Geriatrics fellowship during COVID-19: expanding impact, using innovation and maintaining balance.

The COVID-19 pandemic provided an opportunity for geriatricians, especially geriatrics fellows, to demonstrate leadership in a crisis that has significantly affected the 65 and older demographic. Given their expertise in care delivery to complex, multimorbid patients, as well as their ability to navigate different healthcare settings, geriatrics fellows became a valuable resource during the pandemic, particularly at one large, urban academic health system. Their training in patient-centered, value-based care helped determine the best course of action for patients not only in the hospital, but also in the community.

Using Medicare Annual Wellness Visits and telehealth to enhance ambulatory geriatrics education among medical students.

The Medicare Annual Wellness visit (AWV) was mandated as a fully covered benefit for older adults to enhance preventive care and improve healthcare outcomes. Although the benefit of conducting AWV is proven, its adoption in primary care is far from universal. The COVID-19 pandemic affected medical education and clinical care in unprecedented ways.

Navigating the Cancer Screening Decision for Patients with Dementia.

Purpose Of Review: The risks of developing cancer and dementia both increase with age, giving rise to the complex question of whether continued cancer screening for older dementia patients is appropriate. This paper offers a practice-based clinical approach to determine an answer to this challenging question.

Recent Findings: There is no consensus on the prevalence of cancer and dementia as co-diagnoses.

Geriatrics and palliative medicine leadership is needed now more than ever: What are the training gaps?

Background: Geriatrics and palliative medicine specialists are uniquely trained to provide expert coordinated care for older adults and seriously ill and complex patients. Health system leadership geared towards this patient population is critically important as society ages. Currently, there is no standardized approach to teaching core leadership skills.

Creating a Colocation Unit for End-of-Life Care during a Pandemic.

Palliative care seeks to support the physical, psycho-social and spiritual needs of patients and families who are facing life threatening diseases. Advantages of establishing a palliative care unit, or alternatively co-locating patients, include promoting optimal physical and psychological symptom management; increased family satisfaction; and facilitating resource allocation. To design a stand-alone hospital unit to provide end of life care during a pandemic.

ACE Model for Older Adults in ED.

The emergency department (ED) is uniquely positioned to improve care for older adults and affect patient outcome trajectories. The Mount Sinai Hospital ED cares for 15,000+ patients >65 years old annually. From 2012 to 2015, emergency care in a dedicated Geriatric Emergency Department (GED) replicated an Acute Care for Elderly (ACE) model, with focused assessments on common geriatric syndromes and daily comprehensive interdisciplinary team (IDT) meetings for high-risk patients.

Building a Supportive Oncology Practice that Impacts Emergency Department Visits, Hospice Utilization, and Hospital Admission.

Introduction: Palliative care remains underutilized despite evidence supporting its value. Multiple professional organizations have endorsed broader and earlier access to palliative care, yet barriers exist that impede successful implementation of palliative care. We report on development of an ambulatory palliative medicine practice (Supportive Oncology) embedded within an academic cancer center.

Integrating case management and palliative care.

Most seriously ill Americans live at home under the care of their primary physician and with the support of family caregivers. To reduce costs while simultaneously improving the quality of patient care, insurers have increasingly turned to the concept of case management. While case management is targeted to individuals with life-threatening illnesses, palliative care assessment and interventions are typically not included in the management protocols.

Geriatric hospital medicine.

Over the last decade, there have been dramatic developments in hospital geriatric care. These improved practices have been supported by the development of quality indicators, which allow physicians and other health care professionals to monitor and measure targeted processes and outcomes of care. This new understanding of the clinical complexity and heterogeneity of the hospitalized elderly population should not be perceived as solely the purview of geriatricians.

Assessing the outcome of a palliative care educational initiative.

Purpose: In 1997, a biweekly, 18-month Palliative Care Seminar Series was started at Mount Sinai School of Medicine as a way to explore participants' beliefs about palliative care and to instill the knowledge, skills, and attitudes needed to improve care at the end of life. The goal of this study was to examine the effects of Mount Sinai's Palliative Care Seminar Series on faculty development and personal growth.

Methods: Twenty of 42 respondents were interviewed immediately after completing the Seminar Series.