Category Archives: Geriatric Medicine

Dr. Eckstrom: ‘Cultural Shift’ Needed to Improve Care of Older Adults

Elizabeth Eckstrom, MD, MPH

Geriatrician Elizabeth Eckstrom, MD, MPH, shares her professional perspective on caregiving in the book she co-authored, The Gift of Caring.

Valentine’s Day is just around the corner, and gift giving will abound. It makes me think of those who give the gift of selflessly caring for others, such as those family and friends who care for their older adult loved ones.

There are many resources to help these family caregivers. The Gift of Caring: Saving Our Parents from the Perils of Modern Healthcare is one new resource that shares both a personal and professional perspective on caring for older adults.

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Telling Our Story

Click on image to read the article.

Click on image to read the article.

A headline in Tuesday’s New York Times asks a very important question: “As the population ages, where are the geriatricians?

The story, by Katie Hafner, describes the shortage of geriatrics and gerontologic expertise in our health system today. It features the important and compelling work of our colleague Elizabeth Eckstrom, MD, and her team at Oregon Health and Science University, where we have funded a number of grant projects, notably in geriatric nursing and care models. The story also features comments from several John A. Hartford Foundation Change AGEnts who work every day to share their precious expertise in caring for older adults.

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Tools You Can Use: New Collaborative Guideline Spotlights Optimal Care for Older Adults Undergoing Surgery

TS_121011_surgeons_400pMy 77-year old father underwent surgery two years ago and I recall how frightening it was for him, my mother, and our entire family. Unfortunately, our fear was realized when he had a terrible post-operative infection that sent him to the emergency room and on to a follow-up surgery.

Sadly, he and my mom were not given good hospital discharge instructions and they ignored signs of problems far too long. No follow-up appointment with his primary care provider had been set, either, which could have averted the complication (and to this day, I kick myself for not catching that).

It could have been much worse. For patients older than my father with more chronic conditions, even surgery that is technically perfect can be fraught with danger and poor outcomes without the application of geriatric best practices that address the whole-person needs of the patient.

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Making the Voices of Older Americans Heard in Health Policy

This is the last in a series of six Health AGEnda posts on the 2014 Annual Report.

This is the last in a series of six Health AGEnda posts on the 2014 Annual Report.

Editor’s Note: The John A. Hartford Foundation’s 2014 Annual Report features five profiles of Hartford Change AGEnts whose work is representative of the kinds of practice and policy change the initiative is making. Read Harnessing the Power of Hartford Change AGEnts for more on the Change AGEnts Initiative. Today, we meet Renée Markus Hodin, Carol Regan, and Gregg Warshaw, MD, of Community Catalyst, who are working to bring the perspectives of older adults and aging-expert health professionals to efforts to improve care for the vulnerable population eligible for both Medicare and Medicaid. The John A. Hartford Foundation Board of Trustees recently approved a three-year, $1.5 million renewal grant to expand Community Catalyst’s work. This post concludes our special Health AGEnda series spotlighting the stories and videos of Hartford Change AGEnts profiled in the Annual Report.

As a geriatrician, Gregg Warshaw, MD, has watched with mounting frustration as older adults are bounced back and forth between nursing homes and hospitals—decisions often driven by the different financial models used by Medicare and Medicaid.

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Hartford Grantees, Friends Shine at AGS Annual Meeting

National_Harbor_400pMost of our John A. Hartford Foundation staff have come to the banks of the Potomac River in National Harbor, MD, this week for the annual scientific meeting of long-time grantee and partner, the American Geriatrics Society (AGS). It’s always a great opportunity to catch up with valued friends and colleagues, learn about the latest advances in aging and health research, and celebrate those who have made important contributions to the field.

This year is no exception. In fact, it is gratifying to see how many of those being honored by AGS this week have been part of the Hartford Foundation community, through grants, scholarships, fellowships, and partnerships.

Steven R. Counsell, MD

Steven R. Counsell, MD

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Making Electronic Health Records Responsive to Needs of Older Adults (Really Meaningful Use)

EHR_shutterstock_150374810_300pI was recently in New Orleans and coincidently listened to an interview with Robert Wachter of the University of California, San Francsico talking about health IT and his new book on where the nation stands regarding electronic health records (EHRs).

Somehow, the temptations of the French Quarter and the problem of EHRs combined in my mind to produce the image of the nation’s health system out on the town, binging on HITECH Act ARRA money, blackout drunk, and waking up married to some very inappropriate electronic health record system.

This isn’t exactly how it happened, but most of the bloom does seem to be off the rose of the electronic medical record and we are in a phase of regret and disillusionment. Physicians have been complaining for years about the hours added to their days by the workflow disruption of digital data entry and the breach in the relationship with patients created by interacting with the computer, rather than the person. At the same time most of the anticipated fabulous features of EHRs are still in the anticipated stage.

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Geriatric Emergency Medicine: The Time to Act is Now
Part Two

Teresita Hogan, MD

One of this blog post’s authors, Teresita Hogan, MD, speaks on care transitions during the Geriatric EM Boot Camp in Milwaukee.

Editor’s Note: In our Feb. 19 Health AGEnda post, the team we’re informally calling the Hartford Geri EM Champions shared information about the first two Geriatric Emergency Medicine Boot Camps and a meeting hosted by the John A. Hartford Foundation in late January to discuss new opportunities to improve acute care of older adults. Today, in the second of two parts, our EM experts discuss why our current system is failing older Americans, and share their vision for better emergency department care that can both serve the needs of older adults and contribute to a more efficient and value-based health care system.

The acute care provided to older adults in emergency departments (ED) across the country, and world, is often inadequate and sometimes dangerous.

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Geriatric Emergency Medicine: The Time to Act is Now

Drs. Kevin Biese and Jan Busby-Whitehead

One of this blog’s authors, Dr. Kevin Biese, right, and Dr. Jan Busby-Whitehead lead a collaborative project at UNC-Chapel Hill to develop a unique model of a geriatric emergency department (ED) focused on improving care transitions.

Editor’s Note: This is the first of two parts.

“Geriatric Emergency Medicine”—As health professionals in Emergency Medicine (EM) who have chosen to focus on the geriatric population, we wish we could claim the topic brings a sense of excitement and opportunity to EM physicians worldwide.

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When It Comes to Geriatrics Expertise, If You Can’t Change the Numbers, Change the Game

“Whoever said nothing is impossible obviously hasn’t tried nailing Jell-O to a tree.”—John Candy

As the year comes to a close, there are many lists of the best and worst in almost every imaginable category for 2014. Here at Health AGEnda, we have made an annual practice of reviewing the workforce in training data—specifically, the number of graduating resident physicians choosing additional training in geriatric fellowship programs—published in the Journal of the American Medical Association (JAMA). (Read Boxing Day Brings Glad Tidings for Geriatrics Field from 2013, Decline in Geriatric Fellows Defies Pay Boost: +10% = -10% from 2012 and Falling Leaves, Falling Numbers from 2011.)

I recently saw one of my charts presented (without attribution :-( ) in a Washington briefing session on the workforce available to care for older adults, so I guess I have to keep updating them.

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MSTAR Program Shines at Reception for Supporters

Hartford Trustees Kathryn D. Wriston, left, and Lile R. Gibbons, at a recent reception honoring them as personal supporters of the MSTAR program.

Hartford Trustees Kathryn D. Wriston, left, and Lile R. Gibbons, at a recent reception honoring them as personal supporters of the MSTAR program.

Over the past 20 years, the Medical Student Training in Aging Research (MSTAR) program—a summer internship that draws physicians-in-training into the field of geriatrics and aging research—has supported more than 2,000 medical students.

We celebrated the program’s 20th anniversary and its remarkable record last week with a reception honoring John A. Hartford Foundation Trustees and other individuals who have personally donated to the sustainability of this initiative, administered by the American Federation for Aging Research (AFAR).

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