The Portal of Geriatrics Online Education

Internal Medicine

Palliative Care of a Patient with End-Stage Liver Disease: An Unfolding Case Study

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

This case study was developed for use in academic coursework and as a standalone training for health care providers (MDs, ARNP, Pharmacists, Social Workers, Nurses). This unfolding case study about the management of an adult in the midst of a health crisis. This case is a composite of many actual cases seen in clinical practice. During the course of this case study, learners are presented with information as the providers learn of the patient’s emergent and ongoing health concerns – from his Emergency Department admission through the development of his palliative care plan. Learners are asked to make decisions and use their best judgment about how to care for this patient and family.

Educational objectives: 

By the end of this case study, the learner will be better able to:

  1. Understand the natural history and disease management of end stage liver disease (ESLD).
  2. Use evidence-based practice to collaboratively develop and refine goals of care for patients with chronic, progressive conditions.
  3. Work interprofessionally to ensure the best quality of care for the patient and family.
Date posted: 
Fri, 09/14/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/15/2018
Contact Person/Corresponding Author:



Suggested Citation:
Palliative Care of a Patient with End-Stage Liver Disease: An Unfolding Case Study. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Elder Care A Resource for Interprofessional Providers: Urinary Tract Infections 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: 

Urinary Tract Infections in Long-Term Care​ 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. List the criteria for diagnosis of urinary tract infection (UTI)
  2. Define asymptomatic bacteriuria
  3. Appropriately manage common clinical situations that are often misdiagnosed at UTI
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, 08/06/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/01/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Urinary Tract Infections in Long-Term Care. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Elder Care A Resource for Interprofessional Providers: Hearing Loss and Cognitive Assessment

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

Hearing Loss and Cognitive Assessment 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 why hearing impairment can influence the results of cognitive assessments
  2. Identify cognitive assessment instruments that do not rely on a patient’s ability to hear
  3. Explain what to do if there is concern that impaired hearing is affecting the results of a cognitive assessment
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, 08/06/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/31/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Hearing Loss and Cognitive Assessment. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Aging and Immunity: The Important Role of Vaccines

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

Immune function wanes in all adults—whether healthy or sick—as they age into their fifth decade and beyond. Their bodies become less adept at recognizing and stopping pathogens, and the ability to develop and maintain immunity declines. Also known as  immunosenescence, age-related decline in immunity significantly contributes to the susceptibility of older adults to serious conditions, including influenza, pneumonia, and shingles.

Patients often believe that by living a healthy lifestyle, they can avoid illness and disease. While exercising, getting recommended screenings, and eating right are important for staying healthy, they alone do not prevent older adults from acquiring vaccine-preventable diseases. For older adults who feel, and generally are, healthy, it can be difficult to recognize that immunosenescence is occurring or what impact it may have. Underappreciation for immunosenescence could at least partially explain why adult vaccines remain significantly underutilized, despite their ability to stimulate and heighten immune response and boost waning immunity in older adults. According to the National Center for Health Statistics, in 2015, only 57% of Americans aged 65 years or older received a tetanus vaccine in the prior 10 years, 64% had received a pneumococcal vaccine, and only 34% had ever received a herpes zoster vaccine. Among adults 50 years and
older, four vaccine-preventable diseases alone—influenza, herpes zoster, pneumococcal disease, and pertussis—cost the United States more than $26 billion annually.

Ensuring that adult patients receive recommended vaccines is an important way to prevent unnecessary infections and reduce health care costs. Health care professionals play a key role in this process, specifically, they should:

  • Assess their adult patient’s immunization status
  • Strongly recommend vaccination at every opportunity using the 4R approach: Recommend, Repeat, Remind, Review
  • Have a program that supports in-practice vaccine administration
  • Refer patients to a health care professional who administers vaccines if you do not
  • Document vaccine administration and submit to the immunization registry

Vaccination is a critical component of protecting the health of individuals as they age. Providing a strong recommendation for vaccination at each encounter increases the likelihood of an individual accepting a vaccine, reducing the risk for debilitating illness, and protecting quality of life.

Educational objectives: 
  • Provide healthcare professionals with an understanding of the biological impact of aging on immunity,
  • Provide information to support the value of vaccination by exploring herpes zoster in depth and the role that age-related decline in immunity plays in this vaccine-preventable illness,
  • Offer practical tips and strategies for supporting aging patients’ health and overcoming barriers that may contribute to low rates of adult vaccination.
Publications from, presentations from, and/or citations to this product: 
Date posted: 
Mon, 08/06/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 07/19/2018
Contact Person/Corresponding Author:



Suggested Citation:
Aging and Immunity: The Important Role of Vaccines. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Elder Care A Resource for Interprofessional Providers: The Medicare Annual Wellness Visit

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

The Medicare Annual Wellness Visit 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 Medicare payment coverage for an annual wellness visit, including what patients do or do not have to pay
  2. Explain what is included in a Medicare annual wellness visit
  3. Explain how to correctly bill for services, unrelated to the annual wellness visit, that are provided during an annual wellness visit
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, 08/06/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/31/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: The Medicare Annual Wellness Visit. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Elder Care A Resource for Interprofessional Providers: Ethnic, Racial, and Cultural Perceptions in End-of-Life Issues

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

Ethnic, Racial, and Cultural Perceptions in End-of-Life Issues 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. Define ethnic and cultural identity
  2. State differences between various ethnic/cultural groups in their perceptions of end-of-life issues
  3. Improve your communication about end-of-life issues when discussing these issues with patients from ethnic/cultural groups different than your own
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: 
Wed, 07/25/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 05/22/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Ethnic, Racial, and Cultural Perceptions in End-of-Life Issues. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Elder Care A Resource for Interprofessional Providers: Anxiety in Older Adults - Pharmacotherapy

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

Anxiety in Older Adults - Pharmacotherapy 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. Describe appropriate pharmacotherapy for coexisting depression and anxiety in older adults
  2. Institute pharmacotherapy for anxiety in older adults at appropriate doses
  3. Appropriately manage benzodiazepine therapy in patients who have been on long-term treatment
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: 
Wed, 07/25/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 05/22/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Anxiety in Older Adults - Pharmacotherapy. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Where's the Fall Risk?

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

One in four older adults have a fall or fall-related injury every year. “Where’s the Fall Risk?” is an interactive educational game that allows learners to discuss falls prevention in the home environment and think of potential solutions. Learners will be in groups of 2-6 people and use the provided picture to circle the fall risk areas in the given amount of time. The teams will then present the total number of areas by room and propose solutions for each fall risk area. A point will be given for each circled area and solution. The discussion portion of the game provides learners the ability to identify and fix high fall risk areas in the home. 

 

Educational objectives: 
  1. Understand what aspects of the home environment are considered fall risks
  2. Think of creative solutions to fix these fall risk areas
  3. At the end of the game, be able to have an active discussion with patients regarding falls prevention in the home environment
Additional information/Special implementation requirements or guidelines: 
Materials:
The game is best played in a group setting with teams composed of about 2-6 people.
  • Diagram of the home environment (PowerPoint provided)
  • Pen/Marker to circle fall risk areas
  • Timer
  • White board to keep track of points
Instructions:
Please print the provided diagram of the home environment. Groups of 2-6 people with a minimum of 2 groups.
Identification Phase:
  1. Set timer for 2 minutes and provide groups with the home diagram
  2. Start timer and have groups circle areas in the home that are considered fall risks. Suggestion to groups: it is easier to go room by room
  3. Once time is up, set pens to the side.
Solution Phase:
  1. Set timer for 2 minutes and provide groups with a sheet of paper.
  2. Start timer and have groups discuss why they circled the area as a fall risk and think of a solution for the fall risk area (of note, groups may not use “get rid of the item” as a solution).
  3. Once time is up, set pens to the side.
Discussion Phase:
  1. On white board, create a grid with group names at the top and rooms on the side (“Outside”, “Living Room”, “Kitchen”, “Dining”, “Bedroom”, “Bathroom”)
    1. Depending on how much time you have, it may be faster to discuss some rooms together: Outside & Living Room, Kitchen & Dining, Bedroom & Bathroom
  2. Start the discussion by going from room to room. Each team will get 1 point if they can identify a fall risk area and provide a solution. Of note, this is a key opportunity to discuss and talk about these high fall risk areas. You may propose other solutions and open it up to discussion with other groups as well.
  3. The winning team has the most points at the end of the game. 
Date posted: 
Wed, 07/25/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sat, 05/26/2018
Contact Person/Corresponding Author:



Suggested Citation:
Where's the Fall Risk?. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

Hartford Institute for Geriatric Nursing: Overview of Resources

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

The Hartford Institute for Geriatric Nursing (HIGN) at NYU Rory Meyers College of Nursing offers a number of evidence-based online resources for nurse educators, nursing students, and professionals. Many of these resources area available through our clinical resource page, known as ConsultGeri, which is accessible through HIGN’s website. Resources are available for purchase by logging in to our eLearning portal. A number of HIGN’s resources provide continuing education credits for professionals. 

For more information, please visit http://www.hign.org.

Educational objectives: 
  1. Provide evidence-based online resources for nurse educators, nursing students, and professionals.
  2. Provide educational resources on various geriatric topics (such as dementia, chronic disease management, and presentation of illness in older adults) that apply acute care, long-term care, and home settings.
  3. Provide assessment tools for professionals, such as the Try This: Series.
Date posted: 
Tue, 04/17/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 04/17/2018
Contact Person/Corresponding Author:



Suggested Citation:
Hartford Institute for Geriatric Nursing: Overview of Resources. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

ACUTE MANAGEMENT OF OLDER ADULT FOUND DOWN WITH ALTERED MENTAL STATUS

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

This case study was developed for use in academic coursework and as a standalone training for health care providers (MDs, ARNP, Pharmacists, Social Workers, Nurses). This unfolding case study about the management of an older adult in the midst of a health crisis. This case is a composite of many actual cases seen in Emergency Departments. During the course of this case study, learners are presented with information as the providers learn of the patient’s emergent and ongoing health concerns – from her Emergency Department admission through her Intensive Care Unit stay. Learners are asked to make decisions and use their best judgment about how to care for this patient.

Educational objectives: 

 

  • Apply knowledge of evidence-based care provision to an older adult found with altered mental status after a ground level fall
  • Describe the contributions of the interprofessional team to care management
  • Demonstrate effective communication during handoffs in care
Publications from, presentations from, and/or citations to this product: 

Citations are listed at the bottom of the screen throughout the case study.

Date posted: 
Fri, 07/27/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 05/22/2018
Contact Person/Corresponding Author:



Suggested Citation:
ACUTE MANAGEMENT OF OLDER ADULT FOUND DOWN WITH ALTERED MENTAL STATUS. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/207

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