As a complementary service to our Geriatric Evaluation and Management Clinic, the geriatrics Post-Hospital Clinic (PHC) was recently established for prompt follow-up assessment and care of our geriatric patients and their caregivers after hospital discharge. This article describes the initial benefits of the PHC, which include early medical evaluation that prevented worsening of patient’s condition, medication reconciliation that prevented adverse patient outcomes, referrals to community services that augmented delivery of care, and caregiver support and education that mitigated caregiver stress. (Annals of Long-Term Care: Clinical Care and Aging 2008;16[5]:20-24)

Medical malpractice cases against long-term care (LTC) facilities and the providers who work in them are increasing. There are legitimate concerns about both the quality of care provided in LTC and the unscrupulous pursuit of unreasonable cases by aggressive plaintiffs’ attorneys. Lawsuits are expensive to defend and settle, and are both time-consuming and anxiety-producing. Following some simple risk management strategies can reduce the risk of being involved in medical malpractice litigation. These include improving communication between providers, patients, and their guardians; ensuring good documentation of care; addressing high-risk areas of care; ensuring timeliness of visits; and attention to the accuracy of admission orders. (Annals of Long-Term Care: Clinical Care and Aging 2008;16[5]:27-29)

Thirty percent of acute pancreatitis cases occur in older adults. Morbidity and mortality are increased in this population as compared with younger cohorts. Acute pancreatitis is more often caused by biliary obstruction and less often caused by alcohol in older patients. Elevations of serum amylase and lipase are nonspecific, occurring in a variety of nonpancreatic disorders, many of which have overlapping clinical signs and symptoms. The diagnosis may be more challenging in geriatric patients due to normal aging changes of pancreatic parenchyma and ducts, which may mimic findings in pancreatic inflammatory or neoplastic disease. Identification of adverse prognostic factors permits risk stratification leading to early contrast-enhanced computed tomography scan, prophylactic antibiotics, or transfer to an intensive care unit. To avoid misdiagnosis and improve outcomes, clinicians must be aware of the diverse spectrum of acute pancreatitis in older patients in ambulatory as well as long-