Journal of the American Geriatrics Society
-
Career development is rarely formalized in the curricula of geriatric fellowship programs, and the training of new generations of academic leaders is challenging in the 1 year of fellowship training. To effectively prepare fellows for academic leadership, the University of Rochester's Division of Geriatrics, in collaboration with the Warner School of Graduate Education, created a yearlong course to achieve excellence in teaching and career development during the 1-year geriatric fellowship. Nine interdisciplinary geriatric medicine, dentistry, and psychiatry fellows completed the course in its initial year (2005/06). ⋯ The course provided opportunities to teach and assess all six of the Accreditation Council of Graduate Medical Education core competencies. This academic career development course was intended to prepare geriatric fellows as the next generation of academic leaders as clinician-teacher-scholars. It could set a new standard for academic development during fellowship training and provide a model for national dissemination in other geriatric and subspecialty fellowship programs.
-
Dehydration is a serious acute condition in older adults associated with significant morbidity and mortality. Hypodermoclysis (HDC; the infusion of fluids into the subcutaneous tissue) can provide an alternative to intravenous (i.v.) rehydration of older adults. This article reviews the relevant literature on the use of HDC to treat mild to moderate dehydration in older adults. ⋯ The evidence indicated that HDC is as effective as i.v. rehydration of older adults with mild to moderate dehydration. The literature cites advantages of HDC over i.v. hydration, including the same number of or fewer complications, cost savings, greater patient comfort, and less nursing time to start and maintain the infusion. It remains unclear from the literature why HDC is used infrequently in the United States.
-
Multicenter Study
Geriatric Pain Measure short form: development and initial evaluation.
To develop and evaluate a short form of the 24-item Geriatric Pain Measure (GPM) for use in community-dwelling older adults. ⋯ The GPM-12 demonstrated good validity and reliability in these European and U.S. populations of older adults. Despite its brevity, the GPM-12 captures the multidimensional nature of pain in three subscales. The self-administered GPM-12 may be useful in the clinical assessment process and management of pain and in pain-related research in older persons.
-
To assess how care is delivered for mental disorders using videotapes of office visits involving elderly patients. ⋯ Little time is spent on mental health care for elderly patients despite heavy disease burdens. Standards of care based on a count of visits "during which a mental health problem is discussed" may need to be supplemented with guidelines about what should happen during the visit. System-level interventions are needed.