All PGY2 residents spend 4 weeks on a required Geriatrics rotation. Residents will participate in a variety of experiences with older patients in settings ranging from hospice to nursing home to primary care clinic. During the block, the resident will participate in continuity clinic four times a week at Sinai Community Care. Individual experiences are described below under teaching/ learning activities.
Goals and Objectives
Provide formal training to internal medicine residents in geriatric medical care in the primary care setting.
Provide residents with specific learning objectives, knowledge, skills, and attitudes that will prepare them to provide quality medical care to the geriatric population.
Increase the number of physicians with specific interest in geriatrics and/or gerontology.
By the end of this rotation, residents will:
Attitudes:
Have respect and compassion for older persons, with particular attention to issues of autonomy and dignity.
Appreciate the importance of maintaining and restoring function and quality of life in older adults, especially those with chronic incurable conditions.
Realize the importance of family and the entire social network in patient care.
Appreciate the value of interdisciplinary team approach.
Appreciate the heterogeneity of the elderly population
Knowledge:
Know the normal changes in physiology that accompany aging
Interpret the results of tests of physical, emotional, and cognitive abilities.
Describe risk factors for, evaluation of, and treatments for a variety of geriatric syndromes, including weight loss, polypharmacy, depression, falls, frailty, dementia, delirium, and incontinence.
Understand the principles of geriatric rehabilitation.
Appreciate the pharmacodynamic and pharmacokinetic aspects of prescribing medications to an elderly population.
Identify the roles of interdisciplinary team members.
Be able to describe the advantages and limitations of providing care to geriatric patients in a variety of settings
Strategize to minimize hospitalization and improve the transition to and from hospitals when hospitalization is necessary.
Understand how care is paid for and regulated in various care settings
Evaluate and manage patients who are dying.
Skills:
Be competent at administration and interpretation of standardized assessment instruments.
Diagnose and manage patients with multiple chronic illnesses and functional disabilities.
Diagnose and manage patients with acute and chronic medical illnesses in combination with psychiatric illness.
Be able to incorporate the patient’s values and preferences into medical decision making and goal setting.
Assess decision making capacity and assist in establishing medical care directives.
Effectively participate in interdisciplinary teams.
Be able to coordinate care between settings (acute care, chronic care and nursing home).