FlourishCare Model of Integrated Care: The Validation of the Flourish Index-Revised.

Background And Objectives: This study validates the Flourish Index-Revised (FI-R), a tool evaluating integrated healthcare models. The original Flourish Index (FI) was developed in 2018 and has been refined to align with the FlourishCare (FC) Model (Model) for geriatric primary care.

Research Design And Methods: The Model provides integrated biopsychosocial healthcare to older adults.

A Statewide Survey to Understand Barriers to Utilization of the Medical Orders for Scope of Treatment Form among Emergency Medical Service Providers.

Advance care planning allows communication of end-of-life goals. The Kentucky medical orders for scope of treatment (MOST) form became a legal medical order in 2015. The Kentucky MOST Coalition formed in 2017 to implement MOST.

Exploring the intersection of structural racism and ageism in healthcare.

The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare.

The Interprofessional Education Exchange: The Impact of a Faculty Development Program in Interprofessional Palliative Oncology Education on Trainee Competencies, Skills, and Satisfaction.

The interprofessional education exchange (iPEX) provides education, training, and mentoring to select interprofessional faculty trainee teams for development and implementation of interprofessional education (IPE) in palliative oncology. To evaluate the impact of the iPEX project on trainees' self-efficacy in IPE skills and IPE competencies. A pre-/post-test design was used to evaluate trainees' progress.

"Opening eyes to real interprofessional education": results of a national faculty development initiative focused on interprofessional education in oncology palliative care.

The purpose of this study was to evaluate participants' feedback related to their experience in the Interprofessional Education Exchange (iPEX) program, a training initiative for faculty development in interprofessional oncology palliative care education. Participants voluntarily submitted a written reflection using a guide. The research team used qualitative content template analysis techniques to determine codes and categories based on the reflections and selected representative quotations (meaning units) from the data.

Pneumonia in older adults.

Purpose Of Review: The purpose of this review is to address the relevant issues surrounding older adults with community-acquired pneumonia (CAP) today.

Recent Findings: Approximately 1 million people >65 years have CAP in the US per year, which is more than previously reported (or realized). Older adults are vulnerable to the increasing prevalence of viral CAP, as the SARS-CoV-2 pandemic emphasizes, but pneumococcus is still the most common pathogen to cause CAP.

Implementing Chief Resident Immersion Training (CRIT) in the Care of Older Adults: Overcoming Barriers and Promoting Facilitators.

The Chief Resident Immersion Training (CRIT) in the Care of Older Adults curriculum was developed at Boston University School of Medicine to improve the care of older adults through an educational intervention. The curriculum targeted chief residents (CRs) because their role as mediators between learners and faculty provides the greatest potential impact for transmitting knowledge. The goals of CRIT are to: (1) provide education on geriatric principles and on teaching/leadership skills, (2) foster interdisciplinary collaboration, and (3) complete an action project.

The Relationship Between Culture of Safety and Rate of Adverse Events in Long-Term Care Facilities.

Objective: The aim of the study was to assess the relationship of culture of safety dimensions and the rate of unanticipated care outcomes in long-term care facilities (LTCFs) using the Agency for Healthcare Research and Quality framework of resident safety culture.

Methods: Cross-sectional survey data were collected on 13 dimensions of culture of safety in five LTCFs from registered nurses, licensed practical nurses (LPNs), nursing assistants, administrators/managers, administrative support, and rehabilitation staff. Secondary data on falls in the five LTCFs from quarters 1 to 3 of 2014 were obtained from the Centers for Medicare and Medicaid Services in February 2015.

Human Flourishing and Integrated Care Models: The Development of the Flourish Index.

Background And Objectives: In evaluating integrated care models, traditional quality measures do not account for functional and quality of life factors, affecting older adults with multiple chronic conditions. The objective of this study was the development and validation of the Flourish Index (FI), an instrument to evaluate integrated care, using a determinants of health model.

Research Design And Methods: The study took place within the evaluation study of the Flourish Model (FM).

Overcoming barriers to interprofessional education in gerontology: the Interprofessional Curriculum for the Care of Older Adults.

A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE) is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas.

Medicine as It Should Be: Teaching Team and Teamwork during a Palliative Care Clerkship.

Background: Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills.

Objective: Our objective was to assess the learning of senior medical students during a palliative care rotation.

A case of inappropriate apolipoprotein e testing in Alzheimer's disease due to lack of an informed consent discussion.

Background/objective: Apolipoprotein E (APOE) genetic testing is used to assist in the diagnosis of Alzheimer's Disease (AD). Whenever genetic testing is performed, an informed consent process should occur.

Methods: In this case, a patient with memory loss presented to the neurologist.

Unlocking the closed door: arguments for open access hospice.

The traditional view of standard hospice (SH) care is that once begun, the doorway toward curative and other forms of nonpalliative treatment is irrevocably locked. We will argue that such a traditional view needs to be reassessed in light of new arguments and data regarding access to these avenues of treatment. We will argue that patients should be supported in their transition from SH to open access hospice (OAH).

A nationwide VA palliative care quality measure: the family assessment of treatment at the end of life.

Objectives: To evaluate the FATE (Family Assessment of Treatment at End of Life) Survey for use as a nationwide quality measure in the VA health care system.

Design: Nationwide telephone survey.

Setting: Five VA medical centers.

Meeting American Council of Graduate Medical Education guidelines for a palliative medicine fellowship through diverse community partnerships.

Background: The field of hospice and palliative medicine has grown to include more than 50 fellowship training programs. In 2007 hospice and palliative medicine received American Board of Medical Specialties (ABMS) recognition as a subspecialty of medicine. Palliative medicine fellowships will begin formal accreditation under the American Council of Graduate Medical Education (ACGME) in 2008.

Eliciting goals of care in a nursing home.

Objectives: To identify enablers and barriers facing providers and staff in initiating Goals of Care (GOC) discussions with patients in the nursing home.

Design: Qualitative methods, one-on-one interviews. The interviews began with eliciting the participant's definition of GOC.

Eliciting Goals of Care in a nursing home.

Objectives: To identify enablers and barriers facing providers and staff in initiating Goals of Care (GOC) discussions with patients in the nursing home.

Design: Qualitative methods, one-on-one interviews. The interviews began with eliciting the participant's definition of GOC.

Evaluation of an educational intervention to encourage advance directive discussions between medicine residents and patients.

Introduction: Most medical schools are remiss in preparing physicians in end-of-life communication skills. As a result, many residents are uncomfortable with approaching the patient, have not developed the skills required to discuss the patients' wishes, and avoid end-of-life conversations.

Objective: To evaluate an educational intervention focused on teaching residents skills to discuss advance directives.

Pneumonia in older residents of long-term care facilities.

Compared with community-dwelling persons, residents in long-term care facilities have more functional disabilities and underlying medical illnesses and are at increased risk of acquiring infectious diseases. Pneumonia is the leading cause of morbidity and mortality in this group. Risk factors include unwitnessed aspiration, sedative medication, and comorbidity.

Diagnostic challenges in Creutzfeldt-Jakob disease: case report.

Sporadic Creutzfeldt-Jakob disease (CJD) is the most common prion disease. The diagnosis can be confirmed only by histological examination of brain tissue obtained at biopsy or at autopsy. Because of the transmissible nature of the disease, autopsy or brain biopsy cannot be performed at many institutions, which poses numerous challenges in confirming the diagnosis.