The Portal of Geriatrics Online Education

CNS/Neuroanatomy/Neuroscience

ACUTE MANAGEMENT OF OLDER ADULT FOUND DOWN WITH ALTERED MENTAL STATUS

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

This case study was developed for use in academic coursework and as a standalone training for health care providers (MDs, ARNP, Pharmacists, Social Workers, Nurses). This unfolding case study about the management of an older adult in the midst of a health crisis. This case is a composite of many actual cases seen in Emergency Departments. During the course of this case study, learners are presented with information as the providers learn of the patient’s emergent and ongoing health concerns – from her Emergency Department admission through her Intensive Care Unit stay. Learners are asked to make decisions and use their best judgment about how to care for this patient.

Educational objectives: 

 

  • Apply knowledge of evidence-based care provision to an older adult found with altered mental status after a ground level fall
  • Describe the contributions of the interprofessional team to care management
  • Demonstrate effective communication during handoffs in care
Publications from, presentations from, and/or citations to this product: 

Citations are listed at the bottom of the screen throughout the case study.

Date posted: 
Fri, 07/27/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 05/22/2018
Contact Person/Corresponding Author:



Suggested Citation:
ACUTE MANAGEMENT OF OLDER ADULT FOUND DOWN WITH ALTERED MENTAL STATUS. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/197

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
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/197

Evaluation and Management of Late Life Psychosis

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

This self-directed, web-based, interactive educational module addresses the evaluation and management of psychosis in older adults.

Educational objectives: 

After reviewing this module, learners should be able to:

1) list examples of psychotic symptoms.

2) describe the steps involved in performing a diagnostic work-up.

3) summarize treatment principles.

Additional information/Special implementation requirements or guidelines: 

Author:  Mary Camp, MD

Geriarician:  Amit Shah, MD

Medical Illustrator:  Lindsay Oksenberg, MA

Date posted: 
Tue, 01/20/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/20/2015
Contact Person/Corresponding Author:



Suggested Citation:
Evaluation and Management of Late Life Psychosis. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/197

Cognitive Assessment in the Elderly

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

This module demonstrates how to administer the Montreal Cognitive Assessment Test (MoCA).  The MoCA was created to screen patients who present with mild cognitive complaints and who usually perform in the normal range on the Mini-Mental State Examination or MMSE.

Educational objectives: 

After reviewing the module, learners should be able:

  • to know when to utilize the MoCA to screen a patient.
  • to know how to perform and score the MoCA.
Additional information/Special implementation requirements or guidelines: 

Quicktime is needed to view this video.

Author:  Mary Ellen Quiceno, MD

Geriatrician:  Belinda Vicioso, MD

Medical Illustrator: Lindsay Oksenberg, MA

Date posted: 
Tue, 12/02/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 12/02/2014
Contact Person/Corresponding Author:



Suggested Citation:
Cognitive Assessment in the Elderly. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/197

Brief Cognitive Screening in Older Adults

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

This module provides an overview of a variety of brief cognitive screening measures that exist in the public domain and can easily be integrated in care settings that serve older adults. The online module is designed to be an interactive didactic experience, which includes short videos, reflection questions, and experiential exercises.

Although this module is best implemented as a group activity with partners (particularly Section 3, which includes role play as both clinician and patient), it can be adapted and completed individually as well.

Educational objectives: 
  1. Discuss the purpose of evidence based brief cognitive screening instruments
  2. Review pros and cons of five brief screens
  3. Practice administration and scoring of brief cognitive screens.
Additional information/Special implementation requirements or guidelines: 

The entire course for Brief Cognitive Screening for Older Adults is hosted on the Oklahoma Geriatric Education Center (Ok-GEC) website through the Donald W. Reynolds Dept of Geriatric Medicine at the University of Oklahoma Health Sciences Center (OUHSC). http://www.ouhsc.edu/okgec/documents/Sorocco_Online_Courses/BriefCognitiveScreenCourse.pdf and consists of three sections:

  1. Intro to Brief Cognitive Screens for Older Adults: Includes link to webinar and two open-ended reflection questions (Survey Monkey link).
  2. Selecting a Brief Cognitive Screen for Older Adults: Includes link to webinar, links to download and review 5 brief cognitive screening tools, and reflective question (Survey Monkey link).
  3. Experience Using a Brief Cognitive Screen for Older Adults: Includes link to webinar, an experiential exercise of provider/patient role play (you will need to find a partner for this exercise) with instrument of choice (from the links provided in Section 2) to practice administration and scoring, reflective question, and final learner and course assessments (Survey Monkey link).
Date posted: 
Tue, 09/23/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 05/01/2015
Product Viewing Instructions: 
Please view course at: http://www.ouhsc.edu/okgec/documents/Sorocco_Online_Courses/BriefCognitiveScreenCourse.pdf
Contact Person/Corresponding Author:



Suggested Citation:
Brief Cognitive Screening in Older Adults. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/197

It's My Old Back, Again: An Approach to Diagnosing and Managing Back Pain in the Older Adult.

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

Assessing and treating pain in older adults is of critical importance for nearly all health care providers. Back pain is a common, costly, disabling, yet under-addressed condition in this population. Specifically, musculoskeletal conditions, such as back pain - the focus of this educational module - are the leading causes of pain as adults age. This self-directed, web-based, interactive educational module addresses the evaluation and management of back pain in older adults. The audience for this module is anyone who provides care (both out-patient and in-patient) for older adults with back pain.

Educational objectives: 

1) Summarize the prevalence and impact of back pain in older persons.

2) Describe how to clinically evaluate back pain including a detailed examination.

3) List the differential diagnosis of back pain in older persons.

4) Explain how to manage the most common etiologies of back pain in older adults.

4) Summarize the risks, benefits and guidelines for specific pharmacologic management of back pain in older adults and how to minimize and monitor for adverse effects.

5) Summarize the various non-pharmacological approaches to managing back pain.

6) Describe which situations are appropriate for referral to more specialized care.

Date posted: 
Tue, 10/15/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 10/15/2013
Contact Person/Corresponding Author:



Suggested Citation:
, and . It's My Old Back, Again: An Approach to Diagnosing and Managing Back Pain in the Older Adult. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/197

Delirium: Prevention and Management in Hospitalized Elders

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

This course is intended for interdisciplinary members of the healthcare team in the hospital setting to improve knowledge of issues surrounding delirium in the elderly hospitalized patient. This 23-question module focuses on the evidence behind the recognition, prevention, and management of delirium in the geriatric patient.

Educational objectives: 

Upon completion the learner will be able to:

1. Use the Confusion Assessment Method to screen for delirium.

2. Understand features that differentiate delirium from dementia.

3. Name at least  five risk factors for delirium and techniques that target each risk factor to prevent the development of delirium.

4. Name at least three drugs that should be avoided in the geriatric patient.

5. Understand basic principles to the management of delirium, including work-up, behavioral management, and pharmacologic management.

6. Understand the importance of documentation of delirium and ways to improve transitions of care.

Additional information/Special implementation requirements or guidelines: 

This program will consist of 23 multiple choice questions on delirium in the geriatric patient in the hospital setting. The module will begin with two questions every other day in a single email from the website, www.qstream.com. This website will facilitate the delivery of questions and answers to the participant. You must log in to the website from the link posted above.

  •  If a question is answered incorrectly, the participant will receive the same question 5 days later.
  •  If a question is answered correctly, the participant will receive the same question 14 days later.
  •  If the participant answers the question correctly two times in a row, the question is then retired from the program and  is no longer repeated.
  •  The participant will complete the program when all 23 questions are retired (each question is answered correctly twice in  a row).  However, CE credit may be given when the program is 80% completed.

Given these parameters, it is estimated that the participant will complete the program in less than three months.

Participants may receive credit or contact hours ONLY by completing 80% of the questions in a module AND completing the end of module survey in LESS than four months time of enrollment.

Date posted: 
Wed, 11/13/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 11/13/2013
Product Viewing Instructions: 
You must register for the class and create a username
Contact Person/Corresponding Author:



Suggested Citation:
and . Delirium: Prevention and Management in Hospitalized Elders. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/197

Elder Care: A Resource for Interprofessional Providers: Amyloid Imaging for Alzheimer's Disease

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

Amyloid Imaging for Alzheimer's Disease  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. Describe what is seen on a positive vs a negative florbetapir amyloid scan in Alzheimer’s disease
  2. List three situation in which a florbetapir amyloid scan may aid in determining if a patient has Alzheimer’s disease.
  3. State the most common dementia (other than Alzheimer’s disease) that may have a positive florbetapir amyloid scan
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: 
Wed, 05/15/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 12/30/2016
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care: A Resource for Interprofessional Providers: Amyloid Imaging for Alzheimer's Disease. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/197

Elder Care: A Resource for Interprofessional Providers: Communicating with Patients who have Dementia

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

Communicating with Patients who have Dementia 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. List 3 verbal strategies that can improve communication with patients who have dementia
  2. List 3 non-verbal strategies that can improve communication with patients who have dementia
  3. List 3 things to avoid when talking to patients who have dementia
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."

For more information on this series, go to http://www.reynolds.med.arizona.edu/EduProducts/El...

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.

Date posted: 
Tue, 01/08/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 03/06/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care: A Resource for Interprofessional Providers: Communicating with Patients who have Dementia. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/197

Elder Care: A Resource for Interprofessional Providers: Not all Dementia is Alzheimer's Disease

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

Not all Dementia is Alzheimer's Disease 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. List the 3 most common causes of dementia, other than Alzheimer’s Disease (AD)
  2. List common characteristics of those 3 non-Alzheimer’s dementias
  3. List 4 features of a dementia-like illness that should raise concern about causes other than AD
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."

For more information on this series, go to http://www.reynolds.med.arizona.edu/EduProducts/El...

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.

Date posted: 
Thu, 08/02/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 05/31/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care: A Resource for Interprofessional Providers: Not all Dementia is Alzheimer's Disease. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/197

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