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.
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).
Many of the John A. Hartford Foundation’s grant projects are working hard to improve the quality of health care for the older adults who are dually enrolled in both Medicare and Medicaid.
As a group, these low-income, older adults have more complex health conditions and a greater need for coordinated, geriatrics-expert care that meets their own individualized health goals.
To improve quality and reduce costs in this population, states are working with the federal government and local managed care health plans to integrate the financing and care delivered through Medicare and Medicaid. Changes are happening fast as states experiment with delivering care to this population of “duals” through these health plans, many of which have never had experience caring for an older adult population with complex conditions.
Let’s say you are 80 years old and about to undergo surgery. Perhaps it was an unexpected fall that placed you in the emergency department and you’ll need an orthopedic surgeon to repair your hip. You’ll undergo anesthesia during the procedure and afterwards will likely require rehab.
All of the physicians who might care for you—from the ER doc to the anesthesiologist to the physical medicine/rehab physician—have spent years and years of training to specialize in their discipline.
But do they know about the drugs that should be avoided in older patients? Do they appropriately assess for frailty or cognitive impairment? Do they understand the risk factors for post-operative delirium (an acute state of confusion) and how to mitigate them?
From left, Cherie Brunker, Meg Wallhagen, Rosanne Leipzig, and Aanand Naik put their pieces of the puzzle together to complete the picture at the recent Change AGEnts event at the AGS annual meeting.
For the thousands of researchers and clinicians who have been a part of the John A. Hartford Foundation’s programs during the past three decades, we are pleased to invite you to put your geriatrics expertise to work by becoming an active Hartford Change AGEnt.
You can now enroll in the online Change AGEnts Community, where you can find other Change AGEnts and work together to make our health care system better for older adults and their families.
Jennie Chin Hansen, CEO of AGS, left, with Cory Rieder, the Hartford Foundation’s executive director and treasurer.
In honor of the American Geriatrics Society’s (AGS) annual meeting opening today in Orlando, we want to reflect on the key role this partner organization has played in our joint efforts to improve the health of older Americans.
Over the years, AGS has been one of our largest and most frequent grantees, leading a diverse array of projects. Many grants have aimed at strengthening the field of geriatrics, such as the leadership development award through the AGS affiliate organization, the Association of Directors of Geriatric Academic Programs (ADGAP) or the Health Outcomes Research Scholars through another affiliate, the Foundation for Health in Aging.
Cory Rieder, PhD, left, with Dr. David H. Solomon. Dr. Rieder will receive the David H. Solomon Memorial Public Service Award,, named for the geriatrics pioneer who died last year.
One of the highlights of our year is the annual meeting of the American Geriatrics Society (AGS). AGS is a long-time grantee and partner of ours and their yearly meeting is an opportunity for us to learn about the latest scientific advancements in geriatric care and get valuable “face-time” with our grantees and scholars.
The AGS meeting is also a time for health professionals with geriatrics expertise to acknowledge each other’s hard work and accomplishments. In addition to the highly energizing support we all receive just from being around like-minded colleagues, formal awards given by the society help to inspire and motivate all of us by spotlighting important work that is making a difference in the lives of older adults.
A hospital emergency department can be a chaotic and dangerous place for older adults, resulting in poor outcomes, distress, and dissatisfaction for them and their families.
We’ve had several posts on Health AGEnda related to emergency department (ED) care of older adults (See Building a Better Emergency Department for Older People, Collaboration Across Departments and Foundations Leads to Improved Emergency Care , and Can EMTs Improve Outcomes for Older Adults Leaving ER?). Older people use emergency rooms in greater numbers than younger adults, and once admitted are more likely to have an emergent or urgent condition, be hospitalized, and be admitted to a critical care unit.
Fortunately, there’s a growing cadre of passionate emergency medicine physicians with geriatrics expertise who are trying to improve emergency care for older people. This is happening in part through the American Geriatrics Society’s Geriatrics for Specialists Initiative and the Jahnigen Scholars program, which we’ve funded for years. The Atlantic Philanthropies and others have supported the Jahnigen Scholars as well as work in specialty nursing care, reaching out to emergency nurses to build their geriatrics expertise.
From left, Dziadzia, Rachael Watman, and Rachael’s grandmother in 1971.
My grandfather, Albert Chura, was born on Valentine’s Day in 1907, on a boat en route to the United States from Poland. His family wanted to make a better life in America. And after a lifetime of doing so, at the age of 83, he died on my birthday.
Valentine’s Day always makes me think of Dziadzia (Polish for Grandfather and oddly pronounced Judgie—“Mom, that can’t be how you spell it!”)
Two years ago, I wrote a blog titled Confused About Post-Operative Confusion about my father’s experience with post-op delirium after he had triple bypass surgery. It obviously struck a chord with many.
Even now, it consistently remains one of the most-visited pages on our website, and has drawn 26 comments from people who are caregivers themselves and whose relatives experienced symptoms of delirium similar to my father. And more comments continue to be posted even after two years. Usually our blogs receive comments from grantees/policy people, professionals, etc. It is less common that our blogs reach caregivers.
What we’ve discovered is that there are many caregivers and others faced with similar circumstances who are hungry for information on post-op delirium and are finding my blog post through various internet search engines.