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Faculty:
Pat Borman, MD
Resident Chairperson:
(2005 - 2006): Oana Marcu
The practice of geriatrics embodies intensive application of nearly all the traditional principles of Family Medicine. These principles include:
Geriatric skills and knowledge are acquired longitudinally throughout the three years of residency. In the second and third years, special attention is devoted to learning geriatric principles as outlined below. The AAFP has designated geriatrics as a segment of the certifying exam which is to be especially evaluated. After the curriculum outline are the AAFP objectives and goals for geriatrics: Geriatric Medicine Training for Family Practice Residents in the 21st Century also available at www.aafp.org. Geriatric Didactics With 6 didactic presentations every 18 months the geriatric didactic series covers the following topics:
Geriatric Assessment Second year residents will have the opportunity to develop skills in geriatric assessment. During their own continuity clinics each resident can work with one of the geriatric faculty to become familiar with geriatric assessment skills and the common tools for screening elderly for functional decline and geriatric syndromes. Four clinics throughout the second year will solidify the knowledge and skills for geriatric assessment. Goals and Objectives Knowledge
References: 1. Palmer RM. Geriatric Assessment. Medical Clinics of North American. Nov 1999. 2. Foley KT, Palmer RM. Evaluation of Frail Elderly: Tools for Office Practice. Hospital Medicine. June 1996. 3. Miller KE, Zylstra RG, Standbridge JB. The Geriatric Patient: A Systematic Approach to Maintaning Health. American Family Physician, Feb 2000. Geriatric Assessment Tools:
R2 Geriatrics Rotation 1. Mary Jane Lambert, MD will supervise residents in guided introduction to nursing home care. Residents should contact her before their rotation starts. Dr. Lambert’s nursing home day is Monday so residents should be scheduled with this in mind. Mary Jane Lambert, Group Health Cooperative, 835 King Street #815, Seattle. 206-326-4450. lambert.m@ghc.org An initial orientation session is required, where an overview of the rotation is given along with handouts on assessment tools. Residents will meet with the director of nursing services at Kline Galland Home to receive a tour of the facility. Min Ahn, RN Kline Galland Home 7500 Seward Park Ave. S (just south of Othello St.) 206-725-8800 The resident will make nursing home rounds with Dr. Lambert or her geriatric nurse practitioner twice a week. Part of the rotation will be to visit the Ballard Transitional Care Unit and see the workings of an assisted living facility. Dr. Lambert will help arrange these experiences. An exit meeting with Dr. Lambert to assess the rotation upon completion is required. 2. The residents will also contact Swedish Home Care Services to set up home visit experiences with the home health care team. Hospice involvement is also recommended. Jan Mueller Director of Swedish Home Care Services 5701 6th Ave S #504 Seattle, WA 98108 206-386-6602 3. Long term care with Pat Borman, MD and include: Time with the geriatric fellows at ElderPlace, a program for all inclusive care of the very frail elderly Additional nursing home exposure with Dr. Borman or Dr. Troyer A palliative care self study course 4. Long term care with Eric Troyer, MD and the geriatric fellows at Bessie Burton Sullivan. Page Dr. Troyer at 405-7081 or e-mail on First Class. Plan on two half-days mostly on Friday mornings. 5. Elderplace with Assad Kazemi, MD at 5900 Martin Luther King Jr. Way S. Phone: 320-5325. Plan for at least two half-days to learn about all-inclusive care for the frail and elderly. Times available Tuesday mornings, Wednesday afternoons, and all day Thursdays. 6. Geriatric Fellows are available for outpatient experiences at First Hill clinic on Monday afternoons or Thursday mornings. 7. Swedish Home Care Services schedule with Cindy Thompson at 386-6602. Residents can participate in Home Health Services or Hospice visits. R2 and R3 Long Term Care Longitudinal Experience After each second year resident has completed their continuity clinic month they will be assigned a patient at either Kline Galland or Bessie Burton Sullivan Nursing Homes. The resident will manage all aspects of the long term care of this patient until graduation under the supervision of the geriatric faculty. Part of the long term care experience will be to learn about Medicare and Medicaid regulations for long term care institutions. Residents will also acquire knowledge about non-institutional long term care options for the functionally impaired. Goals and Objectives Knowledge Skills References: R3 Geriatric Rotation
AAFP Geriatric Medicine Training For Family Practice Residents in the 21st Century Knowledge Residents must demonstrate knowledge about established and evolving biomedical, clinical, and social aspects of geriatric medicine practice and the application of this knowledge to patient care. Topic areas of particular importance include: Dementia Pressure Ulcers Delirium Sensory Impairment: Hearing, Vision Depression Elder Abuse Incontinence Polypharmacy Falls/Mobility/Balance Malnutrition Immobillity Residents must be able to provide patient care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health of the older adult. Residents are expected to: Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Specifically, residents are expected to: Demonstrate interpersonal and communication skills that result in effective information exchange and teaming with older patients, their families and professionals from varied disciplines.
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