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Gerinotes January 2019.Indd GERINOTES Academy of Geriatric Physical erapy Th is Issue President’s Message Editor’s Note Policy Talk: Post-acute Care Payment is Changing My Opinion: Productivity, an Ambiguous but Widely Sighted Monster Debility and Functional Decline in Long-term Care Facilities: Are We Part of the Problem? A Multi-disciplinary Event to Celebrate Falls Prevention Awareness Day National Fall Prevention Awareness Day Celebrations RIC RIAT PH Knowledge Translation – What Is It? E YS G IC F A Persistent Postural Perceptual Dizziness in the O L Elderly: A Theoretical Hypothesis for a Y T Missed Diagnosis in the Underserved Population M H E E Impact or LSVT-BIG on Functional Outcomes R in a Patient with Parkinson’s Disease: A Case Study D A A P C External Gait Cues: Improving Gait in Persons with Y A Parkinson’s Disease GET LIT A m n o Core Values: Measurement in Older Adults e ti ri ia ca c n so 3D Pharmacology: Management of Depression, Ph s ys py A Delirium, and Dementia in Older Adults ical Thera January 2019 | Volume 26, No. 1 TABLE OF CONTENTS President’s Message .......................................................... 3 Knowledge Translation – What Is It? ............................. 16 Greg Hartley Mariana Wingood, Mary Milidonis Editor’s Note .................................................................... 4 Persistent Postural Perceptual Dizziness in Michele Stanley the Elderly: A Theoretical Hypothesis for a Missed Diagnosis in the Underserved Population.......... 18 Policy Talk: Post-acute Care Payment is Changing .......... 5 Jeffrey R. Guild Ellen R. Strunk Impact or LSVT-BIG on Functional Outcomes in My Opinion: Productivity, an Ambiguous a Patient with Parkinson’s Disease: A Case Study .......... 20 but Widely Sighted Monster ............................................ 9 Blake A. Hampton, Niamh Tunney, Daryll Dubal Gabriel Alain External Gait Cues: Improving Gait in Persons Debility and Functional Decline in Long-term with Parkinson’s Disease ................................................ 24 Care Facilities: Are We Part of the Problem? .................. 11 Alex Piersanti Heidi Sue Moyer GET LIT A Multi-disciplinary Event to Celebrate Core Values: Measurement in Older Adults ................... 26 Falls Prevention Awareness Day ..................................... 13 Carole Lewis, Valerie Carter Bonnie L. Rogulj, DeAnn Taylor 3D Pharmacology: Management of Depression, National Fall Prevention Delirium, and Dementia in Older Adults ...................... 28 Awareness Day Celebrations .......................................... 14 Roslyn D. Burton Mariana Wingood Publication Title: GeriNotes Statement of Frequency: 5x/year; January, May, July, September, and November Authorized Organization’s Name and Address: Academy of Orthopaedic Physical Therapy, APTA, Inc. For Academy of Geriatric Physical Therapy, APTA., 2920 East Avenue South, Suite 200, La Crosse, WI 54601-7202 Newsletter Deadlines: March 10, May 10, July 10, September 10, November 10 Editorial Statement: GeriNotes is the official magazine of the Academy of Geriatric Physical Therapy. It is not, however, a peer-reviewed publication. Opinions ex pressed by the au thors are their own and do not necessarily reflect the views of the Academy of Geriatric Physical Therapy, APTA. The Edi tor reserves the right to edit manuscripts as neces sary for publication. Copyright 2019 by the Academy of Geriatric Physical Therapy, APTA. All advertisements that appear in or accompany GeriNotes are accepted on the basis of confor ma tion to ethical physi cal therapy standards, but acceptance does not imply endorsement by the Academy of Geriatric Physical Therapy, APTA. IN HONOR/MEMORIAM FUND Each of us, as we pass through life, is supported, assisted and nurtured by others. There is no better way to make a lasting tribute to these individuals than by making a memorial or honorary contribution in the individual’s name. The Academy of Geriatric Physical Therapy has established such a fund which supports geriatric research. Send contributions to: The Academy of Geriatric Physical Therapy | 3510 East Washington Avenue | Madison, WI 53704 Also, when sending a contribution, please include the individual’s name and any other person you would like notified about your contribu- tion. If you are honoring someone, a letter will be sent to that person, and if you are memorializing someone, the surviving family will be notified of your contribution. In the field of geriatric physical therapy, we receive many rewards from our patients, associates, and our mentors. A commemorative gift to the Academy of Geriatric Physical Therapy In Honor/Memoriam Fund is a wonderful expressive memorial. President’s Message Greg Hartley, PT, DPT Our collec- or various other government agencies (1) AGPT provides education that en- tive voice mat- on a wide variety of proposed rules and hances practice by producing value, ters. As many of regulations. In 2018, AGPT submitted empowering advocates, and promoting you are aware, comments to HHS on the proposed the use of evidence informed practice; Reader’s Digest rules for SNF PPS, IRF PPS, and Home (2) AGPT attracts, engages, and mobilizes published an Health PPS; IMPACT Act implementa- physical therapists, physical therapist article (Septem- tion; proposed opioid rules for residents assistants, and students serving aging ber 2018) titled in long-term care; and a letter to the adults; and “14 Exercises to editor of the New York Times regarding (3) AGPT builds relationships to expand Never Do After an article they published titled, “Costly its influence and the reach of physical Age 50.” The Rehab for Dying is on the Rise at Nurs- therapy. article was misleading and full of age- ing Homes, a Study Says” (https://www. ist information. It quickly generated nytimes.com/2018/10/12/business/ There are several objectives and a backlash among therapists on social nursing-home-residents-rehabilitation- strategies embedded within each goal. media, prompting a combined response therapy.html). The AGPT’s comments Transparency (information sharing, from the AGPT and APTA (https://ge- are always aligned with our mission communication), collaboration (inter- riatricspt.org/news/index.cfm?#n428). to improve access to promote physical nal and external partnerships), advo- Within a few hours of receiving the let- therapist best practice and to advocate cacy (anti-ageism, payment and policy), ter to the editor from APTA and AGPT, for optimal aging. These comments are evidence-based practice and education, Reader’s Digest retitled the article to in the public domain but are admittedly and health promotion/prevention/well- “Exercises You Should Modify If You’re difficult to find. The AGPT has begun ness and themes in each of the strategies. Over 50” (https://www.rd.com/health/ posting our comments to our own web- I am excited to get to work on this bold fitness/exercises-to-modify-over-50/). site in an effort to inform our members and energetic plan. Implementation of While the title changed, most of the of all of our advocacy work. Look for the plan will require many volunteers. content did not. Thankfully, Reader’s them in the News Section (https://geri- Some activities do not require a long- Digest invited APTA, AGPT, and indi- atricspt.org/news/). term commitment and are quick tasks. vidual physical therapists to write a fol- This commitment to transparency Some tasks require ongoing commit- low-up article that was later published and advocacy is directly related to the tee work, while others will be handled as “Myths You Shouldn’t Believe About Academy’s 2019-2021 strategic plan. In by short-term task forces or micro- Fitness Over 50” (https://www.rd.com/ early October 2018, AGPT leadership volunteers (volunteers who commit to health/fitness/myths-shouldnt-believe- met to develop a new strategic plan, one quick task). Please watch for calls fitness-after-50/). I am very proud of including a revised vision and mission. for volunteers and check the website our members and the PT/PTA com- The vision, mission, and overall goals frequently. We cannot achieve our vision munity at large for speaking up against will be presented to the membership without your help! the original ageist article and supporting for endorsement during the member’s With that, I would like to thank the our response and the subsequent follow- meeting at CSM this month. Members members who volunteered their time to up article. This series of events is perfect received information about the new develop this language and plan. I am example of how we can work together language and strategic plan in eNews, inspired by all of you. Your dedication and have a broad societal impact. email, and on the website. The proposed to the AGPT, APTA, and aging adults While the Reader’s Digest articles vision, “Embracing aging and empower- is admirable. I cannot wait to see where got mainstream and widespread atten- ing adults to move, engage, and live well,” this takes us! And let us know how you tion, there are many examples of activ- describes a vision of the Academy’s out- can help by going to https://geriatricspt. ism AGPT participates in on behalf ward facing societal role in the future. org/volunteer/index.cfm. of its members and aging adults. This The proposed mission, “Building a com- form of advocacy occurs quite regularly munity that advances the profession of but is often less visible. Examples of this physical therapy to optimize the experience include comments submitted by AGPT of aging,” defines the Academy’s internal to the Department of Health and Hu- approach to reach the goals and ulti- man Services (HHS), the Centers for mately, the vision. There are 3 primary Medicare and Medicaid Services (CMS), goals in the 2-year plan. They are: GeriNotes, Vol. 26, No. 1 2019 3 Editor's Note Michele Stanley, PT, DPT HAPPY One of the missions of GeriNotes GET LIT, the popular and KT NEW YEAR! I is to illustrate the works and projects of based regular column by Carole Lewis keep thinking the component SIGs of the Academy of and Valerie Carter returns this month that I should Geriatric PT.
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