Geriatric Medicine Home

 

Geriatric Elective Home

Purpose of this Rotation

Resources

Primary care (office-based)

Ralston-Penn Center

VA Clinic

Radnor Practice

Specialty Clinics

Osteoporosis Clinic

Penn Memory Center

Sleep Disorders Clinic

Home Visits

Nursing Home Care

Penn-Center for Rehabilitation and Care (PCRC)

VA Nursing Home (VANH)

PACE (Program of All-Inclusive Care of the Elderly)
PACE article

LIFE

Didactics

Geriatric Academic Conferences

Grand Rounds & Journal Club
Fellows Conferences
GIF Conferences

EBM

Overview
Project/Case Conference

Hospice

 

 

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Outpatient Geriatrics Rotation for
Family Medicine and Internal Medicine Residents

Penn Center for Rehabilitation and Care (PCRC)

Penn Center for Rehabilitation and Care (PCRC) is a 124-bed skilled nursing facility offering long- and short-term care. Team members include nurses, social workers, dietitians, physical, occupational and speech therapists, and a recreation therapist.

I. Criteria for Nursing Home Placement

  • Medical
  • Functional
  • Psychosocial

II. Geriatric syndromes, disorders and issues in the long-term care setting choice of individual appropriate course of action, use of standardized assessments, methods to utilize multidisciplinary care/evaluation, differential diagnosis, therapeutic intervention via a specific case approach

  • Rehabilitation
  • Palliative Care
  • Health care maintenance
  • Neuropsychiatric and behavioral disturbances
  • Incontinence both urinary and fecal
  • Pressure Ulcers
  • Malnutrition with eating problems
  • Sensory deficits especially visual and audiologic
  • Syncope and dizziness
  • Falls/gait instability
  • Cardiovascular disease including hypertension and coronary artery disease/confusion with gastrointestinal disorders
  • Infection including UTI and pneumonia
  • Neurological disorders including stroke, movement disorder, seizures
  • Endocrinologic disorders

III. Criteria for determination of acute hospitalization

  • Level of aggressiveness
  • Complicating issues
  • Nursing home capabilities

General Nursing Home Objectives

  • Learn skills necessary to perform a new patient admission or readmission and appreciate the importance of acquiring complete and facilitating adequate medical record transfers from various institutions.
  • Appreciate the importance of the intra-agency transfer form.
  • Appreciate the complexities of long-term care and the importance of the compete geriatric assessment in nursing home settings.
  • Gain a better understanding of issues specific to nursing home care including but not limited to wound care, fall prevention, monitoring complications related to polypharmacy and iatrogenesis, and prevention of weight loss.
  • Appreciate the roles of the multiple ancillary services involved in nursing home patient care and the unique care model that exists in which a limited number of caregivers (RNs, NPs, LPNs, CNAs, MDs, etc.) provide care to a large number of frail patients.

Contact Information

Lesley Carson, MD
Penn Center for Rehabilitation and Care
3609 Chestnut St. (corner of 36th and Chestnut)
Philadelphia, PA 19104