Wednesday, February 15, 2012

Falls Elevator Speech

The need has arisen to explain to policy makers and other important big-shot-type people why falls and the elderly is such a big deal.  I have been working on an “elevator speech” – a 30 second persuasive summary that will compel one to action.  I’m trying to incorporate all of the fact sheets I have seen since I joined the Carolina Geriatric Education Center and learned about the excellent falls prevention work done by NC AHEC’s.  Here goes:
“Falls are not inevitable.  Conservatively research shows 1 in 5 falls can be prevented.  Falls are the result of many interacting factors. People are at risk if they have:
a.      Problems with their balance or gait
b.      More than 4 medications
c.      Vision problems or an out of date eyeglass prescription
d.      Tripping hazards in their homes…………..All of these can be managed to reduce the likelihood of a fall. 
In 2010, 2.3 million elderly Americans (605,300 in NC) were sent to the Emergency room because of a fall and over 20,000 (837 in NC) died. Falls are the 6th leading cause of death for those over age 65.  More than half of the people hospitalized due to a fall have to go to a nursing home. 
The average hospital stay for a fall in 2008 was just over $20,000.  All told Medicare and other insurance companies spend 28 billion dollars per year treating injuries from falls.  Falls prevention is a good return on investment.  For every $1 we spend on prevention programs we save $1.60 in direct medical costs.  In one study, documented savings were as much as $500 per patient per year.  Another comprehensive, large scale review of the research estimated we could prevent half a million falls – total cost savings 5.8 billion per year. 
Since its inception The Carolina Geriatric Education Center (CGEC) under the Center for Aging and Health at UNC has trained over 10,000 health care practitioners on falls risk management.  Mountain AHEC and Southern Regional are conducting a research study under the CGEC covering 25 North Carolina Counties which documents the life and cost savings.” 

Wednesday, December 28, 2011

Booze and Pills Catch up to the aging

A quick note to share a story from the News and Observer.  Recently HRSA asked the Carolina Geriatric Education Center about training on substance use and abuse for providers.  Mental health in general is also on their radar screen.  Many of you already realize that the aging Baby Boomers are bringing some different challenges into the exam room

Thursday, December 15, 2011

If I Fell Down Would a Tongue Depressor Help?

So what is a Geriatric Education Center supposed to do?  There are 5 goals written into the law that drives the grant.  #1 is the biggie!
  1. Improve the training of health professionals in Geriatrics
  2. Develop & Disseminate Curricula related to the treatment of health problems of the elderly
  3. Support the training and retraining of faculty to provide instruction in Geriatrics
  4. Support continuing education for health professionals who provide Geriatric care
  5. Provide students with clinical training in hospitals, nursing homes, ambulatory care and senior centers
So, in a nutshell, create course material and train all kinds of providers.  

More and more though we are interested in proving that the WHAT that we do makes a DIFFERENCE.   

Just because The Carolina Geriatric Education Center Partners have trained over 10,000 doctors, nurses, Pas, NPs, pharmacists, social workers, physical therapists etc etc…..does that mean that care has been improved?  So HRSA is pushing us towards documenting change in clinical practice that results from all of this training.  

Mountain AHEC lead the way last year recruiting three physician practices and letting us track whether Falls Prevention Training produces more thorough screening of the population.  Last year Southern Regional AHEC piloted with a small CCRC and now they are expanding to 3 community based practices.  Both MAHEC and Southern Regional found trends that indicate practice change DOES occur and screening rates go up even with 1 hour trainings.  Awareness is raised and buy-in created to create a culture of screening.

It’s not just about training anymore! It’s about outcomes.  Imagine you are in a doctor’s office and you see all of the diplomas and tongue depressors.  So you assume he or she knows what to do with those tools and that you will get better.  But what if she puts the tongue depressor not uh in your mouth?  Same idea.

Thursday, December 8, 2011

Top 10 moments from Gerontological Society of America this year

I fulfilled a lifelong dream of mine by attending the Gerontological Society of America conference in Boston last month.  There were so many interesting topics but here are a few of my highlights:

1.      I met Phil Clark from the Rhode Island Geriatric Education Center who is the guru of Interdisciplinary team training
 2.      Heard some interesting research on using the Wii and Playstation to help older adults prevent falls.  Yes, they should play Wii bowling.
3.      Learned about some wacky shoes that challenge people with random chaotic perturbations to improve balance.  Basically the shoes try to make you fall down and you catch yourself.
4.      I heard the latest news on grant funding for research in Geriatric Mental Health.  They are interested in basic science but there are translational opportunities as well especially around depression.
5.      Learned some video shooting techniques for online learning
6.      Downloaded an app on my Droid that reminds physicians about preventative recommendations
7.      Studied the use of GPS detection systems in the home to monitor the elderly for falls.  Yes it was a little creepy but the GPS can detect the motion of a fall so it could be ideal early warning system for frail community residents. 
8.      Played with the Pogoe website.  Check it out                       .
9.      Discovered the pros and cons of e-health literacy.  Doctors don’t always like it when patient surf the web.
10.    Got great feedback from HRSA on our Evidenced Based research on falls in Mountain and Southern Regional.  They really like what we have planned for practice based change.
Was so glad to get to go and represent the excellent work AHECs in North Carolina are doing on behalf of the CGEC.