CALTCM typically holds its Annual Meeting in April, sandwiched between the Annual Meetings of the American Geriatrics Society and AMDA. For those of us in the field of Geriatrics and Post Acute and Long Term Care, it can get kind of crazy. This year, we’re trying something different. We’ve moved the Annual Meeting to October 8-10, 2020. This also gives us more time to promote the meeting and work on growing our membership.
On January 27, 2020, the saga that began in 2013 with a lawsuit against the California Department of Public Health (then captioned CANHR v. Smith) finally concluded, although some details remain to be worked out. The bottom line is that in skilled nursing facilities, the Epple/IDT process, sometimes referred to as an Ethics Committee or Bioethics Committee (even though the composition of such a committee in nursing homes is rarely as robust as it is for hospital Bioethics Committees), is able to make decisions for incapacitated, unrepresented nursing home residents—including all psychotropics and end-of-life decisions—but a non-facility-affiliated resident representative must be part of the process.
In the last issue of the WAVE, I reported on the potential direct clinical value of an excellent AMDA Webinar on Sleep Disorders in Older Adults. In that Webinar Dr. Kitamura mentioned a number of factors which could aggravate restless leg syndrome (RLS). One of those, the prescribing of SSRI’s directly applied to one of my older patients with RLS who was requesting Ativan, because her Ropinirole was no longer working. A month prior, I had started her on Lexapro for depression and had recently advanced the dose to 10 mg daily.
As some of you know, 2019 ended with the closing of my Post-acute & Long-term Care practice. In the process, I turned over the care of my patients to 3 other physicians and my 2 facility Medical Directorships to 2 of my colleagues. Having been the Medical Director for over 33 years at my CCRC, I have had some time to reflect on this role, beyond the CMS expectations and AMDA guidelines ((https://paltc.org/product-store/amda-model-medical-director-agreement-and-supplemental-materials-medical-director).
For more information from the CDC on this years Flu activity, go to: https://www.cdc.gov/flu/index.htm
