PALTtalk

AMDA On-The-Go | Advance Care Planning

Karl Steinberg, MD, HMCD, CMD
Dr. Karl Steinberg has been a nursing home and hospice medical director in the San Diego area since 1995 and is currently chief medical officer for Mariner Health Central, a 20-facility California corporation, and is medical director at Life Care Center of Vista, Carlsbad by the Sea Care Center, and Hospice by the Sea. He also makes home visits on behalf of Scripps Healthcare. Dr. Steinberg received his bachelor’s in biochemistry from Harvard and studied medicine at The Ohio State University College of Medicine, then did his family medicine residency at UC San Diego.
Dr. Steinberg is past chair of AMDA’s Public Policy Committee for many years in addition to being editor-in-chief emeritus of the monthly periodical, Caring for the Ages, and is the current Society  Vice-President.
References:
T. Fulmer, PhD, et. al. Physicians' Views on Advance Care Planning and End-of-Life Care Conversations.", JAGS, July, 2018
Gillick, M. R., M.D. "Advance Care Planning" NEJM, 2004
Prater, L. PhD., "Examining Age Inequalities in Operationalized Components of Advance Care Planning: Truncation of the ACP Process With Age", JPSM, April, 2019
National POLST Paradigm

AMDA On-The-Go | Deprescribing Live from Atlanta

Daniel Haimowitz, MD, CMD
Dr. Daniel Haimowitz is a board-certified internist and geriatrician. He earned his Doctor of Medicine from Jefferson Medical College and completed his residency at Thomas Jefferson University Hospital. He received his Bachelor of Science degree from Pennsylvania State University. Haimowitz has been in private practice in Levittown since 1986. An active state physician at St. Mary Medical Center, Haimowitz is the medical director of St. Mary’s Geriatric Assessment Program and several area nursing homes and assisted-living communities. He served as the medical director of the Genesis PACE, LIFE at Home in Delaware County.

AMDA On-The-Go | The State of Geriatric Medicine Education

Heidi White, MD
Dr. White's clinical expertise involves the care of older adults, especially care transitions, long-term care, and post-acute care. She services as the Vice-Chief of Clinical Affairs in the Geriatrics Division At Duke University. She has worked with peer faculty to develop clinical programs including Peri-operative Optimization of Senior Health (POSH) and Health Optimization Program for Elders (HOPE) which is a transitional care program from the hospital to skilled nursing facilities.
 
References:
M. Tinetti, MD, Mainstream or Extinction: Can Defining Who We Are Save Geriatrics?, JAGS, 2018
GERIATRICS WORKFORCE BY THE NUMBERS, AGS, 2017
M. Castellucci, Geriatrics still failing to attract new doctors, Modern Healthcare, 2018

AMDA On-The-Go | A practical guide to Telehealth

Suzanne Gillespie, MD, RD, CMD
Suzanne Gillespie MD, RD, CMD, is Associate Professor of Medicine in the Division of Geriatrics/Aging and Associate Professor of Emergency Medicine at the University of Rochester School of Medicine and Dentistry. She is board-certified in Internal Medicine, Geriatric Medicine and Hospice & Palliative Medicine.
 
 
 
References:
S. Gillespie et. al, Standards for the Use of Telemedicine for Evaluation and Management of Resident Change of Condition in the Nursing Home", JAMDA, 2019
Telehealth-PALTC-Guide, Westhealth, 2019

AMDA On-The-Hill | Vol. III

The latest policy news from Director of Policy and Advocacy Alex Bardakh.
 
 
Questions? Email Alex at abardakh@paltc.org
 
* AMDA-On-The-Hill podcasts are not eligible for CMD credits   
 

AMDA On-The-Go | Acute Care Readmissions

Joseph G. Ouslander, MD
Joseph G. Ouslander, M.D., is Professor and Senior Associate Dean for Geriatric Programs at the Charles E. Schmidt College of Medicine at Florida Atlantic University and Professor (Courtesy) at the Christine E. Lynn College of Nursing at FAU in Boca Raton, Florida. He is a graduate of Johns Hopkins University and the Case Western Reserve School of Medicine. Among Dr. Ouslanders' many achievements and contributions in the field of geriatric medicine and care is the creation and dissemination of Interventions to Reduce Acute Care Transfers (INTERACT), a quality improvement program that assists long-term care facilities and programs in improving care, and reducing unnecessary hospitalizations and their related complications and costs.
 
References:
J. Ouslander, et. al., "Evaluation of Nursing Facility Resident Safety During Implementation of the INTERACT Quality Improvement Program", JAMDA, 2018
Jencks, SF, et. al., "Rehospitalizations among Patients in the Medicare Fee-for-Service Program", NEJM, 2009
Gozalo, P, et. al., "End-of-Life Transitions among Nursing Home Residents with Cognitive Issues", NEJM, 2011
Ouslander, JG, et al, "Interventions to Reduce Hospitalizations from Nursing Homes: Evaluation of the INTERACT II Collaborative Quality Improvement Project", JAGS, 2011
Ouslander, JG, et al, "Hospital Transfers of Skilled Nursing Facility (SNF) Patients Within 48 Hours and 30 Days After SNF Admission", JAMDA, 2016
Flint, LA, et al, "Perspective: Rehabbed to Death", NEJM, 2019

AMDA On-The-Go | Personalized music listening for assisted living residents with dementia

Episode 24
Winston Liu, BS, Duke Univ.
Winston Liu, BS is an MD/PhD student at the Duke University School of Medicine. He graduated from the University of Maryland in 2015 with a degree in bioengineering. He recently joined the Bohórquez Laboratory for his PhD training, and he is dissecting a neural circuit that transduces sensory cues from gut luminal microbes to brain areas that control behavior. During his first two years of medical school, he helped to develop a personalized music listening program for assisted living residents with dementia. Winston aims to become an independent physician-scientist focused on the interactions between our mind and other organ systems.
 
References:
Kelly Murphy MD, Winston Liu BS, et al, "Implementation of personalized music listening for assisted living residents with dementia", Geriatric Nursing, 2018
Cohen, Dan MSW "More Music, Fewer Meds", AMDA 2016 Conference
CDC.gov
American Music Therapy Association
Linda Gerdner, Stanford geriatric education center

AMDA On-The-Go | Treating and Preventing C Diff

Milta Little, DO, CMD
Milta Little, DO, CMD, is an Associate Professor of Medicine at St. Louis University in the Division of Geriatric Medicine. She is board certified in General Internal Medicine, with added qualifications in Geriatric Medicine. She serves the division as Program Director of the Geriatric Medicine Fellowship. Her primary scholarly interest is interprofessional health education to improve the care of the frail geriatric patient. Dr. Little has been on the St. Louis Magazine Best Doctor list since 2013. She is a Certified Medical Director and as such, has been a medical director at a number of Skilled Nursing Facilities. She served AMDA on the board of directors from 2012-2016 and from 2017 to present.
 
References:
M. Little, "TREATING AND PREVENTING CLOSTRIDIUM DIFFICILE INFECTION IN LONG-TERM CARE FACILITIES", Managed Healthcare Connect, Nov, 2018
C. McDonald, et. al."Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)", Clinical Infectious Diseases, Volume 66, Issue 7, 19 March 2018
Leffler, DA and Lamont JT, "Clostridium difficile Infection”, New England Journal of Medicine, 2015
Lessa, FC, et. al., “Burden of Clostridium difficile Infection in the United States", New England Journal of Medicine, 2015

AMDA On-The-Go | Ethics - SED by AD

Ethics - SED by AD
James Wright, MD, PhD, CMD
James Wright, MD, PhD, CMD, is Vice Chair of AMDA-PALTC’s Ethics Committee. He holds a Masters of Arts in Theological Studies from Union Presbyterian Seminary and a Certificate in Bioethics from Loyola University, Chicago. Dr. Wright is currently writing a book addressing the theological, medical and ethical implications of dementia, called “Love Endures”. He is medical director of three facilities in Richmond, Virginia.
References:
AMDA White Paper, "The Role of a Facility Ethics Committee in Decision-Making at the End of Life", March, 2008
Paula Span, "The VSED Exit: A Way to Speed Up Dying, Without Asking Permission", York Times, 2016
Ivanovic, N., et al, "Voluntary stopping of eating and drinking at the end of life - a 'systematic search and review' giving insight into an option of hastening death in capacitated adults at the end of life.”, BMC-Palliative Care, 2014
Wax, J. et al, "Voluntary Stopping Eating and Drinking”, Journal of the American Geriatrics Society, 2018

AMDA On-The-Go | SNF / ER Transition Process

Episode 21: SNF/ER Transition Process
Dr. Adam Perry
 
Adam Perry, MD, is an emergency physician and fellowship trained geriatrician. He is Assistant Professor of Medicine at the Geisinger Commonwealth College of Medicine. He is also a faculty member of the Geriatric Emergency Department Collaborative, in which capacity he presents nationally on clinical and quality improvement topics at health systems implementing emergency department geriatric initiatives.
 
 
References:
Gettel et. al. The Impact of Incomplete Nursing Home Transfer Documentation on Emergency Department Care", JAMDA, October, 2018
Adam Perry, MD; Firas Saidi, MD, CMD "The Emergency Department Joins the Interdisciplinary Team: Strategies to Improve Acute Care Transitions and Reduce ED Capture", AMDA Annual Conference, Grapevine, TX
Robert Burke, et al. "Identifying Potentially Preventable Emergency Department Visits by Nursing Home Residents in the United States", JAMDA, 2015