Podcasts about american geriatric society

The Connection Between Community Mobility, Exercise, and Cognitive Health. Nutritionist Leyla Muedin weighs in on the impact of community, mobility and exercise on cognitive function and overall health. She reviews recent studies, including one from the Journal of the American Geriatric Society, highlighting how greater community and mobility can be associated with better cognitive function, and another study from the journal Aging Cell that demonstrates exercise's beneficial effects on brain health at the cellular level in mice. Additionally, Leyla discusses the harmful effects of air pollution on brain health and the importance of a holistic approach, emphasizing both physical activity and healthy lifestyle choices to mitigate cognitive decline and improve well-being.

Steven Lee, Co-Founder and CEO of Ianacare, is in the business of supporting caregivers by working with employers, health plans, and providers to offer services that patients and their families need. Effective hospital-at-home and home non-clinical care models show a reduction in hospital readmission and cost of care. This care navigator approach allows caregivers to keep patients in their homes and reduces employee absenteeism. Working with partners, Ianacare has applied to be an approved provider in the new CMS program GUIDE, the Guiding and Improved Dementia Experience program, to expand the application of this model. Steven explains, "This has become really critical. For one reason, good caregiving in the home keeps patients in the home and out of institutions. And that's a win-win-win for everybody. Patients prefer being in the familiar surroundings of their home. We all would prefer to age in our own homes. It's cheaper for the healthcare system. Every inpatient admission or ER visit prevented by a family care member is thousands of dollars saved in the healthcare system."   "So it's really a win-win-win. The numbers and the research out there clearly prove these caregivers' critical role. I'll cite a couple of studies. There's a UPMC study that shows when family caregivers are involved and engaged in care plans, hospital readmissions decrease by 25%. Conversely, there's a study from the Journal of American Geriatric Society when patients have caregivers who are depressed, burnt out, or tired, they experienced a 73% increase in ED utilization and $2,000 higher medical costs over six months. So, to summarize, good caregiving keeps patients in the home, and that's why this is important."   "What we've done is bring together all the layers of resources you might need at some point in the care journey into one easy-to-use experience. We have a platform accessible through a browser or smartphone, and it starts by matching you up with unlimited access to a care navigator who's your right-hand expert to not only guide you through decisions and planning but also ensure things get done." #Ianacare #Caregivers #HospitalatHome #HospitalReadmission #CareNavigators #CMSGUIDE #AlzheimersDisease Ianacare.com Download the transcript here

Steven Lee, Co-Founder and CEO of Ianacare, is in the business of supporting caregivers by working with employers, health plans, and providers to offer services that patients and their families need. Effective hospital-at-home and home non-clinical care models show a reduction in hospital readmission and cost of care. This care navigator approach allows caregivers to keep patients in their homes and reduces employee absenteeism. Working with partners, Ianacare has applied to be an approved provider in the new CMS program GUIDE, the Guiding and Improved Dementia Experience program, to expand the application of this model. Steven explains, "This has become really critical. For one reason, good caregiving in the home keeps patients in the home and out of institutions. And that's a win-win-win for everybody. Patients prefer being in the familiar surroundings of their home. We all would prefer to age in our own homes. It's cheaper for the healthcare system. Every inpatient admission or ER visit prevented by a family care member is thousands of dollars saved in the healthcare system."   "So it's really a win-win-win. The numbers and the research out there clearly prove these caregivers' critical role. I'll cite a couple of studies. There's a UPMC study that shows when family caregivers are involved and engaged in care plans, hospital readmissions decrease by 25%. Conversely, there's a study from the Journal of American Geriatric Society when patients have caregivers who are depressed, burnt out, or tired, they experienced a 73% increase in ED utilization and $2,000 higher medical costs over six months. So, to summarize, good caregiving keeps patients in the home, and that's why this is important."   "What we've done is bring together all the layers of resources you might need at some point in the care journey into one easy-to-use experience. We have a platform accessible through a browser or smartphone, and it starts by matching you up with unlimited access to a care navigator who's your right-hand expert to not only guide you through decisions and planning but also ensure things get done." #Ianacare #Caregivers #HospitalatHome #HospitalReadmission #CareNavigators #CMSGUIDE #AlzheimersDisease Ianacare.com Listen to the podcast here

In the realm of addressing health disparities and fostering health equity, the intricacies of socioeconomic factors and their profound influence cannot be understated. In this podcast episode, we welcome Dr. Laura Samuel, an Assistant Professor at the Johns Hopkins School of Nursing, whose expertise in addressing socioeconomic disparities offers profound insights that contribute to the broader dialogue on health equity. Tune in as we explore the interplay of socioeconomic factors that shape health outcomes, and discover the transformative potential of this work in reshaping the landscape of health disparities. References Samuel L, Dwivedi P, Hladek M, Cudjoe T, Drazich B, Li Q, Szanton S. The effect of COVID-19 pandemic-related financial challenges on mental health and well-being among US older adults. Journal of the American Geriatric Society. October 2021. Samuel L, Crews D, Swenor B, Szanton S, et al. Supplemental Nutrition Assistance Program Access and Racial Disparities in Food Insecurity. JAMA Network Open. June 2023. Samuel L, Wright R, Taylor J, Lavigne L, Szanton S. Social Norms About Handling Financial Challenges in Relation to Health-Protective Capacity Among Low-Income Older Adults. The Gerontologist, May 2022. -| The Health Equity Podcast Channel is made possible with support from Bayer G4A. Learn more about how Bayer G4A is advancing equity, access and sustainability at G4a.health -| This episode originally aired on November 2, 2023 on Aging Fast & Slow. Listen, follow and subscribe here.

Dr. Carr is a Professor of Geriatric Medicine in the Department of Medicine and Neurology at Washington University at St. Louis. Dr. Carr is a clinician in the Memory Diagnostic Center and Geriatric Assessment Clinic at WU where he maintains an outpatient consulting practice in dementia and geriatric care. He is involved in Alzheimer's Disease drug trials and was the site PI in the GRADUATE trial and the Green Memory Trial in the WU Alzheimer's Treatment Unit. He has been and/or currently is a principal investigator or co-investigator on research, national guidelines, and/or educational initiatives related to Alzheimer's and/or medical conditions and driving with funding through NIA, NEI, and Missouri Department of Transportation. He also has been active in consulting work with NHTSA, TIRF, University of Toronto, Medscape, UpToDate and the American Geriatric Society. He has been the primary author or co-author on over 100 peer review manuscripts and chapters, most related to older drivers. In this episode we discuss:How to reduce risk of alzheimersWhy you should care about azlheimers in your 30sHow much alcohol is safe for your brainHow to improve your memory for the long termThis episode is brought to you by Timeline Nutrition, PaleoValley, Inside Tracker, 1stPhorm Join me at the Forever Strong Summit on January 13-14 for a transformative in-person experience, where I will share cutting-edge insights on optimizing health, performance, and longevity, empowering you to unlock your full potential. Don't miss this exclusive opportunity to learn from renowned experts in the field – secure your spot at https://drgabriellelyon.com/forever-strong-summit/Order Dr. Lyon's Book Forever Strong - https://drgabriellelyon.com/forever-strong/Mentioned in this episode:15% Off Your Purchasehttps://paleovalley.com/drlyon10% off your first order of Mitopurehttps://timelinenutrition.com/DRLYONVisit 1st Phorm Website for Free Shipping on orders $75+http://www.1stphorm.com/drlyonInside Tracker 20% Off the Entire Storehttps://info.insidetracker.com/drlyon

Dr. Alex Germano // #GeriOnICE // www.ptonice.com  In today's episode of the PT on ICE Daily Show, Modern Management of the Older Adult lead faculty Alex Germano as she discusses the topic of medication management in older adults. She talks about the importance of screening for inappropriate medications and what to do when such medications are found. Medication management is a crucial component of falls prevention programs, as many older adults are on medications that may not be suitable for them. Alex emphasizes the need for clinicians to assess medications as part of their overall approach to fall prevention. Take a listen to learn how to better serve this population of patients & athletes. If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION 00:00 - ALEX GERMANO Good morning, everyone. Welcome to the PT on Ice daily show brought to you by the Institute of Clinical Excellence. My name is Alex Germano, a member of the older adult division. Today, what we're going to be talking about is a question that came up at our course this weekend in Falls Church, Virginia. It was about how to handle inappropriate medication, how to screen for it, and what to do after you learn that your patient's taking a quote unquote inappropriate med for an older adult. The older adult division is really finishing off 2023 strong. We have eight more course offerings this year alone. This weekend in particular we're going to have Christina out in Fountain Valley, California. We're in New Jersey next weekend and Annapolis, Maryland the first weekend of November. Additionally, you can catch us in New York, Westmont, Illinois, Chandler, North Carolina, Spring, Texas, and Portland, Maine, before 2023 closes out. So we hope to see you out there. I wanted to expand on this topic a bit more. 01:31 - MEDICATION MANAGEMENT It's all about medication management and how we encourage clinicians to look at medications and what do we do when we find an inappropriate medication. I feel really passionate about this topic and we really do As a component of our falls prevention programs, we need to be looking at meds, screening them, because a lot of our older adults are on a lot of medication that they should not be on. So, as part of the World Guidelines for Fall Prevention in Older Adults, medications are deemed as a domain that we need to assess. If you work in more acute settings, so maybe like acute care, skilled nursing facilities, home health, you likely have to do some sort of medication screening. You're asking about meds, they're in a system, the system or the EMR that you use actually may flag inappropriate medications already. I've heard that in the home health world that some of the it's more of the medication interactions that are being flagged versus like type of medication that we should be weary of. But if you're in outpatient settings, you may ask about medication intake on eval. but you might just write that down and then that's it. Even my, um, uh, EMR that I use and I'm working in an outpatient on wheel setting is just, you put in the meds and that's it. There's no followup. The system doesn't help me in any way. It's kind of on, on, it's my responsibility rather to perform some type of medication reconciliation, look at the meds, make sure they're on the appropriate ones. Okay. Now, if we have older adults on our caseload, we can't just ask about medications. We really need to double check some of these meds because they can have a huge impact on our patient's physical function, their lives. And it's absolutely part of our scope of practice because these medications can impact our patient's balance, their fatigue, their overall physical function and exercise tolerance. So it's definitely worth it to get familiar with some of these classes of medications. Older adults, it's important to know one, why is this a problem? 04:23 - IMPACT OF MEDICATION ON PATIENTS Older adults handle medications differently. There's a few changes that occur with age. We have an increase in body fat and a decrease in our total body water, and this could change the half-life of certain drugs. The clearance of the drugs through the hepatic system or the renal system, so liver or kidneys, also changes as a result of age, and then if you have a disease process on top of it, that will affect medication clearance. Okay, so drugs aren't being, are not leaving our patients' bodies as well, so we often see higher levels of drugs circulating systemically, which could cause negative side effects. Now, it's not really our role to decide if my patient's hepatic function or renal function is appropriate for a certain medication. And, you know, that's not our job. We are trusting the medical providers out there prescribing medications and, you know, deciding what our patient needs and at what dosage. But I argue as people and I'm sorry, as medical providers who spend a lot more time with patients, we have a unique opportunity to visualize the impact of medications that affect our patients functionally. We have the ability to see our patients for many hours after they start using a medication, whereas doctors may not see them until months away. They might not be asking about the new medication until months after. They might not have a follow-up for a while. I mean, the current state of our medical system is that many people aren't even seeing their doctors for months and months in between. So if the patient isn't tolerating the medication or if we find that the medication isn't working for their lifestyle, and I'll explain that in a minute, we are the perfect provider to alert the other medical providers on the team about this situation. So first, how do we even know that a medication is inappropriate? What are we screening for? We will link and the Instagram post of the American Geriatric Society beers criteria. Okay. They have a 2023 edition that is available to be viewed. Usually we were seeing that the free one was like a few years back, but now the 2023 version is free and open access. We recommend becoming familiar with these classes of medications so that if they appear on your patient's medication list, you know that you are going to have kind of a red flag in your mind that you're going to want to monitor for any symptoms and really define if this medication is appropriate for the patient. This document organizes medications considered to be inappropriate for older adults or those with certain diseases. They organize medications that should be used with caution, any other potential drug interactions, or medications that need to be adjusted based on renal function. Again, not entirely our scope, but we will be aware because if we see symptoms in our patient, we're going to want to report that. It also gives you a rationale for use with each medication class. That's very helpful when you go to talk with the prescribing physician because it's important to give a rationale or to cite this criteria in order to kind of get them listening and get them to really take you seriously when you go to report a medication issue. 08:43 MEDICATION INTAKE CHALLENGES Now it's not only important to screen the type of medication, but it's very important to screen how your patient takes their medication. This seems really the, I always say it seems dumb. It's really not dumb. It's very important, but you really wouldn't know how many issues there are with medication intake unless you were watching your patient take a lot of meds, which lucky for me, when I work in people's homes, I see a lot of things. Okay. Do, does your patient just use the pill bottle to pour out into their hand every morning to take their meds? Do they use a pill container? Do they use pill packs, which are those things that you can, um, order where all of their medication comes in like a nifty pack. They just rip it open and take it. It's great to ask your patient or their caregiver the current way that they take medications. And to ask if there's any barriers to that medication intake, again, I have a ton of privilege being in people's homes, seeing the way they take meds, and you'd be surprised how many people have barriers to taking medication. It could be cognitive, where they have to take medication three times a day, and they are used to only taking it once a day, or once at the end of the day. All right, hopefully we're back. I lost you for a second. And if your patient has to take medications more than once a day, that is going to increase the risk that something goes wrong. And if your patient happens to nap through med time, they miss a dose in the middle of the day, they don't have anyone there to remind them of that, that can also cause many problems. Some of our patients have difficulty with dexterity and their ability to pour medicines out from the pill container and into their hand and getting all of those small pills from their hand to their mouth. That's why you might find medication or pills kind of all over. Sorry, I'm going to ditch Instagram at this time. That's why you might find medications kind of all over the floor when you get to their house. They're having trouble getting small pills from their hand to their mouth. There's also many people that struggle maintaining, managing their meds and getting their pill containers to be filled appropriately. This is all great to screen for because these are all problems, physical therapy, but more so occupational therapy can help with. Occupational therapists are who I've personally leaned on to help with some of these dexterity problems, equipment problems, cognition issues, just because their scope of practice is a lot bigger and they are really experts at med management. So say now you have identified a problem medication. For example, my patient was given Xanax, which is a common benzodiazepine for daily management of high blood pressure. That is a super strange recommendation immediately caused a red flag in my mind because I know benzodiazepines are not supposed to be used for the beers criteria, but I connected the patient's past medical history with problems with this med. This patient has vestibular implications. has peripheral neuropathy and clinical levels of frailty so he's already quite weak and very unsteady so adding on a medication that increases false risk could be really dangerous now what i didn't do was i i didn't immediately call the doctor and complain about this prescription i let them i let the patient see if I let the patient trial the Xanax. He really was interested in doing so because the doctor said so, but I remained on high alert, monitoring for symptoms. They thought that because he had a lot of anxiety that the medication or Xanax would decrease his anxiety and drop his blood pressure. We didn't see a big change in blood pressure on subsequent visits. And he started to tell me really how woozy he felt in the morning and how he felt more very, very tired throughout the day after taking the medication. This is exactly when it's time for us to step in. Some of our patients may be on contraindicated meds and they may also feel fine and have no symptoms. They've taken them for years. They don't have a problem. If they're on a contraindicated med, however, it's just important we try to see if they have any concerning symptoms or just continuously ask or check in about them. So do they have fatigue or dizziness? At this point, we want to communicate with the prescribing physician regarding our concerns. I have sent letters with my patients to their doctor's appointments because sometimes it's hard to connect with the doctor. But I very often just call in to the nursing line to discuss the medication use. I let them know what I'm seeing in terms of symptoms and some of how the medication may be interacting between my patient's lifestyle. and the symptoms they have and their physical function. And then I kind of align that all with the recommendation based on the beer's criteria. I always cite it, like I said before, because it can just give you more power in this space. I have never, this is again, very personal, but I've never been met with a doctor that was not interested in exploring a different medication choice, or just at least talking through the symptoms and at least coming to a consensus of why the medication is appropriate for now. Many times the doctor is very willing to change or remove the medication. I think it's all about our approach here and not coming off a little too hot. We just have to come off with curiosity and just asking about, you know, just relaying symptoms, relaying data, relaying a rationale. And oftentimes I'm met with a really good response from the doctors. Now, it would also be wise to make some community connections with a local pharmacist or somebody who can help your patient with general medication questions, dosing questions, or if they're interested in getting a medication reconciliation. You may have to do some work to discover what pharmacists in the area offer. There may be virtual services available for certain patient populations. I'm thinking like the VA, for example, has some resources. There may also be private pharmacists helping with this. But again, this is very specific to your community. I would probably try to connect with that like small local pharmacy. Those folks are going to be great at having the time and the willingness to dive into medication reconciliations with your patients. So really, in summary, let's start leaning into our role as advocates for our patients' medication intake. If anything new gets added, or if your patient's been on medication for decades, it's part of our role to screen for symptoms of these meds, especially if they're on that inappropriate list for older adults. We can check on how our patient is able to take meds, see any barriers to taking medication. Remember, less doses per day is better for this population. Make sure we have people to communicate these problems with, that we get comfortable being advocates with physicians, that we get comfortable making connections with pharmacists in the area, so that we have a place to refer our patients if necessary. Getting patients off certain medications or getting them changed to a better medication well tolerated by older adults can truly have impacts on their life and function far more than any resistance training that we can give them. Deadlifts are definitely life changing, but if you can get off a scary medication that's making you feel dizzy and unsteady, then that can be far more powerful. So think about leaning into that space and we look forward to hearing how it goes. See you next Wednesday. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

This 2023 revision of the American Geriatric Society's Beers Criteria for Potentially Inappropriate Medications (PIMs) in older adults includes major recommendations for the safe use of anticoagulants and for avoiding the initiation of aspirin for primary cardiovascular disease, oral and transdermal estrogens in postmenopausal women, sulfonylureas as first, second or add-on therapy for diabetes, and the use of highly anticholinergic medications. Additional areas that have been updated include how PIMs can exacerbate drug-disease and drug syndromes, important drug-drug interactions, and drugs that require alterations in dosing in renal impairment. Pharmacists should be cognizant of these changes to the AGS Beers Criteria so that they can use this tool to help optimize their older adults' medication regimens.  The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Geriatric medicine focuses on healthcare for adults over the age of 65, and falls are a common and serious health concern for this population. Falls are often multifactorial, usually associated with a decline in someone's cognitive or physical ability. Every year, more than 1 in 4 adults over the age of 65 fall at least once, but less than half tell their healthcare providers. The most effective way to lower fall risk is to have a fall screening with a healthcare provider and to come up with preventative measures and interventions. Contact your local community center or senior center for information on exercise, fall prevention programs, and options for improving home safety.For more information on geriatric medicine, visit the American Geriatric Society's website. Learn more about falls in older adults, risk factors, prevention, and management by visiting the following sites:CDC's page on older adult fall preventionMedlinePlus's resources on falls and preventionThe Fall Prevention Center of Excellence's comprehensive resource database for independent living (from the USC Leonard Davis School of Gerontology)CDC's STEADI program and resources (Stopping Elderly Accidents, Deaths, and Injuries)AgriSafe Networks resources on slips, trips, and falls for agriculture workersHome modification to make your home saferHome modification suggestions for older adults in rural areasHome modification suggestions for renters with disabilitiesHome modification suggestions for older veteransElder fall prevention for Native AmericansHere are the links for the data referenced in this episode: age of agricultural producers, non-fatal injury data, and fatal injury data.Sign up for the AgriSafe newsletter: https://www.agrisafe.org/newsletter/View upcoming webinars: https://www.agrisafe.org/events/Script...

Guest Speaker is Consultant Geriatrician, Dr. Osi-Ogbu. Dr. Osi-Ogbu is an American-trained and board-certified Geriatrician. She is a Fellow and Member of the American Geriatric Society, and a Fellow of the West African College of Physicians. Today is #WEAAD World Elder Abuse Awareness Day (WEAAD) was launched on June 15, 2006 by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations. The purpose of WEAAD is to provide an opportunity for communities around the world to promote a better understanding of abuse and neglect of older people by raising awareness of the cultural, social, economic and demographic processes affecting elder abuse and neglect. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/health4naija/support

Kate Wilber is the Mary Pickford Chair in Gerontology and director of the Secure Old Age Lab at the USC Leonard Davis School. She's also the co-director of the National Center on Elder Abuse, which is housed at the Keck School of Medicine of USC. She recently spoke to George Shannon about her research, including her work exploring ways to provide long-term care services and supports that allow older adults to be as independent as possible and the challenges and opportunities that technology provides in this area. Quotes from this episode On building on lessons learned during the pandemic “I think a lot of what we saw were challenges that we already knew were there - how fragmented services are, how older adults can be at risk of isolation, how important the home community-based services and programs and opportunities to interact are for everybody. And I think showing the importance of community, which we didn't have during the pandemic, except a bit on social media and phone calls and maybe people getting together outside. So the key question is, how do we take the learning and the recognition of what we already knew into the future to build on these important lessons, to do better with our aging service delivery? I was going to say our aging service delivery system, but that's a huge problem. There isn't a system; there's just a lot of different components of a system.” On innovations in long-term care and supports “We have to prepare for an aging population. And until recently I felt like we didn't do that great a job preparing, but I see a lot of exciting innovations, which to some extent may have been jump-started a little bit because of the challenges of the pandemic. We have a variety of models of senior living and I think we're going to see more innovation there or the innovations that have been developed take off because they did better in the pandemic too. So if we look at what kind of care was best for older adults who maybe were isolated or need long term services and supports during the pandemic, how do we build on that? And how do we make sure that we translate what we know into reasonable programs and policies.” On barriers to implementing technology solutions “People not only need to have some kind of device. They need to have broadband, it needs to work. And we've seen that in some parts of the country, especially in rural areas, broadband it's not available. All the things we take for granted, electricity, water, et cetera, how much is this an essential service that we'll do a better job providing across the nation in areas where it doesn't exist very effectively now. And then as I said, how do we help people learn? And what are the particular cultural competencies required for trainers? What are the different uses that people want? This gets back to being person-centered and engaging the people that will be the end-user users and understanding what's most effective for them. There are still a fairly large proportion of older adults who don't have access to any sort of computer; some have smartphones. And there is this notion, I guess, if we build it, they will come. Or if we give it to them, they'll use it, it would be the way of talking about that. But there's a variety of barriers. And if you hand somebody a box with a computer in it and say, ‘There you go, you're now going to go on the other side, the right side of the digital divide.' They're not. So what can we learn about how to help people use technology in a way that is useful for them effective, meaningful?” On telehealth “So this will be a time saver. I think that's pretty clear, but the nursing facilities have to invest in it. The staff have to invest in it. They have to learn how to do it. And one of the things we're seeing is they thought the residents would be the most resistant and they're not. They're like, 'Okay, if I can see my doctor this way, fine.' But I think the question is, how is it used, where is it most effective and where is it not a good replacement for a physician coming to the facility? So, there's a fair amount of literature developing on this, but I think there's so many exciting innovations that are rolling out and we need to build on what we're learning and make them better and be more effective in the next generation of telehealth and facilities and helping people on the digital divide connect. So all these things are really exciting opportunities to learn how to connect.” On person-centered care “So the idea behind person-centered care is that people have different needs. Of course, they also have different preferences, different preferences for care and for services and for supports and for contributing and giving back and primarily and mostly as with all of us, for controlling their lives and the decisions that are made. So person-centered care recognizes that the power should live with the individual in terms of the ability to make decisions about care informed decisions. But I think sometimes, we, as professionals can see, oh, this would be best for this person. And professionals are extremely busy also. And so it kind of overlooks sometimes the person's needs and preferences and working in areas like elder mistreatment and elder self-neglect. A lot of times people have legitimate reasons for wanting things that we don't necessarily think would be the best choice, but person-centered care asks us to really get in touch with what's behind those preferences. And to what extent can we ethically honor them and this is something I see the field doing a much better job thinking about and working on and great things have been written. And the American Geriatric Society a few years ago had an expert panel come together and develop a definition and sort of protocols for this. And I think that's really moving the field. One more thing I'll say is that ageism contributes here. So we make assumptions about older people that they can't express their preferences adequately. And providers talk to the caregiver, not the older person. Or they say this is what needs to be done. So I think there's also a culture change of recognizing that it's about the older person. And we start with the older person, and that's not to say that there aren't age-related increased likelihoods, but not inevitabilities of memory issues and things of that kind. And so we need to be clear that the person has the capacity to express their preferences, but we start with person-centered. The elder is the person who whatever is happening is happening on behalf of, or for, or with. And that's where we start.” On students “That's our future. … Our legacy is you see the students that go through our program and they're very excited about learning and they bring innovation and enthusiasm, and then they go out and do wonderful things and they become the leaders of the field. And you could see that across the board in so many areas.”

In the world of Human Resources, there's no shortage of available content if you're studying the importance of the candidate experience, the onboarding process, and employee engagement. Find the right people, assimilate them quickly and effectively, and constantly seek opportunities to improve or enhance the employee experience. Add to that the "Great Reshuffle" phenomenon, and you have a hiring & retention focus like few times ever before.But...when was the last time you had a strategy session to discuss potential retirees? For that matter, who even discusses "retirement" anymore? Is that still a thing? The days of the gold watch and the pension are now part of nostalgia; formal succession planning is still a critical process, but "Most people spend more time planning a wedding than they do planning retirement." At most companies, the first mention of retirement is when the employee alerts you to the fact and the process of finding a replacement begins in earnest. Donuts in the breakroom, a nice write-up in the newsletter and Bob's Your Uncle.And that's a shame. Did you know there is a 40% increase in depression in the first year of retirement [Institute of Economic Affairs, 2017]? Or that 61% of those in retirement state they mostly/always feel alone [Journal of the American Geriatric Society, 2019]? Suicide rates double, healthcare costs increase and most importantly - "Purpose" is often lost.Meet John Briggs, one of the Managing Partners at Authentica. John and his team have developed a unique program specifically designed to purposefully prepare the retiree for their next phase of life. The program, "Covered Bridge" focuses on an intentional pause (see, there's your title) to prepare the future retiree for life beyond their profession.Get your ears on and give it a listen, won't you? #Hardballer #RideOrDie

It's “In the News…” Got a few minutes? Get caught up! Our top stories this week include headlines from the ATTD Conference - that's the Advanced Technologies and Treatments for Diabetes Conference. There's a bit of new information about the Dexcom G7, Beta Bionics announces it will release pivotal trial results, and news of the first AID system using the Libre 3 is announced. Along with ATTD there's news about type 2 diabetes and grocery stores, all types of diabetes and nursing homes and a person with T1D is on the cover of British Vogue. Learn more about T1D Exchange here  Join us LIVE every Wednesday at 4:30pm ET Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about AFREZZA* *Click here to learn more about OMNIPOD* *Click here to learn more about DEXCOM* Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX This week ATTD begins – that's the Advanced Technologies and Treatments for Diabetes Conference, so you can expect to hear a lot of news. I'll include some here, some next week and we've got future interviews lined up with a lot of the companies making headlines.. XX First up, a peek at more features in Dexcom's G7 system. It's approved in Europe but not the US and features what they're calling more meaningful alarms. You can silence more alarms, including urgent low & sensor fail for up to six hours, there's also a new 12 hour grace period at the end of the 10-day sensor life. It's already been announced the G7 has a much shorter warm up period, only half an hour, and is much smaller. -- Also at ATTD, Beta Bionics will be releasing Pivotal Trial Results of the iLet Bionic Pancreas. The iLet is a pump – connected to a CGM that is designed to autonomously determine and deliver insulin doses to control blood glucose levels. You'll recall this pump was originally designed to deliver both insulin and glucagon.. but the current iteration is insulin only. They says this pivotal trial population was more diverse and representative of the United States type 1 diabetes community than any previous pivotal trial of an automated insulin delivery system. We'll have more info on what these trials actually said next week. https://www.globenewswire.com/news-release/2022/04/25/2427846/0/en/Pivotal-Trial-Results-of-the-iLet-Bionic-Pancreas-To-Be-Presented-at-ATTD.html XX The first automated insulin delivery system using the FreeStyle Libre has been announced. This is in Europe and it's the Libre 3, Ypsomed pump and CamDiab software system. Expected by the end of the year, this is described as a self-learning app, a hybrid, closed-loop system that runs on an Android smartphone and can be tuned to users as young as one year old https://www.fiercebiotech.com/medtech/abbott-launches-diabetes-team-ypsomed-camdiab-bring-artificial-pancreas-system-europe XX And a new consensus meeting on Time in Range. In 2019, diaTribe formed the Time in Range Coalition, whose goal was to ensure that Time in Range (TIR) becomes the primary glucose metric for daily management, complemented by A1C, in diabetes care globally. But there isn't an internationally consensus on the use of CGMs in clinical trials. This meeting will help standardize those methods. XX Other highly anticipated – or at least well-publicized- studies coming to ATTD include those from Tandem and Omnipod and almost every big diabetes tech company. Lots more to come next week and we already have interviews set with Dexcom and Beta Bionics to we'll talk about all this in the long format episodes in weeks to come. XX Overtreating type 2 diabetes is apparently very common in nursing homes.. which can be a big problem as people get older and may require changes. New study in the Journal of the American Geriatric Society show about 40% of nursing home residents with type 2 diabetes may be overtreated. These researchers say one big issue is that at admission, residents are given a very big medical work up, but that isn't followed up on year to year. Often as people age, its recommended their A1C is maintained a bit higher, for safety reasons, so a target A1C could easily change years or even months after someone moves into assisted care or a nursing home. https://www.healio.com/news/endocrinology/20220422/diabetes-overtreatment-common-in-nursing-homes-with-little-medication-deintensification XX Right back to the news in a moment but first we've got a new sponsor. As I mentioned, The T1D Exchange Registry is an online research study, designed to harness the power of individuals with type 1 diabetes. It's a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy. Sign up at T1DExchange.org slash Stacey (that's S-T-A-C-E-Y). XX New survey looking at how people with diabetes rate their grocery stores. From D-Q&A this was a big survey, more than 5-thousand people statistically representative of all people with diabetes in the United States. They found more than half of people with diabetes did not feel very supported in maintaining their preferred eating habits at home. 28% of low-income people with diabetes find it somewhat or very challenging to find their preferred foods when grocery shopping. Stores rated best? Aldi, Publix, Costco, H-E-B, and Hyvee. The worst rated were BJ's, Vons, Shaw's, Ralphs, Tops & Randalls https://d-qa.com/major-grocery-chains-failing-to-meet-the-needs-of-people-with-diabetes/ XX Last year she made big news by walking the runway with her Omnipod visible, this year Lila Moss is – we think – the first person with type 1 on the cover of Vogue magazine. She did an interview with them that's on YouTube – I'll link up the video. She says she has an Apple air tag attached to her Pod PDM. Going through her handbag essentials, she included glucose tabs and talked about how her diabetes is something she doesn't keep hidden but just isn't always visible. Just nice to see a matter of fact interview featuring type 1. https://www.youtube.com/watch?v=5piEaumF6f0 XX On this week's long format episode, you'll hear from Civica RX – this is the company pledging to put out insulin without making a profit. We'll hear why they think this will work and how soon it'll be available for purchase. Next week we're talking about a new mental health conference for people with diabetes – it's virtual so you can participate from anywhere. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

In this week's episode, Chris speaks with Dr. Steven Berk; Dean, Executive VP, and Provost of Texas Tech University's Health Science Center, about his journey and philosophy as a leader. Drawing from his memoir “Anatomy of Kidnapping”, Dr. Berk recounts his struggle with working in between the healthcare system while trying to preserve the ethics of health workers. Dr. Berk talks about how he trusts his family and colleagues to keep him anchored and focused on doing the right thing.Sharing his harrowing story of being held at gunpoint and having to say a potentially last goodbye to his son, Dr. Berk emphasizes the importance of a leader to stay calm and logical even in a moment of crisis. By communicating with the kidnaper with calm and talking about back pains and listening to his life stories, Dr. Berk potentially saved his own life; by telling his son a benevolent and convincing lie, Dr. Berk protected his family from imminent danger. This experience not only reminded him to appreciate life and cherish time with loved ones, but also the responsibility of a leader to share the emotional burdens, such as grief, anxiety, and fear of their friends, colleagues, and families, to guide them through tough times.Utilizing the lessons the incident taught him, Dr. Berk strives to nurture the next generations of physicians as better professionals and better people. He wants to teach the right professional ethics to students, but also make sure that they are not mistreated in the healthcare system.More About Our Guest:Appointed Dean of the School of Medicine and Executive Vice President in 2006 and Provost at Texas Tech University Health Sciences Center in 2010, Dr. Steven Lee Berk M.D graduated from Boston University School of Medicine and completed his Internal Medicine residency and infectious disease fellowship at Boston City Hospital. He specializes in Internal medicine and infectious disease. In 1979, Dr. Berk moved to Johnson City in Tennessee in 1979. He joined the newly formed medical school at East Tennessee State University, where he became the Chief of Infectious Disease in 1982 and professor of Medicine in 1986. He later became the chairman of the Department of Medicine in 1988. In 1999, Dr. Berk joined the faculty of Texas Tech University Health Sciences Center, where he held the positions of Regional Dead for the Amarillo Campus, professor of Medicine, and Mirick-Myers Endowed Chair in Geriatric Medicine.He was appointed as Dean in 2006. He is the author or co-author of over 120 peer-reviewed publications and four textbooks. He is a Fellow of the American College of Physicians, the Infectious Disease Society of America, the American Geriatric Society, and the American College of Chest Physicians. He has served on the NIH Special Advisory Panel on the evaluation of vaccines against infections in the elderly, on the editorial board of the Journal of the American Geriatric Society, and as a reviewer for most Internal Medicine and Infectious Disease journals. He serves on the Board of Directors Nominating Committee for the Association of American Medical Colleges and is chair of the AAMC community-based deans subcommittee. Click this link to see the full description!---------------------------------------------------------------------------------------------https://www.ttupress.org/9780896726932/anatomy-of-a-kidnapping/https://www.linkedin.com/in/steven-berk-758192a/https://www.ttuhsc.edu/

In this Question and Answer episode of Season 2 of the Demystifying Diversity Podcast, hosts Daralyse Lyons and Zack James are joined by geriatrician and aging expert Lena Makaroun, as the three of them explore ageism and the ways in which anti-ageist attitudes show up in our society. They focus on self-examination, allyship, inclusion, intergenerational connection and other tangible skills that each of us can utilize to become allies in the fight against ageism. Daralyse, Zack, and Dr. Makaroun revisit some of the key points from the first two episodes of the Ageism series, then respond to listener questions. In this episode, you will learn about: The importance of diversity of exposure in eliminating not just ageism, but all of the -isms that shape our perceptions of individuals and the groups they comprise. The critical role of agency in maintaining personal identity, and how it relates to ageism. How paternalism is NOT allyship, and the ways in which paternalistic attitudes hinder a person's agency. The role that age has as an intersectional identity that interacts with and impacts all other elements of individual personhood. The ways in which we can all become part of the solution as we work together to combat ageism, with a particular focus on older and younger folx. The different ways in which ageism can be presented, overtly or implicitly, and how coming from a place of curiosity can eliminate our own ageist assumptions and biases. The organizations referenced in this episode include: American Geriatrics Society HelpAge USA Gerontological Society of America The Frameworks Institute Anti-ageist children's books we recommend: Harry and Walter by Kathy Stinson Mr. McGinty's Monarchs by Linda Vander Heyden My Teacher by James Ransome Meena by Sine Van Mol To get in contact with Lena Makaroun, this episode's guest expert, email her at: lena.makaroun@va.gov or lkm35@pitt.edu Our guest in this episode is Dr. Lena Makaroun, MD MS: Lena Makaroun is an Assistant Professor of Geriatric Medicine and Pepper Scholar at the University of Pittsburgh and a core investigator at the VA Pittsburgh Healthcare System Center for Health Equity Research and Promotion. Dr. Makaroun's research focuses on social determinants of aging health and elder abuse. Specifically, her current work aims to broaden our understanding of multifaceted contributors to elder abuse, risk and susceptibility in order to improve elder abuse detection in the healthcare setting. Her goal is to develop evidence-based interventions to address elder abuse and improve health outcomes, safety and quality of life for this population. Dr. Makaroun completed her undergraduate degree at the University of Pennsylvania, M.D. at Weil Cornell Medical College and M.S. in Health Services at the University of Washington School of Public Health. In addition to her research, Dr. Makaroun loves caring for older veterans in her geriatrics clinic at the VA. She serves on the Board of Directors for the American Geriatric Society where she is co-chairing the society's Intersection of Structural Racism and Ageism in Healthcare initiative and is an associate editor for the journal: Innovation in Aging. Click here for the episode transcript.

Is The Truth About UFOs Out There? Over the past several years, U.S. Navy pilots have reported several instances of ”unexplained aerial phenomena” while in flight. They've recorded videos that show shapes that appear to move in unusual ways, zooming and turning in ways  beyond the capabilities of our own aircraft. After several members of Congress requested an explanation for the videos, the government put together a report on the phenomena.   The report, however, doesn't definitively answer the question of what the observations show. While it does say that the observations aren't of secret U.S. technology, it has no conclusions on whether the reports show foreign technology, camera artifacts, or something else—like alien technology. Seth Shostak, senior astronomer at the SETI Institute, spends his time searching for signs of intelligent life elsewhere in the universe. He says that while he does believe intelligent alien life exists—and may even be discovered within the next 20 years or so—he does not think the sightings included in the government report indicate alien visitors. He shares his reasons for skepticism with host Sophie Bushwick, as well as talks about people's desire to believe in extraterrestrials.  Rats Learn To Hide And Seek  One of the most wonderful things about the internet is how you could spend years watching videos of animals at play. There's the classic cat-playing-with-a-box genre. You can also watch a dog playing jenga. And you can type in pretty much any combination of animals, along with the word “playing,” and find adorable videos—like a baby deer, rough-housing with a lemur. Incredible stuff.  Neuroscientist Juan Ignacio Sanguinetti of the Humboldt University of Berlin gets inspiration for his work by watching home videos like that. And in his latest work, in the journal Science, he describes playing hide-and-seek—with rats. Making Music To Sharpen Aging Brains While research continues on drugs that can slow or reverse the- damage of Alzheimer's disease, there is already evidence for a lower-tech intervention: music. Research on the benefits of listening to music has found some evidence that it can activate regions of the brain not damaged by disease progression, soothe emotional disturbances, and promote some cognitive improvement in later stages of Alzheimer's. A new analysis in the Journal of the American Geriatric Society earlier this year looked at a different question. Can making music, whether by playing a musical instrument or singing, have an effect on the brains of people in the early stages of cognitive decline? The team focused specifically on people experiencing ‘mild cognitive decline,' which can be the first step in a progression toward Alzheimer's disease or more serious dementia. The researchers found evidence from 21 studies, involving more than 1,400 participants around the world, that yes, playing musical instruments, singing, or otherwise participating in making music can have a small but consistent benefit in recall, and other measures of brain health. Lead author Jennie Dorris, a professional percussionist turned PhD student studying rehabilitation sciences, talks to guest host Sophie Bushwick about the evidence for cognitive improvement, and what questions still remain about the effects of active music participation on the brain.

In this episode, I had the honor to speak with Dr. Shenikqua Bouges. Dr. Bouges is a faculty member in the Division of Geriatrics and Gerontology within the Department of Medicine at the University of Wisconsin. Dr. Bouges is a member of the American Geriatric Society, the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment, and the American College of Physicians. Dr. Bouges was also a recipient of the 2020-2021 UW-Madison Outstanding Woman of Color Award. Tune in for a learning session on Alzheimer's disease.  

The 4M's Framework: MEDICATION with Ayo Bankole PhD, RN and Tahira I. Lodhi MD   "Do the Brown Bag with your pharmacist too; because there are drug-drug interactions, drug-food interactions, and drug-supplement interactions to be aware of. Make sure that you're very clear about everything you are taking"    — Melissa Batchelor, PhD, RN, FNP-BC, FGSA, FAAN  _________________________________________________________________________________________________   We all hear about the increasing rates of health care services and how costly prescription medications can be, especially for older adults. But these costs can grow higher if you don't take the prescription correctly. The figures are especially troubling for older adults. Roughly 23% of nursing home admissions are attributed to an older individual's failure to self-manage their prescribed drugs at home. About 21% of drug-related health problems are induced by patients, whether by mistake or failing to stick to their prescription regimens. Also, while having their medicines, up to 58 % of older adults commit some fundamental mistake, with 26% committing errors. These statistics are alarming, and that is the primary reason why Medication is such a critical part of the 4M's Framework and part the Age-Friendly Systems are highly encouraged in nursing homes and health care systems. In today's episode, we are joined by Drs. Ayo Bankole PhD, RN, and Tahira I. Lodhi, MD. Join us as we engage in meaningful discussions about one component of the 4M's Framework: Medication and learn how to make sure that your medications are age-friendly.    Part One of 'The 4M's Framework: MEDICATION'.   Overview of Medication as an Essential Component of the 4M's Framework    In implementing the 4M's Framework to achieve an age-friendly healthcare system, we want to ensure that Medication does not interfere with the other M's, which are: What Matters, Mentation and Mobility across care settings. To do that, we should have a clear definition of the terms associated with the medication. Two of these terms are polypharmacy and medication reconciliation.  What is Polypharmacy?   Tahira I. Lodhi MD explained that polypharmacy is too many medications in simple terms. She also said that when you see a patient with a medication that does not have a corresponding diagnosis documented, that's also polypharmacy by one definition.    "Whichever situation you are in, whether you are by the bedside in the hospital, in outpatient or long-term care settings, be very aware of the definitions of polypharmacy and be ready to address them." -Tahira I. Lodhi, MD (03:21-03:35)   What is Medication Reconciliation?   Ayo Bankole, PhD, RN, expounded that medication reconciliation involves reviewing the medications a patient is taking and comparing them to the medicines on file. Medication reconciliation ensures no discrepancies, such as medication duplication, missing prescriptions, and inappropriate medications.     Patient Education: Things to Look for or to Report to a Provider   Use a Medication Administration Sheet   When you get that medication list from the hospital or your provider, it often comes in a list. This can be overwhelming, so using a “real time” document can help reduce medication errors - particularly if there is more than one person trying to help the older adult. Write down your medications in the order you would need to take them in a day, rather than trying to use the list in the format typically given to patients. And write  [Can we link this form? https://drive.google.com/drive/u/1/folders/11CoEC6kj3bRw7k4yFHdjgTxIS8WqqYVD] Crystal - we created this document for EP21, but doesn’t seem to be included in the brand article?  Keep a Medication List   With that, Ayo Bankole PhD, RN suggests keeping a medication list. Your medication list should include the following; Any medications you're taking, and this includes vitamins and supplements or herbal supplements. The medication list is not only the medicines that are prescribed by a physician or a nurse practitioner. It also includes other medications that might be over-the-counter supplements that your patient might be taking. Include the name of the medications you are taking, the dose, and where the medicine is used. Include the name of the prescribing doctor  Have phone numbers of your pharmacist or your doctors on the list as well.    Teach the “Brown Bag” Review   Aside from keeping medication lists, Tahira I. Lodhi MD also suggests teaching patients the Brown Bag review. She pointed out that doing the Brown Bag Review leads your patient to gather all the medications, put them in the bag, and bring them on every visit. Once they are in the clinic, either your medical assistant or you take out those medications, put them on a table where the patient can see them.    The review brings you and your patient on the same page about what medications they are taking, what supplements they are taking, etc. This is an excellent opportunity to know whether your patient is aware of why they're taking this medicine, what doses they're taking. Furthermore, Brown Bag Review is a unique tool a provider can use to avoid polypharmacy in their patients.    What To Look For Or Report To Providers?   For patients experiencing polypharmacy, monitoring for any side effects and signs and symptoms is essential.  The following are the signs to look out for and should be reported to providers ASAP; Loss of appetite Diarrhea Fatigue  Weakness Change in mental status Confusion Hallucinations  Changing mood and behavior   Part Two of 'The 4M's Framework: MEDICATION'.   Medication Assessment   For the second part of the interview, Drs. Lodhi and Bankole mentioned Medication Assessments. They shared that there are assessments or tools students or practicing providers can use when prescribing medications to older adults. These criteria are validated tools and are widely used. Two of them are Beer's criteria and the STOPP and START criteria.   Beer's Criteria  Beer's Criteria for medications is a medication list that is put out by the American Geriatric Society. This is a list of potentially inappropriate medications for older adults. These medications carry different side effects, potential complications, and medication interactions, which account for many adverse drug reactions in the more aging adult population.  "I would tell students to be careful about Beer's criteria. The list of medications doesn't mean they are contraindicated. It means they are to be used very carefully, to be prescribed very carefully."- Tahira I. Lodhi MD(14:02-14:19) STOPP and START Criteria STOPP (Screening Tool of Older Persons' Prescriptions) and START (Screening Tool to Alert to Right Treatment) are more commonly used in Europe and was developed by the European Consensus Group. Still, it could also be used by providers and practitioners in the United States.  The STOPP criteria are similar to the specifications of medications that could be stopped or suggest medicines for discontinuation. On the other hand, the START part is the right treatment. Those are the recommended treatments for older adults, including the pneumonia vaccine and those recommended treatments for the more aging adult population.  Interventions and Best Practices After you've done a medication reconciliation and reviewed the Beers Criteria, Dr. Lodhi shared some of the best practices that providers can use.   Deprescribing (both dose reduction and medication discontinuation)   First, she advised that you should look at the medications the patient is taking. Make sure there is no polypharmacy. Then, be ready to adjust the dose on every visit. Assess how they are doing in terms of the medication. For example, with antihypertensive, look at the patient's self-monitoring of blood pressure. If it's consistently on the low side or there are signs of orthostatic hypotension, decrease the dose and at the same time have a plan of how you're going to follow in the future.     Pharmacy Consult   Secondly, Dr. Lodhi stressed out that your pharmacist is your friend and never hesitate to call them. She says, "Your pharmacists oversee your patient's prescriptions. They regularly make their recommendations because it's regular monitoring and quality control in long-term care settings." So make sure you reach out to your pharmacist frequently.   Re-evaluate on each visit with every provider   Lastly, Dr. Lodhi emphasized that every provider should guarantee that the medications are used as prescribed. Moreover, providers should also ensure that they'll go back to the patient's chart whenever they're asked to refill a prescription. They should always double-check for schedules and indications when to continue medications.  About Tahira I. Lodhi MD  I graduated from medical school in 1999. My Family Medicine training was at Virginia Commonwealth University and Geriatrics fellowship training at George Washington University.  My interest is Geriatrics primary care practice and teaching. Since graduating from Fellowship in Geriatrics in 2011, I have had medical students, residents and fellows join me in traditional and non-traditional settings, including hospital, clinic and classrooms but also assisted living, post-acute and long term care settings. I am also interested in workflow improvement through deploying available technology. My goal is to help my patients get simplified, patient-centered care, while collaborating with an interdisciplinary team.  About Ayo Okanlawon Bankole Ph.D, RN Ayo Okanlawon Bankole Ph.D, RN is a clinical assistant professor at GW Nursing. She is also one of the faculty members affiliated with the George Washington University/Medstar Washington Hospital Center academic partnership and scholarship program, W-squared. Dr. Bankole has practiced as a nurse in multiple areas within the acute care and community care setting. She is also committed to nursing education and she has been teaching nursing students since 2013 (in both part-time adjunct and full time appointments). Dr. Bankole's overall research goal is to contribute to research that improves health outcomes and wellbeing for older adults with complex healthcare needs. Her specific research interest are: aging, chronic disease self-management, theoretical approaches to chronic disease self-management and multi-morbidity.  About Melissa Batchelor, PhD, RN, FNP,  FGSA, FAAN I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11) and then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the faculty at George Washington University (GW) School of Nursing in 2018 as a (tenured) Associate Professor, where I am also the Director of the GW Center for Aging, Health, and Humanities. Find out more about her work at https://melissabphd.com/. References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234383/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573668/

In this episode I speak to Dr Purva Gupta, about things that we can do to improve our skin according to where we are in our cycle. Dr. Purva is a DHA certified medical practitioner, certified by Sharjah University in Aesthetic medicine, with over 12 years of international experience in Aesthetic, Functional-Integrative, Geriatric and General medicine and healthcare management in USA, UAE and India. She is a member of American Geriatric Society and is practicing at Cocoona Center for Aesthetic Transformation, Dubai. Dr Purva has tremendous experience practicing skin care and cosmetic medicine combining her knowledge of medicine, dermatology and aesthetics to give the best possible results to her patients. Apart from this, she is a passionate mother, wife, daughter and friend. She holds other talents like freestyle singing and dancing including Indian classical dance, swimming, racing, and blogging/writing about social causes to be able to help humanity and kids, specially. You can follow or get in touch with Dr Purva on Instagram

Steven Lee Berk, MD, is the Dean of the School of Medicine and Executive Vice President for Clinical Affairs at Texas Tech University Health Sciences Center at Lubbock. Dr. Berk graduated from Boston University School of Medicine and completed his Internal Medicine residency and Infectious Disease fellowship at Boston City Hospital. He is the author or co-author of over 150 peer-reviewed publications and four textbooks. Dr. Berk has served on the NIH Special Advisory Panel on the evaluation of vaccines against infections in the elderly, on the editorial board of the Journal of the American Geriatric Society, and as a reviewer for most Internal Medicine and Infectious Disease journals. He has served on the Board of Directors Nominating Committee for the Association of American Medical Colleges (AAMC) and chaired the AAMC community-based deans subcommittee for eight years. It is inevitable throughout our journey in medicine that we will find role models that inspire us each day. But how do we discern what kind of physician makes the best role model? Today, Dr. Steven Berk explains that the best physicians to emulate are the ones who are highly skilled in bedside manner. Physicians who are present with their patient, spend time with that patient, and then share their experience and knowledge with upcoming students and residents are the kinds of doctors we should be seeking out and learning from. He also explains how important it is to foster emotional intelligence in the field of medicine. And in order to do that, we must work toward creating classrooms and environments that encourage diversity. And we must commit to spending time with—and learning from—different backgrounds, different cultures, and different ideas. Pearls of Wisdom: 1. Develop qualities of staying calm and clear headed, no matter how stressful the situation. 2. Gratitude is one of the key qualities of a good mentor and student, and this will keep us on the right path. 3. Be committed to patient care. The more committed to patient care you are, it will make overcoming challenges more manageable. 4. Continue to build enthusiasm in medicine: Remember why we started, and keep that passion alive throughout your years. At the end of the day, keep a holistic eye on our profession. Read more about Dr Berk's memoir of being kidnapped and how the principles from his medical training helped him successfully navigate the crisis. It's a compelling read for all, especially medical students and residents. Get your copy here: https://www.amazon.com/Anatomy-Kidnapping-Steven-L-Berk/dp/0896726932

Lecture SummaryIn this podcast I talk about my experiences with adverse drug reactions working as a Hospitalist. I then provide a brief summary of the 2019 American Geriatric Society Beers Criteria. "Beers List" reviews medications which are potentially inappropriate to use in elderly patients.Key Points- At least 10% of the patients I admit to the hospital are the direct result of the medications they have been prescribed.- Bleeding, falls, altered mentation, kidney and electrolyte problems, and overdose are the most common adverse reactions I see in my practice- The American Geriatric Society publishes a Beers Criteria, every 3 years, to highlight medications that are potentially harmful in elderly patients (> 65 years)- Avoid mixing multiple medications with strong anticholinergic properties.- Read this paper if you treat elderly patients!- I often break these guidelines in my practice, but I try to be aware of potential problems so I can identify adverse reactions quickly and remove culprit medications.ReferencesBeers Criteria/List. American Geriatric Society. 2019 addition

Benefits Of Your Fitness Program: What contributed to Health and Disease from The National Health Interview Survey What is the best Tranquilizer? What Dr. Walter Bortz, head of the American Geriatric Society exposed about Anti-Aging The Most Important part of the Best Fitness Program Certain Diseases that can be lowered with the Proper Fitness Program

A discussion of feeding tubes and recommendations from The American Geriatric Society and The Alzheimer Association. We review articles and findings to help with decision making.

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/ Today we are going to discuss a presentation we heard at the AMMG conference in Tucson last October. The presentation was given by Dr. Angela DeRosa. Dr. DeRosa is the Medical Director of Belmar Pharmacy in Colorado. Her presentation covered six main themes and we want to speak to you about several of them today, in particular, her concept of statistical homicide and her discussion regarding the evidence surrounding the Womens' Health Initiative and how it relates to the current understanding of hormonal medicine. One of the major thought- provoking issues in modern medicine is the concept that there are two different expectations facing physicians in regard to the goal of treating patients:  one is the goal of working toward a long life, disregarding the quality of a patient's life. The other is the goal of a quality of life as our endpoint of treatment. For example, if a patient has an aggressive lung cancer and there must be a decision made between treating her with a type of chemo that causes daily nausea vomiting and incapacitation, but offers a slightly longer life (an extension of less than a year), versus living half the time in fairly good condition until the last month of life. There are drug regimens that provide the first option are usually extremely expensive and offer longer life without quality. The second option is a slightly shorter life with more quality to connect with her loved ones before she dies.  In the past doctors were trained to pursue a longer life with no regard to the quality of that life.  In the recent past we began to wonder about the intelligence of that decision.  What would I do if I had the choice?  These are extreme examples and at BioBalance I have created a much different idea that does not make patients choose between length of life or quality of life.  The only requirement for me to treat a patient to achieve a longer life with quality, is some “lead time”…..I need to treat my patients before they get sick!  In general, modern medicine and all the research that is the basis for decision making in medicine today is geared to making people live longer.  The goal of medical research is keeping people alive….they consider it a “win” as long as that person is breathing, however impaired, or unable to care for herself.  The new paradigm is that of quality of life as the endpoint, keeping patients from being housed in nursing homes and from having to be cared for by their families.  To do that you need muscle mass so you don't fall and so you can walk without a walker.  Quality of life means being able to connect to your spouse sexually, by keeping your libido for as long as you want and enjoy it. We are working on preventing Alzheimer's disease by decreasing inflammation, diabetes and avoiding toxic substances that contribute to that disease. Dr. Derosa lectured on the same things I teach my patients every day.  She maintains that many of the guidelines for doctors regarding treating and diagnosing illness do not make any recommendations towards treating a patient to achieve optimal health, and therefore quality of life. “Modern scientific medicine prefers laboratory measurements rather than assessing patient's symptoms; regardless of the fact that it is the symptoms that make up syndromes.” One of the syndromes that we treat every day is menopause. 1.1 billion women will be in menopause in the 2020. Medicine looks at menopause as one or two symptoms such as hot flashes and a dry vagina.   BioBalance Health® looks at menopause as a syndrome that changes women's lives for the worse and impairs their ability to enjoy life and be productive. We feel it is important to treat women as if their mental capacity, physical health, and sexual life are relevant and important and that the best way to take care of these issues is to replace their sex hormones (estradiol and testosterone) that are lost to the changes occurring at menopause. If you replace these hormones to the same level of hormones you had in your thirties, you will age in a healthier and stronger way, maintaining your abilities to function and remain relevant and independent! According to the Journal of the American Geriatric Society, you will hit menopause before you are fifty, and your life expectancy is about 80. Why should you spend thirty years of your life broken down and sick? We believe that you do not need to experience life this way and that replacing your lost hormones is the treatment of choice for maintaining strength, mental acuity, and independence throughout your life. This should be a Newsflash to mainstream medicine: Staying healthy with hormones keeps you from getting life-threatening illnesses! Menopause causes estrogen and testosterone deficiency. The primary symptoms of estrogen deficiency are: Hot flashes PMS worsening Night sweats Irritability Dry skin Insomnia Depression Mood swings Forgetfulness Vaginal dryness Heart palpitations Increased allergies The primary symptoms of Testosterone deficiency are: Low libido Weight gain Loss of focus Anxiety Depression Muscle pain Mood swings Sugar cravings Fatigue Belly fat Dr. DeRosa presented information identifying the long -term consequences of hormone deficiencies, the same illnesses that I list in my book the Secret Female Hormone, among them: Insulin resistance and diabetes Cardiovascular disease Osteoporosis Dementias Cancers In her discussion of the data provided by the Women's Health Initiative, she presented the concept of statistical homicide: “the triumph of long odds over common sense”.   

In this episode, we discussed that employees with older parents may not anticipate the challenges as caregivers to fully prepare for the unexpected time off. There is no playbook for someone entertaining the caregiving phase. The cost to employers is very high. Dr. Mike Wasserman shares insights both as a physician and his personal stories of caregiving. A quote -“if you treat your parents as children, you are going to have a hard time”. Most people are not taught to be caregivers and often don’t anticipate the enormity of the job. Bio: Dr. Wasserman co-founded Senior Care of Colorado, which became the largest privately-owned primary care geriatric practice in the country, demonstrating that high-quality primary care could be delivered to seniors in a cost-effective manner. Senior Care of Colorado was sold to IPC, The Hospitalist Company in 2010. Dr. Wasserman is passionate about educating others on how geriatric medicine can function effectively in today's healthcare environment. Dr. Wasserman was the CEO of Rockport Healthcare Services, overseeing the largest nursing home chain in California. He was the President and Chief Medical Officer for GeriMed of America, a Geriatric Medical Management Company located in Denver. He graduated from the University of Texas, Medical Branch, and completed an Internal Medicine residency at Cedars-Sinai Medical Center and a Geriatric Medicine Fellowship at UCLA. He spent five years with Kaiser-Permanente in Southern California where he opened Kaiser's first Geriatric Consult clinic. He is an active member of the American Geriatric Society for thirty years. From 2000-2004, he was a Public Commissioner for the Continuing Care Accreditation Commission. He co-chaired Colorado's Alzheimer's Coordinating Council and serves on the boards of the Wish of a Lifetime Foundation, The Foundation for Health in Aging, and CALTCM (California Association for Long Term Care Medicine). Dr. Wasserman has spoken extensively and been published on a variety of topics involving Geriatrics, Alzheimer’s Disease, Practice Management, and Managed Care. Follow Dr. Wasserman on LinkedIn and on Twitter Hope you enjoy the conversation. If you'd like to share your own stories, please submit it to our website at www.NurXur.com

Geriatrician: Why? A Geriatrician is much more than a physician who simply cares for old people. Geriatricians must, above all, have a genuine fondness for the elderly, and a deep and widening knowledge of the problems they face. Diane’s special guest this week, Dr. Laurie Jacobs, President of the American Geriatric Society is

We recently did an episode on the impact of intergenerational trauma (https://yourparentingmojo.com/intergenerationaltrauma/) , which was about how the ways we were parented, and even the ways our parents were parented, ends up influencing the relationship we have with our children – and often not in a positive way. But there’s another side to this story: relationships between the generations can actually have enormously beneficial effects on children’s lives, even when these are affected by issues like radically different parenting styles, and mental illness. Today we explore the more positive side of intergenerational relationship with Dr. Peter Whitehouse, who (along with his wife, Cathy) co-founded The Intergenerational School in Cleveland, OH, which is now part of a small network of three schools that use this model. Have you ever thought about how you talk about ageing effects what your children think about older people?  (I hadn’t, but I have now!)  Do you struggle to navigate the difference between the things your parents want to say to and buy for your child, and your own values?  Do you worry about what your child might think of their grandparent’s absent-mindedness or volatility?  Join us as Dr. Whitehouse and I navigate a path through these and other issues. References Babcock, R., MaloneBeach, E.E., & Woodworth-Hou, B. (2016). Intergenerational intervention to mitigate children’s bias against the elderly. Journal of Intergenerational Relationships 14(4), 274-287. Bessell, S. (2017). The role of intergenerational relationships in children’s experiences of community. Children & Society 31, 263-275. Bostrom, A-K., & Schmidt-Hertha, B. (2017). Intergenerational relationships and lifelong learning. Journal of Intergenerational Relationships 15(1), 1-3. Even-Zohar, A., & Garby, A. (2016). Great-grandparents’ role perception and its contribution to their quality of life. Journal of Intergenerational Relationships 14(3), 197-219. Flash, C. (2015). The Intergenerational Learning Center, Providence Mount St. Vincent, Seattle. Journal of Intergenerational Relationships 13(4), 338-341. George, D.R., & Whitehouse, P.J. (2010). Intergenerational volunteering and quality of life for persons with mild-to-moderate dementia: Results from a 5-month intervention study in the United States. Journal of the American Geriatric Society 58(4), 796-797. Geraghty, R., Gray, J., & Ralph, D. (2015). ‘One of the best members of the family’: Continuity and change in young children’s relationships with their grandparents. In L. Connolly (Ed.), The ‘Irish’ Family (pp.124-139). New York, NY: Routledge. Hake, B.J. (2017). Gardens as learning spaces: Intergenerational learning in urban food gardens. Journal of Intergenerational Relationships 15(1), 26-38. Hawkes, K., O’Connell, J.F., Jones, B.G.B., Alvarez, H., & Charnov, E.L. (2000). The grandmother hypothesis and human evolution. In Adaptation and Human Behavior: An Anthropological Perspective, edited by L. Cronk, N. Chagnon & W. Irons, pp. 231-252. New York: Aldine de Gruyter. Kirkwood, T., Bond, J., May, C., McKeith, I., & Teh, M. (2010). Mental capital and wellbeing through life: Future challenges. In C. Cooper, J. Field, U. Goswami, R. Jenkins, & B. Sahakian (Eds.), Mental capital and wellbeing (pp. 3–53). Chichester, UK: Wiley-Blackwell. Low, L-F., Russell, F., McDonald, T., & Kauffman, A. (2015). Grandfriends, an intergenerational program for nursing-home residents and preschoolers: A randomized trial. Journal of Intergenerational Relationships 13(3), 227-240. Murayama, Y., Obha, H., Yasunanaga, M., Nonaka, K., Takeuchi, R., Nishi, M., Sakuma, N., Uchida, H., Shinkai, S., & Fujiwara, Y. (2015). The effect of intergenerational programs on the mental health of elderly adults. Aging and Mental Health 19(4), 306-316. Schwartz, L.K., & Simmons,...

In today’s podcast, we’ll talk with XinQi Dong, Director of Rutgers University’s Institute for Health, Health Care Policy, and Aging Research. In addition to the institute directorship, Dong will serve as the inaugural Henry Rutgers Professor of Population Health Sciences. Most recently, he was a Professor of Medicine, Nursing, and Behavioral Sciences at the Rush University Medical Center and the Associate Director of the Rush Institute for Healthy Aging. His research and advocacy have been recognized by many national and international organizations, including awards by the American Public Health Association, American Geriatric Society, Gerontological Society of America, and International Congress of Gerontology and Geriatrics. He was the first geriatrician to receive the National Physician Advocacy Merit Award by the Institute on Medicine as a Profession. This year, he was elected to the prestigious American Society of Clinical Investigation. He has served as a commissioner for the Commission on Law and Aging at the American Bar Association, and he chaired the workshop on elder abuse prevention for the Institute of Medicine’s Global Violence Prevention Forum. A native of China, he completed his geriatric fellowship at Yale University Medical Center.

Challenge your beliefs on the efficacy of pervasive treatments used in dementia with expert Eric Widera, MD, Professor and clinician-educator in the Division of Geriatrics at the University of California-San Francisco. We explore the use of cholinesterase inhibitors, antipsychotics for behavior disturbances, feeding tubes, medications and supplements used for weight gain (inspired by Choosing Wisely and the American Geriatric Society’s “Ten Things Clinicians and Patients Should Question”). Plus, we introduce our new correspondent, Dr. Leah Witt, Geriatrics Fellow at UCSF. Written and produced by: Jordana Kozupsky, NP, Nora Taranto, MS3, Leah Witt, MD; Edited by: Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Self Assessment Questions Take the quiz now!  Time Stamps 00:00 Disclaimer 00:37 Guys set up the show 02:00 Dr Widera’s bio 03:15 Getting to know our guests 13:10 Picks of the week 16:40 Clinical case: new diagnosis of dementia 17:40 Discussing dementia with patients and caregivers 23:42 Cholinesterase inhibitors 27:35 Stopping cholinesterase inhibitors 33:35 Follow up to therapy 36:05 Dealing with behavior disturbances 39:15 DICE approach 44:17 Risks of antipsychotic medications 48:00 Use of benzos or sedative hypnotics 49:45 Melatonin for delirium or sleep 52:00 Mirtazapine 53:54 Clinical case: patient with dementia not eating 54:40 Feeding tubes 59:40 Dysphagia and NPO orders 62:04 Misinformation on malnutrition and girth creep 65:10 Thickened liquid challenge 70:25 Appetite stimulants 72:38 Megestrol 73:54 Take home points from Dr Widera 79:17 Outro Tags: dementia, donepezil, cholinesterase, inhibitor, antipsychotic, behavior, disturbance, agitation, benzodiazepine, supplement, feeding, tube, restraints, thickened, liquids, geriatric, choosing, wisely, american, society, ags, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

You'll see renewed focus on appropriate med use in patients 65 and older...due to new Beers Criteria from the American Geriatrics Society. Continue to think of these guidelines as a "warning light" to be cautious with certain meds...NOT a "stop sign" to always avoid them. PPIs are new to the list. Discourage using PPIs for over 8 weeks without a good reason, such as chronic oral steroid use. Explain PPIs are linked to a higher risk of C. difficile, fractures, pneumonia, etc. Help patients taper off a PPI if needed. Advise lowering the dose, then taking it every OTHER day for a week or more before stopping. "Z drugs" (zolpidem, zaleplon, eszopiclone) are a concern now when used for ANY duration...not just over 90 days. Potential harms...such as delirium, falls, and fractures...seem to outweigh any benefit. Keep in mind not to turn to benzos...they're still on the list and aren't safer for sleep. Instead, emphasize nondrug strategies. Or consider suggesting low doses of trazodone or doxepin...or ramelteon. Nitrofurantoin used to be discouraged for UTIs if CrCl < 60 mL/min. But now feel comfortable suggesting it short-term if CrCl ≥ 30 mL/min...since new evidence supports its safety and efficacy in these patients. Digoxin should now be saved for atrial fib or heart failure patients only when other options aren't enough...since it may increase mortality. If digoxin must be used, recommend a max of 0.125 mg/day. Warfarin with amiodarone, anticholinergic combos, and other interactions can be riskier in seniors. Suggest avoiding if possible. Direct oral anticoagulants (dabigatran, etc), famotidine, gabapentin, and others may cause more side effects in renal impairment. Advise reducing the med's dose or avoiding it...based on renal function. Expect the Star Ratings high-risk med list to catch up eventually.

Join Teena and Salah as they discuss his interest in mental health research and his findings as principle investigator of the article, “Greater Prevalence and Incidence of Dementia in Older Veterans with PTSD” (Post-Traumatic Brain Disorder) which was published in the Journal of the American Geriatric Society, September 2010 … Read more about this episode...