Geriatric Medicine Review

This is a Live Lecture 7-Night Bermuda Cruise Conference
Round-trip Cape Liberty (Bayonne), New Jersey and is held aboard Royal Caribbean's Explorer of the Seas.

Topics and Objectives:

1. Falls Prevention and Management
Objectives: After this session, the learner will be able to:

• Define falls
• Understand gait and balance disturbances in the elderly
• Implement a falls management program for long-term care residents
• Apply quality measures to benefit patient care and practice reimbursement

2. Osteoporosis
Objectives: After this session, the learner will be able to:

• Understand the Institute of Medicine report on vitamin D
• Review definitions of osteoporosis by DEXA and FRAX
• Utilize therapies that include bisphosphonates, PTH and inhibitors of the RANK/RANKL/OPG system
• Recommend appropriate vitamin D therapy
• Council patients on calcium supplementation and cardiovascular risk
• Summarize the various dental guidelines on osteonecrosis

3. Mild Cognitive Impairment: A Dozen Years Later
Objectives: After this session, the learner will be able to:

• Define Mild Cognitive Impairment in both amnestic and non-amnestic disease states
• Understand the potential implications of early diagnosis of dementia for patient care outcomes
• Describe progress in biomarker research for Alzheimer’s disease

4. Alzheimer’s Disease – Diagnosis and Management
Objectives: After this session, the learner will be able to:

• Evaluate patients for symptoms of cognitive and functional loss
• Identify and manage depressive symptoms in dementia
• Apply appropriate drug and non-drug interventions for patients with dementia
• Counsel families and caregivers at all stages of disease

5. Anemia and CKD in the Elderly
Objectives: After this session, the learner will be able to:

• Discuss prevention methods for anemia in CKD with a healthcare team and older patients
• Identify patients who are at-risk of developing anemia of CKD
• Develop therapy courses for older people with CKD that combine healthy lifestyle choices and medication
• Describe best practices in the management of anemia and CKD

6. Nutritional Disorders
Objectives: After this session, the learner will be able to:

• Understand that adequate nutrition is a prerequisite for the maintenance of good health and optimum efficiency
• Place greater emphasis on Vitamin D and bone health
• Identify disturbances in protein metabolism
• Recognize and intervene in clinical situations of dehydration

7. Management of Constipation
Objectives: After this session, the learner will be able to:

• Evaluate interdisciplinary strategies to overcome common barriers that hinder the optimal management of chronic constipation in health care settings
• Discuss the key components of a facility-wide approach to managing chronic constipation
• Describe the implementation of appropriate bowel protocols in health care settings
• Outline the elements of treatment plans that can be tailored for individual residents for chronic constipation to prevent severe complications

8. Depression in the Elderly
Objectives: After this session, the learner will be able to:

• Recommend primary and adjuvant therapy for the depressed elderly patient
• Utilize the PHQ-9 in all practice settings
• Identify opportunities for non-drug interventions for depression including cognitive behavioral therapy

9. Management of Chronic Non-malignant Pain in the Elderly
Objectives: After this session, the learner will be able to:

• Understand the pathogenesis of pain
• Evaluate pain in elderly patients
• Apply recent guidelines in pain management
• Choose appropriate drug therapy and multimodal interventions for the relief of pain

10. Improving Safety and Reducing Medication Errors
Objectives: After this session, the learner will be able to:

• Identify medications that place long term care residents at high risk of medication misadventure
• List mechanisms available to decrease the risk of medication errors in select environments
• Identify the major areas of medication risk in the elderly residents
• Outline strategies to improve medication safety

11. COPD and the Management of Respiratory Disease in the Elderly
Objectives: After this session, the learner will be able to:

• Evaluate interdisciplinary strategies to overcome common barriers that hinder the optimal management of COPD in health care settings
• Discuss the key components of a facility-wide approach to managing respiratory illness
• Implement the appropriate use of nebulizers, MDIs and oxygen for long-term care residents

12.Hospice and Palliative Care – Prognostication and Communication
Objectives: At the end of this session the learner will be able to:

• Describe definitions and differences
• Identify different prognostication instruments
• Understand regulatory issues
• Identify problems and solutions in the long term care hospice
• Develop communication skills regarding end of life

13.Transitions in Care
Objectives: At the end of this session the learner will be able to:

• Apply the principles of INTERACT in long term care environments "Interventions to Reduce Acute Care Transfers”
• Consider Project BOOST for hospital transitions “Better Outcomes for Older adults through Safe Transitions”
• Understand the principles underlying Project RED
“Re-Engineered Discharge”

14.Case Discussions
Objectives: At the end of this session the learner will be able to:

• Address any additional discussion items not previously reviewed
• Present cases for all to consider
• Review information not clearly stated

Key Applications

• Apply geriatric care quality indicators into every day practice
• Effectively manage common geriatric syndromes and conditions in different settings of care
• Re-engineer clinical practice to improve quality, efficiency, and safety in geriatric patients
• Participate in innovative models of geriatric care that will evolve as Medicare changes its reimbursement policies

Conference Sessions generally take place during the days at sea (as cruise itinerary allows) to avoid conflicts with Ports of Call or evening entertainment.