PALTtalk

AMDA On-The-Go | Oral Health

Dr. Karin Arsenault
Dr. Karin Andrenyi-Arsenault graduated with a Bachelor of Science in Anatomy from McGill University. She earned her Doctor of Dental Medicine from Tufts University School of Dental Medicine in 1994 and went on to receive a Master’s in Public Health in Health Care Management from Harvard University. She completed a Mini-Residency in Geriatric and Long-Term Care at the University of Minnesota. She held the position of Dental Director at the South Boston Community Health Center and later was involved in developing and implementing the group practice clinical system at Tufts University School of Dental Medicine. In January, she returned to academia to pursue her interests in geriatrics and public health as Clinical Director of the Geriatric Center Program.
 
References:
D. S. Michaud, et. al. “A Prospective Study of Periodontal disease and Pancreatic Cancer in US Male Health Professionals",, JNCI, 2007.
Catherine Saint Louis, In Nursing Homes, an Epidemic of Poor Dental Hygiene" NYT, 2013.
Helene Ragovin, For Most Seniors, Oral Health Goes Uncovered" Tufts Now, 2019.
"Experts discuss oral health disparities, issues affecting older Americans", ADANEWS, 2016.

AMDA On-The-Go | Thyroid Diseases

References:
JC 9 5 19 References.docx
TSH Target in Srs Lancet 15.docx
Rx Effects on Thyroid NEJM 19.pdf
Thyroid Presentation.pdf, Gregory Gahm, MD

JAMDA On-The-Go | June 2019

This podcast will spotlight articles from the June 2019 issue of JAMDA. JAMDA is the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Host: Wayne Saltsman MD, PhD, CMD
Guests: Philip Sloane MD, MPH; Mallory Brown, MD
References:
Dr. Platts-Mills, et. al., Increasing the Value of Emergency Visits for Long-term Care Patients: When Less is More and More is More", JAMDA, June 2019

AMDA On-The-Hill | Volume VI

 
 
The latest policy news from Director of Policy and Advocacy Alex Bardakh.
Questions? Email Alex at abardakh@paltc.org
Related Resources:
Article on Physician Fee Schedule and Quality Payment Program Proposed Rules
Article on Skilled Nursing Facilities Final FY 2020 Payment and Policy Changes Rule
Info on Advanced Alternative Payment Models

AMDA On-The-Go | Challenges in Assisted Living Facilities

Dr. Steven Fuller
Dr. Steven Fuller earned his master’s degree and Ph.D. in physiology, and his D.O. in human medicine at Michigan State. He completed his internal medicine training at Henry Ford Hospital in Detroit, and completed his pulmonary and critical care training at Johns Hopkins Hospital, where he remained as an associate in the physiology department for several years. Fuller is the founder and president of House Calls, a service that delivers onsite primary care to retirement communities. Additionally, he is the founder and president of Illumination Analytics, a health analytics service that measures and tracks the health of assisted living residents. Fuller also founded and currently serves as the president of Straight Line Connect, an online program that teaches assisted living community staff how to prevent hospital readmissions.He is a triple board certified physician/entrepreneur who develops programs in support of an Integrated Care model of senior housing. This model includes 3 equal, interactive, and mutually supportive team members: real estate, hospitality, and healthcare.
 
References:
Fuller, Steven, PhD, “Seven Challenges Assisted Living Must Get Right",, Caring for the Ages, 2019.
Fuller, Steven, et. al., Blog | Illumination Analytics
"Life and Death in Assisted Living”, Frontline July, 2013
National Center for Assisted Living
Center for Excellence in Assisted Living

CMDA Journal Club | Chronic Obstructive Pulmonary Disease

Eric Yeager, MD Travis Neill, PA-C, MMS Assistant Medical Director - Vivage
References:
Cedric Daubin, "Procalcitonin algorithm to guide initial antibiotic therapy in acute exacerbations of COPD admitted to the ICU: a randomized multicenter study", Springer, 2018
Eosinophilic inflammation in COPD: prevalence and clinical characteristics", Agora Research Letters
Travis Neill, COPD Pearls" PA-C, 8/1/19
Anthony W Huckle, et. al.,"Prophylactic Antibiotic Use in COPD and the Potential Anti-Inflammatory Activities of Antibiotics", Respiratory Care, May, 2018
Yaeger, Abx in COPD working document

AMDA On-The-Go | Impact of Delirium in PALTC

Dr. James Rudolph
Dr. James Rudolph is a Professor of Medicine at the Warren Alpert School of Medicine at Brown University, Director, Center of Innovation in Long-Term Services and Support at the Providence V.A. His area of expertise is the relationship of atherosclerosis to functional (cognitive and physical) deficits in older persons, particularly after surgery. His research accomplishments include: identification of which patients will develop delirium (acute change in cognitive function) after surgery, survival of nursing home patients who are admitted to the Intensive Care Unit, and the development and validation of the Anticholinergic Risk Scale. He has authored more than 20 publications on this topic.
References:
Rudolph, J.L. et. al., "Dissecting Delirium", Clinical Geriatric Medicine, 2017.
Forsberg, M. "Delirium Update for Post-acute Care and Long-term care settings: A narrative review". Journal of the American Osteophathic Assoc., 2017.
Rudolph, J.L. et. al., "Postoperative Delirium: Acute Change with Long-Term Implications", Anesthesia & Analgesia, 2011.

AMDA On-The-Go | The Evolving Role of the APP in PALTC

Dr. Debra Bakerjian is a clinical professor, at the Betty Irene Moore School of Nursing at UC Davis and the former senior director for nurse practitioner and physician assistant clinical education and practice. She currently teaches interprofessional education and team-based care in areas of quality improvement, geriatrics, and patient safety. Previously, Dr. Bakerjian was a Betty Irene Moore School of Nursing Postdoctoral Fellow with specialties in health policy and system change.
References:
Bryant-Lukosius D., et. al.; "Advanced practice nursing roles: development, implementation and evaluation.", PubMed, 2004.
Bakerjian, D. (2008). "Care of nursing home residents by advanced practice nurses: A review of the literature. Research in Gerontological Nursing", 1(3), 177-185.
Bakerjian, D., & Harrington, C. (2012). "Factors associated with the use of advanced practice nurses/physician assistants in a fee-for-service nursing home practice: A comparison with primary care physicians". Research in gerontological nursing, 5(3), 163-173.
Bakerjian, D. (2018). "Nurse practitioners and primary care for older adults. In Primary care for older adults", (pp. 159-172). Springer, Cham.
Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation, "The Future of Nursing, Leading Change, Advancing Health", National Academies Press (US); 2011.
K. Melillo, PhD, A-GNP-C, FAANP, FGSA, et. al.; "Comparison of Nurse Practitioner and Physician Practice Models in Nursing Facilities", Annals of Long-Term Care: Clinical Care and Aging. 2015
John Iglehart, “Expanding the Role of the Advanced Nurse Practitioner—Risks and Rewards", NEJM, 2013

CMDA Journal Club | June 6

Serotonin Risk / Lee Anneberg
Use of Statin in LTC / Dr. Bruce Smith, & Dr. Gregory Gahm
Journal Club Resources:
Detecting and Managing Serotonin Syndrome PDF
Reexamining Recommendations for Treatment of Hypercholesterolemia in Older Adults PDF

AMDA On-The-Go | Suicide Prevention in Long-Term Care Facilities

Elizabeth Conti, Ph. D.
Dr. Conti is staff Psychologist at the Michael E. DeBakey VA Medical Center, and Assistant Professor at Baylor College of Medicine. She is licensed psychologist in the state of Texas and the embedded psychologist in the Cancer Center and outpatient palliative care at the Houston VA. She is passionate about suicide prevention (particularly for older Veterans), late life mental health, and improving the well-being of medically ill populations. Her post-doctoral training included health services research and quality improvement in large healthcare systems.
 
References:
U. S. Surgeon General Report;"2012 National Strategy for Suicide Prevention: Goals and Objectives for Action", PubMed, 2012.
Stanley, B., et. al. "Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk", Cognitive and Behavioral Practice, May, 2012.
Choy, C., "Suicide in palliative care setting", Annals of Palliative Medicine, Dec. 2017.
Mezuk, B., PhD., et. al."Suicide Among Older Adults Living in or Transitioning to Residential Long-term Care, 2003 to 2015", JAMA, June, 2019.
Miller, D, “When a Patient Dies by Suicide—The Physician’s Silent Sorrow”, NEJM, 2019
VA / Mental Illness Research, Education and Clinical Centers
* Opinions expressed are solely the responsibility of Dr. Conti and do not necessarily represent the views of the Department of Veterans Affairs or the U.S. government.