Issue

Assistive and Smart Technologies: Improving Older Adults’ Quality of Life

admin — Fri, 05 Sep 2008 17:54:52 -0400

**sub**Assistive Technologies to Improve Function**endsub**
Helen Hoenig, MD, Assistant Professor, Division of Geriatrics, Department of Medicine, Duke University, and the Center on Aging and Human Development, Duke University Medical Center, Durham, NC, began by discussing several categories of assistive devices. These mechanisms include mobility aids, walkers, and canes; bathroom equipment, such as raised toilet seats, bathtub benches, and hand-held showers; self-care devices, including reachers, long-handled sock aids and button aids; and augmentative devices, such as hearing aids and eye

Culturally-Sensitive Decision Making in End-of-Life Care

admin — Fri, 05 Sep 2008 17:54:52 -0400

**sub**Introduction to Cultural Considerations in End-of-Life Care **endsub**
Fred A. Kobylarz, MD, MPH Assistant Director of Family Practice and Assistant Professor of Family Medicine at UMDNJ – Robert Wood Johnson Medical School, New Brunswick, NJ, opened the symposium with statistics on minority groups among the elderly in the United States. Presently, over 16% of American older adults belong to ethnic minority groups, with an increase of 217% projected for the future. Hispanic-Americans are predicted to increase by 320%; African-Americans by 130%; Asian-Pacific Islanders by 295%; and

To Force Feed the Patient With Dementia or Not to Feed: Preferences, Evidence Base, and Regulation

admin — Fri, 05 Sep 2008 17:54:52 -0400

Michael D. Cantor, MD, JD, Special Assistant to the Director, National Center for Ethics, Department of Veterans Affairs, Washington, DC, discussed when and if food and water can be withheld from a nursing home resident. There are three important considerations when making this determination: autonomy, surrogate decision-making, and the best-interest approach.

Dr. Cantor used a case discussion to illustrate a person who fits the common profile of someone who resides in a nursing home. Mr. Smith is an 89-year-old resident with advanced Alzheimer’s disease (AD) who is dependent for all of

From the 5th Edition of the Geriatrics Review Syllabus: Gastrointestinal and Oral Diseases & Disorders

admin — Fri, 05 Sep 2008 17:54:52 -0400

Karen E. Hall, MD, PhD, Assistant Professor at the Department of Internal Medicine, Division of Geriatric Medicine, University of Michigan, Ann Arbor, and Research Scientist, GRECC, at the Ann Arbor VA Medical Center, MI, suggested that esophageal cancer, like colon cancer, may begin with a progression of mutations rather than a single causative event such as acid reflux.

Current recommendations include that patients with high-grade dysplastic lesions should be referred for endoscopy (to rule out Barrett’s esophagus) and possible surgery. Dr. Hall feels, however, that patients with m

Legal and Criminal Investigation of Health Care Fraud in the Long-Term Care Setting

admin — Fri, 05 Sep 2008 17:54:52 -0400

**sub**Investigation of Health Care Fraud Among Long-Term Care Practitioners **endsub**
Stuart Silver, a Supervisory Special Agent of the FBI, Atlanta, GA, who heads a squad of agents investigating health care fraud in Atlanta and monitors all health care fraud activity in the state of Georgia, began his presentation by quoting a startling figure of $100 billion as an estimate of the sum that is lost to health care fraud each year. He explained that this figure is obtained by calculating 10% of annual health expenditure in the country. While health expenditure is now at approximately $1.35 b

Pharmacotherapy Update 2002

admin — Fri, 05 Sep 2008 17:54:52 -0400

**sub**What’s New About Old Medications **endsub**
J. Mark Ruscin, PharmD, Assistant Professor, Department of Pharmacy Practice, University of Colorado School of Pharmacy, Denver, CO, noted that the session would focus on seven studies published within the last year, several medications approved prior to 2001, and how these all fit into the practice of geriatric medicine.

Dr. Ruscin first discussed the Warfarin and Aspirin for the Prevention of Recurrent Ischemic Stroke (WARS) study, which compared warfarin and aspirin in secondary prevention. Dr. Ruscin stated that one could conclude

From the 5th Edition of the Geriatrics Review Syllabus: Prostate Disease and Male Sexual Dysfunction

admin — Fri, 05 Sep 2008 17:54:52 -0400

**sub**Benign Prostate Diseases **endsub**
Tomas Griebling, MD, Assistant Professor of Urology and Assistant Scientist for the Center on Aging at the University of Kansas, Lawrence, KS, spoke about prostate disorders. He reviewed benign conditions of the prostate that affect older adults, including benign prostatic hyperplasia (BPH) and prostatitis.

Benign Prostatic Hyperplasia
Benign prostatic hyperplasia affects almost all men over the age of 40 in the U.S. Symptoms most commonly consist of urinary urgency, frequency, a decreased force in the urinary stream, nocturia, a feeli

Strategies for Financial Survival in Geriatric Practice: Managing a Primary Care Geriatric Practice Involved in Long-Term and A

admin — Fri, 05 Sep 2008 17:54:52 -0400

In an attempt to describe how a private group practice in geriatrics operates and the various ways in which it can be successful, Jeffrey E. Escher, MD, Acting Associate Program Director for Gerontology, and Associate Professor of Clinical Medicine, New York Medical College, used his own metropolitan New York-based practice as an example. The 20-year-old practice is located mainly in the southern part of Westchester County and the northern section of Bronx County and has contracts primarily with nursing homes, assisted living facilities, outpatient clinics, physician practice members, and nurs

Washington Update

admin — Fri, 05 Sep 2008 17:54:52 -0400

Lawmakers continue to debate the politically-charged issue of prescription drug coverage for seniors. The U.S. House of Representatives, on a near party-line vote of 221-208, approved a GOP-backed $350 billion Medicare reform package on June 28. House Democrats strongly oppose the Republican prescription drug plan contained in the bill and introduced their own 10-year drug benefit plan estimated to cost between $800 billion and $1 trillion. However, the GOP leadership blocked Democrats from offering their proposal on the House floor.

At press time, the Senate was expected to consider a dr

Who Can Stay at Home and in Command: Judging Safety and Competency in Older Individuals

admin — Fri, 05 Sep 2008 17:54:52 -0400

**sub**Overview of Factors Which Predict an Individual’s Ability to Control Personal Finances and Select Living Situations**endsub**
After older patients receive medical care, agencies are often reluctant to allow them to return to their homes if the patients are thought to be unsafe in their environment. Sanitation, spoiled food, unkempt houses, and fear that they will wander or that they will not receive sufficient care are some of the many concerns that prevent older patients from living alone. “What we’re faced with are what factors should be measured in determining whether somebody