Geriatric

Geriatric / en Sat, 21 Jun 2025 09:20:43 -0500 Wed, 21 May 25 13:05:17 -0500 AHA House Letter Supporting Improving Seniors鈥� Timely Access to Care Act /lettercomment/2025-05-21-aha-house-letter-supporting-improving-seniors-timely-access-care-act <div class="container"><div class="row"><div class="col-md-8">May 21, 2025<div class="row"><div class="col-md-6">The Honorable Mike Kelly U.S. House of Representatives 1707 Longworth House Office Building Washington, DC 20515</div><div class="col-md-6">The Honorable Ami Bera, M.D. U.S. House of Representatives 172 Cannon House Office Building Washington, DC 20515</div></div><div class="row"><div class="col-md-6">The Honorable Suzan DelBene U.S. House of Representatives 2311 Rayburn House Office Building Washington, DC 20515</div><div class="col-md-6">The Honorable John Joyce, M.D. U.S. House of Representatives 2102 Rayburn House Office Building Washington, DC 20515</div></div>Dear Representatives Kelly, DelBene, Bera and Joyce:On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners 鈥� including more than 270,000 affiliated physicians, 2 million nurses and other caregivers 鈥� and the 43,000 health care leaders who belong to our professional membership groups, the 黑料正能量 Association (AHA) is pleased to support your legislation, the Improving Seniors鈥� Timely Access to Care Act.Inefficient prior authorization requirements are a pervasive problem among certain plans in the Medicare Advantage (MA) program that result in delays in care and add financial burden and strain to the health care system. Your bipartisan legislation would address these issues through streamlining prior authorization requirements under MA plans by eliminating complexity and promoting uniformity that would reduce the wide variation in prior authorization methods that frustrate both patients and providers.Specifically, your bill would establish an electronic prior authorization standard to streamline approvals, reduce the time a health plan is allowed to consider a prior authorization request, require MA plans to report on their use of prior authorization, including the use of artificial intelligence in prior authorization and the rate of approvals and denials, and encourage MA plans to adopt policies that adhere to evidence-based guidelines.Thank you for your support in improving the prior authorization process to increase patient access to care and reduce the burden for providers. We look forward to continuing to work with you on this issue and urge Congress to pass this bill to ensure all Medicare beneficiaries have access to timely and appropriate care. &nbsp;Sincerely, /s/ Stacey Hughes Executive Vice President</div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/05/aha-house-letter-supporting-improving-seniors-timely-access-to-care-act-5-21-2025.pdf" target="_blank" title="Click her to download the AHA House Letter Supporting Improving Seniors鈥� Timely Access to Care Act PDF.">Download the Letter PDF</a></div></div></div></div> Wed, 21 May 2025 13:05:17 -0500 Geriatric Improving Behavioral Health for Older Adults: Lessons from Henry Ford Health /advancing-health-podcast/2025-05-14-improving-behavioral-health-older-adults-lessons-henry-ford-health Mental health and substance use disorders in older adults are frequently underdiagnosed and underserved. In this conversation, Zaira Khalid, M.D., senior staff geriatric psychiatrist at Henry Ford Behavioral Health Hospital, discusses the unique physical, emotional, and social needs of patients over 65, the hospital's compassionate and multi-disciplinary approach to whole-person care, and how to recognize the silent struggles of older loved ones and provide support.<hr><div></div><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript </h2> </summary> 00:00:01:02 - 00:00:27:03 Tom Haederle Welcome to Advancing Health. Experts say mental health issues and substance use disorders in people over age 65 is underreported, under-diagnosed and deserves much more attention than it gets. In today's podcast, we learn more about how the brand new Henry Ford Behavioral Health Hospital created a designated unit dedicated to older adults to help focus on their behavioral health needs. 00:00:27:05 - 00:00:55:24 Rebecca Chickey Hello, my name is Rebecca Chickey and I am the senior director of behavioral health for the 黑料正能量 Association. And it's my honor to be joined today by Dr. Zaira Khalid, who is the senior staff geriatric psychiatrist at Henry Ford Behavioral Health Hospital, which is located in West Bloomfield, Michigan. Today, our discussion is entitled Improving Behavioral Health for Older Adults: Lessons from Henry Ford Health. 00:00:55:26 - 00:01:25:08 Rebecca Chickey Thank you so much for being here with us today. What I'd like the listeners to learn and hear first from you is what is the situation? What's the prevalence of psychiatric, or substance use disorders in individuals who are 65 and older? And what are the perhaps unique circumstances that older adults may experience that may drive conditions such as depression or anxiety? 00:01:25:10 - 00:01:50:15 Zaira Khalid, MD Rebecca, thank you for having me. Thank you for shedding light on this very, very important topic that I think doesn't get enough attention and should be getting much much more attention just because of the need that there is. So in terms of mental health and substance use disorder treatment, it is definitely underreported and underdiagnosed in our elderly patients. 00:01:50:17 - 00:02:25:15 Zaira Khalid, MD Having said that, the numbers are still very high. So, patients who we look at that may be, let's say admitted to the hospital with medical concerns and have medical comorbidities. Their prevalence of having psychiatric disorders is going to be anywhere between 40 to 50%. That's very, very high. Substance use disorders in the elderly...I believe the last time I saw a good study was in 2022. Eleven in 60 adults, older adults, had a substance use problem. 00:02:25:17 - 00:02:55:00 Zaira Khalid, MD And that's only those that are being diagnosed. You know, I can tell you from personal experience, it's a lot higher than that. We just don't recognize it. So a lot of our elderly are struggling, not getting the help they need, not seeking the help they need due to various factors. But what leads them to where they are with their mental health and where they are with their psychiatric health are that they're a unique population, they go through stressors that the majority of the other population doesn't. 00:02:55:02 - 00:03:20:23 Zaira Khalid, MD They're at a stage in life where they are losing their loved ones around them. They're losing their friends that they've had their entire life. They are retiring from their jobs, which is what gave them meaning in their life. Their kids are moved out of the home, busy with their lives. That was a huge part of their life that gave them meaning - parenting, raising their kids. 00:03:20:25 - 00:03:54:29 Zaira Khalid, MD They're now sometimes, most of the time, having to give up their homes, and they're moving into assisted living or nursing homes. And it's a completely different environment, completely different level of independence. They're not driving anymore. So all of those things put together, I think, would be stressful for any one of us. And once you add on medical problems like not being able to walk as well, having diabetes, possibly a stroke, it just leads to sort of a concoction of items that's going to lead to poor outcomes 00:03:54:29 - 00:03:56:18 Zaira Khalid, MD if not intervened. 00:03:56:21 - 00:04:23:18 Rebecca Chickey Absolutely. I saw my own mother go through this, and now my husband's parents have done exactly what you've described. They've moved into an assisted living facility. My father in law is now 94 and wheelchair bound. And my mother in law is younger and still active. And so there's also that sort of strain. Luckily, they do still have friends that are their age that are in that same living facility 00:04:23:19 - 00:04:31:00 Rebecca Chickey so that's helping offset. But, but it doesn't eliminate all the other challenges that you described. 00:04:31:02 - 00:04:34:27 Zaira Khalid, MD Yeah. Social isolation is very real and very dangerous. 00:04:34:29 - 00:04:54:22 Rebecca Chickey Absolutely. So tell me, in the design and the development of the new Henry Ford Behavioral Health Hospital, what did you do to better meet and accommodate the needs of the older adult population? Both perhaps from a physical design, but, additionally, from a treatment design. What's your approach? 00:04:54:25 - 00:05:20:29 Zaira Khalid, MD Well, we wanted to make sure we had a designated spot and a separate unit, a physically separate unit that was dedicated to older adults so we could focus on the design being different and accommodate all their needs. Simple things like having handrails on the walls in the hallways so that they were able to hold them and walk, which, you know, is not something that you commonly see in an inpatient psychiatric hospital. 00:05:21:01 - 00:05:48:14 Zaira Khalid, MD Having a courtyard outside that allows for more relaxation. It's surrounded by trees. There's benches, sunlight. Which is very different than some of the other courtyards we may have for a younger population where they we want them to be a little bit more active. So they've got basketball hoops and such. Things like having call lights. So, a psychiatric hospital, generally we don't have call lights because it can be a safety measure. 00:05:48:17 - 00:06:06:25 Zaira Khalid, MD We don't want to have a lot of cords and strings. But for our geriatric unit, we wanted to make sure we have those in case there's a fall while they're using the restroom. We have more bathrooms on this unit that are ADA accessible and have shower chairs so they're able to sit and take a shower with handheld showers so they don't have to stand for too long. 00:06:07:02 - 00:06:29:17 Zaira Khalid, MD Those would be kind of some of the design, major design elements that we've tapped into account. And the other was really having staff that has been trained and experienced in dealing with this population and knows what to look for. And it's not just about the treatment they get here, but also what we set them up with once they leave here and staff that has the knowledge of that. 00:06:29:17 - 00:06:51:19 Zaira Khalid, MD So how do we set them up with resources that is going to keep them involved in the community, keep them active? And how do we give them tools that they can learn here and continue to utilize outside of here? So that's a social worker that is well versed in some of the resources we have here. The PACE program, which is designed for the elderly, day programs for the elderly. 00:06:51:21 - 00:07:18:22 Zaira Khalid, MD We've got activity therapy that is used to doing activities that, you know, may be designed for those with less cognitive reserve, and sometimes it may just be as simple as musical instruments because that's the cognitive capacity we have. We had exercise equipment that some of the activity therapists can bring on to the unit and teach them how to do exercises, just, you know, sitting in the dayroom. 00:07:18:25 - 00:07:36:13 Zaira Khalid, MD It's something that they can translate into their own living rooms when they get discharged. So we really wanted to make sure that the staff is able to identify those needs in these patients and help them teach some of the skills that they can also translate outside of here, because this is just a week of their life or two weeks of their life. 00:07:36:16 - 00:08:07:02 Rebecca Chickey I had a thought while you were describing all the talents of the staff that you've recruited and wondering - I'm kind of leading the jury here. Also, staff who care and who look forward to working with individuals who are in perhaps their last decades of life. And it's been my experience working in health care for over 30 years now, that there's often less of a shortage for people to work in the labor and delivery unit. 00:08:07:09 - 00:08:20:28 Rebecca Chickey They want to see the new life come forward. They want to work with the babies and the new moms. But geriatric care has had its own challenges. So has that been something too, that you've focused in on to find those people with that passion? 00:08:21:00 - 00:08:41:03 Zaira Khalid, MD 100%. So everyone that works on the geriatric unit, the staff that has always voiced that they want to work on the geriatric unit and always has in the past. So our social worker has been in geriatrics for a long time. Our activity therapist has been in geriatrics for a long time. So I mean, I love working with the older adults, it's all I do. 00:08:41:05 - 00:09:00:12 Zaira Khalid, MD So all of us share that passion and I think that's why we work so well as a team. I think that's why our patients can see that when they're here and getting the care that they want. So for sure, I think passion has a lot to with it. It's not a population that most people choose to work with or want to work with. Something 00:09:00:12 - 00:09:11:17 Zaira Khalid, MD I've never understood why - I think it's the absolute best population, the sweetest population, and the most rewarding population you could work with. But the passion of the team is definitely there. 00:09:11:20 - 00:09:34:20 Rebecca Chickey Wonderful. I think another, not to say that that what I'm about to say doesn't exist in individuals who are under the age of 65, but often individuals who are 65 or older may have physical illnesses as well. Their diabetes may have gotten to a certain stage or their congestive heart failure. So how do you integrate physical and behavioral health? 00:09:34:22 - 00:09:59:07 Zaira Khalid, MD It's a wonderful question. So one of the things that I'm very passionate about is cut down their meds. A huge problem we have in our geriatric population is poly-pharmacy, meaning they see multiple doctors because they need to. And there's a lot of multiple medications being put in. And sometimes they interact. They cause side effects. Then medications are prescribed to counter those side effects. 00:09:59:07 - 00:10:25:25 Zaira Khalid, MD And this is a population very sensitive to that. So we have a fantastic family medicine team that we work with very closely. They're in-house seven days a week. A wonderful pharmacist who helps us. And we really try to treat the patient as a whole. So for example, let's say someone gets admitted for uncontrolled anxiety and they've also got diabetes. 00:10:25:27 - 00:10:51:27 Zaira Khalid, MD My first approach is not to go ahead and prescribe them something for anxiety. It's to look at their blood sugars, because we know fluctuations in blood sugars caused anxiety, geriatric or not. It's just it's much more prevalent in geriatrics because they're more sensitive to blood sugar fluctuations. So my first thing is let me work with my family medicine counterpart and let's get these blood sugars under control. 00:10:51:29 - 00:11:13:17 Zaira Khalid, MD And if we're still seeing the anxiety, then yes, we will intervene with something that is safe, doesn't interfere with their diabetes medicines, their heart medicines, and try to treat those. Working with nutrition, who's here and making sure that these patients have the adequate diet, have the adequate protein levels in order to gain some strength back that they might have lost. 00:11:13:19 - 00:11:21:24 Zaira Khalid, MD So putting all those teams together and really having that multidisciplinary approach to patient care, I think is what works really well. 00:11:21:27 - 00:11:33:22 Rebecca Chickey Yeah. Whole person care. Who knew? The brain is connected to the rest of the body. Do you have a story you'd like to share for the listeners? A success story when you've seen this approach be used? 00:11:33:25 - 00:11:55:06 Zaira Khalid, MD Yes. Actually, the diabetes medication, a story I just example I shared with you was a real life patient. So, I mean, these are all sort of lessons learned, and educating families on how important, you know, managing their blood sugars are. We see this day and night. Another very common thing that I see a lot of times is the sleep. 00:11:55:08 - 00:12:15:20 Zaira Khalid, MD You know, a lot of our elderly have trouble sleeping. That leads to irritability the next day. That may lead to behaviors like agitation in a nursing home, or they're coming in because they might have hurt someone in a nursing home. And when we really kind of think back and look back into it, one of the biggest things is sleep. 00:12:15:20 - 00:12:36:19 Zaira Khalid, MD It's not that they are agitated because they have bipolar disorder or they have something else going on. It's sleep and having to target that. And once they've gotten a good night's rest for a few nights, they're a completely different person. And I think we can all relate to that. I mean that nobody does well without sleep, but these patients and their brains are much more sensitive to that. 00:12:36:21 - 00:13:10:18 Rebecca Chickey Absolutely. So I have a couple more questions before we wrap up. The first is if one of the listeners is thinking about creating such a program as yours in their own organization, whether it's in a freestanding psychiatric hospital like yours, or they're going to try to adapt it inside a general acute care hospital, do you have maybe 2 or 3 things that you think you did as you were planning for this that really provided the successful foundation that you're operating from now? 00:13:10:21 - 00:13:37:06 Zaira Khalid, MD So I think number one is what you touched on earlier, having staff that is passionate about this population. It is not an easy population. There's a lot of medications, there's a lot of social factors that are involved. I think one of the other key elements is collaborating with your community resources. We can only do so much. They are going back into the community, and they're going to need those resources. 00:13:37:13 - 00:14:06:25 Zaira Khalid, MD So knowing what those resources are, knowing how to refer patients to those resources is going to be extremely, extremely important. Those are two of the biggest things I think that leads to success when treating geriatric patients. And then having a collaborating counterpart that is going to be medicine, because these patients have significant comorbidities that you're going to need the help of your family medicine colleagues, or your internal medicine colleagues. 00:14:06:27 - 00:14:13:07 Zaira Khalid, MD I think if you can work together as a team with them, you can really, really help these patients significantly. 00:14:13:09 - 00:14:33:27 Rebecca Chickey Well, I'm so inspired. If I had the capability to go start one of these programs, I think I would do it right now. But, I don't. Thankfully, we have professionals like you and the wonderful team at Henry Ford Health. My last question to you is, do you have words of inspiration or a call to action that you'd like to share with the listeners of this podcast? 00:14:33:29 - 00:14:56:16 Zaira Khalid, MD Sure. I think Call to Action, for me, the biggest thing would be check in on your older loved ones, please. I think a lot of them are part of a generation that doesn't talk about mental health. They're from a generation that did not necessarily believe in mental health. And, had the mindset of just keep pushing and it'll get better. 00:14:56:16 - 00:15:22:08 Zaira Khalid, MD Just keep going and you'll get better. And sometimes it doesn't. Check in on them. Also, please keep a close eye on them for any substance use. We continue to see a rise in substance use in our elderly. It's really leading to a lot of other complications as well. So, you know, I'll give you an example. For example, if a grandmother falls down the stairs, our first instinct is she's old, she tripped and she fell. 00:15:22:10 - 00:15:46:18 Zaira Khalid, MD We don't ever test her, or very rarely do we test her for alcohol. Was she intoxicated? Is that why she fell? It's not our first thought. So please look at those things. Look at their safety in their home. See if they're involved in the community or if they're spending all their weeks in their apartment. Get them involved volunteering at the library, community center. 00:15:46:25 - 00:15:55:23 Zaira Khalid, MD Day programs, whatever it may be. Giving them a purpose, giving them a routine can be so, so beneficial for them. 00:15:55:25 - 00:16:06:13 Rebecca Chickey That's wonderful and exceptional. And thank you so much for your willingness to share your passion, your time, your expertise and to inspire others on this really important journey. 00:16:06:16 - 00:16:14:27 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </details></div> Wed, 14 May 2025 00:00:00 -0500 Geriatric AHA infographic: The Realities of Behavioral Health in Older Adults聽 /news/headline/2025-05-02-aha-infographic-realities-behavioral-health-older-adults Older adults may be in circumstances that exacerbate challenges to accessing behavioral health care and have complex needs that can complicate behavioral health treatment. This new <a href="/infographic-realities-behavioral-health-older-adults">infographic</a> gives statistics about how behavioral health care needs change in an aging population.&nbsp; Fri, 02 May 2025 14:34:49 -0500 Geriatric Butler Hospital leads research, education and community outreach on Alzheimer鈥檚 /role-hospitals-butler-hospital-leads-research-education-and-community-outreach-alzheimers <div class="container"><div class="row"><div class="col-md-9"><div class="col-md-6"><img src="/sites/default/files/2025-01/THS-butler-alzheimers-research-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Butler Hospital in Providence, R.I., is leading research studies on prevention, diagnosis and treatment of Alzheimer's disease and related dementia through its multifaceted Memory and Aging Program (MAP)." width="700" height="532"></div>Butler Hospital in Providence, R.I., is leading research studies on prevention, diagnosis and treatment of Alzheimer's disease and related dementia through its multifaceted Memory and Aging Program (MAP). It鈥檚 an urgent health concern as Alzheimer鈥檚 currently has no cure.Nearly 7 million people in America are living with Alzheimer鈥檚, the most common cause of dementia. Though the disease is not a normal part of aging, the greatest known risk factor is increasing age. It鈥檚 estimated that 1 in 3 adults over age 65 dies with Alzheimer鈥檚 or another dementia, according to the <a href="https://www.alz.org/alzheimers-dementia/what-is-alzheimers" target="_blank">Alzheimer鈥檚 Association</a>.Part of MAP at Butler Hospital is a prevention registry for people with normal memory or mild memory loss interested in participating in a research study or clinical trial. Several active studies on preventing and treating Alzheimer鈥檚 are open for enrollment, led by MAP鈥檚 team of neurologists, neuropsychologists, research and clinical nurses, interns and post-doctoral fellows, and research assistants.In addition, MAP is expanding its Spanish-language outreach initiatives. Hispanic people are 1.5 times more likely to develop Alzheimer's compared to non-Hispanic white individuals. MAP partners with local health clinics and community centers to offer memory screenings, educational programs on brain health and aging, and research opportunities to historically marginalized communities. Presentations and information are offered in English and Spanish.To further increase outreach, MAP recently implemented an advance translation system that offers a wider range of languages and improved translations.Learn more about <a href="https://www.butler.org" target="_blank">MAP</a> and its <a href="https://www.butler.org/memoryandaging/beyond-translation-the-memory-and-aging-programs-culturally-tailored-approach-to-raising-alzheimers-awareness-in-the-hispanic-community" target="_blank">community outreach efforts</a>.</div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/innovation">Innovation, Research and Quality Improvement</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Tue, 21 Jan 2025 10:28:20 -0600 Geriatric AHA podcast: Preparing for the Future 鈥� How the Age-Friendly Health Systems Initiative Is Transforming Care for America's Aging Population聽 /news/headline/2024-12-02-aha-podcast-preparing-future-how-age-friendly-health-systems-initiative-transforming-care-americas In this conversation, Dave Eaker, geriatric program manager at Atrium Health, and Shannon Morton, assistant vice president of patient care services at Atrium Health Cabarrus, discuss the reasons the organization joined the Age-Friendly Health Systems Initiative, the infrastructure being developed across the system and the difference it has made for the aging population. <a href="/advancing-health-podcast/2024-12-02-preparing-future-how-age-friendly-health-systems-initiative-transforming-care-americas">LISTEN NOW</a> &nbsp;<div></div> Mon, 02 Dec 2024 15:50:41 -0600 Geriatric The Work of Action Communities in Age-Friendly Health Systems /advancing-health-podcast/2024-09-23-work-action-communities-age-friendly-health-systems Since 1982, The John A. Hartford Foundation has been a national leader in&nbsp;raising awareness and improving health care for older adults. In this conversation,&nbsp;Rani Snyder, vice president, Program at The John A. Hartford Foundation, discusses the importance of Action Communities in age-friendly care, and why health organizations should use the tools they provide to build exceptional care frameworks.<hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript &nbsp; </h2> </summary> 00:00:00:12 - 00:00:35:01 Tom Haederle Just six years from now, by 2030, the Census Bureau projects that people age 65 and older will account for more than one fifth of the U.S. population. This game-changing statistic is driving society to rethink how it responds to the health concerns and needs of so many older adults. Fortunately, a movement across the country and spreading globally, known as age-friendly health systems, is here to help. 00:00:35:03 - 00:01:14:08 Tom Haederle Welcome to Advancing Health, the podcast from the 黑料正能量 Association. I'm Tom Haederle with AHA communications. Since the early 1980s, the John A. Hartford Foundation has been a national leader in improving health care for older adults. AHA has been a key partner in the movement. In today's podcast, Raahat Ansari, senior program manager for population health with AHA, is speaking with Rani Snyder, a vice president with the Foundation, to explore why health organizations of every type should consider participating in an action community and integrating the evidence-based principles of age-friendly health systems into their own care networks. 00:01:14:11 - 00:01:28:27 Raahat Ansari Thank you so much for being here with us today, Rani, and having worked with you and the John A. Hartford Foundation for many years, I would love for you to tell our listeners today a little bit about the vision and how this work got started. 00:01:28:29 - 00:02:03:17 Rani E. Snyder I would love to do that. Thank you, Raahat. The John A. Hartford Foundation has a very long history in funding in aging. So, we started our work specific to aging in health in 1982, which, if you think about it, means 42 years of funding specific to aging. So much of that work started with building geriatrics expertise in medicine and nursing and social work, interdisciplinary team care and ultimately also in a variety of models of care. 00:02:03:19 - 00:02:24:09 Rani E. Snyder Our current president, Terry Fulmer, came in about nine years ago. She brought me in shortly thereafter as the vice president for program, and she was really charged to move the needle. We built all this expertise, all these fantastic innovations, and they weren't spreading the way we really wanted to see them spread for the growing number of older adults in our country. 00:02:24:11 - 00:02:28:07 Raahat Ansari Interesting. We know there's a lot of work that needs to be done, but not enough happening to make it move. 00:02:28:09 - 00:02:49:28 Rani E. Snyder That's exactly right. So there was sort of a frustration on our part, because we had been in the field for all those years. You know, we celebrate longevity apparently also in our funding. There's a frustration with that know-do gap that exists when it comes to the best possible care for older people. So, we understood at that point that we needed to determine how to go big. 00:02:50:01 - 00:03:15:25 Rani E. Snyder We understood that the way to do that is to build on collaboration and partnerships. And so we partnered with the Institute for Health Care Improvement. We partnered with the 黑料正能量 Association and health systems themselves, in addition to the creators, the real leaders, of creating those evidence-based models and innovations to come up with what we now call age-friendly health systems. 00:03:15:27 - 00:03:40:11 Raahat Ansari Thank you. That is so amazing to hear, and it's always rejuvenating to hear how this work started and the importance of it, because we all know that this work is just so important. And, you know, one little anecdote that I'll just share is hearing from people participating in our action communities. Everybody knows someone who's getting older. Everyone cares about someone who's getting older and is getting older themselves. 00:03:40:14 - 00:04:00:01 Raahat Ansari So I think that's one other really big driver of this work that people will find a real connection to it. So, with that being said, the AHA has an Action Community coming up in September, and we're looking for folks to join us in that seven-month-long virtual Action Community. But I'd love to hear from you. Tell us, what's the selling point? 00:04:00:01 - 00:04:05:15 Raahat Ansari Why should an organization participate in the Action Community? What's the opportunity for them there? 00:04:05:21 - 00:04:28:00 Rani E. Snyder Absolutely. And I'm going to start by stepping a little, a half step back to say what an Action Community is. So, an Action Community is a seven-month process by which a health system can learn how to implement age-friendly health systems care in their system, in any given site of care, whether it's a hospital or clinic or a nursing home. 00:04:28:02 - 00:04:35:22 Rani E. Snyder So, we sometimes get a laugh out of the fact that it's free. The Action Community is free to join the community, but guess what? It's not really free. 00:04:35:22 - 00:04:36:21 Raahat Ansari That's so true. 00:04:36:24 - 00:04:54:24 Rani E. Snyder It's underwritten by the John A. Hartford Foundation, because we feel so passionately that this kind of care that is best care, best evidence-based care for older adults at any site of care, from the kitchen table to anywhere they go for their care and then back home again, wherever home may be, that we are willing to underwrite the cost. 00:04:54:25 - 00:05:17:01 Rani E. Snyder So, I would say to any health system that is considering the increasing number of older adults and some of the difficulties that come with best care for people who have oftentimes multiple and chronic complex needs. Don't leave that money on the table. We're putting it up, so they should really take advantage of this opportunity. And that's just one of the reasons; there are a whole host of reasons. 00:05:17:01 - 00:05:38:06 Rani E. Snyder Some of the others include the fact that there's really powerful peer-to-peer learning in the action communities, because there are teams from other sites of care and other health systems all across the country that sign up for an Action Community. There often are over 100 different individual units, team units, that are doing this work, and that's really cool. 00:05:38:07 - 00:05:51:22 Rani E. Snyder Also, there are a variety of other things that come with it. So, for example, there's coaching support along the way from, in this case, the 黑料正能量 Association. But there are also Action Communities that are put on by the Institute for Health Care Improvement. 00:05:51:23 - 00:05:51:24 Raahat Ansari That's right. 00:05:51:25 - 00:05:52:12 Rani E. Snyder And others. 00:05:52:12 - 00:05:53:26 Raahat Ansari State-based ones. 00:05:54:03 - 00:06:07:20 Rani E. Snyder Absolutely. So, there are a lot of ways to go about it. And we, the John A. Hartford Foundation, don't particularly care where you join as long as you do. It's just that the AHA Action Community that's coming up is perfect timing. 00:06:07:21 - 00:06:09:24 Raahat Ansari Exactly. It's all about the timing. 00:06:09:25 - 00:06:30:08 Rani E. Snyder Absolutely, absolutely. The upcoming Action Community for AHA starts in September. So, the other thing I want to reference, though, with regard to why would you want to join an Action Community, why would you want to participate in age-friendly health care and the movement that it has become? It really comes down to outcomes, and this is what is really important to so many hospitals. 00:06:30:08 - 00:06:36:29 Rani E. Snyder So, I'm going to speak across the board instead of citing a particular either site of care or health system. 00:06:37:00 - 00:06:43:24 Raahat Ansari I'm sure that's impossible to do because there's so many hospitals that have such good outcomes. But yes, we'd love to hear a general, a general sense. 00:06:43:24 - 00:06:54:23 Rani E. Snyder You are 100% right. 100% right. So, some of the kinds of outcomes we are hearing about are decreased length of stay. Do these sound like things that hospitals care about, decreased readmissions? 00:06:54:23 - 00:06:55:05 Raahat Ansari Right. 00:06:55:07 - 00:07:04:21 Rani E. Snyder The other one that's really interesting, and this is a little more anecdotal than some of the studies I've seen in individual sites, is we keep hearing of increased workforce satisfaction. 00:07:04:28 - 00:07:14:03 Raahat Ansari That's amazing because it's so important right now to the field in terms of retention and safety and just being healthy, and especially with Covid and the long hours. That is amazing. 00:07:14:03 - 00:07:40:18 Rani E. Snyder That's a winner right there. And we know it's something that hospitals and health systems everywhere are really aware of, really conscious and working on. And then there's this one really cool example of a health system that studied as a part of determining what the outcomes have been of their age-friendly health systems work, studied time given back to patients and families, in not having to go to extra appointments and not having to go for the readmissions, those kinds of things. 00:07:40:21 - 00:07:54:19 Raahat Ansari Oh, that is so powerful. And that just gets back to the 脪what matters脫 of this, right? As a part of one of the 4Ms, how do you want to spend your time and what matters to you and that that is so huge that you've got some time back to do the things that you love. 00:07:54:24 - 00:08:10:24 Rani E. Snyder Exactly. And to speak in sort of hospital parlance, you know, it's back to patient satisfaction. And that also matters very much to the, maybe not the bottom line; well, maybe the bottom line, but certainly to the reputational and other sort of assets of any health system organization. 00:08:10:27 - 00:08:30:18 Raahat Ansari That's right. That's amazing. So, with the age-friendly health systems work, we at the AHA have been doing this for a little while now. And the AHA has released a new initiative called the Patient Safety Initiative. And as a part of that, we're learning that we can expand this, and we can bring in folks from all levels of the hospital leadership. 00:08:30:18 - 00:08:54:27 Raahat Ansari And so, the one new area that we're looking into is including the board members. And how are you bringing them into the conversation? How are you leveraging their expertise and what they bring to the table? How are you leveraging that to advance the work of age-friendly within your organization? So, I know that you, congratulations, have recently become a committee member of the Mid Coast Hospital, which is part of MaineHealth, the elder and home care committee. 00:08:55:01 - 00:09:09:10 Raahat Ansari So, I know that you've been recently appointed to that. Can you tell us a little bit about what your plan is and what you would recommend other trustees to do to ensure that their hospital and health system is bringing age-friendly care to their organization? 00:09:09:12 - 00:09:31:01 Rani E. Snyder Absolutely. So, this is a hospital in my hometown, in my home state in Maine, Brunswick, Maine. And so I've joined this committee. And I think that it's really important as we're thinking about the numbers of older adults and the ways that we are serving them to ask the questions that both speak to the needs of a hospital or a health system. 00:09:31:01 - 00:09:52:25 Rani E. Snyder And that comes down again to things like lowering costs, improving safety, improving quality and that also serve the patients. So, I'm actually feel really fortunate because the committee I just joined, the elder and home care committee, has even before I came, decided to take on age-friendly, health-systems-based care for their nursing home, and they were in the process of doing that work. 00:09:52:26 - 00:09:53:25 Raahat Ansari Perfect timing. All about timing, right? 00:09:53:25 - 00:10:21:21 Rani E. Snyder Exactly, exactly. So, I don't even have to push it. But I can ask the kinds of questions that raise these issues so that hospitals and health systems and fellow board members are aware that these resources are out there. I mean, if we're talking about hospitals, we're talking about age-friendly health systems, as well as some of the other initiatives that our foundation supports and that are very complementary and integrated with age-friendly health systems like geriatric ED care. 00:10:21:21 - 00:10:49:12 Rani E. Snyder So, through the American College of Emergency Physicians and their accreditation for geriatrics EDs, or the American College of Surgeons Geriatric Surgery verification, which is another hospital-based program. So, if you're asking the kinds of questions that indicate that you're both looking at the bottom line, looking out for the hospital, but quite frankly aware of and understanding and pushing the importance of caring for the older people in that health system, you're basically it's a win-win or a win-win-win, It's a lot of wins. 00:10:55:00 - 00:11:14:24 Raahat Ansari Right, everybody wins. And I think that's a fantastic answer. And in that answer, I actually think I heard a little bit about the last point that I want to take to make sure that we touch on. And again, we've been working together for many years now. And when we started this work, we were really focused on the inpatient setting, which made sense, and we had a lot of impact there. 00:11:14:26 - 00:11:21:09 Raahat Ansari And I would just love for you to talk a little bit about how far we've come and the work that we still have left to do. 00:11:21:11 - 00:11:45:25 Rani E. Snyder Absolutely. And I really want to give credit here to our president, Terry Fulmer. This is very much her baby. I will say I was there at the very first meeting, but I am not the driver on this one. It's been so exciting to see that the ways that this work has taken off, the fact that the 4Ms of best evidence-based care for older adults is something that really has a lot of traction with both clinicians and the public. 00:11:45:25 - 00:11:59:10 Rani E. Snyder People understand what it means to ask, assess and track what matters to older people, to pay attention to medications, to focus on mobility as a measure of essentially function. 00:11:59:14 - 00:12:10:20 Raahat Ansari Sure. Isn't it so interesting how it just like, pulls everyone, to get like anybody, like you just said, that a provider or a patient, anybody can just easily latch onto it. It's super simple, I love that. But yes, please continue. 00:12:10:20 - 00:12:34:01 Rani E. Snyder Absolutely. Well, and the only one left that I haven't mentioned yet, is mentation, which is anything of the mind. You know, if you were a geriatrician, you'd be thinking of the 3Ds: dementia, delirium, depression, right? But really, it's anything cognitive. So, we started out our full group together with IHI and AHA and the others, started out thinking about it as a hospital-based possibility but very quickly realized that that was necessary but insufficient. 00:12:34:06 - 00:12:34:22 Raahat Ansari Correct. Yeah. 00:12:34:22 - 00:13:00:09 Rani E. Snyder And that older people get care that either helps or frankly can harm them in a whole host of settings. So, we, a couple of things have changed over the almost nine years, I'd say eight or nine years of this work. First of all, we just started a new expansion of the work that is systemwide. So up until now, through the Action Communities, a particular site of care might join. 00:13:00:09 - 00:13:24:07 Rani E. Snyder It might be a hospital unit, it might be an ambulatory clinic, it might be a nursing home, as I mentioned. And those sites are a single site. But what we're doing now is working with 30 systems that have volunteered, that have signed up because they see and feel the importance of this and have seen, quite frankly, some of the positive outcomes, to push it across all of the different settings ultimately in their systems. It's super exciting. 00:13:27:08 - 00:13:59:00 Raahat Ansari Yeah, and that's really interesting. And I think that's like one other key point for those who might not have participated in the age-friendly work to date is that this framework fits in any unit, and even being in a single organization, it could mean something very different based on from one unit to the next. And that's the whole point of this framework, is that it can be tailored to fit the needs of the unit in the organization, whether the type of setting you're in, you know, you had spoken about the hospital that you're working with is a little bit of a rural in a rural area. 00:13:59:00 - 00:14:14:12 Raahat Ansari You know, we also have critical access hospitals and, you know, within the rural areas, of course, and academic medical centers. So just this is literally tailored. You can tailor this to fit any care setting. So, and I think, you know, you mentioned that it's in the convenient care clinics. The CVS. 00:14:14:14 - 00:14:38:05 Rani E. Snyder Yes. Absolutely. Well so we're now moving to spread through all parts of the health system. So, we started with age-friendly health systems, with the geri-ED work that I mentioned and the surgery work, the geriatric surgery verification. Well, now we're talking about, as you mentioned, CVS minute clinics, all of the minute clinics in the country have been in the process for several years now of becoming age-friendly, which is super exciting. 00:14:38:05 - 00:14:59:06 Rani E. Snyder In addition, I mentioned nursing homes and ambulatory care settings. PACE sites. So, for folks who are not familiar with what PACE is, it's an acronym that stands for Programs of All-Inclusive Care of the Elderly. Really, it's everywhere. And in fact, there are crosswalks to some of the community-based organizations that are doing work in partnership now with health systems as well. 00:15:01:10 - 00:15:19:28 Raahat Ansari That is so amazing. And we could talk for hours, but I know we're at time. So just wanted to thank you one last time and pause to say if there are any other comments that you wanted to just give to our Action Community, people are thinking about joining or people who are well on their path, anything you additional you might want to share. 00:15:20:01 - 00:15:42:10 Rani E. Snyder I would love to. There are some other expansion areas that I didn't mention, so that includes things like age-friendly health systems for caregivers. So, caregivers are themselves a twofer, right? Because it's their health impacts not only themselves but also the person they're caring for. So, this is not just about the care recipient, but the person who's doing the work for them. 00:15:42:10 - 00:16:05:01 Rani E. Snyder And really working that in. The Veterans Administration is doing this work across the country. So, we're very excited about that. And we're really thinking through and implementing age-friendly care in home-based primary care. This is care for people who can't get out of their home to go to a primary care clinician of some sort. Hospital at home. 00:16:05:01 - 00:16:38:17 Rani E. Snyder So back to the hospital. But really thinking about that kind of hospital-level care at home for those people where it's appropriate, and many, many others are joining the movement. So, the last thing that I guess I'll say is that there are other funders, who have, who are increasingly joining this work as well. So, depending on where a health system is, there may be funders in your community that will help you to not just join an Action Community because we fund those, but to really implement the principles of age-friendly care, to measure the age-friendly care that they're implementing. 00:16:38:18 - 00:16:53:17 Raahat Ansari That's huge. So that data, right, not only helps the organization itself, it can help other teams that are looking, then thinking about it, to build that case and bring that back to their own organization. So, there's so much data out there. Be sure to look for it on all of our websites. 00:16:53:17 - 00:17:13:12 Rani E. Snyder You bet. Thank you. We're doing some work with UCSF to be sort of the national clearinghouse of some of that work, and to lead some of the evaluation and outcomes on the age-friendly health systems work. So, we invite everybody to join us. All we want, really, is to make sure that every older adult, everywhere they are, gets the best possible care. 00:17:13:19 - 00:17:16:14 Raahat Ansari I love that. Thank you. Thanks for being here with us today. 00:17:16:15 - 00:17:17:24 Rani E. Snyder My pleasure. 00:17:17:27 - 00:17:26:08 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts. </details> </div> Mon, 23 Sep 2024 08:23:27 -0500 Geriatric For A-fib Patients, a Life Without Blood Thinners /role-hospitals-medical-university-south-carolina-fib-patients-life-without-blood-thinners <div class="container"><div class="row"><div class="col-md-9"><div class="col-md-5"><img src="/sites/default/files/2024-09/ths-musc-watchman-700x532.jpg" data-entity-uuid data-entity-type="file" alt="MUSC. A female doctor listens to an older male patients heart." width="700" height="532"></div>For years, the first-line treatment for atrial fibrillation, or A-fib, has been blood thinners. A-fib, which is a cardiac rhythm abnormality, can lead to other health complications, including strokes 鈥� it鈥檚 estimated that 90% of all strokes happen in patients who have A-fib.The problem with blood thinners is exactly what makes them so effective: They prevent blood clots. This is good when trying to avoid a stroke, but can cause complications when A-fib patients undergo surgery, fall, or have a history of other bleeding problems.The WATCHMAN device solves that issue. It鈥檚 essentially a small plug placed on the left atrial appendage that prevents blood clots from forming there and traveling to the brain. It鈥檚 a simple solution. L. Garrison Morgan, M.D., director of the Structural Heart Disease program at the Medical University of South Carolina, says that his team can implant the device in about 15 minutes. The patients are on bed rest for about two hours, and then they go home. In the past six years, MUSC patients have experienced a 99.5% success rate and zero major complications. How did Morgan鈥檚 team get so good? In August, they completed their 800th WATCHMAN procedure.But it鈥檚 no longer just a matter of volume. 鈥淭here are clinical trials that we were part of that are essentially giving patients the option of having a WATCHMAN device as a first-line therapy,鈥� Morgan said, which would mean that A-fib patients would never have to go on blood thinners for their condition.鈥� 鈥淚t鈥檚 very safe. It鈥檚 effective. It鈥檚 quick. And it gives the patient a lifetime鈥檚 worth of stroke prevention from one simple procedure.鈥� <a href="https://web.musc.edu/about/news-center/2024/08/22/musc-health-columbia-medical-center-downtown-helps-hundreds-get-off-blood-thinners-with-watchman">Read more about MUSC and WATCHMAN here</a>.</div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/innovation">Innovation, Research and Quality Improvement</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 19 Sep 2024 19:13:46 -0500 Geriatric CMS launches model aimed at improving dementia care聽 /news/headline/2024-07-08-cms-launches-model-aimed-improving-dementia-care The Centers for Medicare &amp; Medicaid Services July 8 announced over 400 participants in a new model focused on improving dementia care. The <a href="https://www.cms.gov/priorities/innovation/innovation-models/guide">Guiding an Improved Dementia Experience (GUIDE) Model</a> began July 1 and seeks to reduce strain on unpaid caregivers as well as offer care coordination and management, caregiver education and support, and respite services. CMS will also test an alternative payment for participants delivering key support services to people with dementia, including comprehensive, person-centered assessments and care plans, care coordination, and 24/7 access to a support line. People with dementia and their caregivers will have access to a care navigator to help them access services and support, including clinical services and non-clinical services such as meals and transportation through community-based organizations. Mon, 08 Jul 2024 16:02:43 -0500 Geriatric AHA podcast: Caregivers Need Care, Too聽 /news/headline/2024-05-29-aha-podcast-caregivers-need-care-too As Americans age, health care is seeing a shift in addressing the unique needs of older adults, but what about those caring for their loved ones? Diane Mariani, program manager at Rush University Medical Center, discusses their Caring for Caregivers program, which shares resources and guidance to family and friends who care for older adults, while helping them better manage their own health and wellness. <a href="https://www.youtube.com/watch?v=lRIIvSuEmMc">WATCH NOW</a> Wed, 29 May 2024 14:39:11 -0500 Geriatric AHA podcast: Providing Behavioral Health Support for Older Adults /news/headline/2024-05-22-aha-podcast-providing-behavioral-health-support-older-adults Behavioral health conditions among older populations are often underrecognized, undertreated and stigmatized, according to the World Health Organization. Learn how West Virginia鈥檚 Broaddus Hospital works to identify and meet the unique mental health needs of their older community members with Senior Life Solutions, its intensive outpatient group therapy program designed for patients 65 and older. <a href="/advancing-health-podcast/2024-05-22-providing-behavioral-health-support-older-adults">LISTEN NOW&nbsp;</a> Wed, 22 May 2024 14:35:11 -0500 Geriatric