The Portal of Geriatrics Online Education

Psychiatry

Elder Care A Resource for Interprofessional Providers: Animal-Assisted Interventions for Older Adults - Part 2

:  
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: 

Elder Care A Resource for Interprofessional Providers: Animal-Assisted Interventions for Older Adults - Part 2 is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. Take proper steps if a patient is hoarding animals
  2. Respond correctly to inappropriate requests from patients to write letters supporting their need for emotional support animals
  3. Find out about local regulations regarding pets in nursing home
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”. 
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.

Date posted: 
Wed, 03/14/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sun, 12/31/2017
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Animal-Assisted Interventions for Older Adults - Part 2. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/228

Mini-Cog Clinical Evaluation Exercise (Mini-CEX)

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
0
Abstract: 

This Mini-Cog Clinical Evaluation Exercise (Mini-CEX) is a revision of the Ehrlich and Freeman's (2011) Clinical Evaluation Exercise (Mini CEX) Mini-Cog with the addition of assessing if there was time in communication of the test with patients and families. It is designed to use with a learner during an actual patient encounter. The teacher observes the learner during the patient encounter and completes the form. The teacher then reviews the form with the learner and provides feedback of what skills were observed, partially observed, not observed, not applicable and comments about the encounter.

Educational objectives: 

The learner who is administered this Mini-Cog Mini-CEX will:

1)be observed performing a Mini-Cog with a patient.

2)receive feedback about their Mini-Cog clinical skills and communcation skill with patients.

3)obtain a record of their clinical skill in performing a cognitive sceening using Mini-Cog.

Date posted: 
Mon, 01/23/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 01/23/2017
Contact Person/Corresponding Author:



Suggested Citation:
Mini-Cog Clinical Evaluation Exercise (Mini-CEX). POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/228

Healthy Brain, Healthy Mind

:  
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: 

'Healthy Brain, Healthy Mind' (HBHM) is a five session educational course for patients and other older adults (ie, caregivers) that nonstigmattically addresses mental health. Now also translated into Spanish, HBHM  teaches participants twelve pathways to a healthy brain and mind (including healthy diet, sleep practices, remaining active, social engagement, self-advocacy, menaging emotions, continued learning, positive self-talk, gratitude, resilience, connecting with nature, and service to others) while discussing stress management and goal setting. Training materials include a facilitator's guide and participant workbook. This curriculum can also be used as a model for healthcare provider communication with older adults.

Educational objectives: 

After completion of this program, participants will be better able to understand stress management.

After completion of this this program, participants will understand the working relationship with physiological and mental health.

Date posted: 
Fri, 10/14/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 10/14/2016
Contact Person/Corresponding Author:



Suggested Citation:
Healthy Brain, Healthy Mind. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/228

Goals of Care Conversation Curriculum (GOCCC) Training

:  
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: 

We developed a 3-part curriculum for teaching the basics of communication about goals of care (GOC) in older persons targeted towards medical students, residents, fellows, and faculty. There are 3 modules: 

1. Communicating Serious News - identifies strategies for effective communication and especially communicating serious news to patients or family members and improving our ability to transmit this news in an empathic and effective manner.

2. Goals of Care Discussion -focuses on the essential components of a GOC discussion; initiation, understanding the patient and family perspective, surrogate decision making, and concluding remarks clarifying and summarizing key discussion points and areas of understanding.

3. Managing conflict with patients and families - focuses on how to address frustrated and perhaps angry patients or family members who sometimes don’t feel that they are being listened to.  As providers, we are often put in this situation with few resources or skills to help guide us on how to deal with the patient’s and family’s emotions as well as our own. 

Each module contains a didactic lecture (45-60 minutes), examples of faculty role play (10-15 minutes), and instructions for participant role play activities. Each module is focused around a clinical case scenario done in dyads (30 minutes), and a sample evaluation form. Each module is best done in 2-hour sessions and in small groups (10-20 participants) but can be modified for 1-hour sessions. The content is applicable to a range of learners although the participant role play will likely be more meaningful for the more advanced learners.

Educational objectives: 

At the end of Module 1: Discussing Serious News, students, residents, and faculty will be able to:        

a.      Use curiosity and good listening skills to understand patient coping styles

b.      Describe empathic and effective approaches to discussing serious news

c.       Identify strategies for discussing prognosis

At the end of Module 2: Basic GOC, students, residents, and faculty will be able to:

a.       Be comfortable and effective in talking with patients and families about goals of care for patients with serious life-threatening, or chronic conditions

b.      Describe goals of care discussions as an essential component of the practice of medicine accepted within the mainstream of legal, moral, and ethical principles

c.       Articulate the complexity and subtleties of surrogate decision-making,  and the concept of substituted judgment

d.      Practice the key components of goals of care discussions in a simulation as a means of gaining competence and confidence in conducting GOC conversations

At the end of Module 3: Managing Conflict, students, residents, and faculty will be able to:

a.       Manage conflict in an effective and empathic manner to de-escalate anger and frustration experienced by patients and families during serious illness

b.      Recognize that in life-threatening situations, anger is a common response

c.       Describe communication techniques for diffusing anger

d.      Apply recommended skills to manage conflict and guide patients, families, and other clinicians through difficult decisions

Date posted: 
Mon, 06/20/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 08/08/2019
Contact Person/Corresponding Author:



Suggested Citation:
Goals of Care Conversation Curriculum (GOCCC) Training. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/228

3D (dementia, depression, delirium) Flipped Classroom Didactic for Medical Students

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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: Dementia, delirium, and depression are core minimum competencies outlined by the AAMC (Association of American Medical Colleges) for medical students by graduation. Focus groups with Hopkins’ medical students found that they had variable clinical experiences with 3Ds during neurology and psychiatry rotations and found it challenging to take a history from a patient with cognitive impairment.
Methods: A joint curriculum was established with psychiatry and neurology core clerkship directors for third and fourth year medical students. Pre-session: PowerPoint with information on 3Ds, mini-cog, 4AT, and PHQ-9. Using pre-recorded simulated videos, students completed worksheets and discussed in class. Additionally we incorporated an in person caregiver interview. We assessed students’ knowledge with in-class audience response questions, pre and post evaluations on how well learning objectives were addressed, and three month post didactic to assess behavior change. This curriculum will be repeated 4 more times during 2015-2016 academic year.
Results: In the first 3 quarters, 64 students completed didactic. Students scored 44-78% correct on 3/6 knowledge test questions (other 3 questions scored >90% correct). Students demonstrated most improvement in use and interpret mini-cog for dementia screen and 4AT for delirium screen as well as communication skills with patients and caregivers. No self-reported change pre and post didactic for students’ ability to differentiating between dementia and depression, or between dementia and delirium. Most importantly, a majority of students identified the importance of communicating with caregivers and providing support not only for the patient, but also for the caregiver. At three months follow up survey (75% completion rate), students identified communication techniques and understanding caregiver’s challenges as the most useful “take home” points from didactic.
Conclusions: Overall the 3D didactic was well received by medical students. They improved in identifying when to use screening tools for 3Ds, which may translate from knowledge to behavior at their next rotations. They also overwhelmingly identified the importance of communicating and assessing caregivers’ needs. More data will be collected during additional sessions this academic year. This curriculum could be easily disseminated without much additional resources.

Educational objectives: 

Knowledge & Skills objectives:
1. Recognize, compare and contrast  delirium, dementia, and depression in various clinical presentations.
2. Formulate a differential diagnosis and implement initial evaluation in a patient who exhibits delirium, dementia, or depression by evaluating video interviews among patient, caregiver, and provider triad communication skills.
3.  Assess an older patient with delirium, initiate a diagnostic work-up to determine the root cause (etiology), by identifying predisposing factors and differential diagnosis of delirium, by utilizing  non pharmacologic strategies for delirium.
4. Perform and interpret a cognitive assessment in older patients for whom there are concerns regarding memory or function by demonstrating the ability to differentiate the result of 4AT (rapid assessment test of delirium) based on video interview of delirious patient.  Proficiency to use Mini-Mental Status Exam (MMSE)and mini-cog to determine cognitive impairment.

Program/process Objectives:
• ≥ 95% of medical students in neurology and psychiatry rotation will attend the dementia day.
• Of students who attended didactic in person, 100% of the medical students will have demonstrated the ability to distinguish dementia, delirium, and depression using worksheets based on video interviews.

 

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

AGS poster presentation 2016

AGS Educational Showcase 2016

Date posted: 
Tue, 07/26/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/26/2016
Contact Person/Corresponding Author:



Suggested Citation:
3D (dementia, depression, delirium) Flipped Classroom Didactic for Medical Students. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/228

Elder Care A Resource for Interprofessional Providers: Discussing Cognitive Aging with Patients and Families

:  
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: 

Discussing Cognitive Aging with Patients and Families is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 
  1. Define cognitive aging
  2. Explain the difference between fluid intelligence and crystalized intelligence
  3. Identify a clinical test that can be used to assess speed of medical processing
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”. 
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.  

Date posted: 
Thu, 06/30/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 06/30/2016
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Discussing Cognitive Aging with Patients and Families. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/228

Ambulatory Geriatrics Curriculum for Internal Medicine Residents Module on BPSD: Agitation and Behavioral Problems in Dementia

:  
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: 

In 2012, 5.4 million Americans are diagnosed with Alzheimer’s Disease.  Lifetime risk of experiencing BPSD (Behavioral and Psychological Symptoms of Dementia) is nearly 100%.  BPSD is associated with increased morbidity and nursing home placement and is potentially treatable.  The information in this curriculum has been created to help the general internal medicine residents have a structured approach to the evaluation and management of BPSD.  This is the 3rd topic covered in a four part ambulatory geriatric curriculum that was developed for internal medicine residents.  To learn more about the successful ambulatory curriculum developed, please  check out  manuscript by Chang C1, Callahan EH, Hung WW, Thomas DC, Leipzig RM, DeCherrie LV. A Model for Integrating the Assessment and Management of Geriatric Syndromes Into Internal Medicine Continuity Practice: 5-Year Report. Gerontol Geriatr Educ. 2015 Jul 9:1-15.

Educational objectives: 

At the conclusion of this module, learners will be able to:

  1. Define BPSD
  2. Evaluate BPSD
  3. Discuss the Guidelines for Management of BPSD
    • Nonpharmacologic Interventions
    • Pharmacologic Interventions
Publications from, presentations from, and/or citations to this product: 

Christine Changab*, Eileen H. Callahanab, William W. Hungc, David C. Thomasb, Rosanne M. Leipzigab & Linda V. DeCherrieab A Model for Integrating the Assessment and Management of Geriatric Syndromes Into Internal Medicine Continuity Practice: 5-Year Report Gerontology & Geriatrics Education. Published online: 09 Jul 2015. DOI:10.1080/02701960.2015.1031897.

Date posted: 
Mon, 09/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/12/2016
Contact Person/Corresponding Author:



Suggested Citation:
Ambulatory Geriatrics Curriculum for Internal Medicine Residents Module on BPSD: Agitation and Behavioral Problems in Dementia. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/228

Nonpharmacologic Management of BPSD: Behavioral and Psychological Symptoms of Dementia

:  
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: 

In 2012, 5.4 million Americans were diagnosed with Alzheimer’s Disease.  Lifetime risk of experiencing BPSD (Behavioral and Psychological Symptoms of Dementia) is nearly 100%.  BPSD is associated with increased morbidity and nursing home placement and is potentially treatable.  The information in this curriculum has been created to help the general internist have a structured approach to the evaluation and management of BPSD. 

Educational objectives: 

Participants will be able to:

  1. Define BPSD
  2. Evaluate BPSD
  3. Discuss the Guidelines for Management of BPSD
Date posted: 
Mon, 09/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/12/2016
Contact Person/Corresponding Author:



Suggested Citation:
Nonpharmacologic Management of BPSD: Behavioral and Psychological Symptoms of Dementia. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/228

Geriatric Fast Facts Quizzes

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Estimated time to complete: 
0
Abstract: 

Geriatric Fast Facts (GFFs) [www.geriatricfastfacts.com] is a mobile enabled website which contains 1-2 page concise, peer-reviewed evidence-based educational summaries on key geriatrics topics to increase medical knowledge.

GFF Quizzes are quick, online assessment tools paired with GFF content, to be used by learners at the point of care to assess knowledge of geriatric content aligned with ACGME Milestones.  Design elements include quiz content searchable by topic, links to corresponding GFFs, MCQ/ short answer question formats and ability to include images. Learners enter brief demographic information to start (institution, email of self and up to 1 other) allowing annotated score results, displayed immediately after quiz completion, to be sent to themselves and one other individual (faculty, program director). These quick quizzes, available on hand held mobile devices at the point of care, linked to GFF content provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Educational objectives: 

The Geriatric Fast Fact (GFF) quizzes, available on hand held mobile devices at the point of care, linked to GFF content will provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Additional information/Special implementation requirements or guidelines: 

The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed and accessed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app".

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

Quick Quizzes:  Geriatrics Right in Your Hand & at the Point of Care.  Denson K, Simpson D, Padua K, and the GET Collaboratives at the Medical College of Wisconsin & Aurora Health Care, American Geriatrics Society Annual Meeting, Baltimore, MD, 05/2015

Date posted: 
Thu, 10/08/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/08/2015
Product Viewing Instructions: 
The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app"
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Fast Facts Quizzes. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/228

"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!

:  
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: 

This two hour interprofessional curriculum brings together fourth year medical students and third year pharmacy students in a hands-on, interactive small group session. Learners are given a guide briefly describing the case and delineating five health care members and their roles and expertise in Mr. Moore's healthcare team (Mr. Moore's partner, the outpatient pharmacist, the inpatient intern, etc). A pair of interprofessional facilitators guide learners through the case, utilizing different healthcare team members' roles and expertise to explore methods of medication organization and systemic barriers to accurate and safe discharge medication reconciliation. Learners discover and discuss discrepancies in high-risk medications, gain an appreciation of systems hurdles for patients and healthcare providers during transitions of care, complete an exercise in writing discharge medication instructions, and brainstorm action items to personally employ to overcome systemic hurdles for safer discharge medication reconciliation.

Educational objectives: 

By the end of the two-hour session, learners will work collaboratively to:

  1. Describe the roles and expertise of three health professions that can collaborate to reconcile medications and enhance safety of medication orders at the time of hospital discharge. 
  2. List three potential communication barriers between health professionals involved in discharge planning that contribute to medication errors in vulnerable older adults.
  3. Identify key components of discharge medication lists and instructions to communicate information safely to patients, caregivers, primary care providers and others on the healthcare team.
Date posted: 
Tue, 08/30/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/30/2016
Contact Person/Corresponding Author:



Suggested Citation:
"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/228

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