Full Course Description

Assessments Matter: Getting to the Core of Geriatric Care

The Institute for Healthcare Improvement (IHI) has built a framework to assist in the improvement of geriatric care. This Framework has been named “The 4Ms” (What Matters, Mobility, Mentation, and Medication). This session will discuss how various assessment tools can be implemented and applied within the 4Ms framework to improve care for older adults.

Program Information

Objectives

  1. Analyze the Institute for Healthcare Improvement (IHI) 4Ms framework.
  2. Identify evidence-based assessment tools utilized in the comprehensive assessment of older adults.
  3. Evaluate the use of various geriatric assessments.
  4. Determine how various geriatric assessments fit within the 4Ms framework to ensure age-friendly care.
  5. Implement the use of select assessment tools using the 4Ms framework through a case-study exercise.

Outline

IHI 4Ms Framework

  • Mobility
  • Mentation
  • Mediation
  • What Matters
What Matters
  • Goals of Care – It is more than code status
  • Social Assessment
  • Spirituality Assessment
  • Sexual Assessment
Mentation
  • Cognitive Assessments
    • MINI-Cog
    • MOCA
    • CAM-Short
    • MMSE
    • PHQ-2
Mobility
  • Mobility Assessment
    • BMAT
    • STEADI
    • John Hopkins
Medication
  • Medication Assessment
    • Alcohol abuse screening
    • Beers criteria
    • Stop/Start
    • De-prescribing
Caregiver Assessment
  • Risk of elder abuse screen
  • Elder Assessment instrument
  • Caregiver Strain Index
  • Zarit Caregiver Burden scale
Case Study

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 09/28/2023

Geriatric Pharmacology: Provide Optimal Pharmacotherapy

In the United States those over the age of 85 use a large amount of medical resources including medications. Sequelae from medication usage are common in the elderly and may result in hospitalizations and/or death. This Pharmacy lecture will provide you with the necessary tools to carefully monitor your patients medications and provide optimal pharmacotherapy. We will explore drug/drug and drug/disease scenarios. We will create a plan that will minimize the number of meds one needs to take and maximize the drug's side effect profile to our advantage. We will understand the importance of knowing the BEERS list. Upon completion of these pharmacy lectures you will feel more comfortable with medication management in older adults.

Program Information

Objectives

  1. Define the terms polypharmacy and prescribing/medication cascade.
  2. Describe the elements of a thorough medication history and reconciliation.
  3. Identify prescription and over the counter risk of drug interactions.
  4. Utilize the BEERS criteria to identify potentially inappropriate medications in the older adult.
  5. Identify common medications that may affect current/future disease states.

Outline

What is polypharmacy?

  • Who is at risk?
  • What are the causes?
  • Prescribing Cascade
What is the BEERS list?
  • The American Geriatric Society Beers Criteria
  • What is on the Beers list?
What are drug interactions
  • Drug-drug interactions
  • Drug-food/beverage interactions
Drug-disease interactions
  • How do drug interactions occur?
A pharmacodynamic interaction
  • Why is it important to check for interaction?
  • Do drug interactions occur often?
  • Other factors causing drug interactions?
  • How do I check for drug interactions?
  • What should I do if I find a drug interaction?

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 09/29/2023

Older Adults with Pain: Most Effective Pharmacologic and Non-Pharmacologic Therapies

Pain can very seriously impact activities of daily living and quality of life for our elderly patients. Multiple comorbidities, polypharmacy, and potential for harm make it a challenge to determine the appropriate drug, dosages, and maintenance of therapy. Steven Atkinson, PA-C, MS, will deliver evidence-supported updates for pharmacological and nonpharmacological therapies to manage pain in the elderly.

Program Information

Objectives

  1. Analyze the pathogenesis of pain in the elderly. 
  2. Evaluate screening tools available for the treatment of pain among older adults. 
  3. Differentiate between the most effective pharmacologic and non-pharmacologic therapies for older adults with pain. 

Outline

Pathogenesis of Pain 

  • Acute vs. persistent pain 
  • Nociceptive vs. neuropathic pain 
  • Physiological changes in the elderly 
Assessing the Geriatric Adult for Pain  
  • A comprehensive geriatric exam 
  • Exam for those with dementia 
  • Evaluate screening tool options 
Multimodal Approaches to Pain Management 
  • Non-pharmacological approaches 
  • Pharmacological approaches 
    • Adjuvant therapies 
    • Opioids - Guidelines specific to geriatrics  
    • Cannabinoids  

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants
  • Physicians
  • Physical Therapists
  • Physical Therapist Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Speech Language Pathologists
  • Social Workers
  • Nursing Home Administrators

Copyright : 10/27/2021

Keeping Patients Off the Floor: Identifying Fall Risk and Preventing Falls in Aging Adults Throughout the Continuum of Care

This session will provide insight into identification of potential patient fall risk factors throughout the continuum of care. As falls have been identified by the CDC as a public health challenge, costing aging individuals their independence and quality of life, and related healthcare costs upwards of $50 billion dollars for non-fatal falls, fall prevention has become a nationally recognized initiative. Participants will learn how to integrate approaches to facilitate prevention of falls through appropriate patient management including screening, intervention and referral.

Program Information

Objectives

  1. Determine the magnitude of falls in the aging population.
  2. Identify causes of patient fall risk throughout the continuum of care.
  3. Acknowledge the signs of a patient at risk for falls in common healthcare settings and in the home.
  4. Synthesize the impact of polypharmacy on fall risk.
  5. Integrate strategies for fall prevention.
  6. Perform screening for fall risk and determine appropriate referral services as indicated.

Outline

  • Introduction to falls; magnitude and impact
    • Falls are not part of normal aging
  • Roles of different healthcare professionals in identifying factors that contribute to fall risk and falls, throughout the continuum of care
    • It takes a team
  • Strategies for decreasing or preventing falls in aging adults
    • Looking at the right things, subtle and obvious
  • Polypharmacy and impact on balance and fall causation
    • One versus many
  • Integrating CDC STEADI – Stopping Elderly Accidents, Deaths and Injuries, recommendations for fall prevention

Target Audience

  • Nurses
  • Nurse Practitioners
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Physical Therapists
  • Physical Therapist Assistants
  • Physician Assistants
  • Speech Language Pathologists
  • Other Healthcare Professionals

Copyright : 09/29/2022

Normal Cognitive Aging, Mild Cognitive Impairment, or Alzheimer’s Disease: How to Tell the Difference and Why it Matters

Often an aging patient or client will say and ask: “I just don’t remember as well as I used to … am I getting Alzheimer’s?”.  Clinically, you must ask yourself, is this normal cognitive aging, mild cognitive impairment, or the early stage of Alzheimer’s disease or another form of dementia.  In this session, we’ll review the basics of brain structure and function, describe the five main areas of cognition, learn about some office-based cognitive assessment instruments that require a few to 10-15 minutes to deliver and how to interpret them, identify the essential components of a dementia work-up including reversible causes of memory loss such as depression, and discuss why this matters given we now have three FDA-approved drugs to treat early Alzheimer’s.  Informative yet practical, this session will equip you with knowledge and skills you can use in your practice setting starting today! 

Program Information

Objectives

  1. Describe the structure and function of the brain’s frontal, temporal, parietal, and occipital lobes. 
  2. Define the five main areas of cognitive function including attention and concentration, memory, executive function, language, and visuospatial function. 
  3. Illustrate different office-based methods to assess cognitive function. 
  4. Assess using the Mini-Mental Status Examination and Montreal Cognitive Function Assessment. 
  5. Explain the components of a dementia work-up: history and exam, blood tests, blood and CSF biomarkers, cognitive function assessment, and structural and functional imaging studies. 
  6. Explain why a correct diagnosis of normal cognitive aging, MCI, and AD matter for treatment decisions. 

Outline

Structure and function of the brain lobes 

  • Frontal lobe 
  • Temporal lobe 
  • Parietal lobe 
  • Other: occipital lobe, brainstem, autonomic nervous system 

The five main areas of cognition 

  • Attention and concentration 
  • Memory 
  • Executive function 
  • Language 
  • Visuospatial function 

Cognitive function assessment 

  • 1-, 2- or 3-question very brief assessments 
  • MMSE – mini mental status exam 
  • MoCA – Montreal Cognitive Assessment 

Components of a dementia work-up including depression assessment 

  • History and exam 
  • Mental health assessments 
  • Cognitive function assessments 
  • Blood tests 
  • Structural imaging: MRI 
  • Functional imaging : FDG-PET and Amyloid PET 

The physiology of cognitive aging 

  • Characteristics of normal cognitive aging 
  • Symptoms of mild cognitive impairment 
  • Symptoms of Alzheimer’s disease and other forms of dementia 
  • Differentiating depression from dementia 

Why it matters: anti-amyloid drug therapy – indications, benefits, and risks 

  • Aducanumab (Aduhelm) – first in class 
  • Other anti-amyloid drugs 
  • Other drugs on the horizon 

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 07/20/2023

Patient Centered Care – Re-examine Psychosocial Dynamics

Pulse check! It’s time to re-examine the psycho –social dynamics of the care we give and how many variables affect patient outcomes. Kiplee Bell, MD, PA, will delve into key patient centered care considerations, including: support systems, safety, satiety, security, savings, stress, senility and sleep.  Empower seniors by connecting them with community resources, patient advocates, and financial planners. Empower yourself and your team as a professional caregiver. 

Program Information

Objectives

  1. Identify how workplace culture affects patient compliance and understanding of their disease state. 
  2. Learn how to assess personal and familial patterns of stress that manifest physiologically. 
  3. Integrate successful techniques to ensure team building amongst families and clinicians. 
  4. Avoid pitfalls that raise your liability in practice. 
  5. Assess environmental factors that leave important clues for the patient’s overall wellness – themes across fall prevention, nutrition, sleep and safety. 

Outline

What is Culture 

  • Culture of Caring 
  • Culture of Competency 
  • Culture of Complacency 

Patient Centered Care 

  • Support System 
    • Integrating the patient’s inner circle as a part pf the care regimen 
  • Safety 
    • Wandering systems 
    • Fall Risk 
    • Neglect 
  • Satiety 
    • Barriers to over/Under eating/Failure to thrive 
  • Security 
    • Assess emotional safety 
  • Savings 
    • Financial resources and strategies available 
  • Stress 
  • Senility 
    • Mental fitness and decision-making capacity 
  • Sleep 
    • Sleep hygiene  
    • Understanding the changes in sleep patterns for older adult persons 

How are You? 

  • Checking in  
  • Checking out 
  • Check Yourself 

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 08/14/2023

Effective Geropsych Behavioral Interventions for Older Adults with Cognitive Disorders

This two-hour presentation will provide healthcare professionals with practical knowledge and skills to address common behavioral and psychological symptoms in older adults with dementia. The focus will be on four specific areas: eating and nutrition, sleep disturbances, aggression, and wandering. Participants will learn key concepts of behavior management and learn to apply them in a person-centered, trauma-informed, and culturally responsive manner. Participants will also learn assessment strategies, evidence-based interventions, and key strategies that can be applied across a range of other challenging behaviors.

Program Information

Objectives

  1. Design individualized, evidence-based nonpharmacological interventions for managing eating and nutrition issues, sleep problems, aggression, and wandering in older adults with dementia.
  2. Describe the evidence base for nonpharmacological interventions for behavioral and psychological symptoms of dementia, including their benefits, limitations, and appropriateness for different scenarios.
  3. Assess the physical and social environment to promote positive outcomes for people experiencing behavioral and psychological symptoms of dementia.
  4. Apply concepts of person-centered, trauma-informed, and culturally informed care to the treatment of behavioral and psychological symptoms of dementia.
  5. Differentiate the relative impacts of culture, personal history, and individual preference on the development and treatment of behavioral and psychological symptoms in dementia.
  6. Evaluate ethical dilemmas that may arise in the use of nonpharmacological interventions for people experiencing behavioral and psychological symptoms of dementia.
  7. Determine collaborative problem-solving and knowledge sharing with other members of the health care team to develop effective intervention strategies for complex cases and challenging situations involving older adults with dementia.

Outline

Understand Behavioral and Psychological Symptoms in Dementia

  • Prevalence and risk factors for behavioral and psychological problems including agitation, wandering, sundowning, inappropriate sexual behavior, depression, anxiety, apathy, and sleep disturbances
Assessment of Behavioral and Psychological Symptoms
  • Biomedical factors, e.g., current medical comorbidities, medication side effects
  • Psychosocial factors, e.g., relevant psychosocial history, social environment, sensory stimulation or deprivation, freedom of movement, cultural considerations
  • Select target symptoms appropriate for behavioral and psychological intervention
  • Use an individualized case conceptualization and multi-step problem-solving approach
  • Applications of trauma-informed, person-centered, and culturally responsive care principles in the context of caring for persons with dementia
Foundations of Behavioral Intervention
  • The Antecedent, Behavior, and Consequence (ABC) model of functional analysis
  • Using the ABCs to reduce behavioral and psychological symptoms in persons with dementia
  • Ethical and cultural considerations when considering the use of behavioral analysis
  • Pleasant activity scheduling and other common behavioral interventions
  • Engaging the health care team, staff, family, and other caregivers in behavioral interventions
Eating and Nutrition Problems
  • Assessment of potential causes and contributors to eating and nutrition problems
  • Considerations for promoting adequate nutrition and mealtime engagement
  • Evidence-based nonpharmacological strategies for managing eating difficulties and addressing weight loss
  • Case example(s)
Sleep Disturbance and Insomnia
  • Assessment of potential causes and contributors to insomnia and sleep-wake cycle disturbances
  • Evidence-based nonpharmacological strategies including light and activity therapy, sleep hygiene, routines, and environmental cues
  • Case example(s)
Aggression and Other Disruptive Behaviors
  • Assessment of potential causes and contributors to aggressive behavior
  • Evidence-based nonpharmacological strategies including staff communication techniques, de-escalation, preventative environmental modifications
  • Case example(s)
Wandering and Exit Seeking Behaviors
  • Assessment of potential causes and contributors to wandering and exit seeking
  • Evidence-based nonpharmacological strategies including environmental modifications, safe and appropriate freedom of movement, activity scheduling, exercise routines
  • Case example(s)

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 09/28/2023

Empowering Geriatric Patients

Healthcare professionals need a well-rounded patient centered approach to support and empower patients. Therapists should also be leaders and innovators in easing the transition between levels of care. With improved skills to empower patients, the risk of re-admission can be reduced with more active patient involvement in the plan of care. 

Program Information

Objectives

  1. Determine best practices in promoting patient engagement in the rehab process. 
  2. Develop processes to facilitate smooth transitions between levels of care. 
  3. Assess tools for patients to safely live at home. 
  4. Explore risk reduction for re-admission with more active patient involvement in the plan of care. 

Outline

Transitions of Care 

  • Errors in Transitions Process 
    • Medications 
    • Patient safety 
      • Elderly 
      • Limited medical literacy 
      • High risk medications 
    • Consequences of unsafe discharge 
  • Discontinuity 
    • Providers 
    • Supplies 
    • Follow up 
  • Rehab Involvement 
    • Recommendations for the care setting 
    • Part of ongoing care at a different setting 
  • Care Continuum 
    • Locations 
    • Limitations 

Patient Empowerment 

  • Understanding by the patient of his/her role 
    • Not limited to terminal illness 
    • Non-health care outcome 
  • Patient Skills 
    • Coping 
    • Comorbidities 
    • Depression 
  • Presence of a Facilitating Environment  
    • Partnerships 
  • Enablers and Barriers 

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 07/26/2023

Documentation Hazards for Geriatric Patient Care: Minimal Care Expectations & Regulatory Standards

Knowing what to chart, how to chart, and when to chart is half the battle of charting regardless of the clinical setting.  Rachel Cartwright-Vanzant Ph.D., MS, LHRM, CCRN-K, has extensive expertise testifying and through work as a risk manager.  She will delve into the very latest documentation categories that lend themselves to litigation and highlight the risks specific to the care of geriatric patients, including attention to minimal care expectations and regulatory standards.

Program Information

Objectives

  1. Determine how scribes are effectively used in clinical practice. 
  2. Differentiate between state staffing and federal staffing requirements.  
  3. Choose an implementation practice to manage polypharmacy. 
  4. Apply the standards of pain assessment to medical record entries. 
  5. Analyze physical findings that could represent forensic evidence.   
  6. Determine if a patient has malnutrition from medical record entries. 
  7. Analyze the current issues that may violate resident rights in long term care. 

Outline

Medical Scribes 

  • Aide in managing documentation of physicians 
  • Charting estimated requirements 
  • Qualifications of scribes 
  • Accountability of medical record entries and treatment plan 
Handling of Informed Consent 
  • Competence and capacity 
  • Four dimensions of competence 
  • Biological age compared to numerical age 
  • Logical considerations 
Frailty Screening Tools 
  • Contributes to rising health care cost 
  • Frailty measurement instruments 
  • Delaying declines and promoting resilience outcome 
Nurse Staffing Standards  
  • Staffing requirements 
  • Basic care and resident rights 
  • Clinical measures of poor quality 
  • State deficiencies 
Polypharmacy Management 
  • Coordination of multiple prescribers 
  • Brown Bag review 
  • Medication reconciliation  
  • Mediation appropriateness 
  • Psychotropic medication specific concerns 
Pain Assessment 
  • Limitations to accurate assessment of pain 
  • Guidelines for pain management 
  • Regulatory standards 
Nutrition Screening 
  • Identify patients with malnutrition 
  • Screening tools 
Physical Findings in Injured Older Adults 
  • Documentation tools for elder abuse and neglect 
  • Improve documentation of potential forensic injuries 
  • Online resources 
Ethical Issues in Long Term Care 
  • Rights of residents in nursing homes 
  • Substance use 
  • Resident-to-resident aggressive behavior 
  • Staff-resident abuse 

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants
  • Physicians
  • Physical Therapists
  • Physical Therapist Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Speech Language Pathologists
  • Social Workers
  • Nursing Home Administrators

Copyright : 10/27/2021

Elder Law: Advanced Care Planning, Elder Abuse & Professional Malpractice

The expansion of our geriatric population requires health care professionals to be aware of legal issues relevant to an aging population. This session identifies various types of advanced care planning. Elder abuse and neglect occur daily. This session discusses types of abuse, appropriate interventions, and regulatory requirements to prevent and minimize harm. Case studies with specific examples are incorporated to provide you with “hands on” strategies for implementing safe, effective, legal, and ethical care for our elderly patients. 

Program Information

Objectives

  1. Explain the difference between legal and medical competency. 
  2. Differentiate between an advance directive/ durable health care proxy, a durable power of attorney and a will. 
  3. Identify what constitutes geriatric abuse and the reporting regulations. 
  4. Define the elements of professional negligence/malpractice and the consequences of liability. 

Outline

Advanced Care Planning 

  • Medical competency 
  • Legal competency 
  • Contractual agreements 
  • Power of attorney 
  • Durable power of attorney 
  • Advance directives/living will/health care proxy/durable power of attorney for health care 
  • Guardianships- person/property 
  • Wills/Trusts 

Elder Abuse 

  • Physical 
  • Psychological/emotional 
  • Sexual  
  • Financial or material exploitation 
  • Confinement 
  • Passive and active neglect 
  • Willful deprivation 

Regulatory requirements 

  • Statutory - Duty to report (reasonable belief/slander/libel) 
  • Licensure - fines, probation, suspension, or revocation and Rehabilitation Committee 

Professional negligence/malpractice 

  • Duty or standard of care – reasonable medical certainty/probability 
  • Breach of duty or standard of care 
  • Proximate cause/foreseeability 
  • Consequences of liability - Injury/Damages - compensatory, emotional distress/pain and suffering, and punitive 
  • Defenses – failure to meet burden of proof for all required elements, statute of limitations, contributory negligence, comparative negligence, and Good Samaritan Immunity 

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 07/27/2023

Geriatric Transitions of Care: Comparing Home Health, Assisted Living Communities & Skilled Nursing Facilities

This lecture will provide a comprehensive overview of post-hospital care or discharge care. We will delve into the specific services offered by each, including the level of medical care, assistance with daily activities, and social engagement opportunities. By the end of the lecture, attendees will have a clear understanding of the benefits and considerations associated with each option, empowering them to make informed decisions regarding geriatric discharge. 

Program Information

Objectives

  1. Educate patients and their families about the benefits and services offered at Assisted Living and nursing homes, emphasizing the specialized care and support available for their specific needs. 
  2. Collaborate with home health care providers to develop personalized transition plans, ensuring a smooth transfer of care and continuity of services for patients as they move from home health to Assisted Living and eventually to a nursing home. 
  3. Analyze comprehensive assessments to evaluate the physical, emotional, and cognitive health of patients, identifying any potential barriers or challenges that may arise during the transition process within their scope of practice. 
  4. Practice open communication and coordination among healthcare professionals, including physicians, nurses, therapists, and social workers, to ensure a seamless transition and optimal care coordination for patients throughout their journey. 
  5. Incorporate support and guidance to patients and their families during the transition period, addressing any concerns or questions they may have and providing resources and referrals to community services to enhance their overall well-being. 

Outline

What are the Different Care Settings to Discharge our Geriatric Clients to? 

  • Community Based Care 
  • Home Health Care 
  • Assisted Living Facility 
  • Skilled Nursing Facility 

 

  • Community-Based Care 
    • Older adults with disabilities can live at home with the help of their family and some special programs (I.e. home health) 
  • Home Health Care 
    • "Home health care" includes services such as: 
    • House calls that physicians, nurse practitioners, physical therapist, occupational therapist, speech pathologist and physician assistants make to a person’s home. 
    • Care that nurses, personal care aides, and rehabilitation therapists provide in the home of people with medical needs. These staff often work for home health agencies. 
    • Modifications to the home and technologies that help people with medical needs and disabilities carry out daily activities. 
  • Assisted Living Facilities 
    • Sometimes, an older adult needs more help with personal care than they can get at home from family, other caregivers, or home-based formal support programs.  
    • Assisted living are for these older adults, who needs care that cannot be met in their home, but they do not yet require skilled nursing services available all the time.  
    • This option can provide help to an older adult while protecting their privacy and independence. 
  • Skilled Nursing Facility 
    • Skilled nursing homes provide medical, health, and personal care, as well as supervision to people who need it. Nursing home residents generally have severe illness, disability, or cognitive impairment (problems with thinking, learning, or memory). 
    • The Federal government sets quality standards for nursing homes that serve people who have Medicare or Medicaid coverage. These rules require that nursing homes provide skilled nursing, rehabilitation, and other types of therapies that people may need. State licensure of nursing homes generally follows the federal standards. 
    • Note that the Federal government doesn’t regulate assisted-living and these homes don’t have to offer skilled nursing services like nursing homes do. States regulate assisted living and their rules vary across the country. 

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 07/28/2023

End of Life: Palliative and Hospice Care Benefits

Caring for patients facing the end of their lives requires extreme sensitivity, deep compassion, and extraordinary knowledge. To deliver informed and compassionate care, healthcare professionals need to understand the differences between hospice and palliative care.

You will leave this session with concrete strategies to identify patients for whom aggressive therapy is not appropriate, skills to work through palliative referral and financial considerations, and the latest when it comes to hospice eligibility criteria.

Each end-of-life patient trusted to your care deserves to be optimally supported, on the final journey of their life.

Program Information

Objectives

  1. Determine referral considerations for palliative care.
  2. Analyze the myths surrounding hospice care.
  3. Differentiate between hospice and palliative care services.
  4. Evaluate the eight domains of the National Consensus Project.

Outline

Pillars of Palliative Care 

  • National Consensus Report 
  • Referral considerations 
  • Financial considerations 
  • Barriers and Benefits to PC 
Hospice 
  • Services 
  • IDG/IDT 
  • Medicare benefit (levels of care) 
  • Eligibility criteria 
  • Financial considerations 
  • Barriers and Benefits to Hospice 

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants
  • Social Workers
  • Case Managers
  • Physical Therapists
  • Occupational Therapists
  • Speech Language Pathologists

Copyright : 08/29/2022

Ethnogeriatrics: Cultural Competence for Health Care Professionals

The number and proportions of older adults from diverse ethnic and cultural backgrounds is growing and expected to be one-third of the population by 2050. As a result, more than ever, you are responsible to provide culturally competent care. Tamatha Arms, PhD, DNP, PMHNP-BC, NP-C, will share highlights from her vast clinical experiences caring for diverse patient populations.  An evidence-based cultural competence model will be integral to your own confident delivery of ethnogeriatric care afterwards! 

Program Information

Objectives

  1. Evaluate Kleinman’s Explanatory Model for the care of culturally diverse patients. 
  2. Differentiate the ways culture and ethnicity affect a patient’s response to healthcare providers. 
  3. Apply the concepts of cultural humility when working with patients from diverse cultural groups. 

Outline

  • Ethnogeriatrics: Awareness of unique healthcare needs for diverse ethnic backgrounds 
  • Pentad of culture 
  • Acculturation: Demographics of older adults 
  • Impact of culturally competent care 
  • Kleinman’s Explanatory Model: Application to culturally competent care 
  • Cultural humility 
  • Ways culture affects healthcare: Beliefs and principles, meaning placed on values, actions and responses driven by values 
  • Religious beliefs 
  • Family network and support: Patriarchal vs. matriarchal structure 
  • Respect for authority 
  • Traditional foods and healing practices 
  • Cultural taboos 
  • End of life care decisions 
  • Use of interpreters 

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants
  • Physicians
  • Physical Therapists
  • Physical Therapist Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Speech Language Pathologists
  • Social Workers
  • Nursing Home Administrators

Copyright : 10/28/2021

Wheelchair Evaluations and the Geriatric Population

This session will review the process of obtaining a wheelchair for a client, working with a DME provider, and best practices for billing and developing a plan of care.

Program Information

Objectives

  1. Investigate the process of obtaining a wheelchair through Medicare for a client.
  2. Assess the components of the wheelchair evaluation process for the therapist.
  3. Evaluate the relationship with the ATP in this process.
  4. Appraise the research behind deciding on basic wheelchair components.
  5. Determine possible outcome measures for the plan of care and the LCD and billing guidelines from CMS.

Outline

  • The Medicare Wheelchair Process
    • Medicare process description
    • Timeline
    • LCD summary
    • Billing guidelines
  • Different team members in the process
    • MD
    • Therapist
    • ATP
    • Skin care/wound care professional
  • The Wheelchair Evaluation overview
    • Assessment in home versus clinic
    • Key components
    • LMN and customization
    • Working with different DME companies
    • Should there be a follow up visit?
    • Outcome measures
  • Research behind seating recommendations
    • Factors to consider in geriatric seating choices
    • Skilled nursing challenges

Target Audience

  • Athletic Trainers
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Physical Therapists
  • Physical Therapy Assistants

Copyright : 03/29/2023

Nourishing the Older Adult: Challenges and Controversies

In this session, Liz will provide a general overview of the nutritional needs of older adults and components of nutrition assessment that are unique to this population. She will outline key nutrients needed by older adults, the roles they play, and food sources of those nutrients. She will discuss the use of dietary supplements and other ways to meet an older adult’s unique nutritional needs.  She will also address topics that are perceived to be controversial including the obesity paradox, the use of therapeutic diets for disease management of older adults, and the relationship of diet to cognitive decline.

Program Information

Objectives

  1. Identify at least 4 factors related to aging that can affect nutritional status in older adults.
  2. Demonstrate an understanding of macronutrients needed for the health of older adults.
  3. Demonstrate an understanding of micronutrients needed for the health of older adults.
  4. Select appropriate nutrition interventions to help promote health and longevity in older adults.

Outline

Introduction

  • Demographics and health status of older adults
    • Life expectancy
    • Health status/Health concerns of older adults
    • Where do older adults reside (community dwelling vs. post-acute care)
    • Rates of obesity and frailty
Nutrition assessment of older adults
  • Factors unique to older adults
  • Identifying over nutrition and under nutrition
    • Body mass index
    • Serum albumin
    • Academy/ASPEN criteria for identification of malnutrition
  • Potential barriers to providing effective nutrition interventions
Nutrients needed for good health
  • Food sources
  • Roles of nutrients in the body
  • Use of dietary supplements to meet nutritional needs
  • Meeting nutritional needs when food intake is inadequate
Controversies
  • The obesity paradox
  • Using therapeutic diets to treat disease
  • Can diet prevent cognitive decline?

Target Audience

  • Nurses
  • Nurse Practitioners
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Physical Therapists
  • Physical Therapist Assistants
  • Physician Assistants
  • Speech Language Pathologists
  • Other Healthcare Professionals

Copyright : 09/29/2022

Management of Heart Failure in the Older Population

Heart failure prevalence increases in older adults. Heart failure is also a leading cause of hospital readmissions. Following evidence based clinical practice guidelines can help improve outcomes in older patients with HF and complex co-morbidities. This session will guide you through identifying heart failure and congestive heart failure, optimizing medical treatment, and initiating nonpharmacological treatment. Interdisciplinary team management along with motivational interviewing will also be a focus to deliver patient-centered care

Program Information

Objectives

  1. Identify the type of heart failure.
  2. Evaluate strategies to decrease readmissions in patients with HF.
  3. Determine ways to deliver risk factor modification for HF.
  4. Analyze the medications utilized for HF.
  5. Explain the nonpharmacological strategies utilized in HF management.

Outline

Identification of Heart Failure (HF)

  • HF vs CHF
  • Backward vs Forward HF
  • HFrEF vs HFpEF
  • Assessment
    • Functional classification
    • Clinical manifestations
    • Clinical tools
  • Addressing comorbidities
Prevalence of HF
  • Common reasons for readmissions
  • Preventing readmissions
  • Interdisciplinary Management
Etiology of HF
  • Risk factor modification
  • Precipitants to HF
  • Preventing complications
Medical Management
  • Optimizing medications
  • Device therapy
Nonpharmacological management
  • Sodium and nutrition management
  • Activity
  • Motivational Interviewing

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 09/29/2023

Drug Prescribing and Deprescribing in Older Adults

Older patients often have numerous co-morbidities for which they are prescribed multiple medications, thereby increasing the risk of adverse drug events (ADEs). This risk is compounded by age-related changes in physiology and body composition, which influences drug response. Additionally, evidence suggests that inappropriate prescribing (IP) is highly prevalent in older people and is associated with an increased risk of ADEs, increased morbidity, mortality and healthcare utilization. Learn the drugs not to use and how safely deprescribe them. 

Program Information

Objectives

  1. Plan to minimize adverse drug events and drug-drug interactions for your elderly patients.  
  2. Evaluate the effects of aging on pharmacokinetics.  
  3. Apply the Beers criteria or STOPP/START to geriatric patient case reviews. 
  4. Analyze prescribing and deprescribing strategies for safety and outcome achievement.

Outline

Drug Utilization in the Elderly

The Pathophysiology of Aging 

  • Generalities 
  • Aging and Pharmacokinetics 
    • ADME 

Aging and Pharmacodynamics

Consequence of Overprescribing 

  • Adverse Drug Events 
  • Common Drug-Disease Rxn’s 

Principles of Prescribing 

  • BEERS 
  • STOPP/START 

Principles of Deprescribing

The Top 10 Meds to Avoid In Geriatrics 

Target Audience

  • Nurses
  • Nurse Practitioners
  • Pharmacists
  • Physicians
  • Physician Assistants

Copyright : 05/20/2022

Vaccine-Preventable Diseases in the Older Adults

We know that certain diseases disproportionately impact older adults, resulting in higher rates of hospitalizations, complications, and deaths. In this session, we will discuss the most common vaccine-preventable diseases in older adults, including transmission, clinical presentation, diagnosis, treatment, and prevention. We will also discuss the most current vaccine recommendations and therapies to care for the older adult.

Program Information

Objectives

  1. Name five of the most common vaccine-preventable diseases in the older adult.
  2. Explain why vaccine-preventable diseases disproportionately impact older adults.
  3. Name the top recommended vaccines for older adults and the diseases they can help to prevent.
  4. List 4 strategies for improving vaccine rates in your older patients.

Outline

Burden of Vaccine-Preventable Diseases in the Older Adult

  • Why disease is worse in the older adult
  • Herd immunity
  • The immune response of the older adult
  • Economics of diseases
Influenza
  • Transmission
  • Impact of the disease in the older adult (Hospitalizations, deaths)
  • Diagnostics
  • Treatment
  • Vaccine recommendations
Covid-19
  • Still with us!
  • Why it is more severe in certain individuals (risk factors)
  • Transmission (what we have learned)
  • Diagnosis
  • Current treatments
  • Vaccine recommendations
  • What’s on the Horizon
RSV
  • Not just a childhood disease
  • Extent of the disease burden in older adults
  • Clinical symptoms
  • Diagnosis
  • Treatment
  • Newest vaccines available
Pertussis
  • How are we doing in controlling this
  • Extent of the disease in older adults
  • Vaccine levels in the U.S.
  • Diagnosis
  • Treatment
  • Vaccine recommendations
Shingles
  • Extent of the disease in older adults
  • Clinical signs and symptoms
  • Diagnosis
  • Treatment
  • Vaccine recommendations
Pneumococcal
  • What is it and how does it affect older adults
  • How is it transmitted
  • Complications associated with it
  • Clinical presentations
  • Diagnosis
  • Treatment
  • Vaccine recommendations
Hepatitis
  • Which types are a concern for older adults and which populations?
  • Transmission by type
  • Presentation of each type
  • Diagnosis
  • Treatment
  • Vaccine recommendations
Special populations
  • Vaccines for special populations (Diabetes, traveler, missing vaccines)
What’s on the Horizon
  • Combination vaccines
  • Universal flu
  • Diseases with vaccines under development
Wrapping Up
  • What can the NP/PA do to improve vaccine levels?
  • Why your recommendation matters
  • Having difficult conversations

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 09/29/2023

Dementia: New & Improving Treatments

Alzheimer’s disease, and other dementia types, can profoundly impact the lives of those who suffer from it.  Compared to older treatments, which only targeted symptoms, the newest treatment options for Alzheimer's now target the underlying pathological disease process. Expert geriatric clinician, Steven Atkinson, PA-C, MS, will provide clear updates to immediately make a difference for the dementia patients you treat!

Program Information

Objectives

  1. Select the best drug choices based on dementia type.
  2. Determine the tools to help in the diagnosis of common dementia types.
  3. Analyze CMS treatment coverage policies.
  4. Evaluate common pharmacological treatments for behaviors.
  5. Identify medications to avoid when prescribing for dementia patients.

Outline

  • Drug Utilization Amongst the Elderly
  • Ruling out Delirium and Depression
    • Approaches to Delirium
    • Approaches to Depression
  • Anticholinergic Burden in the Elderly
  • Cognitive Screens
  • Artificial Intelligence
  • Dementia Types
    • SDAT
      • Imaging
      • The biological definition
    • LATE-NC
    • Vascular Dementia
    • Dementia with Lewy Bodies
    • FTD
    • Substance-Induced Dementia
  • Traditional Pharmacological Treatments
    • ChI’s
    • Memantine
  • Newly Approved Alzheimer’s Medications
  • Depression in Dementia
  • Apathy in Dementia
  • Anxiety in Dementia
  • Sleep Disorders in Dementia
  • Weight Loss in Dementia
  • Differences that Make ALL the Difference
  • Beyond Drugs

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 09/28/2023

Brain Changes: Distinguishing Between Aging, Dementia and Depression

How do you tell when someone is experiencing a ‘senior moment’ and when it might be something more? This session will address the differences between ‘normal’ and ‘not normal’ brain aging. It will also help improve your understanding of the brain changes that occur during dementia, and the important ways in which these structural changes contribute to changes in everyday function. In addition, since dementia and depression/anxiety are often closely linked, you will learn the similarities and differences in symptoms of both conditions.

Program Information

Objectives

  1. Distinguish between ‘normal’ and ‘not normal’ processes of aging, including possible early warning signs of dementia.
  2. Analyze the different types of changes in brain structure and function during the progression of dementia.
  3. Evaluate the differences and similarities between dementia and depression/anxiety.

Outline

Differences Between ‘Normal’ and ‘Not Normal’ Aging

  • Common changes in brain function caused by normal aging
  • Signs and symptoms of ‘not normal’ brain changes due tdementia
    • Four truths about all dementias
  • Other possible causes for ‘not normal’ symptoms
Brain Changes During Dementia
  • Size and structure changes
  • Functional changes: Sensory processing, language processing, memory, vision
  • Relation of structural and functional differences tability and personality changes
  • Effective techniques for approaching someone whis living with dementia
Dementia and Depression/Anxiety
  • Common signs and symptoms of depression and anxiety
  • Similarities and differences between dementia and depression/anxiety symptoms

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Physician Assistants
  • Physicians
  • Physical Therapists
  • Physical Therapist Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Speech Language Pathologists
  • Social Workers
  • Nursing Home Administrators

Copyright : 10/26/2021

Recalibrating Care to Retain & Secure Staff & Families

Healthcare professionals have seen drastic changes over the last decade and one of the most stressed groups are those providing geriatric healthcare, especially those involved in dementia care. Lori La Bey will cover how we got here, and the whys behind building recalibrated care models; to not only retain staff but recruit them; as well as how to keep and secure the families you serve.  Lori’s passion will be evident as she shares accumulated knowledge, from experiences and interactions across the world.

Program Information

Outline

How We Attract & Retain Staff & Families 

  • The shift from micro-managing to relationship-based care 
  • Demonstrate how building trust gets us back on track 

Shift Care Culture from Crisis to Comfort 

  • Perceptions & expectations matter 
  • Investigate environmental impacts 
  • Invite change into the equation to improve your services & work environment 
  • Demonstrate multi-sensory care 

Saving Time & Building Teams - Free Resources! 

  • Identify free resources available 
  • Building trust to raise voices, break stigmas & give purpose to all

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 09/28/2023

Caring for LGBTQ Older Adults

The number of LGBTQ+ older adults is increasing. It is estimated that by 2060 there will be 20 million. This population often faces discrimination, inadequate access to care and poor quality of life. They experience higher rates of disability, poor physical and mental health. This seminar will discuss historical perspectives and social challenges that influence LGBTQ+ older adults. Using case studies, strategies and interventions will be discussed to manage chronic medical conditions, mental health and end of life care. Practical tips for making practice changes to be inclusive will also be discussed.

Program Information

Objectives

  • Analyze the historical events and social challenges that affect care of the LGBTQ+ older adult. 
  • Differentiate the barriers of access to care for LGBTQ+ older adults. 
  • Determine strategies to provide individualized care to LGBTQ+ older adults. 
  • Identify practice implications to provide care to LGBTQ+ older adults. 

Outline

Historical perspectives 

  • Timeline of salient milestones 
  • Staying “in the closet” 
  • Current trends 

Social challenges 

  • Discrimination/Stigmatization 
  • Systemic barriers 
  • Levels of stigma 
  • Connections between religion and discrimination 

Barriers to access to care 

  • Lack of trust in providers 
  • Lack resources 
  • Lack of knowledge of healthcare providers 

Gender affirming care interventions 

  • Interview techniques 
  • Trauma informed approaches 
  • Communication best techniques 

Strategies to provide individualized care 

  • Social environmental factors; family of choice, social support 
  • Physical health factors; aging changes, chronic conditions 
  • Psychosocial factors: depression, loneliness, social isolation 
  • Specific issues: HIV, Cardiac disease, Substance abuse, End of life care decisions, Long term care, Dementia 
  • Case studies 

Practice Implications to Improve Care 

  • Clinic climate 
  • Leadership considerations 
  • Staff education 
  • LGBTQ+ friendly documents 
  • 5 A’s: approachability, acceptability, availability, affordability, and appropriateness 

Resources 

  • Terminology 
  • Organizations 
  • Websites 
  • Bibliography  

Target Audience

  • Nurse Practitioners
  • Advance Practice Registered Nurses
  • Nurses
  • Physician Assistants
  • Occupational Therapists
  • Physical Therapists
  • Speech Language Pathologists
  • Nursing Home Administrators
  • Social Workers

Copyright : 07/18/2023