Navigating Healthcare in the Frail Elderly Amidst a Sea Of Change and a Fragmented Care System

by Vanessa Mandal, MD

With the aging of our population, by 2035 the elderly population will outnumber children for the first time in U.S. history. This change in demographics, coupled with the accelerated changes in health care delivery, poses significant challenges for health care providers managing patients with complex chronic illnesses. The shift from fee-for-service to value-based care adds even more complexity. The Saturday May 20th afternoon session brings together a panel of speakers who will present a person-centered approach to providing quality of care near the end of life. End-of-life care entails conversations where providers have to address prognosis, and shared decision making.

Mass Violence in Yountville

by Timothy Gieseke MD, CMD

In about 2010, I was asked by my esteemed colleague, Dr. Denise Rettenmaier, to help with their implementation of the POLST Form.  The Yountville Veterans Home is located in Napa in a setting of exquisite natural beauty. Blended into this home are facilities and staffing similar to what you would find in small acute hospitals.

Like many of you, I was shocked to hear real time of the tragic act of violence in process there, but also glad to hear from our colleague who was safe having found shelter in her locked office.  Our hearts go out to Denise, her colleagues, and the Yountville community. While we wish situations like this were rare, they are becoming increasingly common. Our nursing home familles have seen various disasters in the last year, as such we will feature a talk on “Disaster Preparedness” by Jocelyn Montgomery, RN during our upcoming annual meeting.

Everyone loves a bargain!: A special promotion on a new CALTCM membership with your annual meeting registration!

by Deborah Wolff-Baker MSN, ACHPN, FNP-BC

CALTCM is California’s premier interdisciplinary organization leading the charge for creating best practices, clinical practice guidelines, quality improvement and educational opportunities throughout the Long Term Care continuum.  Have you let your CALTCM membership lapse? Or are you considering membership for the first time? We want you to see the value in CALTCM membership and in the superb educational offerings CALTCM has to offer. In light of this goal, our executive board has innovated again and come up with a winning proposition!  Receive a 25% discount on a new CALTCM membership when you register for the 2018 Annual Meeting, and instantly receive the CALTCM member discounts on your registration!  (The discount alone will pay for your new membership.) You’ll find that being a CALTCM member has many benefits including discounts to outstanding conferences such as the Leadership & Management in Geriatrics course, the Annual Meeting and the Fall Conference.  Members will also enjoy access to practice management tools and many presentations from past conferences.

Clinical Practice Action

by Timothy Gieseke, MD, CMD

Last summer, CALTCM formed the Clinical Practice committee under the able leadership of Dr. David Berman. We are clinicians very much aware of the difficulties our facility teams have upgrading care processes as new knowledge impacts the care we should be providing. With so many of our patients having diabetes as a key factor in their health, we have decided to mine the literature and think strategically with you, about how we might help our teams bring about incremental, sustainable, & measurable improvement in our diabetes care (QAPI). We realize our committee needs a greater representation from the work force we serve. If you are willing to review literature and bring your ideas to our monthly conference calls, we would welcome your participation.  We particularly need volunteers who are:  DON/ADON, Administrator, MDS Care Coordinator, NP/PA, Line RN /APRN, and consulting pharmacist.

Antipsychotic Misuse in Nursing Homes in the News

by Timothy Gieseke MD, CMD 

On February 5th, KTVU TV in Northern California aired an investigative report on Channel 2 for which I’ve attached the written version.  This report was triggered by a daughter’s complaint about the misuse of an antipsychotic in her mother with sudden and persistent adverse effect when the medicine was likely unnecessary. This ultimately led to the daughter moving her mother to a different facility where the medicine was stopped and the patient with dementia returned to a stable baseline status without problem behaviors.

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