Perhaps advanced care nurses and PAs as critical members of the eldercare workforce can be the solution to the workforce concerns. Providing educational opportunities and certification in geriatric care for physician extenders such as advanced care nurses and physician assistants PAs as well as for others on the care team e.
Evidence in the literature reveals good outcomes and patient satisfaction for patients with complex medical needs being cared for by nurse practitioners NPs and PAs. Educating non-geriatricians on key geriatric principles through continuing medical education CME courses can expand awareness of concepts in geriatric care more broadly and help guide when referrals to expert geriatricians are appropriate.
A recent study found an inter-professional intervention by a geriatrician attending multidisciplinary discharge rounds twice weekly and advising when geriatrics consultation would be beneficial resulted in increased use of appropriate geriatric consultation and reduced time to consultation Puelle et al. This is a creative mechanism to maximize the use of scarce geriatric resources.
An additional method to expand opportunities for patients to be evaluated by expert geriatricians is to provide telemedicine geriatric consultative services. Telemedicine offers many means to address the problems of geriatric care in creative ways. The use of electronic medicine, telecommunications, and information management has now found its way into the very fabric of health care.
The use of telemedicine is a fait accompli in much of the world, and it continues to have an increasing role deeply embedded in our electronic practices coupled with social media.
The evidence for successful incorporation of telemedicine into practice is abundant and continues to accrue. This is a great opportunity for medical practice to evolve to new levels of engagement with patients and new levels of attainment in terms of quality elder care. A long-term solution to the geriatrician recruitment crisis would include meaningful reform of the reimbursement system to guarantee financial incentives for those seeking a career in geriatrics. Although a permanent solution will involve changing Medicare reimbursement for geriatricians, other major health care reforms, or other health care system changes, an interim solution that appears feasible is to offer financial incentives that will partially offset the financial burdens for those seeking a career in geriatrics.
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Home care in the U. Go to report. John Elflein. Poskanzer was taking antidepressants but they did not seem to help her symptoms. I was sleeping a lot. I wasn't getting to work. Upon seeing her mother's distress, Poskanzer's daughter made an appointment for her mother with Manisha Parulekar, chief of geriatrics at Hackensack University Medical Center.
Parulekar recommended Poskanzer take steps to improve her quality of life. Parulekar scheduled a sleep study for Poskanzer, which led to discovery that Poskanzer had sleep apnea.
Parulekar also prescribed Poskanzer a new antidepressant and physical therapy in a pool to help Poskanzer regain her stamina, and eventually agreed that Poskanzer, who was overweight, was a good candidate for bariatric surgery. Today, Poskanzer is nearly 80 years old and continues to provide therapy 30 hours a week and feels "full of spirit. Poskanzer said she continues to see her geriatrician every four months, during which time they are able to sit and talk about how Poskanzer is doing.
But often older adults who could benefit from a geriatrician cannot readily find one because of a growing shortage, Span reports. According to Span, the federal model indicates the United States will need 33, geriatricians in to care for elderly patients. But currently there are about 7, U.
As Span reports, the number of graduate fellowship programs training geriatricians, underwritten by Medicare, has not kept pace with demand as the nation's baby boomers age. For instance, a analysis found that, over a year time period ending in the academic year, the number of such graduate fellowship programs increased from to just Aldis Petriceks—the study's lead author, who is currently a medical student at Harvard —said, "It's basically stagnation.
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