The Portal of Geriatrics Online Education

Cognitive, Affective, and Behavioral Health

Dementia: A Practical Approach

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

This one hour video lecture with accompanying PowerPoint slides provides an overview of dementia and how caregivers can better understand the progression of the disease and ways to provide support. The target audience is Interdisciplinary Health Care Professionals. 

 

This material is from the Geriatrics and Gerontology Interest Groups (GGIG) of Vanderbilt University

 

Educational objectives: 

Upon completion of this video lectures, you will be able to:

  • Identify a positive physical approach that will improve your interaction with patients with dementia.
  • Identify how to minimize difficult behaviors and elicit a positive response when giving care to patients with dementia.

 

Date posted: 
Wed, 03/23/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 03/23/2016
Contact Person/Corresponding Author:



Suggested Citation:
Dementia: A Practical Approach. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/4826

"The Psychologist's Role in Assessment and Therapy"

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

This resident education module was developed to educate residents on what other team members do.  The content was organized around the IM-FM geriatric competencies and IM Milestones.  This focus of this module is to explain the psychologist's role in assessment and therapy.

Educational objectives: 
1.Contrast skills/approaches of psychologists from those of other mental health professionals
2.Describe psychologist’s role in evaluating persons with cognitive, emotional, functional problems
3.List mental health problems and adjustment difficulties for which psychologists can be therapeutically helpful
Publications from, presentations from, and/or citations to this product: 

This module was showcased at the 2014 Reynolds Grantee Meeting marketplace.

Contact Person/Corresponding Author:



Suggested Citation:
"The Psychologist's Role in Assessment and Therapy". POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4826

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/4826

Cognitive Assessment in the Elderly

:  
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/4826

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

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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: 

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/4826

An Inter-Professional Education Delirium Simulation Pilot Project

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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: 

Case Overview: Ida Mae Homer is an 80 year-old woman with a 5-year history of Alzheimer’s disease.  Her granddaughter has been staying with her for the last 3 days while her daughter (her usual caregiver) is out of town.  Mrs. Homer is becoming increasingly confused and agitated with increased urinary frequency and incontinence as well as insomnia.  Her granddaughter has tried using Benadryl to help her sleep, however nothing seems to be helping.

Simulation: The set-up for the simulation includes the medical and nursing students reviewing a delirium web module (POGOe #20503) as well as a Situation, Background, Assessment, Recommendation (SBAR) video attached on the right side of this page, then completing pre-test delirium assessment (Delirium Knowledge Survey) and an assessment of attitudes toward teams in training (KidSIM) prior to the simulation.  Next, each medical and nursing student pair meets approximately 10 minutes prior to the simulation to review instructions, introduce themselves, and discuss thoughts and plans for caring for an agitated patient.  The team is then escorted to the “Emergency Room” where the patient and granddaughter (both are standardized patients) are waiting (faculty observes from control room).  The patient is agitated and anxious and is trying to get out of bed.  The team should elicit information from the granddaughter and recognize that the use of Benadryl and the probable urinary tract infection are the likely etiologies of delirium.  The team has a variety of medications available on the med cart (lorazepam, haloperidol, morphine, and hydroxyzine) as well as restraints, and the patient has “IV” access.  The simulation lasts 20 minutes, and approximately 10-15 minutes into the simulation, once the patient is stable and a plan has been established, the medical student calls the “attending” in the control room, and using SBAR, checks out the patient over the phone.  The faculty member then ends the simulation, and the entire team (faculty member, 2 students, and 2 standardized patients) leave the room for an approximately 15-20 minute debriefing session.  Simulations can run staggered if there are resources to have 2 teams and 2 standardized patients, otherwise the next simulation would begin once the debriefing session ends.

Goals for the simulation and topics for discussion during debriefing session:

  1. Diagnose delirium using CAM
  2. Identify potential causes for delirium
  3. Identify appropriate pharmacologic management for delirium (medication as well as dosage)
  4. Inter-professional collaborative practice
  5. Situation, Background, Assessment, Recommendation (SBAR)
Educational objectives: 
  1. The students will be able to evaluate a patient with agitated delirium.
  2. The students will be able to outline appropriate treatment for a patient with delirium.
  3. The students will be able to work effectively with students in other professions in the care of a patient with agitated delirium.
  4. The students will be able to achieve 80% on post-test Delirium Survey.
  5. The students will improve their attitudes and beliefs about teams in training (KidSIM).
Publications from, presentations from, and/or citations to this product: 

The results of this inter-professional education delirium simulation has been presented at the American Academy of Neurology's Consortium of Neurology Clerkship Director's annual meeting, highlighting educational tools.  The results have also been presented at the Johnson County Community College's Annual Healthcare Simulation Conference.  This pilot project has also served as preliminary data for the University of Kansas' successful Reynold’s Foundation Next Steps grant application.

Date posted: 
Mon, 09/29/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/29/2014
Contact Person/Corresponding Author:



Suggested Citation:
An Inter-Professional Education Delirium Simulation Pilot Project. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4826

Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying Hypoactive Delirium When Obtaining Procedural Consent

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

Fellowship Programs must soon comply with the ACGME's Next Accreditation System (NAS) milestone performance tracking and reporting requirement and consider Entrustable Professional Activities (EPAs) to measure learner performance. At the Medical College of Wisconsin (MCW), geriatricians and cardiologists worked together to create and implement a geriatric cardiology educational OSCE for cardiology fellows. Key curriculum content gaps (hypoactive delirium recognition, use of cognitive assessment tools) were identified through cardiology fellow and faculty knowledge/performance gaps on a needs assessment survey/pretest. Curriculum content was delivered using the Objective Structured Clinical Examination (OSCE) educational/assessment method. Fellows self-assessed their competency level in those EPAs both pre and post OSCE curriculum intervention (Unable to Perform (1) - Teach Others (5)). The curriculum session included the OSCEs station followed by a debriefing session and learner self-evaluation.

This OSCE station may be given alone or combined in a two station OSCE session, with our other geriatric cardiology OSCE titled, "Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying End Stage Heart Disease & Clarifying Care Goals."

This resource, also available on MedEDPortal.

Educational objectives: 
  1. Identify subacute delirium in an undiagnosed early-moderate stage dementia patient
  2. Elicit a history substantiating dementia from the patient and daughter
  3. Recognize delirium using the CAM criteria and tool
  4. Determine decisionality of the patient (non-decisional) in regards to medical decision making
  5. Determine decisionality based on the 3 primary requirements for medical decision making (take in information, apply it to self, express a choice)
  6. Identify the decision-maker in the patient’s care (POAHC—daughter) to obtain consent for the cardiac catheterization procedure

Purpose of OSCE station:

By the conclusion of this session, learners will be able to better provide care to geriatric patients in the ACGME Competency Domains including:

  1. Medical Knowledge: through identification of delirium and potential contributing factors.​
  2. Patient Care: applying knowledge of delirium identification to the process of obtaining informed consent for a cardiac procedure.
Additional information/Special implementation requirements or guidelines: 

​Two standardized patients are required for each OSCE learner case (one geriatric "patient" and one "family member/caregiver"). Examination room to conduct OSCE, either with an examination table or bed for the "patient" and two chairs, one for the "family member/caregiver" and one for the fellow.

Publications from, presentations from, and/or citations to this product: 
Date posted: 
Tue, 08/26/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/26/2014
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying Hypoactive Delirium When Obtaining Procedural Consent. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4826

The Adapted Mini-CEX for Geriatric Psychiatry: Communicating with Dementia Patients

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

This Mini-Clinical Evaluation Exercise (Mini-CEX) is designed to observe a trainee obtaining a history from a patient with dementia.  The trainee is given direct feedback on their performance.

Important elements of verbal and non-verbal communication were included in the Mini-CEX based on the literature and the tenets put forth by the Alzheimer’s Society.  The adapted Mini-CEX used in this study assesses the CANMEDS Communicator role specific to geriatric psychiatry.

Educational objectives: 
  1. Demonstrate competence in non-verbal communication with an individual with dementia.
  2. Demonstrate competence in verbal communication with an individual with dementia.
Additional information/Special implementation requirements or guidelines: 

References:

  1. Alzheimer’s Society of Ontario. Living with Dementia - Ways to Communicate. Obtained from: http://www.alzheimer.ca/en/on/Living-with-dementia....
  2. Alzheimer’s Society of UK. What is Dementia - Communicating. Obtained from: http://www.alzheimers.org.uk/site/scripts/document....
  3. Beer LE, Hutchinson SR, Skala-Cordes KK. Communicating with patients who have advanced dementia: training nurse aide students. Gerontol Geriatr Educ. 2012;33(4):402-20.
Date posted: 
Wed, 01/21/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 01/21/2015
Contact Person/Corresponding Author:



Suggested Citation:
The Adapted Mini-CEX for Geriatric Psychiatry: Communicating with Dementia Patients. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/4826

Evaluating the Older Adult's Ability to Live Independently or Drive: An Occupational Therapist's Role in Assessment

:  
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 resident education module was developed to educate residents on what other team members do.  The content was organized around the IM-FM geriatric competencies and IM Milestones.  In this module, the learner will focus on how Occupational Therapists (or "OTs") approach the assessment and treatment of people with potential functional problems.

Educational objectives: 

1. Outline the global approach occupational therapists use to evaluate and treat their clients.

2. Explain assessment process used by occupational therapists to determine ability of cognitively impaired individuals to lilve safely and independently.

3. Explain assessment process used by occupational therapists to determine ability of individuals to drive safely.

Additional information/Special implementation requirements or guidelines: 

For evaluation purposes, there is a pre/post test available from the corresponding author.

Contact Person/Corresponding Author:



Suggested Citation:
Evaluating the Older Adult's Ability to Live Independently or Drive: An Occupational Therapist's Role in Assessment. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4826

The Audiologist's Role in Care of Hearing Loss and Vestibular Disease

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

This resident education module was developed to educate residents on what other team members do.  The content was organized around the IM-FM geriatric competencies and IM Milestones.  The focus of this module is to identify the audiologist's role in evaluating and treating hearing or vestibular concerns and to determine appropriate referral for other professionals in the care of hearing and vestibular problems.

Educational objectives: 


    1. Identify signs and symptoms of potential hearing or vestibular/balance problems.

    2. Identify the audiologist's role in evaluating and treating hearing or vestibular concerns.

    3. Determine appropriate referral for other professionals in the care of hearing and vestibular problems.

Additional information/Special implementation requirements or guidelines: 

For evaluation purposes, there are pre/post test questions available from the author.

Date posted: 
Thu, 01/22/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/21/2015
Contact Person/Corresponding Author:



Suggested Citation:
The Audiologist's Role in Care of Hearing Loss and Vestibular Disease. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/4826

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