The Portal of Geriatrics Online Education

16 HCP: When to override recommendations for treatment

16. Accurately identify clinical situations where life expectancy, functional status, patient preference or goals of care should override standard recommendations for treatment in older adults.

Elder Care: A Resource for Interprofessional Providers: Diabetes:Special Considerations for Older Adults

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

"Diabetes:Special Considerations for Older Adults" 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: 
Objectives:
1. Modify glycemic control goals in older diabetes based on functional status and life expectancy
2. Identify blood pressure and lipid control as higher priorities than glycemic control for reducing the rate of cardiovascular complications in older patients with diabetes
3. Appropriately screen for geriatric syndromes in older patients who have diabetes
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 Geriatric Education Center."
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: Diabetes:Special Considerations for Older Adults. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/119

Cardiac Surgery Risk Assessment Case with EBM Literature

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

Case of an 83 year old Female with progressive dyspnea, orthopnea, and a non-productive cough over 2 months with reduced activity. Discussion questions are included. The EBM Literature focuses on aortic stenosis and mitral regurgitation in patients over 65 years of age.

Educational objectives: 

Determine: - Surgical risk when patients have heart failure symptoms - Are there more limited procedures with less risk and what long term outcomes are known. - Risk of continued medical treatment alone - Do risks increase in presence of other co-morbidities

Date posted: 
Thu, 02/26/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/17/2012
Contact Person/Corresponding Author:



Suggested Citation:
and . Cardiac Surgery Risk Assessment Case with EBM Literature. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/119

Geriatric Health Care Systems Test

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

This is a multiple choice test used as a pre- and post-geriatrics rotation to assess knowledge and skill in planning health systems use for patient care, such as home care, long term care, hospice, etc.

Educational objectives: 

One of the goals of the one month geriatrics residency rotation is to have residents develop competency in providing care and referring patients across systems of care and understand systems-based geriatrics practice. The rotation provides clinical experience in care of older adults in acute, subacute, long term care, ambulatory, and home care settings with exposure to a multidisciplinary team model of care. Seminars include a session on health care systems and transitions of care. At the end of the one-month rotation residents are expected to attain competency in the following areas: 1. Medical evaluation of the older adult in the emergency room setting When is it appropriate not to admit to the hospital? What can be done to insure a safe discharge from the emergency room? 2. Insurance considerations when planning for hospital discharge What does insurance cover? What are the limitations of the available programs? 3. End of life care What are the goals of care? What services are available for patients and families? 4. Caregiver stress How do we help families plan for the long care of their loved ones? What support is available for families and physicians in making these plans? 5. Community care What kinds of support services are offered in the community after hospital discharge? Who pays for long- term care and how is it arranged?

Additional information/Special implementation requirements or guidelines: 

pre- and post-test

Date posted: 
Thu, 09/24/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 01/23/2013
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Health Care Systems Test. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/119

Web-Based Module to Train and Assess Competency in Systems-Based Practice

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

Purpose of the study: The ACGME competency of systems-based practice seeks to increase residents' understanding of the health care system and to train them in the efficient and effective utilization of resources within this system. We developed an interactive, internet-based 30-minute module to train medical residents in the delivery of optimal care to patients by helping them navigate the complex maze of health care resources and to make transitions of care more seamless. The key curricular components of this training module are: 1) the basic elements of Medicare and Medicaid, 2) the various levels of post-acute hospital care for older patients, and 3) the role of provider-to-provider and provider-to-patient communication in patient transitions of care, including the critical elements of an effective discharge summary. Methods: We created an interactive, animated module based on the story of an older patient who presents to an emergency room with focal weakness after a recent hospital stay. It depicts a common scenario that illustrates the importance of communication in the transition of an older patient from one site of care to another. The vignette has been tailored to be applicable to multidisciplinary trainees. Interactive questions are embedded within the case to emphasize key teaching points while continuing to engage the learners.

Educational objectives: 

Specific learning objectives addressed in this module include: 1) The critical elements of an effective discharge summary. 2) How effective discharge communication improves patient outcomes. 3) Basic features of Medicare and Medicaid. 4) How intensity of interventions and support varies, depending on the site of care.

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

Presented at the 5th Harvard Medical School Medical Education Day, November 7, 2006. 

Eskildsen, M. A. (2010, December). Review of Web-Based Module to Train and Assess Competency in Systems-Based Practice. Journal of the American Geriatrics Society, 58(12), 2412-2413. Also available online.

Date posted: 
Fri, 09/04/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 09/04/2009
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Web-Based Module to Train and Assess Competency in Systems-Based Practice. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/119

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