Geriatrics Care

Goal

To become skilled in effective geriatric patient care understanding their possible atypical presenting symptoms and signs, complex co-morbid disease, differing response to diagnostic tests, and atypical reactions to treatments and medications.

Objectives

  • To become familiar with the diagnostic and therapeutic management of the elderly in regards to common medical problems that they may be afflicted with focusing in on their atypical presentations and response to therapy. Common medical syndromes include but are not limited to:
    • Cardiovascular and cerebrovascular disease, diabetes and its complications, urinary tract infections, pneumonia, substance abuse, depression, thyroid disease, fluid and electrolyte disturbances, arthritis, abdominal pain, constipation, anxiety and depression.
  • To become familiar with the diagnostic and therapeutic management of common “geriatric syndromes.” Common “geriatric syndromes” include but are not limited to:
    • Decreased mobility, falls, gait disturbances and balance problems, dizziness, incontinence, malnutrition, sleep disturbances, dementia, delirium, osteoporosis and is complications, hearing and visual impairment, decubitus ulcers.
  • To become familiar with nutritional needs and problems of the elderly.
  • To become familiar with the pharmacologic treatment of the elderly including pharmacokinetic and pharmacodynamic changes associated with aging.
  • To understand the clinical significance of polypharmacy in the elderly and strategies to limit this in patients.
  • To be able to adjust one’s history and physical exam skills to adapt to the mental and physical constraints of the elderly patient.
  • To perform a thorough and accurate mental status examination and understand the results of the test.
  • To be able to identify patients at high risk for falling.
  • To understand the increased risk geriatric patients have for iatrogenic complications and to work at understanding means to monitor for these complications and limit them.
  • To always respect geriatric patients, especially elderly patients with dementia or decreased capacity working to preserve their dignity and modesty at all times.

Core Experiences

  • The student will participate in, LinkAges, a didactic and patient interactive experience consisting of one, ½ day sessions at to local skilled nursing facilities under the instruction of a gerontologist.
  • The student will be active student learner directly involved in patient care under the direct supervision and instruction of an attending, resident and intern physician in the care of inpatients on an academic healthcare team for seven to eight weeks.
  • The student will be active student learner directly involved in patient care under the direct supervision and instruction of an attending in the care of outpatients in a variety of ambulatory settings for two weeks.
  • The student will complete a geriatric curriculum provided below and be evaluated via a geriatric test. The geriatric curriculum will address the Minimum geriatric competencies for medical students.

The Geriatric Curriculum

  • Medication Management
    Reading List
    Drug prescribing for older adults
  • Cognitive and Behavioral Disorders
    Reading List
    Evaluation of cognitive impairment and dementia
  • Dementia syndromes
  • Diagnosis of delirium and confusional states
  • Prevention and treatment of delirium and confusional states
  • Self-Care Capacity
    Reading: FUNCTIONAL ASSESSMENT OF THE ELDERLY PDF document