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.
Contact- Lesley Carson, MD
Location- 3609 Chestnut St (corner of 36th and Chestnut)
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
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