Profiles in Geriatrics

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Lisa M. Walke, MD, MSHA, AGSF

Associate Professor, Department of Medicine (Geriatrics)

Yale University School of Medicine

Physician Member - 2017 AGS Award Winner

When did you know you wanted to be a geriatrics healthcare professional?

My “Aha!” moment came during my internship at Montefiore Medical Center in New York. Before entering medical school I had worked in the breast oncology clinic at Memorial Sloan Kettering Cancer Center. I had entered medical school and internship with plans to become an oncologist. I was fortunate to have had a wonderful mentor, and at the end of my intern year we had a chat.

She told me she saw things in me that I didn’t see in myself—that I was drawn to palliative care (then a relatively new field), for example, and we started talking about geriatrics. I spent time in the geriatrics department, and I realized her encouragement was spot-on.

What’s your favorite thing about working in this field?

Geriatrics satisfies me in so many ways. I love the older adults I care for, in large part because I love hearing their stories. It’s rewarding to help older adults regain function and the ability to interact with people. I’m doubly fortunate in that my work at the Yale University School of Medicine in Connecticut also entails helping train future geriatrics healthcare professionals. My work teaching is every bit as gratifying as my clinical work, though for equally special yet unique reasons. When I work with trainees, I get to see things through their eyes; their perspectives are enlightening. Teaching really is a two-way street!

How has being part of an interprofessional community helped you in your career and professional life?

A terrific aspect of geriatrics is the community it represents. We all seem to be kindred spirits and a success for one is a success for all. I’m definitely living proof of that, because recently, I was extremely honored to receive the AGS’s Outstanding Mid-Career Clinician Educator of the Year Award. It’s a testament to the AGS that our members are so big-hearted: I was thrilled to receive so many congratulatory notes and accolades from my colleagues. Receiving the award was not only a wonderful professional tribute for me but also underscored the importance of the work we do together.

I suppose that’s part of why I’ve been an AGS member since 1999. Events like the AGS Annual Scientific Meetings have helped me celebrate my peers’ successes while also affording me the opportunity to see what they and other leaders are doing. Membership in the AGS is one key way I’ve learned about innovation in our field so I can stay current with research.

Another key aspect of my membership is that it exposes me to the advocacy AGS leads on our behalf. With health policy in flux these days, we all need to be advocates for our field, and—thanks to AGS—I’m inspired to add that to my own list of important things to do.

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Lauren Jan Gleason, MD, MPH

Assistant Professor of Medicine

The University of Chicago

Physician Member – Young Professionals Advisory Group

How did you become involved with the AGS?

As a second year medical student, I had an interest in geriatric medicine and wanted to learn more about the field. While researching a career in the field, I happened to stumble upon the AGS website. On the website, there was an opportunity to signed up for a mentor in order to learn more about the field; therefore, I signed-up not realizing how much of an impact that would have on me and my path in medicine. I was paired with the most amazing mentor who I am still extremely close with 10 years later despite a 600 miles distance between us. She opened my eyes up to the field of geriatrics and what it truly means to be a geriatrician. Additionally, she helped expose me to everything that the American Geriatrics Society does to improve the health, independence, and quality of life of all older people. It was the best decision I have ever made (except for marrying my husband)!  I find AGS to be a very welcoming organization and the mentorship, career guidance, and learning opportunities provided by the AGS to be invaluable. This is truly a testament to the dedication of practitioners in our field. My membership in AGS has provided me with opportunities for professional growth, education, mentorship, leadership and ultimately the resources to provide the highest standard of care for our patients.

What does 'geriatrics' mean to you? (If you're up to the challenge – describe this in 3 words.)

Complexity, Care, Compassion.

How have your personal experiences and stories helped shape the way you practice?

Every day I am shaped by the experiences I have with my patients. But it was early in my medical training that I was fortunate enough to gain exposure to unique opportunities within geriatric medicine to care for the patient as well as the family and caregivers while collectively working to elicit preferences and goals of care. I joke around when teaching my students and residents, “if you have met one 80 year old you have met one 80 year old.” Each patient is unique and I always strive to learn more about each individual as a person, their experiences, their family as well as their values and beliefs so I can help guide their medical care. There is no doubt that geriatric medicine is steeped in rigorous science, but what I love about geriatrics is that care plans can be modeled and adapted to fit each individual’s needs and preferences while still bringing the best that the underlying science have to offer. I find the ability to provide such focused, compassionate care to each individual incredibly meaningful and this is one of many wonderful aspects of geriatric medicine that keeps me invigorated and drives the way I practice.  

 

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Mary H. Palmer, PhD, RNC, FAAN, AGSF

Professor in Aging

The University of North Carolina at Chapel Hill School of Nursing

Nurse Member

What do you value about AGS membership?

The stellar annual conferences advance interdisciplinary collaboration, offering opportunities to network and exchange ideas with colleagues. Having a background in nursing, I value the multidisciplinary collegial environment, which encourages healthcare professionals with an interest in geriatrics to contribute equally. Our collective expertise has influenced the practice of geriatrics, aging research, education, and health policy and has strengthened our voice in advocating for older adults. The AGS and its members share my passion to improve the lives of older adults, and it is my privilege to belong to and serve this valuable organization.

How has AGS membership helped you in your career and professional life?

The AGS has helped me to stay current on clinical issues such as medication management, the quality of care in nursing homes, identifying and treating depression and dementia in older adults, new clinical care guidelines, and the latest in scientific advancements in clinical aging research. I continue to use AGS information and materials as a teaching resource for nursing and other healthcare students and trainees.

The AGS has also proved invaluable in my own research on urinary incontinence in older adults with chronic diseases like heart failure or who undergo hip fracture repair. Many of my research collaborators are AGS members and the scientific meeting is a great venue to network and further these and new collaborations.

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George W. Drach, MD, AGSF

Emeritus Professor of Urology in Surgery

University of Pennsylvania Medical Center

Physician Member – Specialist

How did you become involved with the AGS?

I’m not a geriatrician—my field is urology—but I’ve been involved in geriatrics since the mid ‘90s. I joined the AGS in 1998, and became a fellow of the society in 2012. The AGS has launched and plays key roles in a wide range of programs that improve healthcare for older adults, and this is important to me.

I first got involved with the society after my mother, who had Alzheimer’s, moved to a long-term care facility. I discovered that the urologic care there was poor. I said something to the nursing home, but was, essentially, told to stay out of it because I wasn’t “on staff.” So I went to the American Urological Association and spoke with the then-Secretary of the organization about what had happened. I’ll never forget what he told me. He said, “How interesting! The American Geriatrics Society has called, looking for someone to represent urology in its Geriatrics for Specialists Initiative (GSI).” That’s how I became the GSI’s urologic representative.

What do you value about AGS membership?

I’ve attended every one of the AGS’ annual meetings since becoming a member. To learn more about geriatrics, I made a point of going to the meetings’ educational sessions. They were invaluable. The personal contacts are important; I’ve gotten to know a number of nationally prominent geriatricians very well and personally. Other benefits are all the resources the AGS has created, including Geriatrics at Your Fingertips, and the Geriatrics Syllabus for Specialists.

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Freddi Segal-Gidan, PA, PhD, AGSF

Director

Rancho/USC California Alzheimer’s Disease Center (CADC)

Physician Assistant Member

How did you choose to become a geriatrics health professional?

My path to my practice as a physician assistant (PA) in geriatrics was certainly inspired by my grandmother. A Russian émigré who died at 101, she was still navigating public buses in Southern California when she was 99. Her life was the epitome of what it means to age well.

However, geriatrics wasn’t the first profession I considered. In college, I spent a gap year in Africa. That trip changed my life. I cast aside other career notions (among them becoming a primatologist) and decided to train as a PA. I returned to college back in the U.S. and did my post-grad PA studies at Johns Hopkins University.

Initially, my PA training was in primary care. A former classmate encouraged me to work with him at a multi-disciplinary medical practice in Los Angeles. The practice had just joined the Medicare Advantage program and they needed someone to work with older adults. It became a perfect fit for me.

While there, I was offered a yearlong geriatrics fellowship training opportunity at USC, and that’s when I joined our Society.

What do you value about AGS membership?

I attended my first Annual Scientific Meeting back in 1985 or so, and I realized when I arrived that I was among people who shared my worldview and my commitment to caring for older adults.

Even though there were few other geriatric PAs back then, the physicians, nurse practitioners, registered nurses, and social workers were indeed my kindred spirits.

I’ve built great personal relationships with AGS members over the years, and I’ve been actively involved in various committees. The Annual Scientific Meetings provide great opportunities to meet the people whose research you’ve been following over the years. Another thing I love about the field, and I think this may be unique to geriatrics, is how eager we are to share our knowledge with others. I’ve enjoyed seeing AGS evolve over the years to become totally inclusive, and I really appreciate its focus today on interdisciplinary teamwork.

What do you wish people knew about your job?

One question I get a lot about my work in geriatrics is, “Don’t you find it sad to work with people who are so close to death?” And my answer is that it’s not sad at all. I get to travel to different cultures and even different eras through my work, because older people are so willing to share their life stories. I’ve heard first-hand about experiences I’d previously heard about only in history books. Geriatrics means you don’t just practice medicine; you get to know people, and to take care of them within the context of their own lives.

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Priya Mendiratta, MD, MPH, AGSF

Associate Professor of Medicine, Division of General Medicine and Geriatrics

University of Arkansas School for Medical Sciences

Physician Member

How has being part of an interprofessional community helped you in your career and professional life?

As a clerkship director, I was looking to make changes for fourth year medical students and was feeling alone, so I turned to the greater geriatrics community on MyAGSOnline (AGS’s discussion forum). By posting just one question to ask for advice, I had chairs and clerkship directors from all over the country emailing me and sharing their curriculum, which was extremely helpful. While going for a promotion to Associate Professor with tenure at my university, it was very helpful to find external reviewers. They gave invaluable advice for the promotion. I have to say thank you to my AGS community.

As a young professional, what types of AGS resources are most important to you?

Clinical, educational, and research resources, as well as updates on health policies and new changes proposed.

How have your personal experiences and stories helped shape the way you practice?

I had complications while pursuing my geriatrics fellowship after an emergency surgery. It took a whole year to be fully diagnosed after many physician and specialist visits, and finally was resolved completely when a surgeon patiently listened to my full story. It taught me important lessons to listen to my patients and to believe them, as it can change their quality of life and get them the help they need. It has also helped me make healthier lifestyle choices, which I always discuss and encourage my patients to follow.

What inspires you?

Everyone at AGS inspires me, and that is why I keep coming to the meeting every year. It is an honor to meet hard working, motivated folks in geriatrics who every day go above and beyond what is expected of them to make someone else’s life better.

Do you have a favorite story about a patient, family caregiver, mentor or other person who has touched you personally and/or professionally?

Mrs. D was my first patient in my fellowship at a geriatric clinic. We started rather awkwardly—I introduced myself and told her I was new. She smiled, reassuring me we’d get along fine. At the end of the session she reminded me to send her the lab work early, and complimented me on a thorough visit. We had many more sessions over the next decade.

We discussed more than her health – her life, work and her children. When my twins were born, she brought them hand-knitted sweaters and socks. She never left a visit without seeing a picture of my children or asking how they’re doing. I realized there is never a one-way exchange in a relationship between physicians and patients.

After Mrs. D’s death, I called her daughter and she told me that many times in her last days, she remembered me and proudly discussed with the hospital staff that she had seen all the progress of my career. I feel truly blessed that she was my patient and it was an honor to know her.

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Terry Fulmer, PhD, RN, FAAN, AGSF

President

The John A. Hartford Foundation

Nurse Member

Can you tell us about your professional history before you came to The John A. Hartford Foundation? How did your geriatrics training help you in your leadership positions outside geriatrics?

The Journal of the American Geriatrics Society gave me an excellent opportunity to tell my story in the Pioneers section of the July 2015 issue. In the article, I was able to describe my extraordinary good fortune to begin my career at the Beth Israel Hospital in Boston during the years when the Harvard Division on Aging was founded. Jack Rowe, along with a stellar group of interdisciplinary colleagues, gave me a platform to delve into understanding the essence of acute care geriatric nursing and elaborate on what the profession of geriatric nursing could be. There, I also began my elder abuse research, which to this moment is central to my work. Those years were the harbinger for Nurses Improving Care for Healthsystems Elders (NICHE) and for the exciting work I was able to do at the Hartford Institute for Geriatric Nursing (HIGN) with Mathy Mezey and the outstanding HIGN team. One of the important lessons I learned working in geriatrics is that addressing the needs of older adults improves care for all people. For example, all patients benefit from person-centered care and team care. And because resources traditionally have not been as plentiful in the field of aging as in some other areas, there has always been a strong emphasis on collaboration and partnership. I believe that having that understanding makes me a more effective leader whether I’m working specifically in geriatrics or other areas.

Your career has spanned the clinic, the community, and the classroom in support of expert eldercare. Can you tell us a bit about why you have an interest in geriatrics and what led you to your new position at The John A. Hartford Foundation?

My interest in geriatrics was immediate as a young nurse, when I saw the opportunity to step up and lead improvements in practice for the frail older people who were in our care. There are many ways to influence better care for older adults. Whether you are teaching the next generation of clinicians, conducting research to generate new knowledge that improves care, informing policymakers with research, or focusing on practice models that improve care, there are many ways to make a meaningful difference. I had not considered the role of foundation president as a part of my career trajectory. However, when the opportunity presented itself and I began to explore the possibilities with the search committee, everything fell into place. I knew this would be one more exceptional way for me to improve care of older adults and I am thrilled to be at The John A. Hartford Foundation. This Foundation has shaped my career in innumerable ways and I am so grateful and proud to be able to serve as the President.

 

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Peggy A. Szwabo, PhD, MSW, AGSF

Private Practice

Szwabo & Associates

Social Worker Member

How did you become involved in the AGS?

Early in my career, I was part of a panel presentation - my first contact with the AGS.  I was struck with the approachability of all AGS members, from the world renowned to a variety of interdisciplinary students.  Everyone was accessible and interested in a dialogue or discussion of aging issues. The milieu of the AGS continues to be supportive, encouraging and open.  My involvement has broadened my knowledge and has given me resources and connections at my fingertips.

As a Social Worker member, what types of AGS resources are important to you?

Professional contacts and the accessibility of those members and AGS staff. (Staff even connected me with an unknown relative!) I keep up and participate in legislative and lobbying efforts.  Of particular interest are mental health issues, aging women, and cultural issues.  I have been involved in education and furthering the AGS's goal of interprofessional representation and input in their membership. The AGS has been on the forefront of developing this inclusiveness.

What do you enjoy most about geriatrics?

I am constantly amazed and humbled at the diversity, heterogeneity, and survivorship of this group of individuals. Their stories and the lives they have lived continue to challenge and humble me as a health care provider. One cannot make assumptions about this generation.

How have your personal experiences and stories helped shape the way you work?

I try to maintain an approach of dignity and communication. I listen.  My goal is to help the person say what they want and need and to help translate those concerns to others.  One of my strengths is translating theory, medical issues into very practical steps. Also I believe in the concept of "who you are now, is what you were when”-- how the past affects your present day behavior, for example, living through the depression and how money is spent or saved. Historical time lines can help us understand our patients’ behavior.

Judith L. Beizer, PharmD, CGP, FASCP, AGSF

Pharmacist Member

Clinical Professor

St. John's University

Judith L. Beizer, PharmD, CGP, FASCP, AGSF
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Judith L. Beizer, PharmD, CGP, FASCP, AGSF

Clinical Professor

St. John's University

Pharmacist Member

As a pharmacist member, what types of AGS resources are most important to you?

The AGS provides me with a number of useful resources, both in print and at the AGS Annual Scientific Meeting. The most obvious resource is AGS’s commitment to keeping the Beers Criteria relevant by updating it every three years. Since it was first released, the AGS Beers Criteria has been a useful tool for pharmacists to use when performing drug regimen reviews in nursing homes and when educating prescribers about the appropriate use of medication for older adults.

The Journal of the American Geriatrics Society (JAGS) is also very useful. In fact, that’s how I was introduced to the AGS. I subscribed to the journal for a number of years before I realized that I could join the AGS as a pharmacist. I also use the Geriatrics Evaluation & Management tools and Geriatrics at Your Fingertips. These are easy to use and helpful when teaching students.

The AGS Annual Scientific Meeting is a great meeting for pharmacists to attend. I really appreciate that the AGS makes sure to provide pharmacists with continuing education (CE) credits for a lot of the sessions. The educational sessions are informative and high-quality, and I can get much of my annual required CE from the meeting. The AGS even sponsors a breakfast for pharmacist members. It’s a great time to network and share ideas with other pharmacists practicing in geriatrics.

What inspires you?

I am inspired and motivated by the importance of providing quality and dignified care for older adults. I am inspired by my patients, some of whom live with multiple co-morbidities that can make their care unique but all of whom maintain a positive attitude that’s essential to well-being. 

I am also inspired by my students. It is so important to me that I impress upon my students the importance of geriatric care. I try, by example, to instill in them an appreciation not only for the unique needs of older men and women but also for the role  pharmacists play in older adult care—a role that goes beyond pharmaceutical issues. I tell my students that geriatrics is a holistic practice and a team sport. My favorite quote, one that I include in every rotation schedule, is: “Patients don’t care how much you know, until they know how much you care.” That’s the meaning and joy in practicing geriatrics, no matter the profession. It’s noticing the little things when you enter a person’s room, and asking if there’s anything else you can do for them—whether it’s getting some fresh water or helping them make a phone call. I love taking my students on “social rounds” at the end of the day once we’ve finished with the medication-related issues. It helps them see the men and women they’re caring for as real people, and not just as diagnoses.

What does geriatrics mean to you? (If you’re up to the challenge – describe this in 3 words).

Caring, Complexity, Interdisciplinary.