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