Hospital to home: a geriatric educational program on effective discharge planning.

There has been increased attention on the needs of the burgeoning older adult population, with focus on the limited education and training experiences available in geriatric care. Older adults transitioning between levels of care often require increased attention, and the American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has encouraged greater training opportunities be provided to better understand the needs of this population. The Hospital to Home Program is one model of geriatric training emphasizing many of the AGS recommendations.

Integrating care when the end is near: ethical dilemmas in end-of-life care.

An integrated and collaborative team provides the best clinical care of patients and families during end-of-life moments. Behavioral Health Clinicians (BHCs) bring a skill set for facilitating team interactions, attending to group process, as well as making space for the patient or family voice in the care, often with more time available for these roles. Through a case scenario, this article explores the relevant existing codes of ethics and professional conduct for professionals practicing in integrated care settings as they pertain to end-of-life transitions and care.

Hospital to home: Improving internal medicine residents' understanding of the needs of older persons after a hospital stay.

Physicians-in-training discharge many older patients from the hospital, but few have any knowledge of what happens to the patients they send home, of how discharge plans are applied, or of the difficulties patients and their families face. The authors describe a pilot program, Hospital to Home, at the University of Rochester School of Medicine and Dentistry's internal medicine residency program, which uses home visits as an educational tool in geriatrics training. The program was begun in July 2001, and 23 residents have participated.

Family issues in a psychoeducation group for women with a BRCA mutation.

Few services exist for women who test positive for BRCA1 and BRCA2 mutations despite the distress that they and their families may experience. We present one model of a time-limited family-oriented psychoeducation group to provide information and support for nine women who received positive test results. We report on five family-oriented themes that arose from the discussions: distress about possible transmission to children; family conflict about testing; concerns about disclosure; different coping styles and decision making; and underlying family conflict and unresolved grief.