The Portal of Geriatrics Online Education

Complex or Chronic Illness(es) in Older Adults

Wound Care and Ostomy Nursing

:  
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.  During the course of this module, the learner will be introduced to the specialists who are experts in the field of wound care and ostomy nursing. A practical overview of the major clinical conditions that wound care nurse specialists take care of will be discussed.

Educational objectives: 

1). Introduction to nurse specialists who do this work

2). When to refer

3). Overview of conditions for which they can be helpful

Date posted: 
Tue, 08/18/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/18/2015
Product Viewing Instructions: 
Please turn on the volume on your device before viewing the module and allow a few seconds for the module to load.
Contact Person/Corresponding Author:



Suggested Citation:
Wound Care and Ostomy Nursing. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/4827

Physical Therapists Optimize Movement

:  
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.  The focus of this module is an introduction to the physical therapy profession as a whole with a perspective on its role in health care.  The module outlines the education and training received by professional physical therapists, as well as by physical therapy aides.  Important clinical problems will be described that benefit from physical therapy referral.  The overall therapy process used by physical therapists in caring for patients, starting from their first meeting, is mapped out in this module.  

Educational objectives: 

1. Introduction to the PT profession, its role in health care

2. Outline education and training

3. Review clinical problems that merit referral to PT

4. Map out overall therapy process employed in patient care

Date posted: 
Tue, 08/18/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/18/2018
Product Viewing Instructions: 
Turn on the volume to your device before viewing the module. Allow a few seconds for the module to load.
Contact Person/Corresponding Author:



Suggested Citation:
Physical Therapists Optimize Movement. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/4827

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/4827

Diabetes Management in Long Term Care

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

Guidelines for managing diabetes in older adults and particularly the long-term care population have changed significantly over recent years.  Changes have included redefining HbA1c goals based on patient comorbidities and function.  Additional emphasis has been placed on discontinuing the use of sliding scale insulin in the long-term care population.  The current guidelines are reviewed, and a practical approach to the day-to-day management of diabetes in long-term care is outlined.

Educational objectives: 

1. To review recommended HbA1c goals determined by patient comorbidities.

2. To review recommendations regarding the use of sliding scale insulin in LTC patients.

3. To outline a practical approach to the day-to-day management of diabetes in the long-term care setting.

Date posted: 
Tue, 05/26/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sun, 04/01/2018
Contact Person/Corresponding Author:



Suggested Citation:
Diabetes Management in Long Term Care. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/4827

Gait Disorders 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 educational modules teaches learners how to recognize normal patterns of gait in the elderly and discuss various geriatric gait disorders.  There is a quiz at the end of the module.

Educational objectives: 

After reviewing the module, learners should be able to:

1) observe and assess gait disorders in the elderly.

2) classify and describe gait disorders in the elderly.

3) know when to refer for more specialized care.

Additional information/Special implementation requirements or guidelines: 

Authors:  Richard B. Dewey, Jr., MD; Shilpa Chitnis, MD; Cherian Abraham Karunapuzha, MD

Geriatrician: Amit Shah, MD

Medical Illustrator: Lindsay Oksenberg, MA

Date posted: 
Wed, 12/10/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 12/10/2014
Product Viewing Instructions: 
Quicktime is needed
Contact Person/Corresponding Author:



Suggested Citation:
Gait Disorders in the Elderly. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4827

Degenerative Aortic Stenosis

:  
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: 

The UT Southwestern SAGE Aortic Stenosis module is self-directed learning of degenerative aortic stenosis in the elderly. After completion of the program, medical students will have reviewed the disease, patient presentation, physical exam and treatment of aortic stenosis.

Educational objectives: 

After completion of the aortic stenosis module, learners will be able to describe:

  • anatomy and physiology of aortic stenosis
  • patient symptoms of aortic stenosis
  • diagnosis of aortic stenosis
  • treatment of aortic stenosis
Additional information/Special implementation requirements or guidelines: 

Quicktime is needed to view this material.

Author:  Melane Sulistio, MD

Geriatrician:  Kathryn Eubank, 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:
Degenerative Aortic Stenosis. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4827

Elder Care A Resource for Interprofessional Providers: Frailty in Patients Undergoing Elective and Emergency Surgery

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

Frailty in Patients Undergoing Elective and Emergency Surgery  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 frailty
  2. Explain how frailty influences surgical outcomes for older adults
  3. Explain how to evaluate a patient for frailty
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, 07/17/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 07/11/2019
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Frailty in Patients Undergoing Elective and Emergency Surgery. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/4827

Geriatric Cardiology OSCE: The Hidden Curriculum, Identifying End Stage Heart Disease & Clarifying Care Goals

:  
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 fellow performance. At the Medical College of Wisconsin (MCW), geriatricians and cardiologists worked together to create and implement a geriatric cardiology education OSCE for cardiology fellows. Key curriculum content gaps (identifying end stage heart disease, identifying and discussing palliative care goals in cardiac patients), 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 method. Fellows self-assessed their competency level in those EPAs both pre and post OSCE curriculum intervention. 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 Hypoactive Delirium when Obtaining Procedural Consent."

This resource, also available on MedEDPortal, contains all materials for the geriatric cardiology OSCE regarding end stage heart disease and end of life goal setting, but also contains an additional agenda & timeline and a second evaluation form to be used if the two stations are combined.

Educational objectives: 
  1. Identify end stage cardiac disease in an elderly patient.
  2. Determine the patient’s cognitive and functional capabilities.
  3. Elicit the patient’s goals of care.
  4. Make care recommendations that are consistent with the patient’s life and care goals.

As educators, our goal was to see if the learners were able to recognize that the cardiac disease was at an end stage process, and then follow with an exploration of cognitive, functional and social situations in the context of the patient's goals and wishes to discuss a hospice/palliative care approach. To increase clinical relevance and keep the simulation closer to the reality of clinical care, learners were asked to review the patient's case and discuss plans for his treatment and care. This allows for some learners to make the clinical error of only adjusting medications and suggesting AICD battery replacement if they do not fully assess the patient holistically and delve into their care goals. We believe that this to be a more realistic and powerful way to learn.

Additional information/Special implementation requirements or guidelines: 

This curriculum was successfully implemented in the cardiology fellowship core curriculum but could also be implemented with other levels and types of learners (residents, medical students). Resource limitations may include space and standardized patients.

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

Published first on MedEDPortal

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 End Stage Heart Disease & Clarifying Care Goals. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4827

Can You Swallow This? A Practical Approach to Dysphagia

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

This interactive, "hands-on", small group session emphasizes a practical approach to the diagnosis and management of dysphagia in older adults.  Created by a speech and language pathologist and geriatrician team, the session begins with a brief overview of swallowing anatomy and phases.  A small group brainstorming session then highlights potential etiologies of dysphagia, followed by the use of video fluoroscopic studies and the learners' sampling of thickened liquids and trials of swallowing manoeuvers to make learning "stick".

1) The session starts with the facilitator reviewing a PowerPoint presentation (9 slides).  These slides cover the session learning objectives, the definition of dysphagia and review of  health consequences of dysphagia, and orient the learner to swallowing basics through cross-sectional diagrams of the head and neck describing swallowing anatomy and phases of swallowing.

2) The session continues with a small group brainstorming session with learners working in groups of two or three to fill in a chart listing "what conditions/diseases may lead to dysphagia or aspiration?" The group lists the etiologies under the three headings of swallowing phases (e.g., oral, pharyngeal, esophageal).  The facilitator has the groups share findings with the large group, highlighting key points.

3) The facilitator returns to the PowerPoint Presentation, reviewing key factors in identifying dysphagia through history and physical examination (4 slides).  Evaluation through video fluoroscopy is demonstrated through 5 short video clips (e.g. normal swallow, aging swallow, aspiration, thick/thin liquids modifications).

4) Learners try nectar and honey thickened liquids to experience potential therapy/treatment options and to then practice basic compensatory swallowing strategies.

 

Educational objectives: 

Educational Objectives:

1. Identify the 3 phases of swallowing (oral, pharyngeal, esophageal) and conditions causing potential dysphagia.

2. List 5 factors (clues) that a patient may be at risk for aspiration.

3. List treatment options for aspiration (swallowing exercises, position changes, dietary modification).

Additional information/Special implementation requirements or guidelines: 

Educational Objectives:

1. Identify the 3 phases of swallowing (oral, pharyngeal, esophageal) and conditions causing potential dysphagia

2. LIst 5 factors (clues) that a patient may be at risk for aspiration

3. List treatment options for aspiration (swallowing exercises, position changes, dietary modification)

 

Of Note:

This exercise is designed to cover the practical aspects of swallowing and dysphagia.  It's goal is to help learners identify risk factors for aspiration in older adults and to be able to then implement an initial assessment plan to evaluate the condition further.  Trial of the liquids is done to increase empathy and understanding of the risks and benefits of modifying liquid consistence for patients and the challenges of postural and behavioral modifications as well.  The teacher/facilitator does not need to be an expert in swallowing and dysphagia.  The materials provided are an initial point for teaching and the Frequently Asked Questions/References  (Ask the Speech Therapist Sheet) is designed to supplement the session and to provide a starting place for further study.

While the session is most easily taught as a small group session (6-8 learners), it was taught at the American Geriatrics Society Clinical Skills session to approximately 60 learners.  The small group portions were completed by having learners work with one or two persons next to them to complete the Dysphagia Etiologies Chart, and liquids were passed on trays.

Materials needed for the session:

1. Session Agenda - facilitator (one)

2. Session Agenda - Participants (one for each participant)

3. PowerPoint presentation with included 5 video clips

4. Dysphagia Etiologies sheets - blank (one for each participant or for each small group)

5. Dysphagia Etiologies sheet - answer key (one for the facilitator)

6. Nectar and honey consistency thickened liquids.  These may be made with a starch/thickener product such as "Thickit" (mix the starch with water according to ratios in the product directions - be aware that the liquids thicken further upon standing, so you may need to thin the liquid out with more water), or by purchasing pre-thickened liquids in the two consistencies ( a more expensive, but easier approach).  It is a time-saver and stress-reducer to have the liquids prepared in the small cups prior to the session.  They may be place on the table or passed around via a tray.  It is important to identify which liquid (nectar or honey thickened) is in which cup.  This may be done with a marker "N" or "H" on the cups, or by simply using two different style/color of cups.

7. Small, disposable cups (2 per learner)

8. Spoons and napkins, tray (optional)

9. Frequently Asked Questions/Reference Sheet

 

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

Presented at:

Wisconsin Geriatrics Board Review Course and Update, Lake Geneva, WI, Sept, 2013

Wisconsin Family Medicine Winter Refresher Course, Oconomowoc, WI February 2014

 American Geriatrics Society Annual Meeting, Clinical Skills Session, Orlando, FL, May 2014

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



Suggested Citation:
Can You Swallow This? A Practical Approach to Dysphagia. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4827

Hearing Loss in the Elderly

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

This PowerPoint video and audio discusses the pathophysiology, evaluation and treatment of hearing loss. Communicating with patients with hearing loss will be taught, all in less than 6 minutes.

Educational objectives: 

Understand the causes of hearing loss

Be able to better communicate with patients who have hearing loss

Date posted: 
Mon, 06/30/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 03/16/2018
Contact Person/Corresponding Author:



Suggested Citation:
Hearing Loss in the Elderly. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/4827

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