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Iu Geriatrics PREMIER ISSUE IU GERIATRICS NEWSLETTER OF THE INDIANA UNIVERSITY GERIATRICS PROGRAM & THE INDIANA UNIVERSITY CENTER FOR AGING RESEARCH Spring, 2001 Programs Are Major Source of Pride Volume 1, Issue 1 By David W. Crabb, M.D. campus-based programs, and built a size- Chairman, Department of Medicine able cadre of interdisciplinary specialists Indiana University School of Medicine in geriatric care. These clinical venues and faculty are being used to provide a The demographics of aging are by greater and more structured education now familiar to most of us. There are in Geriatrics for our students, residents, 900,000 adults aged 65 and older living fellows, and faculty. in the State of Indiana. In another 30 Furthermore, the entire program years, this number will nearly double. is closely dovetailed with the health Although older adults comprise about services research activities in the Center 12% of our state population, they for Aging Research. This Center was Steven R. Counsell, M.D. account for nearly 40% of all health care started with the assistance of the Indiana Mary Elizabeth Mitchell expenditures. Internal University Strategic Scholar in Geriatrics Associate Professor of Medicine Medicine physicians will It is mandatory for us Directions Initiative and Director of Geriatrics spend about 50% of their to advance knowledge major support from the Indiana University School of Medicine professional time in the Regenstrief Institute for [email protected] care of older adults. about aging through Health Care. Additional 317-630-6911 In the mid-1990s, the research, and philanthropic support leadership at Indiana translate those established three endowed University recognized the findings into better chairs—the Cornelius implications of this aging care of aging patients and Yvonne Pettinga Chair imperative. Led by faculty in Aging Research, the in the Department of in our educational Mary Elizabeth Mitchell Medicine, the university activities. Chair in Geriatrics, and initiated a new Geriatrics the Richard M. Fairbanks Program in the Division of General Chair in Aging Research. Medicine, now known as the Division The research focus for the Center’s of General Medicine and Geriatrics and 11 core investigators is geriatric health headed by William M. Tierney, M.D. services and behavioral research. Their Christopher M. Callahan, M.D. This program, now in its fifth year, has investigations test new strategies to im- Cornelius & Yvonne Pettinga Scholar produced a dramatic expansion in our prove and measure the quality of health in Aging Research efforts to improve the quality of health care and the quality of self-care. Along Associate Professor of Medicine care for older adults. with the Center’s 23 affiliated scientists, Director, Indiana University Through collaborative funding from their vision is to build an interdiscipli- Center for Aging Research the University, the Health Schools, nary community of scholars whose Research Scientist Regenstrief Institute for Health Care Wishard Health Systems, the Regenstrief creativity and scientific excellence leads [email protected] Institute for Health Care, local philan- to improved health for older adults. 317-630-7200 thropy, and extramural grants, the The development of these twin Department of Medicine is now home programs is a major source of pride for to a nationally recognized and innovative our Department, School, University and program in Geriatric Medicine. The State. I look forward to the continued program has developed state-of-the-art leadership of the Geriatrics Program clinical venues on campus, integrated a and Center for Aging Research as they network of skilled nursing facilities and help us all to provide higher quality care home health care initiatives with our to older adults. The IU Geriatrics Program—Building a Strong Team It takes a very strong diverse team to carry out a big IU Geriatrics Neurology vision. Consider the IU Geriatrics Program vision— Program Faculty Ann Hake, M.D. to provide quality clinical care for older Hoosiers, Neuropsychology to provide needed geriatrics education and training Steven Counsell, M.D. Frederick Unverzagt, Ph.D. experiences for medical students, residents, and Robin Beck, M.D. Palliative Care Program fellows; and to investigate new treatments and Amna Buttar, M.D. Greg Gramelspacher, M.D. health care delivery models for seniors. Christopher Callahan, M.D. Physical Medicine & Future issues of IU Geriatrics will present the Jeffrey Darnell, M.D. Rehabilitation program's clinical, educational and research activi- David M. Smith, M.D. Angela Carbone, M.D. ties, but in this premier issue, we introduce readers Usha Subramanian, M.D. Psychiatry to the Geriatrics Program faculty. The list includes Michael Weiner, M.D. Jeanne Dickens, M.D. faculty geriatricians as well as department specialists Glenda Westmoreland, M.D. Urology who work in clinical venues such as the IU Center David Wilcox, M.D. Thomas Gardner, M.D. for Senior Health, a multispecialty clinic providing consultation and primary care. Complementing the faculty is an interdisciplinary They all work to improve the quality, efficiency, and team of geriatric nurse practitioners, clinical nurse integration of care to older adults and families who specialists, social workers, physical and occupational are coping with the medical, social, and emotional therapists, pharmacists, dieticians, and chaplains. issues of aging. Beck Stars in House Calls Feature patients who live near Wishard. House Calls tries to keep seniors living in their homes as independently as possible. The need for home care in Indiana cannot be disputed—about 250,000 Hoosiers over age 65 have difficulty with activities of daily living such as bathing, getting dressed and walking. House Calls Team (left to right) Robin Beck, M.D., Beck, the director of House Calls, returned to Donna Casper, M.S.W., L.S.W., Bruce Grau, R.N., G.N.P. the Indiana University School of Medicine as a geri- atrician in the fall of 1999 with the goal of starting Readers of the Indianapolis Star had the opportunity to the service for seniors. She completed an Internal meet Indiana University geriatrician Dr. Robin Beck Medicine Residency at IU, followed by a Geriatrics when an edition of the newspaper focused on the Fellowship at the University of Wisconsin. Beck is House Calls for Seniors program. The paper shadowed board certified in Internal Medicine and Geriatrics. Beck last winter as she called on her patient and his In addition to performing clinical duties for wife in their city home. House Calls, Beck spends a portion of her time The main goal of the House Calls program is to supervising and teaching geriatric fellows, housestaff, reach the homebound who otherwise would not and medical students about key areas of senior care receive needed medical care. A team consisting of a such as osteoporosis, dementia, and drug prescrib- geriatrician, a geriatric nurse practitioner, and a social ing. As a member of the IU Geriatrics core faculty, worker all make home visits and spend time together she provides inpatient care in Wishard's Acute Care each week reviewing their patients. for Elders (ACE) Unit and outpatient care at the Operated by Wishard Health Services and IU Geriatric Health Centers and the IU Center for Medical Group, the program is limited to elderly Senior Health. Research Makes IMPACT in Primary Care While researchers await the final patient outcomes, clinical geriatrics providers hope the IMPACT project will make a difference in the lives of seniors who are patients in Wishard’s Adult Medicine Clinical Practice. IMPACT—Improving Care for Late Life Depression— tests the cost effectiveness of a multifaceted disease management program to improve the care of older adults with major depression or dysthymia. The project will determine if a primary care-based collaborative program will improve patient outcomes such as depres- sive symptoms, health related quality of life, quality of care for depression, and The goals of satisfaction with depression treatment for care when compared to IMPACT are to IMPACT Collaborative Team (left to right) care as usual. Depression Clinical Specialist Cora West, R.N., achieve symptomatic Funded by the John A. A.N.P., Geriatrician Amna Buttar, M.D. , and remission, full return Hartford Foundation and Geriatric Psychiatrist Jeanne Dickens, M.D. of psychosocial the California HealthCare functioning, and Foundation, the clinical prevent relapse and trial is conducted in 7 pri- psychiatrist, a geriatrician, and the DCS who coordinates recurrence of mary care systems around all care for depression with the patient’s primary care depression. the country. Christopher physician. The team uses clinical judgment to ensure that M. Callahan, M.D., is the patients enter a stepped care algorithm at the correct principal investigator for the Indiana site. step and that each patient has a treatment plan that is After a patient’s recruitment into the study, the best suited for his or her clinical circumstances and depression clinical specialist (DCS) conducts an initial treatment preferences. assessment and provides patient education, activation, “While there is ample evidence that depression in follow-up and case management. The DCS supports late life can be successfully treated," notes Callahan, antidepressant medication therapy treatment by primary "few older adults receive an adequate dose and duration care providers and is trained to deliver a form of Problem of treatment in the primary care setting.
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