Advances in Long Term Care Medicine

Advances in Long Term Care Medicine

Episodes

  • Ticking Time Bomb: Limiting Antibiotic Resistance in Long Term Care

    Jul 28, 2014 | 15 min
    Hosted by: Eric Tangalos Guest: Paul Drinka Multi-drug resistant organisms (MRDOs), such as Methicillin-resistant Staphylococcus aureus (MRSA), due to antibiotic use are of significant concern. Not only hospitals, but also long-term care facilities, are particularly susceptible to the impact of antibiotic resistance. Dr. Paul Drinka, clinical professor of internal medicine and geriatrics at University of Wisconsin-Madison and the Medical College of Wisconsin-Milwaukee, tells us that one evidence-based approach is to maintain a database of the MRDOs that will help identify clustering of a specific isolate and document a facility's resistance problem, which can then be addressed more precisely...
  • Telehealth: Expanding the Reach of Care

    Jul 21, 2014 | 15 min
    Hosted by: Eric Tangalos Guest: Dan Osterweil Telehealth refers to the constantly evolving tools and technologies used to care for patients remotely. These technologies can be applied in many types of clinics, including long-term care facilities, to improve patient access to care and reduce healthcare costs. Dr. Dan Osterweil, clinical professor in the department of geriatrics at the David Geffen School of Medicine at University of California Los Angeles, and medical director for Silverado Senior Living in Calabasas, California, joins host Dr. Eric Tangalos to discuss some of the current practical applications of telehealth, ways to overcome barriers to implementation and the future outlook ...
  • From Institutional to Inspiring Healthcare Design

    Jul 14, 2014 | 16 min
    Hosted by: Eric Tangalos Guest: John Waugh Design of healthcare environments is about more than style and aesthetics. A skillfully-designed hospital room can encourage a patient's healing process, overall well-being and better health outcomes, while reducing stress by creating comfortable surroundings. Much like medicine, healthcare design is now focusing on using an evidence base to inform best practices in design. How is evidence-based design being incorporated into planning of healthcare spaces? How can small changes in design, such as lighting from below or lowering the height of windowsills, make a big impact on patient experience? John Waugh, design and planning principal for the firm ...
  • The Benefits of Therapeutic Exercise and Physical Activity in Long Term Care

    Jul 14, 2014 | 16 min
    Hosted by: Eric Tangalos Guests: Tim Fox, Mimi Jacobs As people are living longer than ever before with a variety of chronic conditions, modified physical activity can help older patients regain or retain functionality. Indeed, physical therapy is also essential to the recovery of patients who have undergone elective or emergency surgeries. What distinguishes therapeutic exercise from physical activity, and how can exercise programs be tailored to meet the various needs of long-term care residents? How can we effectively "dose" therapeutic exercise, setting up an effective care plan that residents can adhere to? Dr. Tim Fox, founder and executive director of Fox Rehabilitation in Cherry Hill...
  • A Compassionate Presence: Reiki as Alternative Pain Management

    Jul 7, 2014 | 16 min
    Hosted by: Eric Tangalos Guest: Harold Bob If you were told there was a method of reducing pain that was low- or no cost, not harmful, and effective, would you be interested in learning more? Nothing can replace evidence-based medicine, but the human connection between physician and patient can go a long way to reducing patients' pain and suffering. How can Reiki and other alternative healing methods complement conventional evidence-based medicine? Dr. Harold Bob, managing partner of a group practice in Reisterstown, Maryland, and medical director at two nursing homes and a hospice in Maryland, discusses the benefits Reiki has brought to his patients and suggests ways all physicians can appl...
  • Ethnogeriatric Considerations: Toward Culturally Sensitive Care

    Jun 23, 2014 | 16 min
    Hosted by: Eric Tangalos Guest: Alan Abrams As our older patient population grows more diverse, it will become increasingly important to understand how to best communicate with patients, and their families, about values and expectations. In addition, teams of medical providers come from different backgrounds, so good dialogue within the team is crucial to providing quality care to patients. What should we keep in mind when caring for our older patients, who may be from cultures than our own? Dr. Alan Abrams, assistant professor of medicine at Harvard Medical School, emphasizes that the skills of ethnogeriatric communication are learnable, teachable and paramount to medicine. Dr. Eric Tangalo...
  • Kidney Failure and Dialysis in Long Term Care Medicine

    Jun 16, 2014 | 15 min
    Hosted by: Eric Tangalos Guest: Manjula Kurella Tamura How do the processes leading to kidney failure differ for various patient populations? What special considerations should physicians keep in mind when caring for patients in long-term care facilities undergoing dialysis? Dr. Manjula Kurella Tamura, nephrologist and assistant professor of medicine at Stanford University School of Medicine, reviews findings from a study regarding functionality for patients undergoing dialysis. Dr. Kurella Tamura points out that although dialysis may increase longevity, it may not improve quality of life. What is recommended for optimal care of patients with kidney failure? Hosted by Dr. Eric Tangalos.
  • A Proactive Approach to Health Maintenance

    Jun 9, 2014 | 14 min
    Hosted by: Eric Tangalos Guest: Susan Levy When patients are admitted to long term care facilities, it's crucial to conduct a health screening and identify a preventative patient health plan in order to preserve their well-being. What are some of the areas to pay particular attention to when screening a new patient at a long term care facility? What is the role of the family in creating a health maintenance plan? How might an individualized health maintenance plan differ from standard guidelines? Dr. Susan Levy, vice president of medical affairs and medical director at Levindale Hebrew Geriatric Center and Hospital in Baltimore, discusses these and other questions about health maintenance wi...
  • Psychiatric Diagnosis and Care in Long Term Care Medicine

    Jun 2, 2014 | 13 min
    Hosted by: Eric Tangalos Guest: Lory Bright-Long The diversity of residents in long term care medicine can present unique challenges in diagnosing and caring for patients with various psychiatric conditions. What should physicians keep in mind when caring for younger patients, those with Alzheimer's disease, or patients who have had a stroke at long term care facilities? Dr. Lory Bright-Long, clinical assistant professor of psychiatry at State University of New York Stony Brook and certified medical director, discusses the role of the interdisciplinary team in managing patients with psychiatric conditions. Hosted by Dr. Eric Tangalos.
  • Psychiatric Diagnosis and Care in Long Term Care Medicine

    May 26, 2014 | 15 min
    Hosted by: Eric Tangalos Guest: Lory Bright-Long The diversity of residents in long term care medicine can present unique challenges in diagnosing and caring for patients with various psychiatric conditions. What should physicians keep in mind when caring for younger patients, those with Alzheimer's disease, or patients who have had a stroke at long term care facilities? Dr. Lory Bright-Long, clinical assistant professor of psychiatry at State University of New York Stony Brook and certified medical director, discusses the role of the interdisciplinary team in managing patients with psychiatric conditions. Hosted by Dr. Eric Tangalos.
  • Diagnosing and Treating Pressure Ulcers

    May 19, 2014 | 13 min
    Hosted by: Eric Tangalos Guest: David Thomas How common are pressure ulcers in hospitals, nursing homes and other long-term care facilities? What clinical situations put patients at risk for developing pressure ulcers, and how are these wounds diagnosed? Dr. David Thomas, professor of internal medicine and geriatric medicine at Saint Louis University Health Sciences Center, joins host Dr. Eric Tangalos to review strategies for managing pressure ulcers.
  • Assessing and Preventing Dementia

    May 12, 2014 | 16 min
    Hosted by: Eric Tangalos Guest: Alva (Buzz) Baker Among older patients, who is most at risk for developing dementia? How can a team of caregivers at a nursing home best assess dementia, and what are some of the causes of this condition? How can activity programs help to decrease the cognitive decline of residents at long-term care facilities? Host Dr. Eric Tangalos discusses these and other questions about dementia with Dr. Alva Baker, faculty member of the division of geriatric psychiatry and neuropsychiatry at Johns Hopkins University School of Medicine.
  • Interdisciplinary Collaboration in Long Term Care Medicine

    May 5, 2014 | 14 min
    Hosted by: Eric Tangalos Guest: Barbara Resnick How is interdisciplinary collaboration of crucial importance in long term care medicine, and how can a team of health care providers communicate most effectively? What are some of the challenges presented by interdisciplinary collaboration? Dr. Barbara Resnick, professor in the department of organizational systems and adult health at the University of Maryland School of Nursing, discusses collaboration in geriatric and long term care medicine with host Dr. Eric Tangalos.
  • Addressing Nutritional Needs in Long Term Care Residents

    Apr 28, 2014 | 16 min
    Hosted by: Eric Tangalos Guest: John Morley Weight loss, especially among older patients, can be a key indicator of other health problems. How much weight loss is safe, and at what point should physicians address any potential underlying causes of weight loss, including nutritional deficiencies? What are the most common symptoms of dehydration, which can be even more challenging to recognize than nutritional deficits? Join host Dr. Eric Tangalos as he reviews these and other questions with Dr. John Morley, the Dammert Professor of Gerontology at Saint Louis University Medical Center.
  • The Culture Change Model in Long Term Care Medicine

    Apr 21, 2014 | 13 min
    Hosted by: Eric Tangalos Guest: Karen Leible Does the 'culture change' model at long term care facilities involve a simple re-design of aesthetics, or does this model encourage an entirely different way of structuring long term care? How challenging is it to implement a culture change, or patient-centered model, especially at facilities that have operated under a traditional model for decades? Dr. Karen Leible, chief clinical officer for Pinon Management, a long term care management and consulting firm in Colorado, discusses these questions and more with host Dr. Eric Tangalos. How can culture change help to empower patients?
  • Anemia in the Long Term Care Setting

    Apr 14, 2014 | 14 min
    Hosted by: Eric Tangalos Guest: Charles Cefalu What are the various types of anemia found in long-term care settings, and which types are the most common? What are some of the underlying causes of both chronic and acute anemia? Dr. Charles Cefalu, clinical professor and chief of the section of geriatric medicine at Louisiana State University Health Sciences Center, talks about how physicians can be alert to symptoms of anemia, which are often non-specific. What is the relationship between falling and anemia? Dr. Eric Tangalos hosts.
  • Communicating With Families: Maintaining Realistic Expectations

    Apr 7, 2014 | 13 min
    Hosted by: Eric Tangalos Guest: David Brechtelsbauer When meeting a patient's family for the first time, what information should physicians be prepared to provide, and how can physicians best address the family's expectations? What are the goals of the family meeting that should be addressed? Dr. David Brechtelsbauer, associate professor of family medicine at the University of South Dakota School of Medicine, offers some communication tips for the first visit physicians have with a patient and their family. Dr. Eric Tangalos hosts.
  • Why I See Only Nursing Home Patients: A Doctor's Manifesto

    Mar 31, 2014 | 15 min
    Hosted by: Eric Tangalos Guest: Gregory Zydiak There are quite a few misconceptions about long term care and geriatric medicine. Many young physicians shy away from long term care medicine because they fear they won't be able to make enough money, or that they will burn out quickly. But Dr. Gregory Zydiak, medical director of a skilled nursing facility in Saint Louis, thinks the opposite is true. He believes long-term care medicine is a fruitful, rewarding and challenging career. Dr. Zydiak created a practical guide for a career in long-term care medicine, available here. Dr. Eric Tangalos hosts.
  • How Do We Assess Long Term Care Facilities?

    Mar 24, 2014 | 14 min
    Hosted by: Eric Tangalos Guest: Charles Crecelius There are many different types of long term care facilities, including nursing homes, skilled nursing facilities and assisted living facilities. Dr. Charles Crecelius, clinical instructor of internal medicine and geriatrics at Washington University School of Medicine in St. Louis, explains the services these different facilities provide, and offers some suggestions to physicians about ways to assess long-term care facilities. Dr. Eric Tangalos hosts. You can visit Medicare's Nursing Home Compare website here.

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