Enhancing Advance Care Planning Communication: An Interactive Workshop With Role-Play for Students and Primary Care Clinicians.

Introduction: Increased clinician training on advance care planning (ACP) is needed. Common barriers to ACP include perceived lack of confidence, skills, and knowledge necessary to engage in these discussions. Furthermore, many clinicians feel inadequately trained in prognostication.

Handing Off the Older Patient: Improved Documentation of Geriatric Assessment in Transitions of Care.

Objectives: To improve assessment and documentation of function, cognition, and advance care planning (ACP) in admission and discharge notes on an Acute Care of the Elderly (ACE) unit.

Design: Continuous quality improvement intervention with episodic data review.

Setting: ACE unit of an 866-bed academic tertiary hospital.

Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care.

Advance care planning (ACP) is increasingly implemented in oncology and beyond, but a definition of ACP and recommendations concerning its use are lacking. We used a formal Delphi consensus process to help develop a definition of ACP and provide recommendations for its application. Of the 109 experts (82 from Europe, 16 from North America, and 11 from Australia) who rated the ACP definitions and its 41 recommendations, agreement for each definition or recommendation was between 68-100%.

Discussing physician-assisted dying: physicians' experiences in the United States and the Netherlands.

Purpose Of The Study: This study aims to further our understanding of the experiences of physicians when discussing physician-assisted dying (PAD) within the context of doctor-patient relationships in various sociolegal settings. Although patients bring up PAD in diverse settings, little is known about how physicians experience these discussions, and such experiences have not been directly compared across countries.

Design And Methods: A total of 36 physicians in the Netherlands and the United States (including Oregon) were interviewed using individual semistructured interview guides.

Approaches to suffering at the end of life: the use of sedation in the USA and Netherlands.

Background: Studies describing physicians' experiences with sedation at the end of life are indispensible for informed palliative care practice, but they are scarce. We describe the accounts of physicians from the USA and the Netherlands, two countries with different regulations on end-of-life decisions regarding their use of sedation.

Methods: Qualitative face-to-face interviews were held in 2007-2008 with 36 physicians (18 from the Netherlands, 18 from the USA), including primary care physicians and specialists.

Gynecologic care of elderly women.

Evaluation and management strategies for addressing abnormal bleeding, discharge, urinary symptoms, and sexuality amongst elderly women are presented.

Perceived needs for geriatric education by medical students, internal medicine residents and faculty.

Context: Traditional methods of setting curricular guidelines using experts or consensus panels may miss important areas of knowledge, skills, and attitudes that need to be addressed in the training of medical students and residents.

Objective: To seek input from medical students and internal medicine residents ("trainees") on their perception of their needs for training in Geriatrics.

Design: Two assessment methods were used (1) focus groups with students and residents were conducted by professional facilitators and the transcripts analyzed for areas of agreement and divergence and (2) geriatric medicine experts and ward attendings were surveyed to examine training gaps raised by trainees during Geriatric Guest Attending Rounds.

Potentially modifiable resident characteristics that are associated with physical or verbal aggression among nursing home residents with dementia.

Background: Physical aggression by nursing home residents is a burden to residents and staff. The identification of modifiable correlates would facilitate developing preventive strategies. The objectives of the study were to determine potentially modifiable resident characteristics that are associated with physical aggression and to correlate these characteristics with verbal aggression.

Nursing home practitioner survey of diagnostic criteria for urinary tract infections.

Objectives: To identify clinical and laboratory criteria used by nursing home practitioners for diagnosis and treatment of urinary tract infections (UTIs) in nursing home residents. To determine practitioner knowledge of the most commonly used consensus criteria (i.e.