Effect of an innovative model of complexity care on family caregiver experience: Qualitative study in family practice.

Objective: To investigate the experiences of family caregivers who participated in an innovative model of interprofessional team-based care specifically designed for elderly patients with complex care needs.

Design: Qualitative study.

Setting: Large academic family practice in Toronto, Ont.

The IMPACT clinic: innovative model of interprofessional primary care for elderly patients with complex health care needs.

Problem Addressed: The growing number of elderly patients with multiple chronic conditions presents an urgent challenge in primary care. Current practice models are not well suited to addressing the complex health care needs of this patient population.

Objective Of Program: The primary objective of the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic was to design and evaluate a new interprofessional model of care for community-dwelling seniors with complex health care needs.

The assessment and treatment of a complex geriatric patient by an interprofessional primary care team.

Mr K is an 89-year-old married man with a number of comorbid conditions and multiple recent falls. He was referred to the IMPACT clinic (Interprofessional Model of Practice for Aging and Complex Treatments) as his primary care physician was concerned about his declining health and the growing care giver burden on his wife. Mr K's condition was deteriorating while the complexity of his case was increasing; therefore, an in-depth team assessment was sought to determine the best management plan and to assess his capacity to remain at home (his expressed preference).

Still dizzy after all these years: a 90-year-old woman with a 54-year history of dizziness.

This report presents the case of a 90-year-old female with a 54-year history of dizziness, which has been exhaustively investigated. Over the years, the patient made 59 visits to her family doctor and 18 visits to various specialists, as well as emergency department visits and hospitalisations. In detailing the exhaustive investigations and referrals that the patient has undergone over many years (with inconclusive results), this case illustrates the myriad challenges in diagnosing and treating chronic dizziness in the older.

The remarkably high prevalence of epilepsy and seizure history in fetal alcohol spectrum disorders.

Background: Fetal alcohol spectrum disorder (FASD) is the umbrella term that describes the range of adverse developmental outcomes that may occur in the offspring of mothers who drink alcohol during pregnancy. FASD is associated with several comorbidities including epilepsy. The objective of the study was to evaluate the prevalence of epilepsy or a history of seizures in subjects with FASD and the contribution of relevant risk factors.