Advances in Long Term Care Medicine

How can creating a more positive emotional experience for patients with dementia or Alzheimer's diminish behavior issues and improve quality of life? Tena Alonzo, director of research and co-director of the Palliative Care for Advanced Dementia program at Beatitudes Campus in Phoenix, discusses a common-sense approach to creating a comforting environment for those with dementia and Alzheimer's, which focuses on meeting each patient's unique needs. What simple steps can long-term care facilities and caregivers take to enhance the lives of patients with cognitive disorders? Dr. Eric Tangalos hosts.

Regulations regarding nurses as prescribing agents of physicians in long-term care facilities are more restrictive than in the hospital setting, because controlled substance licenses are not currently approved for nursing homes in most states. These restrictions can make it challenging for long-term care patients to receive timely access to narcotics. Dr. Matthew Wayne, medical director, geriatric medicine, University Hospital Richmond Medical Center in Richmond Heights, Ohio, and assistant professor of medicine at University Hospitals Case Medical Center in Cleveland, suggests revisions to some provisions of the Controlled Substances Act in order to ensure long-term care patients have access to pain medications when they need them the most. What hurdles are the most significant impediments to improving patient care with appropriate access to narcotics, and how can medical professionals best navigate the waters until revisions are made to the current law? Dr. Eric Tangalos hosts.

Because residents in long-term care facilities often have comorbidities, polypharmacy can be an issue. What are the most common types of adverse drug events that can occur among long-term care patients taking multiple medications? Dr. Steven Handler, assistant professor in the department of biomedical informatics and the department of geriatric medicine at the University of Pittsburgh School of Medicine, and the medical director for long-term care health information technology for the University of Pittsburgh Medical Center, says the current methods for monitoring medications in nursing homes are inadequate for protecting against adverse drug events, and suggests ways to improve medication safety in long-term care. What tools might help practitioners in long-term care better detect and prevent adverse drug events? Dr. Eric Tangalos hosts.

With palliative and hospice care, there is no one-size-fits-all approach. What differentiates these two types of care and how can physicians decide which approach to palliative or hospice care is best for each patient? Dr. Peter Winn, professor in the department of family medicine at Oklahoma University School of Medicine in Oklahoma City, discusses various types of care at the end of life, and outlines conditions that might require such care. What are some of the challenges to providing effective palliative and hospice care, and how can physicians best discuss realistic expectations with families and patients? Hosted by Dr. Eric Tangalos.

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 Tangalos hosts.