UCSF AGRC ITT Course Syllabus


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AGRC Intedisciplinary Team Training in Geriatrics Course
Course Website
Spring 2008

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Course Faculty

Rebecca Conant, MD, Assistant Clinical Professor, Director, UCSF Housecalls Program, Dept. of Medicine, Division of Geriatrics, UCSF

Susan Hyde, DDS, MPH, PhD, Assistant Adjunct Professor, Dept. of Preventive & Restorative Dental Sciences, School of Dentistry, UCSF

Kirby Lee, PharmD, Assistant Clinical Professor, Dept. of Clinical Pharmacy, School of Pharmacy, UCSF

Lynda Mackin, MS, RN, NP, Associate Clinical Professor, Dept. of Physiological Nursing, School of Nursing, UCSF

Course Coordinator

Lydia Jackson , email: ljackson@medicine.ucsf.edu, phone: 514-0706

WEEK 1 (4/2): Introduction to the Course and Home Care/Medicare/Community Services

Required Reading

Weiss, R. L., Milone-Nuzzo, P., Zuber, R. F. (2003). A tool to assess homebound status. Home Healthcare Nurse, 21(11), 774-777.
UCSF Access: Link directly to Full Text (via Lippincott Williams & Wilkens) or UC E-Links for this access to this article.

Please skim the following resources (available on the Medicare website)

"Medicare & You" 2006: Summary Handbook for Medicare beneficiaries. Found at: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf.
Center for Medicare and Medicaid Services (2004). Your Medicare Benefits: Your Health Care Coverage in the Original Medicare Plan. Found at:
http://www.medicare.gov/Publications/Pubs/pdf/10116.pdf.

Additional Resources

www.calnhs.org - California Nursing Home, Home Care Agency and Hospice Agency Comparisons
www.cahsah.org - California Association for Health Services at Home (916) 641-5795
www.cms.hhs.gov - Center for Medicare Services
www.medicare.gov - Has Nursing Home Comparisions, Home Health Comparisons, and enrollment information and criteria
AARP Website - Explains Medicare and supplemental coverage
Home Care Compare Site

Additional Recommended Reading

Rice, D. P. & Fineman, N. (2004) Economic implications of increased longevity in the United States. Annual Review for Public Health, 25, 457-473.
Medicare drug benefit realities: MedScape E journal commentary
http://www.medscape.com/viewarticle/464964
Eng, C., Padulla, J. & Eleazur, G. (1997). Program of all-inclusive care for the elderly (PACE): An innovative model of integrated geriatric care and financing. Journal of the American Geriatrics Society, 45, 223-23

WEEK 2 (4/9): Geriatric Assessment

Additional Resources

John A. Hartford Geriatric Interdisciplinary Team Training Program Website. www.gitt.org
The Hartford Institute for Geriatric Nursing Initiative, Try This Series
Growth House Guide to Death, Dying, Grief, Bereavement, and End of Life Resources

Additional Recommended Reading

Geriatric Assessment. Palmer RM. Med Clin North Am. 1999 Nov;83(6):1503-23
Comprehensive Geriatric Assessment. Helping your elderly patients maintain functional well being. Rockwood K, Silvius JL, Fox RA. Postgrad Med. 1998 Mar;103(3):247-9, 254-8, 264.
Clark, P. (1995). Quality of life, values, and teamwork in geriatric care: Do we communicate what we mean? The Gerontologist, 35(3), 402-411.
Farrell, M., Schmidt, M. & Heinemann, G. (2001). Informal roles and stages of interdisciplinary team development. Journal of Interprofessional Care, 15, 281-295.
Hansen, H., Bull, M. & Gross, C. (1998). Interdisciplinary collaboration and discharge planning communication for elders. Journal of Nursing Administration, 29, 37-46.
Leipzig, R., Hyer, K., Wallerstein, S., Fairchild, S., Cassel, C. & Howie, J. (2002). Attitudes toward working on interdisciplinary health care teams: A comparison by disciplines. Journal of the American Geriatrics Society, 50, 1141-1148.
Qualls, S. & Czirr, R. (1998). Geriatric health teams: Classifying models of professional and team functioning. The Gerontologist, 28, 372-376.

WEEK 3 (4/16): Medications

Required Reading

AGRC Online Curriculum (http://ucsfagrc.org) Module 2: Biology and Physiology of Aging - Section 2.4 (Pharmacologic considerations)

Additional Resources

Family Caregiver Alliance, see Caregivers' Guide to Medications and Aging
at www.caregiver.org
National Council on Patient Information and Education (NCPIE), "Tools For Consumers" at www.talkaboutrx.org
California State Board of Pharmacy, Consumer Info: Consumer Tips at www.pharmacy.ca.gov
American Association of Retired Persons (AARP) at www.aarp.org

Additional Recommended Reading

Hughes CM. Medication non-adherence in the elderly: how big is the problem? Drugs Aging, 2004; 21(12):793-811.
Hanlon JT et al. Update on drug-related problems in the elderly. The American Journal of Geriatric Pharmacotherapy, 2003; 1(1):38-43.
Karki SD et al. Impact of a team approach on reducing polypharmacy. Consultant Pharmacist, 1991;6:133-137.
Montamat SC et al. Management of drug therapy in the elderly. New England Journal of Medicine, 1989; 321:303-309.
Williams B. Geriatric Therapy. In Koda-Kimble M, Young L (ed): Applied Therapeutics: The Clinical Use of Drugs. Philadelphia, Lippincott Williams & Wilkins. 2001: 97.9-97.11.

WEEK 4 (4/23): Nutrition and Oral Health

Required Reading

Chavez EM and Ship JA. Sensory and motor deficits in the elderly: impact on oral health. J Public Health Dent 2000;60(4):297-303.

Additional Resources

Oral Assessment form:
http://ucsfagrc.org/module_four/section_two/14_oral_dental_health.html
CDC Aims to Prevent Oral Diseases Among Older Americans
http://www.asaging.org/media/pressrelease.cfm?id=85

Additional Recommended Reading

Ship JA, Duffy V, Jones JA, Langmore S. Geriatric oral health and its impact on eating. JAGS 1996;44:456-464.

WEEK 5 (4/30): No Session

WEEK 6 (5/7): Mobility in the Home and in the Community

Required Reading

AGRC Online Curriculum (Module Home Page )
Module One: DEMOGRAPHY AND EPIDEMIOLOGY
Module Four: ASSESSMENT OF THE GERIATRIC PATIENT
Geriatric Lectures, "Falls in the Elderly" by Bree Johnston, MD, MPH, Found at: http://www.ucop.edu/agrp/docs/sf_falls.ppt

Additional Resources

Falls and Hip Fractures Among Older Adults, CDC Fact Sheet
Preventing Falls in the Elderly, Information for Patients and their Families

Additional Recommended Reading

Podsiallo, D & Richardson, S. (1991). The Timed Up and Go: A Test of Basic Functional Mobility for Frail Elderly Person. J Am Geriatr Soc, 39, 142-148.
Tinetti, M. E., Baker, D. I., McAvay, G., et al (1994). A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med, 331, 821-827.
Tinetti, M. E., Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319, 1701-1707.
Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319, 1701-1707.

Ethics and Discussion

Additional Resources

Conservatorship Paperwork - Capacity Declaration
Advance Health Care Directive Kit - Sample from the California Medical Association

Additional Recommended Reading

Resolving Ethical Dilemmas. A Guide for Clinicians. Bernard Lo. 2000. Lippincott Williams & Wilkins. Chapters 8-13. Pages 69-111.
"Ethical Patient Care: A Casebook for Geriatric Health Care Teams."
Editors: Mezey, Mathy D.. Cassel, Christine, K., Bottrell, Melissa M., Hyer, Kathryn, Howe, Judith L., and Fulmer, Terry T. (2001) Johns Hopkins University Press.