The Portal of Geriatrics Online Education

Medical Ethics

Elder Care A Resource for Interprofessional Providers: HIPAA and Working with Family Caregivers

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

HIPAA and Working with Family Caregivers 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. Explain what is HIPAA
  2. Use professional judgement to determine if it is appropriate to share information with a caregiver
  3. Know how to approach information sharing with caregivers in situations involving suspected elder abuse
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: 
Mon, 01/28/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 12/19/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: HIPAA and Working with Family Caregivers. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/209

Interprofessional Geriatric Education and Training in Texas: Elder Mistreatment

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

Although estimates vary, it is generally believed that 11% of the elderly are abused. According to the National Incidence Study on Elder Abuse, approximately 450,000 elderly experienced abuse each year. If self-neglect is included, the number increases to 551,000. Elder mistreatment is too large of a problem for any one person or one discipline to resolve. Incorporating the expertise of all the members of the interprofessional healthcare team is critical to determine the facts in the situation and the motives of the people involved. Healthcare providers can only see what is presented in the clinical setting. There is so much of the story that may not be manifested in a routine exam and encounter. Having all team members knowledgeable about the sometimes subtle signs of elder mistreatment is helpful for eliciting information and devising a holistic intervention plan.

The University of North Texas Health Science Center (UNTSHC) Reynolds Interprofessional Geriatric Education and Training in Texas (IGET-IT) Program has developed an Elder Mistreatment module as part of the Interprofessional Communication Improvement Modules (ICIM) Elder Safety series. The ICIM Elder Safety modules were created in collaboration with the National Board of Osteopathic Medical Examiners (NBOME) and are supported, in part, by a grant from the Donald W. Reynolds Foundation. The goal of the Elder Safety ICIMs is to provide innovative and sustainable programs to improve the ability of physicians to work with other health disciplines in teams to provide better care for geriatric patients. The care of older adults can be very complex and studies have shown that a team approach can be most effective in leading to quality outcomes.

 

Educational objectives: 

Upon completion of this activity, participants will be able to:

  • Define “elder mistreatment”
  • Describe the prevalence of elder mistreatment in the US
  • Define the multiple forms of elder mistreatment
  • Identify risk factors for elder mistreatment
  • List indicators of elder mistreatment
  • Prioritize the steps of elder mistreatment assessment
  • Determine the approach for including an elder mistreatment assessment in an IP team model of geriatric assessment
Publications from, presentations from, and/or citations to this product: 

Marquez Hall, S. (2016, May). Assessment Tool for Elder Safety on the Topics of Falls Risk and Elder Mistreatment. Presented at American Geriatrics Society Annual Scientific Meeting Education Product Showcase, Long Beach, CA.

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Product Viewing Instructions: 
Select your activities and add them to your cart. In the cart, click Proceed to Checkout. You will be prompted to create a new account or log in to your existing one. Once your account is created, you will be directed back to complete your registration.
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Geriatric Education and Training in Texas: Elder Mistreatment. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/209

The Geriatric Experience Multimedia Menu for Residents and Medical Students on Geriatrics Rotation

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
3
Abstract: 

This multimedia menu was created to add variety to a geriatrics rotation for third- and fourth-year medical students and family medicine residents while exposing learners to different aspects of the social and ethical issues integral to the care for older adults. The menu includes multiple books, movies, online videos and podcasts that learners may choose from during an assigned half-day of the rotation. Afterward, learners complete a written, personal reflection that is submitted to the course director. Reflective ability is an important skill for practicing physicians that is rarely taught in a formal curriculum. This simple menu broadens the breadth of the geriatric rotation and creates an opportunity to practice reflection. 

Educational objectives: 

After completing this experience, learners will:

1. Critically reflect on clinical experiences through the lens of multimedia portrayals of issues related to older adults. 

2. Discuss ethical issues related to the care of older adults. 

3. Describe new insights from a variety of media types and apply these insights to future practice. 

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Contact Person/Corresponding Author:



Suggested Citation:
The Geriatric Experience Multimedia Menu for Residents and Medical Students on Geriatrics Rotation. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/209

Building Caregiver Partnerships Through Interprofessional Education

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

Family caregivers are on the frontlines managing complicated chronic illnesses, assisting with day-to-day functioning, and providing direct care to manage symptoms and improve the quality of life of their loved ones. Yet, health professions students, medical/surgical residents, and care providers receive little, if any, training on the vital role that caregivers play on the healthcare team and how, effective partnering optimizes patient care throughout the illness trajectory and at end-of life.

The goal of Building Caregiver Partnerships through Innovative Interprofessional Education is to create effective partnerships between healthcare providers and family caregivers to reduce the burdens, ease suffering, and enhance the meaning of the caregiving experience for the patient, family and health care providers.  The project centers on a 20-minute film, No Roadmap: Caregiver Journeys, which features the compelling stories of four caregiving families. The film and companion discussion guides as well as resources for case-based learning and structured clinical encounters are freely accessible on the website. http://www.neomed.edu/medicine/palliativecare/building-caregiver-partnerships/

The website is designed so that faculty can easily select the materials that best fit their learners’ needs and the time constraints within their programs. The curricula is appropriate for medical, pharmacy, nursing, and other health professions educational programs at both undergraduate and graduate levels. Additionally, tools have been developed for interdisciplinary team-based forums and health provider training.  For medical/surgical residency programs, relevant ACGME milestones are identified. 

Educational objectives: 

The objectives of the educational tools are to prepare learners to:
• Describe home-based eldercare as a shared experience and the importance of building a relationship with family caregivers and care recipients based on trust, compassion and open communication; 
• Describe the vital role of family caregivers as important, but under recognized, members of the health care team;
• Discuss the meaning and challenges of family caregiving;
• Engage caregivers in meaningful discussions to identify the needs, values and goals of their caregiving family;
• Identify resources to address caregiver concerns and provide ongoing support; and
• Provide holistic team-based care to family caregivers that improves the quality of life for the care recipient and the caregivers. 

 

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

~~Date/Location Meeting/Forum Presentation Title Presenter(s)
Jan 28-31, 2016, Phoenix, Arizona; Society of Teachers of Family Medicine; 45 min presentation;  Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Clerks;  D. Sperling; J.T. Thomas

March 10-13, 2016; Chicago, Ill;  American Academy of Hospice and Palliative Medicine;  60-min workshop; Using Film to Foster Empathetic Partnerships between Care Providers and Family Caregivers;  J. Drost; E. Scott; M. Scott; D. Damore; S. Radwany

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Poster; Building Caregiver Partnerships Through Innovative Health Professions Education; E. Scott, S. Radwany, D. Drost, K. Baughman, B. Palmisano, M. Sanders

May 19-21, 2016; Long Beach, Ca; American Geriatrics Society; Educational Product Session; Building Caregiver Partnership Through Innovative Health Professions Education; J. Drost; B. Palmisano

May 25, 2016; NEOMED Department of Family and Community Medicine Resident Scholarship Day; 15 min presentation; Exploring Caregiver Journeys: A Curricular Tool for Family Medicine Residents; D. Sperling; J.T. Thomas
 

Date posted: 
Mon, 12/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 05/19/2017
Contact Person/Corresponding Author:



Suggested Citation:
Building Caregiver Partnerships Through Interprofessional Education. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/209

Assessing Capability of Medical Decision Making Capacity

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

A multifacted program focused on Assessment of Medical Decision Making Capacity. It includes the following education and assessment tools:

 

  • Elder Care Provider Sheet, “Medical Decision-Making Capacity”
  • A needs assessment for all medical and surgical specialties
  • Just-in-time reference cards
  • Mini-CEX to assess residents

 

Educational objectives: 

Determine if the patient has the:

  • Ability to clearly communicate their choice for treatment or non-treatment
  • Ability to understand the relevant information (regarding medical condition and treatment)
  • Ability to understand the situation and the consequences of treatment options
  • Ability to reason about treatment choices, consistent with personal values

 

 

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: 
Mon, 09/28/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 03/29/2018
Contact Person/Corresponding Author:



Suggested Citation:
Assessing Capability of Medical Decision Making Capacity. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/209

Interprofessional Collaborator Mini-Course

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

Physicians (and other health professionals) are often expected to participate with teams of health professionals; however, postgraduate training infrequently includes interprofessional (IP) or team training.  Thus, this curriculum was developed to teach and demonstrate the knowledge, skills and attitudes which lead to successful IP collaboration.  While created for an audience of in-training physicians, it may be used with other health professional audiences.

During a four-week geriatrics rotation, medicine interns complete a fifty-minute, in-person, multimedia lecture to introduce the IP collaborator concept and the Canadian and American IP competency frameworks. The IP pocket card is demonstrated and interns complete a guided, team-meeting video observation exercise. Using a SurveyMonkey, narrative reporting tool, interns analyze team competencies that they observe or initiate during geriatrics team meetings during the rotation. They report on two interactions. They complete a closing SurveyMonkey questionnaire and have an in-person debriefing.

Educational objectives: 

Given opportunity to work with interprofessional teams for patient care on the Geriatrics Block Rotation:

  • Learner will recognize interprofessional competencies.
  • Learner will understand the role of interprofessional collaborator.
  • Learner will observe and demonstrate the knowledge, skills and attitudes necessary to be an interprofessional collaborator according to CIHC and IPEC competencies
Publications from, presentations from, and/or citations to this product: 
Poster Presentation: Interprofessional Collaborator Curriculum
InterProfessional Care for the 21st Century
Redefining Education & Practice
Jefferson University, Philadelphia, PA
October 2014
Date posted: 
Tue, 06/14/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/03/2019
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Collaborator Mini-Course. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/209

Patient Complexity and Interprofessional Team Care

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

Patient Complexity and Interprofessional Team Care is a geriatrics block rotation mini-course designed to improve medicine trainee’s understanding of health care teams.  It was developed in the setting of a new model of care collaboration for vulnerable seniors, Geriatric Resources for Assessment and Care of Elders.  The course is a blended curriculum offered during a 4-week residency block rotation in geriatrics. It is composed of a web-based, audio, PowerPoint lecture to introduce the Minnesota Complexity Assessment Method (MCAM) tool and application of the tool using paper cases.  The tool is then applied to actual patients discussed at an interprofessional team meeting of the GRACE care management program.

Educational objectives: 

Given a screening of the patient medical record, attendance at the patient’s GRACE interprofessional team meeting and completion of the Minnesota Complexity Assessment Method (MCAM) tool, the health professional trainee will identify patient situation complexity and describe ways that interprofessional team care members address patient care.

Given a printed Likert scale questionnaire, the resident will indicate positive change in degree of agreement with beliefs about interprofessional teams.

Publications from, presentations from, and/or citations to this product: 
Educational Strategies for Addressing Complex Patient Care Symposium
Aida Wen, MD, Todd James, MD, Miho Bautista, MD
October 21, 2013, 2013 Reynolds Grantee 11th Annual Meeting  in Coronado, CA

 

“Beliefs of Medicine Residents Regarding Interdisciplinary Teams,”  Poster presentation American Geriatrics Society Scientific Meeting, Grapevine, TX, May 2-5, 2013

Citation:  James, TC, Westmoreland, GR, Counsell SR. Beliefs of Medicine Residents Regarding Interdisciplinary Teams. J Am Geriatr Soc 2013; 61: Suppl s1; s157 (abstr C87).  http://onlinelibrary.wiley.com/doi/10.1111/jgs.122...

 

The poster described the 12-item physician survey to assess post-graduate medicine resident beliefs regarding interdisciplinary teams.  Resident responses demonstrated that interdisciplinary team participation is perceived as worthwhile. Yet, residents were uncertain about when their patient needed a team. There was significant agreement for having physicians as leaders of teams, and yet there was not clear agreement on team goals. Survey results support development of curricula for medicine residents geared toward teaching when a team approach is indicated and clarifying roles of various team members.

 

“Complexity and Interdisciplinary Team Care” Curriculum Presentation at Reynolds Grantee 9th Annual Meeting, St. Louis, MO, October 23 – 26, 2012

 

“Using a Complexity Tool with Geriatric Patients Teaches Residents Roles of Interprofessional Teams,” Buzz Session Presentation, InterProfessional Care for the 21st Century: Redefining Education and Care conference, Jefferson InterProfessional Education Center, Philadelphia, PA, May 18 – 19, 2012

 

“A New Strategy for Teaching Residents Roles of Interprofessional Teams” Poster Presentation at American Geriatrics Society Scientific Meeting, Seattle, WA, May 3 – 5, 2012.

Citation: James TC, Westmoreland GR, Arenson S, Counsell SR. A New Strategy for Teaching Residents Roles of Interprofessional Teams. .  J Am Geriatr Soc 2012; 60: Suppl s4;  s45 (abstr A84). http://www.americangeriatrics.org/files/documents/...

 

 “Academic Roles and Scholarly Activities” presentation, Faculty Forum, Indiana University Geriatrics, Indianapolis, IN, January 23, 2012

 

“Pilot Testing of a New Curriculum on Patient Complexity and Interdisciplinary Team Care” Poster Presentation at Collaborating Across Borders III, Tuscon, AZ, November 19 – 21, 2011.

 

 

 

Date posted: 
Wed, 04/03/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/03/2019
Contact Person/Corresponding Author:



Suggested Citation:
Patient Complexity and Interprofessional Team Care. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/209

When Eating Problems Arise in Advanced Dementia: An Interdisciplinary Trigger Video

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

This is an interactive seminar centered on a trigger video depicting a family meeting with the treating physician, the speech and language pathologist and the family of a patient with advanced dementia who suffers from dysphagia/poor oral intake. The seminar can be provided to a small group of 4-10 healthcare trainees (medical residents or students, nursing students, speech and language pathology students, social work students). The seminar is designed to present the learners with an interdisciplinary approach to conducting a family meeting on this topic. It starts with reading a case presentation, which is meant to emphasize the need for a family meeting, followed by playing the video until a trigger question comes up. At that point the participants are asked to reflect on the question and share their answers with the group. The group then watches the video exemplifying a way the question can be discussed. The process is repeated for all the trigger questions. At the end of the seminar the trainees are encouraged to debrief on language that could be modeled for goals of care discussions as well as aspects of the discussion that could have been approached differently. They are also provided with all the references used in the video as a resource for future family meetings. Trainees are asked to complete a short retrospective pre/post self-assessment survey. 

Educational objectives: 
  1. Review importance of completing advance directives (applied to patients with dementia); define surrogate decision maker, substituted judgment, and best interest concepts and discuss advance care planning for the case presented.
  2. Describe the natural history of advanced dementia.
  3. Become familiar with potential treatment burdens associated with tube feeding in patients with advanced dementia.
  4. Appreciate various options for eating/feeding in advanced dementia and swallowing problems.
  5. Analyze aspects of difficult conversations with surrogate decision makers.

 

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

Some of the materials for this seminar were presented during the Marketplace at the Reynolds Meeting in Las Vegas, Oct 7, 2014.

 

 "When Eating Problems Arise in Patients with Advanced Dementia- An Interdisciplinary Approach to

Communicating with Caregivers" This interactive seminar was presentated at the Annual

Assembly of the American Association of Hospice and Palliative Medicine Annual Meeting, February 2015, Philadelphia.

 

 

Date posted: 
Fri, 06/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 06/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
When Eating Problems Arise in Advanced Dementia: An Interdisciplinary Trigger Video. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/209

AEGIS - Surgical Informed Consent of the Geriatric Patient: First Do No Harm

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

Informed Consent is an essential surgical skill that has moral, ethical and practical implications for the older patient. This module uses three video trigger tapes that present the “Typical” surgical informed consent, its potential aftermath, and follows with an example of an “Effective” informed consent. This module is part of the Advanced Education in Geriatrics for Surgeons (AEGIS) project.

Educational objectives: 

Upon completion, learners should be able to

1. Describe the informed consent process including components

2. Discuss unique concerns for the geriatric surgical patient during consent

Date posted: 
Wed, 12/04/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 12/04/2013
Product Viewing Instructions: 
Videos are located on the PHUSC Geriatrics Channel on Youtube
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , , and . AEGIS - Surgical Informed Consent of the Geriatric Patient: First Do No Harm. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/209

How to discuss Code Status and make a recommendation

:  
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: 

Code status discussions are often rushed events done during a hospital admission by a doctor that the patient has never met.  The content, and therefore the quality, of these discussions varies widely and often contains very incomplete information that fails to meet a person at their individual health literacy level.  Additionally, once a physician decides to make a recommendation for a DNR status, the methods used may be crude and border on coercive.  

The goal of this lecture is to provide the listener with a complete understanding of CPR outcomes that can be presented flexibly at the level of the health literacy of the patient and family.  Second, the lecture provides a framework for making a recommendation of CPR by not viewing it soley as a health literacy problem but as a fit between a patient's stated values and the likely outcomes of CPR.  In this way, there are many reasons why a person may choose to be DNR.  

First, an evidence review of outcomes are discussed by site of care (inpatient, outpatient and nursing home) including immediate failure, prolonged death in a hospital, survival with impaired neurological status and survival with intact neurological status.  Both absolute and relative rates are presented.  An evidence review of the risks are summarized including the trauma of CPR, what happens when a person fails to survive to hospital discharge and surviving with impaired neurological status.  Success rates in studies are analyzed by diagnosis, age, and functional baseline.  Finally, how to translate the outcomes into goals and values is discussed including when being DNR is appropriate for a patient.  Ideally, the learner will have more tools for helping a patient understand why DNR may be appropriate than before this educational session.  

Educational objectives: 

The purpose of this lecture is to allow the listener to have a much more complete understanding of the pros and cons of CPR and its outcomes and have a framework for making recommendations.  The goal is to move beyond simply thinking about the trauma and success rates of a procedure-oriented CPR discussion and move towards a value-based, patient-centered discussion.

Additional information/Special implementation requirements or guidelines: 

The power point lecture is accompanied by a handout that serves as a literature review.  There is also a bibliography.  In a small group setting, the handout could be the starting point of an interactive discussion.  I usually start by asking the housestaff and students when they have felt a patient who was full code should be DNR, why they felt that way, and how they went about trying to change the code status.  I ask what they communicate and how they communicate it. Having learners provide their own vignettes gets them more engaged in the discussion and at the end they can think about what they might have done differently.  

Date posted: 
Mon, 10/07/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/07/2013
Contact Person/Corresponding Author:



Suggested Citation:
How to discuss Code Status and make a recommendation. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/209

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