Saturday, May 5, 2012

6:30 AM - 12:30 PM
GERIATRIC SURGERY: WE CAN CUT, BUT CAN WE CARE
The Eleventh Annual Meeting of the Section for Enhancing Geriatric Understanding and Expertise among Surgical and Medical Specialists (SEGUE)
CME/CE Credit: 4                   Track: Clinical Practice
Developed and supported by The John A. Hartford Foundation supported Geriatrics-for-Specialists project, Increasing Geriatrics Expertise in Surgical and Related Medical Specialties. This session will focus on two cases: hospitalization of the geriatric patient and the effect on the caretaker and the family; and the peri-operative management of the "Do Not Resuscitate" order. Learning objectives: (1) identify time and financial constraints for the caretaker of an older adult; (2) discuss issues surrounding transitions of care and identify strategies to implement them; and (3) describe and discuss ethical and legal considerations for do not resuscitate orders.

6:30	Breakfast
7:00	Multi-Morbidity Update Jerome Epplin, MD, Litchfield Family Practice Center & Joseph Shega, MD, University of Chicago Medical Center
7:45	Hospitalization of the Geriatric Patient: The Ripple Effect for the Caregiver Moderator: Arvind Nana, MD, University of North Texas Health Science Center Caregiver Burden for the Acutely Hospitalized Geriatric Patient Barbara Muntz, RN, Visiting Nurse Association of Texas Transitions of Care - Options and Issues Amit A. Shah, MD, UT Southwestern Medical Center Case discussion with audience participation Moderator and panelists
9:30	Re-Inventing Risk: Classification and Its Consequences for Surgery in the Elderly Mark D. Neuman, MD, Penn Medicine
10:15	Break
10:30	The Peri-Operative Management of the "Do Not Resuscitate" Order Moderator: Thomas Robinson, MD Nursing Home Patients Undergoing Abdominal Operations - What Outcomes Can We Expect? Emily Finlayson, MD, MS, University of California, San Francisco Why Do Patients Request "Do Not Resuscitate"? Robert A. Pearlman, MD, MPH, University of Washington Ethical Issues for Withdrawing Do Not Resuscitate Orders around An Operation Margaret L. Schwarze, MD, University of Wisconsin Legal Implications of Withdrawing Do Not Resuscitate Orders Cindy Jacobs, RN, JD, University of Washington Revocation of Do Not Resuscitate Orders - What's a Reasonable Peri-Operative Strategy? Geoffrey P. Dunn, MD, FACS, Hamot Medical Center

PLENARY SYMPOSIUM

7:30 – 9:00 AM 
GERIATRICS LITERATURE UPDATE 2012
CME/CE Credit: 1.5                   Track: Clinical Practice
Speakers: William J. Hall, MD, Fine Professor of Medicine, University of Rochester School of Medicine,
Center for Healthy Aging and Robert M. McCann, MD, Professor of Medicine, University of Rochester School of Medicine
Drs. Hall and McCann will review the year's most important published papers. Discussion includes the significance of findings and application to patient care.  Learning objectives: (1) identify areas in clinical medicine where new strong evidence has been uncovered that should affect geriatric practice; and (2) describe the results of a critical appraisal of this evidence; and (3) discuss clinical advances in caring for older adults from a review of approximately 30 peer-reviewed journals January-December, 2011.

9:00 – 10:30 AM 
GUIDING PRINCIPLES FOR THE CARE OF OLDER ADULTS WITH MULTIMORBIDITY: AN APPROACH FOR CLINICIANS
Room: 6 B/C
CME/CE Credit: 1.5                   Track: Clinical Practice
Co-Moderators: Cynthia M. Boyd, MD, Johns Hopkins University & Matthew K. McNabney, MD, Johns Hopkins University
In 2011, the AGS convened an interdisciplinary panel to develop an approach by which clinicians can interpret clinical practice guidelines when caring for older adults with multimorbidity. After a thorough literature review, the panel agreed upon a set of guiding principles for the clinical management of multimorbid patients. This program will present an overview of the guiding principles, strategies for their clinical application, and recommendations for a future research agenda. Learning objectives: (1) describe principles in applying clinical guidelines to multimorbid patients; (2) discuss strategies for applying these principles in a clinical setting; (3) identify barriers to the clinical application of these guiding principles and discuss solutions for overcoming these barriers.

Background and Process of the Interdisciplinary Panel
Matthew K. McNabney, MD, Johns Hopkins University

Guiding Principles for the Care of Older Adults with Multimorbidity
Cynthia M. Boyd, MD, MPH, Johns Hopkins University

Implementing the Principles in Your Practice
Holly M. Holmes, MD, UT MD Anderson Cancer Center

Controversies and Challenges
Nicole J. Brandt, PharmD, CGP, BCPP, FASCP, University of Maryland

Takeaways & Future Research Agenda
Christine S. Ritchie, MD, MSPH, University of California, San Francisco

Question and Answer

 

SYMPOSIA
10:45 AM – 12:15 PM
State-of-the-Art Clinical Updates Session – Part 1
Moderator: Kenneth E. Schmader, MD, Duke University Medical Center
This session will present cutting-edge clinical material, and offer pragmatic advice on how to put this information into practice. Learning objectives: (1) discuss clinical impact/outcomes related to hypertension; (2) discuss clinical impact/outcomes related to nosocomial infections; (3) discuss clinical impact/outcomes related to dermatology.

Hypertension
Mark A. Supiano, MD, University of Utah

Nosocomial Infections
Suzanne F. Bradley, MD, University of Michigan Medical School

Dermatology
Wendy E. Roberts, MD, Generational and Cosmetic Dermatology

 

10:45 AM – 12:15 PM
CONTROVERSIES IN DRUG TREATMENT OF ALZHEIMER DISEASE: WHAT IS MEANINGFUL BENEFIT? 
CME/CE Credit: 1.5                   Track: Clinical Practice
Moderator: G. Michael Harper, MD, Associate Chief of Staff for Geriatrics, Palliative and Extended Care, San Francisco VA Medical Center
Two expert faculty will engage in a  point/counterpoint debate about whether cholinesterase inhibitors provide meaningful benefit.  The session will focus on 3 clinical scenarios:  To start or not? To stop or not? What about the 23 mg formulation?  Learning objectives: (1) review randomized clinical trial data with an emphasis on outcomes that are meaningful to patient or caregiver; (2) discuss potential benefits, harms, and burden of cholinesterase inhibitors.

ProJacobo E. Mintzer, MD, Professor of Psychiatry and Neurosciences, Co-Director of Alzheimer's
Research & Clinical Programs, Medical University of South Carolina

 

Con
Thomas E. Finucane, MD, Professor of Medicine, Johns Hopkins University

10:45 AM – 12:15 PM
UPDATE IN SMART HOME TECHNOLOGIES: “GETTING SMARTER AS WE AGE"
CME/CE Credit: 1.5                   Track: Clinical Practice
Moderator: Lee D. Burnside, MD, MBA, Fellow, Department of Geriatrics, University of Washington
This session will provide the audience with an up to date picture of current, cutting edge, home monitoring (smart home) and tele-health technology for older adults. The presenters will describe application of technology being used to promote independence and safety in older adults who are living independently.
The discussion will include how this technology will bridge the gap between data gathering and extrapolation to clinical application.  Learning objectives: (1) describe current state of research in smart home technology and understand how improved use of smart home technology can provide an increased level of clinical information; (2) discuss how application of home technologies can improve safety, cost and quality of care for older independent individuals; (3) review future trends, challenges, and directions in technology development for older adults and their implications for various demographics; and (4) describe barriers to use including costs, clinical limitations, current legislative framework, patient and family acceptance, technological limitations and societal acceptance.

Smart Home Technology – Current Application and Data Extrapolation
Maureen Schmitter-Edgecombe, PhD, Professor of Psychology, Meyer Distinguished Professor, Washington State University

Gauging Health and Independence: Ambient Independence Measurement with Home-based Pervasive Computing Systems
Jeffrey A. Kaye, MD, Professor of Neurology and Biomedical Engineering, Oregon Health and Science University

Using Telehealth in the Home
George Demiris, PhD, FACMI, Professor, University of Washington, Director, Clinical Informatics and Patient Centered Technologies

10:45 AM – 12:15 PM
GOLD MINE OR MINE FIELD: PRACTICAL ISSUES FOR INVESTIGATORS CHOOSING AND USING SECONDARY DATA
CME/CE Credit: 1.5                   Track: Research
Co-Moderators: Amy S. Kelley, MD, MSHS, Assistant Professor, Mount Sinai School of Medicine; Stephen Thielke, MD, MSPH, Assistant Professor of Psychiatry and Behavioral Sciences, University of Washington; and Dae Hyun Kim, MD, MPH, Staff Physician, Beth Israel Deaconess Medical Center
Developed by the Research Committee and the Junior Faculty Research Special Interest Group.
Geared toward investigators in aging research who are interested in, intending to use, or currently using secondary data, this session will discuss some of the common opportunities and challenges in using secondary data for grant applications and papers.  Learning objectives: (1) determine if existing data sources (investigator-initiated and/or administrative) are adequate to answer the research questions of interest; (2) describe ways to develop an appropriate study design for studies using secondary data and avoid common analytical pitfalls; (3) utilize tips for effective and efficient use of existing investigator-initiated and administrative databases for scientific papers and grant applications; and (4) recognize common technical and administrative challenges in using existing databases including access, cost, and IRB review for human subject research.

Using Secondary Data from Investigator-Initiated Studies: From Research Question to Publication
Jay Magaziner, PhD, MSHyg, Professor and Chair, Department of Epidemiology and Public Health, School of Medicine, University of Maryland 

Building a Relationship with Your Data: First Introduction to Funded Research
Kenneth E. Covinsky, MD, MPH, Professor of Medicine, UCSF

Practical Considerations When Working with Administrative and Federal Data
Ellen P. McCarthy, PhD, MPH, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center  

PAPER SESSION

10:45 AM - 12:15 PM
EPIDEMIOLOGY
Room: 616/617
CME/CE Credit: 1.5                   Track: Research
Developed by the Research Committee
Moderator: Susan Hardy, MD, PhD, University of Pittsburgh School of Medicine
This session presents the latest peer-reviewed research focused on epidemiology with questions and answers to follow. Learning objective: (1) discuss new original research related to epidemiology.

P28 - Risk Factors for Restricting Back Pain in Community-Living Older Persons
Una E. Makris, MD, Yale University

P29 - Falls and Orthostatic Hypotension: Re-examining Limits
Alycia A. Cleinman, MD, University of Mississippi Medical Center

P30 - Sensory and Motor Nerve Function Differentially Relate to Gait Parameters: The Health ABC Study
Elizabeth S. Hile, PhD, PT, NCS, University of Pittsburgh

P31 - Anticholinergic Medication Use, Falls and Fracture in Postmenopausal Women: Results from the Women's Health Initiative
Heidi S. Wirtz, MS, PharmD, University of Washington

P32 - Falls among Adult Patients Hospitalized in the United States: Prevalence and Trends
Erin LD Bouldin, MPH, VA Puget Sound Health Care System

P33 - Psychotropic Drug Changes and Falls in the Nursing Home
Murray Echt, SUNY Downstate Medical Center College of Medicine

 

WORKSHOPS

10:45 AM – 12:15 PM
MODEL GERIATRIC PROGRAMS: GERIATRIC EDUCATION MATERIALS AND METHODS SWAP
CME/CE Credit: 1.5                   Track: Education
Developed by the Teachers Section and sponsored by the Education Committee. 
Moderator: TBA
This workshop presents a forum for teachers of geriatrics education to share topics and materials of common interest, such as program development, curriculum, and educational process and research in teaching and evaluation. Learning objective: (1) describe and exchange geriatrics education and teaching materials.

STEADI-A Fall Prevention Tool kit for Healthcare Providers
Judy Stevens, PhD, National Center for Injury Prevention & Control, Centers for Disease Control & Prevention

Interprofessional Geriatric Clinical Skills Fair
Brooke E. Salzman, MD, Thomas Jefferson University

Improving Uptake of a Falls Educational Program by Focusing on Staff Interactions
Cathleen Colon-Emeric, MD, MHS, GRECC, Duke University, Durham VA Medical Center

Simulation Fosters Interprofessional Skills among Nursing, Pharmacy and Medical Students
Lisa C. Hutchison, PharmD, MPH, BCPS, University of Arkansas for Medical Sciences

An Intervention to Improve Medical Students' Interprofessional Acumen
Rollin M. Wright, MD, MPH, University of Pittsburgh

Community Based Advance Care Planning Education for Older Adults
Charles W. Johnston RN, BSN, UC Davis School of Nursing

 

10:45 AM – 12:15 PM
CODING AND REIMBURSEMENT: STUMP THE PROFESSOR
CME/CE Credit: 1.5                   Track: Clinical Practice
Speaker: Peter Hollmann, MD, Associate Chief Medical Officer, Blue Cross & Blue Shield of Rhode Island
This open workshop will focus on answering your questions about CPT coding and billing, reimbursement rules and related practice management issues. Learning objectives: (1) discuss CPT coding and billing; and (2) describe the PQRI and how this can affect your practice.

SPECIAL INTEREST GROUPS

10:45 AM – 12:15 PM
GERIATRICS CONSULTATIVE SERVICES
Track: Networking
Chair: Taryn Lee, MD
This meeting is open to anyone who provides or is interested in providing geriatric medicine consultative services. Participants will have an opportunity to learn from other practitioners how geriatrics consultative services are provided in various clinical settings. Discussion topics will include the extent to which our services are in demand; types of patients whom we are asked to see; various collaborative efforts with other services; billing processes and concerns; incorporating geriatrics teaching within the consultative setting; and types of problems we encounter.

10:45 AM – 12:15 PM
INFORMATION TECHNOLOGY ISSUES
Track: Networking
Chair:    F. Michael Gloth, III, MD, AGSF
The IT Issues Special Interest Group provides information, support and an organized center for coordinating information and resources to optimize the use of electronic health records in a senior health care environment.  This includes ambulatory and long-term care senior health care settings.  Additionally, the SIG is interested in the use of computerized records to facilitate transitions of care from one setting to another. Beyond the interest in improving communication and health information exchange, this SIG also encompasses interests in telemedicine and computerized assessment/biotechnology advancements.  The current politics of health care reform, reimbursement and research as applicable to information technology are also areas of intense interest for this SIG.

10:45 AM - 12:15 PM
LONG TERM CARE
Room: 615
Track: Networking
Chair: Lynn Chrismer, MD
SIG for Long Term Care is intended for those attendees involved or interested in long term care. It is intended to be a forum to discuss and share information pertaining to current issues in long term care.

10:45 AM – 12:15 PM
OSTEOPOROSIS AND METABOLIC BONE DISEASE
Track: Networking
Chair: Kenneth W. Lyles, MD
The Osteoporosis and Metabolic Bone Diseases Special Interest Group (SIG) will meet to discuss future strategies to promote improved education and care with regards to bone loss in older adults.  The meeting agenda will include developing a symposium topic for the 2013 meeting and establishing leadership for that program.  Other agenda items will include venues for increased communication during the year among the SIG membership, other projects that may be useful in promoting better bone health among seniors, and clarification of the SIG's mission and goals. Anyone interested in participating in the Osteoporosis and Metabolic Bone Diseases SIG is invited to attend the meeting.

11:00 AM – 12:30 PM
RESIDENT & OTHER POSTGRADUATE TRAINEE/ STUDENT POSTER SESSIONS
Track: Research

12:30 – 2:00 PM
RESIDENTS & OTHER POSTGRADUATE TRAINEES LUNCH
Track: Networking
Chairs: Susan Nathan, MD; Lorand Kristof, MD; Ravi Shankar, MD; Liviu Zaha, MD & Gina Luciano, MD
All residents and other postgraduate trainees are encouraged to attend this special interest group meeting. Come and meet others and discuss your own ideas about the field and ways to get more involved in AGS. Geriatricians will be present to discuss geriatrics as a career and opportunities in the field. Lunch will be served.

12:30 – 2:00 PM
AGS/AFAR/JOHN A. HARTFORD FOUNDATION STUDENT POSTER SESSION LUNCH
Track: Networking
Supported by the AGS Foundation for Health in Aging Student Researcher Fund.
The Student Poster Session enables students who participated in the Hartford/AFAR Student Geriatric Scholars Program and other students from all health professional disciplines who are presenting research at the AGS Annual Meeting to discuss their research findings with peers and with leaders in geriatrics and aging research.  Lunch will be served.

SYMPOSIA

12:30 – 2:00 PM
State-of-the-Art Clinical Updates Session – Part II
CME/CE Credit: 1.5                   Track: Clinical Practice
Moderator: Kenneth E. Schmader, MD, Duke University Medical Center
This session will present cutting-edge clinical material, and offer pragmatic advice on how to put this information into practice.
Learning objectives: (1) discuss clinical impact/outcomes related to urinary incontinence; (2) discuss clinical impact/outcomes related to osteoporosis; (3) discuss clinical impact/outcomes related to pressure ulcers.

Urinary Incontinence
Patricia S. Goode, MSN, MD, University of Alabama at Birmingham

Osteoporosis
Kenneth W. Lyles, MD, Duke University

Pressure Ulcers
Barbara M. Bates-Jensen, PhD, RN, FAAN, University of California, Los Angeles

 

12:30 – 2:00 PM
EFFECTIVE CARE TRANSITIONS: THE CALL FOR GERIATRIC LEADERSHIP
CME/CE Credit: 1.5                   Track: Clinical Practice
Moderator: Sally L. Brooks, MD
This session will create the “business case" for Geriatric Medicine and Inter-disciplinary Teams by targeting resources in improving Care Transitions and decreasing avoidable re-hospitalizations. The call for action is now as Hospital and Healthcare Systems respond to the Affordable Care Act and Payers and Physician leaders prepare for an ACO future. Our Society membership created the foundation for these principles of right care, right time, and right place.  Learning objectives: (1) describe the array of interdisciplinary team care management strategies to improve hospital-to-home care management for a variety of specific conditions; (2) utilize strategies to  create the business case with principles that are scalable and replicable in older adult care sites.

Successful Hospital-to-Home Care Management Programs for CHF Patients
Michael W. Rich, MD, AGSF, Washington University School of Medicine

The Urgency for Geriatric Care Leadership Given the Current Healthcare Trends and Environment
Sally L. Brooks, MD, AGSF, Kindred Healthcare

Building a Practice Model with Effective Care Transition Results
Jerome Wilborn, MD, IPC

A Business Case for a Replicable Care Transitions Model
Kyle R. Allen, DO, AGSF, Riverside Health System

12:30 – 2:00 PM
SURVIVAL, DECISION-MAKING AND PALLIATIVE CARE OPTIONS FOR END-STAGE KIDNEY DISEASE
CME/CE Credit: 1.5                   Track: Clinical Practice
Developed by the Ethics Committee.
Moderator: Elizabeth K. Vig, MD, MPH, Assistant Professor, University of Washington, Staff Physician
VA Puget Sound Health Care System
This session will present the benefits and burdens of dialysis in older patients; the Renal Physicians Association’s newly revised guidelines on Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis; and management of bothersome symptoms in older patients with kidney disease.  Learning objectives: (1) identify risk factors for longer and shorter survival after dialysis initiation in the older population; (2) describe elements of informed consent and shared decision-making around dialysis initiation in older patients; (3) assess and manage physical and psychological symptoms in older patients with advanced kidney disease; and (4) describe hospice eligibility criteria for patients with advanced kidney disease.

Helping Older Patients Make Informed Decisions About Dialysis Initiation
Ann O'Hare, MA, MD, Associate Professor, Division of Nephrology, University of Washington

Dialysis Decisions in Older Individuals
Elizabeth K. Vig, MD, MPH

Identifying and Managing the Palliative Care Needs of Older Patients with Kidney Disease
Darrell Owens, DNP, ARNP, Director of Outpatient Palliative Medicine, Harborview Medical Center

Discussion of Cases

PAPER SESSION

12:30 - 2:00 PM
GERIATRIC EDUCATION
CME/CE Credit: 1.5                   Track: Research
Developed by the Research Committee
Moderator: Reena Karani, MD, Mount Sinai School of Medicine
This session presents the latest peer-reviewed research focused on geriatric education with questions and answers to follow. Learning objective: (1) discuss new original research related to geriatric education.

P34 - Impact of a Multi-modal Education Intervention on Urinary Catheter Utilization in Older Adult Inpatients
Richard E. Norman, BSc, MASc, University of Toronto

P35 - A Geriatrics Rotation as a Medicine Elective: A Smart Option for Medical Students?
Annie L. Nguyen, MPH, Medical College of Wisconsin

P36 - Case Presentation as a Direct Observation Method to Evaluate Internal Medicine Residents' Systems-Based Practice Competency
Karin M. Ouchida, MD, Weill Cornell Medical Center

P37 - Replicating a Chief Resident Immersion Training in Geriatrics (CRIT)
Sharon A. Levine, MD, Boston University School of Medicine

P38 - Development and Validation of a Geriatrics Knowledge Test to Evaluate Geriatrics Fellowship Programs
Alia T. Tuqan, MD, University of California, Los Angeles

P39 - The UCSF Interprofessional Aging and Palliative Care Elective
Josette A.Rivera, MD, University of California, San Francisco

 

WORKSHOP

12:30 - 2:00 PM
EDUCATIONAL PRODUCT DEVELOPMENT PEER REVIEW WORKSHOP
CME/CE Credit: 1.5                   Track: Education
Facilitators: Anne Fabiny, MD, Harvard Medical School; Jonathan M. Flacker, MD, AGSF, The Emory Clinic at Wesley Woods; Annette Medina-Walpole, MD, AGSF, University of Rochester; G. Michael Harper, MD, San Francisco VA Medical Center
This session is intended to be a group peer review/ problem?solving process, where each participant has the opportunity to present an educational product they are developing to the group and get feedback about challenges they are experiencing from both their peers and an expert facilitator. Participants will also be expected to serve as peer reviewers and provide feedback to the other participants in their group. A facilitator will be assigned to each group to provide "expert" advice to supplement and enrich the conversation. Learning objectives: (1) utilize feedback received from peer review of an educational product in development; (2) clarify goals and develop action plans for the future; and (3) assess and evaluate challenges experienced by their peers.

12:30 – 2:00 PM
CANCER IN LONG TERM CARE
CME/CE Credit: 1.5                   Track: Clinical Practice
Developed by the Cancer and Aging Special Interest Group & Long Term Care Special Interest Group.
Moderator: Beatriz Korc-Grodzicki, MD, PhD, Chief of Geriatric Service, Memorial Sloan Kettering Cancer Center
The purpose of this workshop is to describe the types of cancer patients in long term care and to provide a framework for clinical decision making. This workshop will discuss some of the challenges in caring for older cancer patients that are residents of nursing homes (NH) including 1) understanding the benefits and risks of providing standard therapy to a vulnerable population 2) presenting best estimates of the current burden of cancer in the long-term-care population, 3) providing a review of the current screening guidelines as they apply to elderly long-term-care patients, and 4) offering experienced-based suggestions for clinicians to help them respond to patient and family concerns about the limitations of cancer care.  Learning objectives: (1) describe the types of cancer patients and the range of acuity in the NH; (2) develop skills for interpreting cancer survival data for patients with other life limiting geriatric conditions; (3) discuss benefits and burdens of cancer screening in the NH; and (4) talk clearly and openly about prognosis and life expectancy with long-term-care residents and their families.

Long-Term Care and Its Resident. Estimating Life Expectancy
Miriam B. Rodin, MD, PhD, CMD, Associate Professor Geriatrics, St. Louis University Medical School

Should this Patient be Screened for Cancer?
James A. Wallace, MD, Co-Director Specialized Oncologic Care and Research of the Elderly (SOCARE), University of Chicago – Oncology/Geriatrics 

How to Discuss Cancer in the Nursing Home with Patients and Families
Rachelle Bernacki, MD, MS, Director of Quality Initiatives, Pain and Palliative Care Program, Dana Farber Cancer Institute

12:30 – 2:00 PM
GENETICS OF LONGEVITY
CME/CE Credit: 1.5                   Track: ResearchDeveloped by the Research Committee.
Moderator: Luigi Ferrucci, MD
Research suggests that human longevity is partly heritable. Longevity genes might slow down the rate of age-related changes in cells, increase resistance to environmental stresses and prevent major chronic diseases and aging phenotypes. This symposium will summarize the state of the art evidence on the genetic component of longevity and start thinking about possible new direction for the future.  Learning objectives: (1) review what genes, combination of genes or gene expression profiles are associated with extreme longevity.

The Genetics of Longevity in Human Studies
Anne B. Newman, MD, MPH, Chair, Department of Epidemiology and Professor of Epidemiology and Medicine, University of Pittsburgh

The Genetics Centenarians
Thomas T. Perls, MD, MPH, Associate Professor of Medicine, Boston Medical Center, Geriatrics Attending Physician and Researcher

Gene Expression and Aging Phenotypes
David Melzer, MBBCh, MSc, PhD, Professor of Epidemiology and Public Health, Peninsula Medical School, Exeter

12:30 – 2:00 PM
HEARING IMPAIRMENT: STRATEGIES TO PROMOTE SAFETY AND QUALITY OF CARE 
CME/CE Credit: 1.5                   Track: Clinical Practice
Moderator: Margaret I. Wallhagen, PhD, GNP-BC, AGSF, Professor, University of California, San Francisco
Designed for practitioners across settings who work with older adults at risk for hearing loss (HL), this workshop provides an update on age related HL; its psychosocial, physiological, and cognitive consequences; its assessment; and strategies promoting safety and quality of care. Hands on experience with technologies that facilitate hearing, including both hearing aids and assistive listening devices, and that promote safety in the home will be provided.  Learning objectives: (1) delineate current understandings regarding the pathophysiology and consequences of age related hearing loss, including its impact on quality of life, safe care, and cognitive status; (2) differentiate between peripheral, cognitive, and central problems impacting hearing; (3) discuss available technologies and resources that facilitate hearing and speech understanding; and (4) describe approaches to effectively and efficiently integrate assessment and treatment into practice routines.

Setting the Stage: Hearing Loss as a Health Issue with Implications for Quality of Life and Safe Care
Margaret I. Wallhagen, PhD, GNP-BC, AGSF

Age-Related Hearing Loss: Epidemiology and Impact on Cognitive Function
Frank R. Lin, MD, PhD, Assistant Professor, Division of Otology, Neurotology, and Skull Base Surgery Johns Hopkins Medical Institutions 

Technologies to Promote Hearing Health
Barbara Weinstein, PhD, Professor and Executive Officer, Audiology (Au.D.) Program, Graduate Center, City University of New York 

SECTION MEETING

12:30 – 2:00 PM
PHYSICIAN ASSISTANTS LUNCHEON
Co-Chairs: Kathy Kemle, MS, PA-C & Freddi Segal-Gidan, PhD, PA-C
All physician assistants are invited to attend this new Section Luncheon. The mission of the PA Section is to increase access to medical services for older adults by promoting participation of physician assistants, in partnership with geriatricians and other physicians who care for older adults throughout the medical and health care delivery system.

SPECIAL INTEREST GROUP MEETING
12:30 - 2:00 PM
MEDICAL HUMANITIES
Room: 613
Track: Networking
Chair: Louise Aronson, MD
Medical Humanities Special Interest Group: Focus on Public Medical Communication to impact policy, advocate for patients, and educate peers, policymakers, and the public in order to improve the care of older adults. Public Medical Communication (PMC) is an emerging field which trains and recognizes health professionals who engage in clear and compelling public communication about health and health care. Traditionally, health professionals have been but minor participants in most public discourse about health and medicine. As a result, medical issues often have been misinterpreted and distorted in the public sector, and opportunities have been missed to affect policy and care by accurately portraying the facts of science, the needs of the voiceless, and the realities of health care. By broadening the view of communication in medicine beyond individual patient-provider interactions and providing training in the skills and lexicon of twenty-first century communication, PMC can help geriatricians and others who care for older adults advocate for the reforms, research, teaching, care needed by elderly patients.
A brief MH SIG meeting will follow the presentation.

SYMPOSIA

2:15 – 3:45 PM
PHARMACOTHERAPY UPDATE: 2012
CME/CE Credit: 1.5                   Track: Clinical Practice
Developed by the Pharmacists Section.
Moderator: Sunny A. Linnebur, PharmD, BCPS, CGP, Associate Professor, University of Colorado School of Pharmacy
Each year, several new medications are approved by the FDA and hundreds of clinical trials are published on existing medications. This new information has an impact on decisions made by health care professionals caring for older adults. The purpose of this symposium is to summarize the changes over the past year in pharmacotherapy. The speakers will examine new information on current medications commonly prescribed to older adults and newly approved medications that may be prescribed for older adults.  Learning objectives: (1) for recently or soon to be approved medications, review the indication for use, mechanism of action, pharmacokinetics, dosing, safety and drug interactions; (2) for recently or soon to be approved medications, compare potential advantages and disadvantages of the newer medications to existing therapies; (3) provide a clinical perspective on FDA updates regarding drugs that are commonly prescribed or important to the care of older adults; and (4) integrate into clinical practice important information from black-box warnings for drugs utilized in older adults.

New Medications: Recent Releases and Coming Attractions
Joseph P. Vande Griend, PharmD, Assistant Professor, University of Colorado, Skaggs School of Pharmacy 

Clinical Perspectives on FDA Updates and Black-Box Warnings
Zachary A. Marcum, PharmD, MS, Assistant Professor, University of Pittsburgh

2:15 – 3:45 PM
H.E.L.P. TO PREVENT HOSPITAL COMPLICATIONS
CME/CE Credit: 1.5                   Track: Models of Care
Developed by the Hospital Elder Life Program Special Interest Group.
Moderator: Sharon K. Inouye, MD, MPH, Professor of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
This symposium will review the HELP model, present clinical results including challenges as well as review the financial/cost implications and benefits of implementing HELP in the hospital. Resources to facilitate individuals starting their own program will be reviewed.  Learning objectives: (1) recognize modifiable risks for delirium and ways to prevent delirium; (2) describe other benefits of HELP/Delirium Prevention, including potential clinical and financial benefits; (3) anticipate barriers/challenges to starting and maintaining a HELP program; and (4) utilize available tools and resources to support implementation of HELP at your own hospital.

What is HELP?
Heidi R. Wierman, MD, Division Director, Geriatrics, Maine Medical Center

HELP as a Model for Quality Improvement in Patient Safety for Elderly Inpatients
Fred H. Rubin, MD, AGSF, Professor of Medicine, University of Pittsburgh School of Medicine

HELP...How to Get Started and Where to go from There
Anne Pizzacalla, BScN, MHSc, Clinical Nurse Specialist, Hospital Elder Life Program Hamilton Health Sciences

2:15 – 3:45 PM
FEEDING TUBE USE IN PERSONS WITH ADVANCED DEMENTIA:  WHERE ARE WE NOW?
CME/CE Credit: 1.5                   Track: Clinical Practice
Developed by the Ethics, Ethnogeriatrics, and Clinical Practice & Models of Care Committees
Moderator:  Ramona L. Rhodes, MD, MPH, Assistant Professor of Medicine, UT Southwestern Medical Center
This educational program aims to discuss the role of the health care provider in the medical decision-making process, alternatives means of nutritional support and feeding techniques in persons with advanced dementia, and current research that is being conducted in this area.  Learning objectives: (1) identify the current landscape surrounding feeding tube insertions in persons with advanced dementia, including racial/ethnic differences in feeding tube insertion patterns; (2) examine the role of decision-support tools in tube feeding decisions in persons with advanced dementia including alternatives to oral feeding; (3) examine the role of the speech-language pathologist in evaluation and treatment of persons with advanced dementia as well as recommendations for nutritional support in this population; and (4) integrate clinical practice guidelines for feeding tube placement decisions in persons with advanced dementia and discuss culturally competent communication to assess preferences in care.

Feeding Tube Insertion among Persons with Advanced Cognitive Impairment: An Overview
Ramona L. Rhodes, MD, MPH 

Oral Feeding Options in Dementia Care and Decision-Making Tools: A Review of the Literature and Current Research
Laura C. Hanson, MD, MPH, Professor, University of North Carolina and Chapel Hill School of Medicine

Feeding Tube Placement in Advanced Dementia: The Speech-Language Pathologist’s Perspective
Helen M. Sharp, PhD, CCC-SLP, Associate Professor, Western Michigan University

Development of Community Guidelines on Long Term Feeding Tube Placement
Patricia Bomba, MD, Excellus Blue Cross Blue Shield

2:15 - 3:45 PM
AGS EXPERT PANEL RECOMMENDATIONS FOR VITAMIN D TO REDUCE FALLS AND INJURIES IN OLDER ADULTS
CME/CE Credit: 1.5                   Track: Clinical Practice
Moderator: James E. Judge, MD, Evercare
This session will review the recommendations of the AGS Expert Panel on Vitamin D supplementation to prevent falls and injuries. Learning objectives: (1) articulate the rationale that reduction in falls and fractures in older adults will require higher supplementation than recommended by the IOM report; (2) assess patients total intake of Vitamin D from all sources; (3) recommend supplementation doses -frequency and IU per dose that will enhance adherence, and achieve serum levels of about 30 ng/ml (75 nMol/l); and (4) determine when serum levels of 25 (OH) Vitamin D should be monitored.

Goals of AGS Expert Panel Convened by CDC
James E. Judge, MD, Evercare

Evidence that Geriatricians Should have a Goal of Achieving a Serum Level of 30 ng/ml (25)OH Vitamin D to Reduce Falls and Injuries in Older Adults
Douglas P. Kiel, MD, MPH, Harvard Medical School

Strategies to Achieve Vitamin D Levels that Will Reduce Falls and Fractures in Many Ways
F. Michael Gloth, III, MD, Johns Hopkins University

 

PAPER SESSION

2:15 - 3:45 PM
HEALTH SERVICES & POLICY RESEARCH
CME/CE Credit: 1.5                   Track: Research
Developed by the Research Committee
Moderator: TBA
This session presents the latest peer-reviewed research focused on health services and policy research with questions and answers to follow. Learning objective: (1) discuss new original research related to health services and policy research.

P40 - Hospitalizations in Pace
Bruce Kinosian, MD, University of Pennsylvania

P41 - Evaluation of a National Care Transition Program
Shiou-Liang Wee, PhD, Agency for Integrated Care (Singapore)

P42 - The Epidemiology of Physically and Verbally Aggressive Behaviors of Nursing Home Residents Directed at Staff
Mark S. Lachs, MD, MPH, Weill Medical College of Cornell University

P43 - Defining Medically Complex Patients Using Chronic Conditions, Healthcare Utilization and Functional Status
William W. Hung, MD, MPH, Mount Sinai School of Medicine

P44 - Risk Factors for Early Hospital Readmission among Low Income Seniors
Tochukwu C. Iloabuchi, MBBS, Indiana University School of Medicine

P45 - Cost-Effectiveness Analysis of Screening for Vitamin D Insufficiency to Prevent Falls and Fractures among Community-Dwelling Older Adults
Richard H. Lee, MD, MPH, Duke University

 

WORKSHOP

2:15 – 3:45 PM

COMPETENCY IN COGNITIVE AND BEHAVIORAL DISORDERS FOR MEDICAL STUDENTS, RESIDENTS, AND OTHER HEALTH CARE PRACTITIONERS
CME/CE Credit: 1.5                   Track: Education
Developed by the Education Committee and the Teachers Section.
Moderator:  Lisa J. Granville, MD, Professor, Florida State University College of Medicine
In the workshop, participants will learn and demonstrate ability to screen and evaluate older patients with dementia, delirium and depression; and will also demonstrate competency in formulating a treatment plan for a patient with abnormal cognitive function, with special attention to patient safety.  Learning objectives: (1) demonstrate competency in administration of validated screening or assessment tools; (2) formulate a differential diagnosis and recommend an evaluation and treatment plan for an older adult with a cognitive/behavioral problem; and (3) utilize an educational tool kit to promote or implement a competency assessment project in the participant's home institution.

Orientation and Introduction to Cognitive and Behavioral Disorders Competency
Zaldy S. Tan, MD, MPH, Assistant Professor of Medicine, Harvard Medical School

Competency in Cognitive and Behavioral Disorders
Lisa J. Granville, MD

Taking Your Competency Home
Hal H. Atkinson, MD, MS, Associate Professor, Wake Forest School of Medicine