • identify whether hip fracture patient is good candidate for surgery.
  • identify risks in performing surgery versus other methods of stabilization.
  • assess preoperative care.
  • assess whether surgery inteferes with standing DNR orders.
  • follow appropriate perioperative care and discharge planning.
Additional information/Special implementation requirements or guidelines: 

Used with 3rd and 4th year medical students.

Date posted: 
Mon, 12/04/2006
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sat, 10/17/2009
Contact Person/Corresponding Author:



Suggested Citation:
Care of the Hip Fracture Patient. POGOe - Portal of Geriatrics Online Education; 2006 Available from: https://pogoe.org/taxonomy/term/1226

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