Guest: Thiruvinva Dharmarajan, MD FACP AGSF   Host: Eric Tangalos, MD  Patients in hospital settings are often screened and promptly treated for venous thromboembolism, or VTE, but perhaps less commonly in long-term care, even though these patients may be at risk. Dr. T.S. Dharmarajan, clinical director of the division of geriatrics at Montefiore Medical Center (North Division) in the Bronx, New York, discusses the medical conditions in long-term care that put patients at risk for VTE, and ways to assess patients for the condition. What anticoagulation medications and treatments may be used for treating VTE in long-term care? Should long-term care clinicians treat VTE as aggressively as hospitals often do, or are there other unique considerations clinicians should keep in mind for managing patients at risk for VTE in long-term care? Dr. Eric Tangalos hosts.  

Guest: Thiruvinva Dharmarajan, MD FACP AGSF Host: Eric Tangalos, MD Patients in hospital settings are often screened and promptly treated for venous thromboembolism, or VTE, but perhaps less commonly in long-term care, even though these patients may be at risk. Dr. T.S. Dharmarajan, clinical director of the division of geriatrics at Montefiore Medical Center (North Division) in the Bronx, New York, discusses the medical conditions in long-term care that put patients at risk for VTE, and ways to assess patients for the condition. What anticoagulation medications and treatments may be used for treating VTE in long-term care? Should long-term care clinicians treat VTE as aggressively as hospitals often do, or are there other unique considerations clinicians should keep in mind for managing patients at risk for VTE in long-term care? Dr. Eric Tangalos hosts.

Venous Thromboembolism Management and Antithrombotic Therapy in Long-Term Care


Host: Eric Tangalos, MD   Guest: Tena Alonzo, MA  How can creating a more positive emotional experience for patients with dementia or Alzheimer's diminish behavior issues and improve quality of life? Tena Alonzo, director of research and co-director of the Palliative Care for Advanced Dementia program at Beatitudes Campus in Phoenix, discusses a common-sense approach to creating a comforting environment for those with dementia and Alzheimer's, which focuses on meeting each patient's unique needs. What simple steps can long-term care facilities and caregivers take to enhance the lives of patients with cognitive disorders? Dr. Eric Tangalos hosts.

Host: Eric Tangalos, MD Guest: Tena Alonzo, MA How can creating a more positive emotional experience for patients with dementia or Alzheimer's diminish behavior issues and improve quality of life? Tena Alonzo, director of research and co-director of the Palliative Care for Advanced Dementia program at Beatitudes Campus in Phoenix, discusses a common-sense approach to creating a comforting environment for those with dementia and Alzheimer's, which focuses on meeting each patient's unique needs. What simple steps can long-term care facilities and caregivers take to enhance the lives of patients with cognitive disorders? Dr. Eric Tangalos hosts.

Focusing on Comfort in Caring for Patients with Dementia and Alzheimer's


Guest: Robert Kane, MD   Host: Eric Tangalos, MD  Deciding between assisted living facilities or nursing homes can be daunting for patients and families. How can healthcare professionals discuss long-term care expectations with patients and families and help with the selection process? Dr. Robert Kane, Minnesota Chair in Long-term Care and Aging at the University of Minnesota School of Public Health and director of the University of Minnesota's Center on Aging, discusses the genesis and evolution of assisted living facilities and nursing homes. What are some of the common precursors to patients and families deciding it is time to choose long-term care, and how can they determine which type of care is best?  Dr. Eric Tangalos hosts.

Guest: Robert Kane, MD Host: Eric Tangalos, MD Deciding between assisted living facilities or nursing homes can be daunting for patients and families. How can healthcare professionals discuss long-term care expectations with patients and families and help with the selection process? Dr. Robert Kane, Minnesota Chair in Long-term Care and Aging at the University of Minnesota School of Public Health and director of the University of Minnesota's Center on Aging, discusses the genesis and evolution of assisted living facilities and nursing homes. What are some of the common precursors to patients and families deciding it is time to choose long-term care, and how can they determine which type of care is best?  Dr. Eric Tangalos hosts.

Choosing Between Nursing Homes and Assisted Living: Helping Patients and Families Decide


Guest: Steven Levenson, MD, CMD   Host: Eric Tangalos, MD  As healthcare reform evolves, so too do the public policies governing long-term care facilities. How can healthcare professionals stay up-to-date with the latest changes in federal and state regulations? What are the differences between regulations governing assisted living versus skilled care environments? How successful have regulations been at facilitating better quality of care in skilled care and assisted living? Dr. Steven Levenson, medical director of six long-term care facilities in Maryland and past-president of AMDA, says that having a "watchful eye" over long-term care facilities is generally useful in promoting quality of care, but laments the fact that there are some inconsistencies in the ways regulations are applied and implemented. How can healthcare providers aim towards regulatory compliance and better patient care, without getting bogged down with seemingly overwhelming details? Dr. Eric Tangalos hosts.

Guest: Steven Levenson, MD, CMD Host: Eric Tangalos, MD As healthcare reform evolves, so too do the public policies governing long-term care facilities. How can healthcare professionals stay up-to-date with the latest changes in federal and state regulations? What are the differences between regulations governing assisted living versus skilled care environments? How successful have regulations been at facilitating better quality of care in skilled care and assisted living? Dr. Steven Levenson, medical director of six long-term care facilities in Maryland and past-president of AMDA, says that having a "watchful eye" over long-term care facilities is generally useful in promoting quality of care, but laments the fact that there are some inconsistencies in the ways regulations are applied and implemented. How can healthcare providers aim towards regulatory compliance and better patient care, without getting bogged down with seemingly overwhelming details? Dr. Eric Tangalos hosts.

A Public Policy Primer for Long-Term Care Professionals: How to Achieve Regulatory Compliance


Guest: Matthew Wayne, MD, CMD   Host: Eric Tangalos, MD  Regulations regarding nurses as prescribing agents of physicians in long-term care facilities are more restrictive than in the hospital setting, because controlled substance licenses are not currently approved for nursing homes in most states. These restrictions can make it challenging for long-term care patients to receive timely access to narcotics. Dr. Matthew Wayne, medical director, geriatric medicine, University Hospital Richmond Medical Center in Richmond Heights, Ohio, and assistant professor of medicine at University Hospitals Case Medical Center in Cleveland, suggests revisions to some provisions of the Controlled Substances Act in order to ensure long-term care patients have access to pain medications when they need them the most. What hurdles are the most significant impediments to improving patient care with appropriate access to narcotics, and how can medical professionals best navigate the waters until revisions are made to the current law? Dr. Eric Tangalos hosts.

Guest: Matthew Wayne, MD, CMD Host: Eric Tangalos, MD Regulations regarding nurses as prescribing agents of physicians in long-term care facilities are more restrictive than in the hospital setting, because controlled substance licenses are not currently approved for nursing homes in most states. These restrictions can make it challenging for long-term care patients to receive timely access to narcotics. Dr. Matthew Wayne, medical director, geriatric medicine, University Hospital Richmond Medical Center in Richmond Heights, Ohio, and assistant professor of medicine at University Hospitals Case Medical Center in Cleveland, suggests revisions to some provisions of the Controlled Substances Act in order to ensure long-term care patients have access to pain medications when they need them the most. What hurdles are the most significant impediments to improving patient care with appropriate access to narcotics, and how can medical professionals best navigate the waters until revisions are made to the current law? Dr. Eric Tangalos hosts.

Improving Access to Controlled Substances in Long-Term Care


Host: Eric Tangalos, MD   Guest: Steven Handler, MD, PhD, CMD  Because residents in long-term care facilities often have comorbidities, polypharmacy can be an issue. What are the most common types of adverse drug events that can occur among long-term care patients taking multiple medications? Dr. Steven Handler, assistant professor in the department of biomedical informatics and the department of geriatric medicine at the University of Pittsburgh School of Medicine, and the medical director for long-term care health information technology for the University of Pittsburgh Medical Center, says the current methods for monitoring medications in nursing homes are inadequate for protecting against adverse drug events, and suggests ways to improve medication safety in long-term care. What tools might help practitioners in long-term care better detect and prevent adverse drug events? Dr. Eric Tangalos hosts. 

Host: Eric Tangalos, MD Guest: Steven Handler, MD, PhD, CMD Because residents in long-term care facilities often have comorbidities, polypharmacy can be an issue. What are the most common types of adverse drug events that can occur among long-term care patients taking multiple medications? Dr. Steven Handler, assistant professor in the department of biomedical informatics and the department of geriatric medicine at the University of Pittsburgh School of Medicine, and the medical director for long-term care health information technology for the University of Pittsburgh Medical Center, says the current methods for monitoring medications in nursing homes are inadequate for protecting against adverse drug events, and suggests ways to improve medication safety in long-term care. What tools might help practitioners in long-term care better detect and prevent adverse drug events? Dr. Eric Tangalos hosts.

Improving Medication Safety in the Nursing Home Setting


Guest: Peter Winn, MD, CMD   Host: Eric Tangalos, MD  With palliative and hospice care, there is no one-size-fits-all approach. What differentiates these two types of care and how can physicians decide which approach to palliative or hospice care is best for each patient? Dr. Peter Winn, professor in the department of family medicine at Oklahoma University School of Medicine in Oklahoma City, discusses various types of care at the end of life, and outlines conditions that might require such care. What are some of the challenges to providing effective palliative and hospice care, and how can physicians best discuss realistic expectations with families and patients? Hosted by Dr. Eric Tangalos. 

Guest: Peter Winn, MD, CMD Host: Eric Tangalos, MD With palliative and hospice care, there is no one-size-fits-all approach. What differentiates these two types of care and how can physicians decide which approach to palliative or hospice care is best for each patient? Dr. Peter Winn, professor in the department of family medicine at Oklahoma University School of Medicine in Oklahoma City, discusses various types of care at the end of life, and outlines conditions that might require such care. What are some of the challenges to providing effective palliative and hospice care, and how can physicians best discuss realistic expectations with families and patients? Hosted by Dr. Eric Tangalos.

Palliative Care in Late-Stage Disease and Hospice


Guest: Karl Steinberg, MD, CMD   Host: Eric Tangalos, MD  "Advance directive" is an umbrella term that encompasses end-of-life documents, including a living will and durable power of attorney for healthcare. Such documents can be scary for many patients, and as such, advance directives are not very common among the general US population. Yet these documents can be powerful tools in ensuring patients receive the type of care they desire. What do physicians need to know about advance directives in caring for patients at the end of life? Dr. Karl Steinberg, associate medical director for skilled nursing care at Scripps Coastal Medical Center in Vista, California, discusses variations, misconceptions and confusion surrounding advance directives, and says there is room for improvement. Many states have enacted Physician Orders for Life Sustaining Treatment (POLST) programs to address end-of-life care issues. What do these programs involve, and how effective are such programs in alleviating confusion with end-of-life care? Dr. Eric Tangalos hosts. 

Guest: Karl Steinberg, MD, CMD Host: Eric Tangalos, MD "Advance directive" is an umbrella term that encompasses end-of-life documents, including a living will and durable power of attorney for healthcare. Such documents can be scary for many patients, and as such, advance directives are not very common among the general US population. Yet these documents can be powerful tools in ensuring patients receive the type of care they desire. What do physicians need to know about advance directives in caring for patients at the end of life? Dr. Karl Steinberg, associate medical director for skilled nursing care at Scripps Coastal Medical Center in Vista, California, discusses variations, misconceptions and confusion surrounding advance directives, and says there is room for improvement. Many states have enacted Physician Orders for Life Sustaining Treatment (POLST) programs to address end-of-life care issues. What do these programs involve, and how effective are such programs in alleviating confusion with end-of-life care? Dr. Eric Tangalos hosts.

Knowing the Facts: Advance Directives and End-of-Life Care


Guest: David Smith, MD, CMD   Host: Eric Tangalos, MD  Nearly three-quarters of patients in long term care have some form of memory impairment or dementia. And while some forgetfulness is a normal part of the aging process, memory loss can also be overlooked as an early symptom of cognitive impairment. How can physicians distinguish between common memory loss and cognitive impairment? Dr. David Smith, professor of family medicine at the College of Medicine at Texas A&amp;M University, College Station; and president of Geriatric Consultants of Central Texas in Brownwood, Texas, discusses the nuances of different forms of cognitive impairment, and emphasizes the importance of early diagnosis. What activities, medications, environments and other strategies can help physicians slow cognitive decline in these patients? Dr. Eric Tangalos hosts.

Guest: David Smith, MD, CMD Host: Eric Tangalos, MD Nearly three-quarters of patients in long term care have some form of memory impairment or dementia. And while some forgetfulness is a normal part of the aging process, memory loss can also be overlooked as an early symptom of cognitive impairment. How can physicians distinguish between common memory loss and cognitive impairment? Dr. David Smith, professor of family medicine at the College of Medicine at Texas A&amp;M University, College Station; and president of Geriatric Consultants of Central Texas in Brownwood, Texas, discusses the nuances of different forms of cognitive impairment, and emphasizes the importance of early diagnosis. What activities, medications, environments and other strategies can help physicians slow cognitive decline in these patients? Dr. Eric Tangalos hosts.

Assessing and Maximizing Cognitive Function in Long Term Care


Host: Eric Tangalos, MD   Guest: Alexandra Papaioannou, MD  Millions of Americans have osteoporosis, but too often, a broken bone is the first indication of this common condition. What osteoporosis screening strategies can help diagnose osteoporosis in its early stages, and what treatment regimens are the most effective? Dr. Alexandra Papaioannou, professor in the department of medicine, and past-director of the division of geriatric medicine with a joint appointment in the division of rheumatology at McMaster University in Ontario, Canada, says it's important to target and prevent both falls and osteoporosis in tandem to reduce fractures. What are optimal amounts of calcium and vitamin D for older, less mobile patients? How can long term care facilities incorporate osteoporosis prevention into their screenings? Dr. Eric Tangalos hosts. 

Host: Eric Tangalos, MD Guest: Alexandra Papaioannou, MD Millions of Americans have osteoporosis, but too often, a broken bone is the first indication of this common condition. What osteoporosis screening strategies can help diagnose osteoporosis in its early stages, and what treatment regimens are the most effective? Dr. Alexandra Papaioannou, professor in the department of medicine, and past-director of the division of geriatric medicine with a joint appointment in the division of rheumatology at McMaster University in Ontario, Canada, says it's important to target and prevent both falls and osteoporosis in tandem to reduce fractures. What are optimal amounts of calcium and vitamin D for older, less mobile patients? How can long term care facilities incorporate osteoporosis prevention into their screenings? Dr. Eric Tangalos hosts.

Healthy Bones, Healthy Body: Osteoporosis in Long Term Care


Advances in Long Term Care Medicine is produced in cooperation with the American Medical Directors Association (AMDA), the only national organization representing long term care physicians and professionals. This series addresses the most relevant clinical and practice management issues facing those working in long term care settings.

Advances in Long Term Care Medicine

Guest: William Smucker, MD, CMD   Host: Eric Tangalos, MD  Delirium often goes unrecognized, even though it is a common condition in long-term care facilities. How can we be vigilant to the symptoms that might suggest dementia? Are patients with dementia most susceptible to developing delirium? What other conditions or medications might put patients at risk for developing delirium? Host Dr. Eric Tangalos welcomes Dr. William Smucker, professor of family medicine at Northeastern Ohio Universities College of Medicine, to investigate preventative strategies physicians might use to prevent development of delirium, and how to best manage the condition.

Guest: William Smucker, MD, CMD Host: Eric Tangalos, MD Delirium often goes unrecognized, even though it is a common condition in long-term care facilities. How can we be vigilant to the symptoms that might suggest dementia? Are patients with dementia most susceptible to developing delirium? What other conditions or medications might put patients at risk for developing delirium? Host Dr. Eric Tangalos welcomes Dr. William Smucker, professor of family medicine at Northeastern Ohio Universities College of Medicine, to investigate preventative strategies physicians might use to prevent development of delirium, and how to best manage the condition.

Considerations in Treating Delirium


Guest: David Thomas, MD, CMD   Host: Eric Tangalos, MD  How common are pressure ulcers in hospitals, nursing homes and other long-term care facilities? What clinical situations put patients at risk for developing pressure ulcers, and how are these wounds diagnosed? Dr. David Thomas, professor of internal medicine and geriatric medicine at Saint Louis University Health Sciences Center, joins host Dr. Eric Tangalos to review strategies for managing pressure ulcers.

Guest: David Thomas, MD, CMD Host: Eric Tangalos, MD How common are pressure ulcers in hospitals, nursing homes and other long-term care facilities? What clinical situations put patients at risk for developing pressure ulcers, and how are these wounds diagnosed? Dr. David Thomas, professor of internal medicine and geriatric medicine at Saint Louis University Health Sciences Center, joins host Dr. Eric Tangalos to review strategies for managing pressure ulcers.

Diagnosing and Treating Pressure Ulcers


Guest: Hosam Kamel, MD, MPH, CMD   Host: Eric Tangalos, MD  Heart failure is a common reason for hospitalization among older adults and long-term care patients. What strategies can help prevent a recurrence of heart failure, and what types of monitoring for exacerbations are most effective in prevention? How can physicians individualize therapy in this population? How crucial are blood pressure and hypertension control in managing patients with heart failure? Dr. Hosam Kamel, director of geriatrics and extended care, at St. Joseph’s Mercy Health Center in Hot Springs, Arkansas and associate clinical professor of geriatrics at the department of geriatrics at the University of Arkansas for Medical Sciences, discusses the goals of managing patients with heart failure in long-term care, and offers pragmatic advice for physicians in managing patients with heart failure. Dr. Eric Tangalos hosts.

Guest: Hosam Kamel, MD, MPH, CMD Host: Eric Tangalos, MD Heart failure is a common reason for hospitalization among older adults and long-term care patients. What strategies can help prevent a recurrence of heart failure, and what types of monitoring for exacerbations are most effective in prevention? How can physicians individualize therapy in this population? How crucial are blood pressure and hypertension control in managing patients with heart failure? Dr. Hosam Kamel, director of geriatrics and extended care, at St. Joseph’s Mercy Health Center in Hot Springs, Arkansas and associate clinical professor of geriatrics at the department of geriatrics at the University of Arkansas for Medical Sciences, discusses the goals of managing patients with heart failure in long-term care, and offers pragmatic advice for physicians in managing patients with heart failure. Dr. Eric Tangalos hosts.

Strategies to Prevent and Manage Heart Failure


Guest: Lory Bright-Long, MD, CMD   Host: Eric Tangalos, MD  The diversity of residents in long term care medicine can present unique challenges in diagnosing and caring for patients with various psychiatric conditions. What should physicians keep in mind when caring for younger patients, those with Alzheimer's disease, or patients who have had a stroke at long term care facilities? Dr. Lory Bright-Long, clinical assistant professor of psychiatry at State University of New York Stony Brook and certified medical director, discusses the role of the interdisciplinary team in managing patients with psychiatric conditions. Hosted by Dr. Eric Tangalos.

Guest: Lory Bright-Long, MD, CMD Host: Eric Tangalos, MD The diversity of residents in long term care medicine can present unique challenges in diagnosing and caring for patients with various psychiatric conditions. What should physicians keep in mind when caring for younger patients, those with Alzheimer's disease, or patients who have had a stroke at long term care facilities? Dr. Lory Bright-Long, clinical assistant professor of psychiatry at State University of New York Stony Brook and certified medical director, discusses the role of the interdisciplinary team in managing patients with psychiatric conditions. Hosted by Dr. Eric Tangalos.

Psychiatric Diagnosis and Care in Long Term Care Medicine


Guest: Bruce Troen, MD   Host: Eric Tangalos, MD  Vitamin D deficiency has been receiving a deluge of media coverage lately, and physicians are likely to hear many related questions from patients, especially long-term care residents and their families. What are the latest developments in vitamin D research, and how can adequate vitamin D levels help prevent falls among our older patients? Even more fundamentally, how do we define vitamin D insufficiency and deficiency? Dr. Bruce Troen, professor of medicine, research scientist at the Geriatric Research, Education, and Clinical Center, and director of the molecular gerontology program at the University of Miami Miller School of Medicine in Miami, Florida, describes the crucial role that vitamin D plays throughout the body, beyond its well-known role in the musculoskeletal system. How common is vitamin D insufficiency among geriatric and nursing home residents? What is the best regimen and dosage to overcome vitamin D insufficiency or deficiency? When should calcium be supplemented to help prevent fractures? Tune in to hear host Dr. Eric Tangalos and this week's guest sift through the latest information on vitamin D.

Guest: Bruce Troen, MD Host: Eric Tangalos, MD Vitamin D deficiency has been receiving a deluge of media coverage lately, and physicians are likely to hear many related questions from patients, especially long-term care residents and their families. What are the latest developments in vitamin D research, and how can adequate vitamin D levels help prevent falls among our older patients? Even more fundamentally, how do we define vitamin D insufficiency and deficiency? Dr. Bruce Troen, professor of medicine, research scientist at the Geriatric Research, Education, and Clinical Center, and director of the molecular gerontology program at the University of Miami Miller School of Medicine in Miami, Florida, describes the crucial role that vitamin D plays throughout the body, beyond its well-known role in the musculoskeletal system. How common is vitamin D insufficiency among geriatric and nursing home residents? What is the best regimen and dosage to overcome vitamin D insufficiency or deficiency? When should calcium be supplemented to help prevent fractures? Tune in to hear host Dr. Eric Tangalos and this week's guest sift through the latest information on vitamin D.

Making the Connection Between Vitamin D, Falls and Fracture Prevention


Guest: Frederick Wendt, RPh   Host: Eric Tangalos, MD  As medication costs continue rising, what strategies can help long-term care facilities reduce drug expenditures, while still providing the best quality of care for patients? Fred Wendt, RPh, vice president of pharmacy services for Senior PharmaStrategies in Burleson, Texas, says one of the most significant pharmacy issues in long-term care is the Drug Enforcement Administration's current position on the nursing facility staff as agent of the physician, with regard to controlled substances. How is the role of the consultant pharmacist changing in long-term care? What programs can help long-term care facilities reign in drug costs, while maintaining high quality care for patients, particularly in the area of diabetes? Dr. Eric Tangalos hosts.

Guest: Frederick Wendt, RPh Host: Eric Tangalos, MD As medication costs continue rising, what strategies can help long-term care facilities reduce drug expenditures, while still providing the best quality of care for patients? Fred Wendt, RPh, vice president of pharmacy services for Senior PharmaStrategies in Burleson, Texas, says one of the most significant pharmacy issues in long-term care is the Drug Enforcement Administration's current position on the nursing facility staff as agent of the physician, with regard to controlled substances. How is the role of the consultant pharmacist changing in long-term care? What programs can help long-term care facilities reign in drug costs, while maintaining high quality care for patients, particularly in the area of diabetes? Dr. Eric Tangalos hosts.

The Impact of Pharmacy Issues in Long-Term Care


Guest: David Dosa, MD, MPH   Host: Eric Tangalos, MD  Long-term care facilities that include pets as residents are finding that fuzzy friends offer not only companionship to their human residents, but also comfort at the end of life. Dr. David Dosa, geriatrician and health services researcher at Brown University in Providence, Rhode Island, and author of Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat, shares his stories about a nursing home cat named Oscar with an uncanny ability to sense when patients are nearing the end of life. What can Oscar teach us about compassionate palliative and hospice care? How prevalent are animal programs at long-term care facilities, and what other benefits do pets offer to residents? How do animal programs fit in with culture change in long-term care? Dr. Eric Tangalos hosts. 

Guest: David Dosa, MD, MPH Host: Eric Tangalos, MD Long-term care facilities that include pets as residents are finding that fuzzy friends offer not only companionship to their human residents, but also comfort at the end of life. Dr. David Dosa, geriatrician and health services researcher at Brown University in Providence, Rhode Island, and author of Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat, shares his stories about a nursing home cat named Oscar with an uncanny ability to sense when patients are nearing the end of life. What can Oscar teach us about compassionate palliative and hospice care? How prevalent are animal programs at long-term care facilities, and what other benefits do pets offer to residents? How do animal programs fit in with culture change in long-term care? Dr. Eric Tangalos hosts.

Pets, Culture Change and Compassion in Long-Term Care


Host: Eric Tangalos, MD   Guest: Manjula Kurella Tamura, MD, MPH  How do the processes leading to kidney failure differ for various patient populations? What special considerations should physicians keep in mind when caring for patients in long-term care facilities undergoing dialysis? Dr. Manjula Kurella Tamura, nephrologist and assistant professor of medicine at Stanford University School of Medicine, reviews findings from a study regarding functionality for patients undergoing dialysis. Dr. Kurella Tamura points out that although dialysis may increase longevity, it may not improve quality of life. What is recommended for optimal care of patients with kidney failure? Hosted by Dr. Eric Tangalos.

Host: Eric Tangalos, MD Guest: Manjula Kurella Tamura, MD, MPH How do the processes leading to kidney failure differ for various patient populations? What special considerations should physicians keep in mind when caring for patients in long-term care facilities undergoing dialysis? Dr. Manjula Kurella Tamura, nephrologist and assistant professor of medicine at Stanford University School of Medicine, reviews findings from a study regarding functionality for patients undergoing dialysis. Dr. Kurella Tamura points out that although dialysis may increase longevity, it may not improve quality of life. What is recommended for optimal care of patients with kidney failure? Hosted by Dr. Eric Tangalos.

Kidney Failure & Dialysis in Long-Term Care Medicine


Guest: Matthew Corso, JD   Host: Eric Tangalos, MD  What developments in long term care litigation have there been in recent years? What types of claims are the most common, and how can physicians and medical directors best protect themselves against frivolous claims? Matthew Corso, attorney at Buchanan, Ingersoll and Rooney, discusses these and other questions about risk management, and provides some helpful tips. Dr. Eric Tangalos hosts.

Guest: Matthew Corso, JD Host: Eric Tangalos, MD What developments in long term care litigation have there been in recent years? What types of claims are the most common, and how can physicians and medical directors best protect themselves against frivolous claims? Matthew Corso, attorney at Buchanan, Ingersoll and Rooney, discusses these and other questions about risk management, and provides some helpful tips. Dr. Eric Tangalos hosts.

Risk Management and Liability in Long Term Care


Host: Eric Tangalos, MD   Guest: Charles Crecelius, MD, PhD  There are many different types of long term care facilities, including nursing homes, skilled nursing facilities and assisted living facilities. Dr. Charles Crecelius, clinical instructor of internal medicine and geriatrics at Washington University School of Medicine in St. Louis, explains the services these different facilities provide, and offers some suggestions to physicians about ways to assess long-term care facilities. Dr. Eric Tangalos hosts. You can visit Medicare's Nursing Home Compare website here. Additionally, senior resources for chronic pain, substance abuse, and addiction include the following:  the Substance Abuse and Mental Health Services Administration, or SAMHSA, offers a search engine of more than 20,000 drug and alcohol treatment providers offering different methods and levels of care across the country. the Forterus Senior Addiction Treatment Center page provides one of the most comprehensive resource for seniors with substance abuse and addiction problems available on the web. 

Host: Eric Tangalos, MD Guest: Charles Crecelius, MD, PhD There are many different types of long term care facilities, including nursing homes, skilled nursing facilities and assisted living facilities. Dr. Charles Crecelius, clinical instructor of internal medicine and geriatrics at Washington University School of Medicine in St. Louis, explains the services these different facilities provide, and offers some suggestions to physicians about ways to assess long-term care facilities. Dr. Eric Tangalos hosts. You can visit Medicare's Nursing Home Compare website <a href="http://www.medicare.gov/NHCompare/Include/DataSection/Questions/SearchCriteriaNEW.asp?version=default&amp;browser=Firefox|3|MacOSX&amp;language=English&amp;defaultstatus=0&amp;pagelist=Home&amp;CookiesEnabledStatus=True" rel="nofollow" target="_blank">here</a>. Additionally, senior resources for chronic pain, substance abuse, and addiction include the following: <ul> <li>the <a href="https://findtreatment.samhsa.gov/" rel="nofollow" target="_blank">Substance Abuse and Mental Health Services Administration, or SAMHSA</a>, offers a search engine of more than 20,000 drug and alcohol treatment providers offering different methods and levels of care across the country.</li> <li>the <a href="http://forterustreatment.com/seniors-and-addiction/" rel="nofollow" target="_blank">Forterus Senior Addiction Treatment Center page</a> provides one of the most comprehensive resource for seniors with substance abuse and addiction problems available on the web.</li> </ul>

How Do We Assess Long Term Care Facilities?


Guest: Alan Lazaroff, MD   Host: Eric Tangalos, MD  How different is the population of long term care facilities today than in decades past, and how will these new resident communities impact delivery of care? Dr. Alan Lazaroff, director of geriatric medicine at St. Anthony Hospitals Senior Health Centers, and president of Geriatric Medicine Associates in Denver, Colorado, talks about the changes long term care facilities have made to better serve the needs of shifting resident demographics, including flexible scheduling and activities. What challenges face nursing homes today that care for younger, sicker or shorter-term patients? Dr. Eric Tangalos hosts. 

Guest: Alan Lazaroff, MD Host: Eric Tangalos, MD How different is the population of long term care facilities today than in decades past, and how will these new resident communities impact delivery of care? Dr. Alan Lazaroff, director of geriatric medicine at St. Anthony Hospitals Senior Health Centers, and president of Geriatric Medicine Associates in Denver, Colorado, talks about the changes long term care facilities have made to better serve the needs of shifting resident demographics, including flexible scheduling and activities. What challenges face nursing homes today that care for younger, sicker or shorter-term patients? Dr. Eric Tangalos hosts.

Not Your Grandma's Nursing Home: Changing Demographics in Long Term Care


Guest: David Brechtelsbauer, MD   Host: Eric Tangalos, MD  When meeting a patient's family for the first time, what information should physicians be prepared to provide, and how can physicians best address the family's expectations? What are the goals of the family meeting that should be addressed? Dr. David Brechtelsbauer, associate professor of family medicine at the University of South Dakota School of Medicine, offers some communication tips for the first visit physicians have with a patient and their family. Dr. Eric Tangalos hosts.

Guest: David Brechtelsbauer, MD Host: Eric Tangalos, MD When meeting a patient's family for the first time, what information should physicians be prepared to provide, and how can physicians best address the family's expectations? What are the goals of the family meeting that should be addressed? Dr. David Brechtelsbauer, associate professor of family medicine at the University of South Dakota School of Medicine, offers some communication tips for the first visit physicians have with a patient and their family. Dr. Eric Tangalos hosts.

Communicating With Families: Maintaining Realistic Expectations


Guest: Tim Fox, DPT   Host: Eric Tangalos, MD   Guest: Mimi Jacobs, MPT  As people are living longer than ever before with a variety of chronic conditions, modified physical activity can help older patients regain or retain functionality. Indeed, physical therapy is also essential to the recovery of patients who have undergone elective or emergency surgeries. What distinguishes therapeutic exercise from physical activity, and how can exercise programs be tailored to meet the various needs of long-term care residents? How can we effectively "dose" therapeutic exercise, setting up an effective care plan that residents can adhere to? Dr. Tim Fox, founder and executive director of Fox Rehabilitation in Cherry Hill, New Jersey, and Mimi Jacobs, founding executive director of the non-profit Fox GERI: Geriatric Education &amp; Research Institute, advocate for the benefits of therapeutic exercise in improving quality of life for all patients. Hosted by Dr. Eric Tangalos.

Guest: Tim Fox, DPT Host: Eric Tangalos, MD Guest: Mimi Jacobs, MPT As people are living longer than ever before with a variety of chronic conditions, modified physical activity can help older patients regain or retain functionality. Indeed, physical therapy is also essential to the recovery of patients who have undergone elective or emergency surgeries. What distinguishes therapeutic exercise from physical activity, and how can exercise programs be tailored to meet the various needs of long-term care residents? How can we effectively "dose" therapeutic exercise, setting up an effective care plan that residents can adhere to? Dr. Tim Fox, founder and executive director of Fox Rehabilitation in Cherry Hill, New Jersey, and Mimi Jacobs, founding executive director of the non-profit Fox GERI: Geriatric Education &amp; Research Institute, advocate for the benefits of therapeutic exercise in improving quality of life for all patients. Hosted by Dr. Eric Tangalos.

The Benefits of Therapeutic Exercise and Physical Activity in Long Term Care


Guest: Charles Cefalu, MD MS   Host: Eric Tangalos, MD  What are the various types of anemia found in long-term care settings, and which types are the most common? What are some of the underlying causes of both chronic and acute anemia? Dr. Charles Cefalu, clinical professor and chief of the section of geriatric medicine at Louisiana State University Health Sciences Center, talks about how physicians can be alert to symptoms of anemia, which are often non-specific. What is the relationship between falling and anemia? Dr. Eric Tangalos hosts.

Guest: Charles Cefalu, MD MS Host: Eric Tangalos, MD What are the various types of anemia found in long-term care settings, and which types are the most common? What are some of the underlying causes of both chronic and acute anemia? Dr. Charles Cefalu, clinical professor and chief of the section of geriatric medicine at Louisiana State University Health Sciences Center, talks about how physicians can be alert to symptoms of anemia, which are often non-specific. What is the relationship between falling and anemia? Dr. Eric Tangalos hosts.

Anemia in the Long Term Care Setting


Guest: Cari Levy, MD   Host: Eric Tangalos, MD  A growing number of young physicians are choosing to work in long term care medicine— a specialty in which high job satisfaction is generally reported. Dr. Cari Levy, assistant professor and director of palliative care at the Denver Veterans' Affairs Medical Center, tells host Dr. Eric Tangalos what she finds most appealing about working in long term care medicine. They take a wide-angle look at the field, from how physicians working in long term care facilities stay connected to a network of fellow geriatricians, to the financial viability of the specialty.

Guest: Cari Levy, MD Host: Eric Tangalos, MD A growing number of young physicians are choosing to work in long term care medicine— a specialty in which high job satisfaction is generally reported. Dr. Cari Levy, assistant professor and director of palliative care at the Denver Veterans' Affairs Medical Center, tells host Dr. Eric Tangalos what she finds most appealing about working in long term care medicine. They take a wide-angle look at the field, from how physicians working in long term care facilities stay connected to a network of fellow geriatricians, to the financial viability of the specialty.

Young Doctors in Love with Long Term Care


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