Browsing by Subject "geriatrics"
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Item Implementing Aging-in-Place Programming for LGBTQ+ Older Adults: A Doctoral Capstone Project(2025-05-08) Gurevitz, Shelley; Wasmuth, Sally; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Fogel, JanineOut of the eight areas of occupation, social participation is a key pillar of health and wellbeing that can be unaddressed by healthcare professionals, such as occupational therapists (OT). Older adults are at significant risk of social isolation and loneliness due to many psychosocial factors; however, older adults who are lesbian, gay, bisexual, transgender, queer/questioning, and other identities (LGBTQ+) are at a greater risk of social isolation and loneliness at an alarming rate. Through a doctoral capstone project, the occupational therapy capstone student developed and implemented an eight-week social support group at an Indianapolis Gender Health clinic, with the purpose to facilitate increased social participation and connection amongst LGBTQ+ older adults. Additionally, aging-in-place elements were used as patient education material throughout the group. The University of California, Los Angeles (UCLA) Loneliness Scale-Revised was utilized as an outcome measure to assess loneliness prior to the support group intervention and following sessions. Qualitative data, such as field notes, were also taken during the last session accompanied by post-group feedback. Responses indicated a moderately high level of loneliness amongst LGBTQ+ older adults who participated in the support group. Additionally, the level of loneliness remained unchanged. This project overall was received positively by group members to foster a sense of identity, inclusivity, and social connection. Additionally, this project adds to the existing LGBTQ+ and gender health programming to support occupational therapy’s role in addressing the needs of LGBTQ+ older adults.Item Implementing Models of Geriatric Care—Behind the Scenes(Wiley, 2018) Chodosh, Joshua; Weiner, Michael; Medicine, School of MedicineInnovative geriatric clinical programs have proliferated in the 21st century, and many have been highlighted in the Journal of the American Geriatrics Society (JAGS). The Affordable Care Act has supported the accelerated innovation of publicized and unpublicized program development, adaptation, and implementation. Many JAGS articles report work conducted in programs with significant improvements in quality; high satisfaction for patients and providers; and for some, reductions in costs. Despite considerable detail, enabling implementers to attempt to adopt reported programs or adapt them to local environments, much less is typically conveyed about the subtleties of the implementation process that led to a successful outcome. Moreover, where we have been given a window into successful initiatives, far less is known about those that failed and even less about why some succeeded but others failed. With a focus on our shared needs as a geriatrics community, to foster the exchange of more‐comprehensive models of successful and failed implementation, we propose publications that address implementation itself—a second layer of reporting about the “hidden” elements that may have been decisive factors in taking an efficacious test, treatment, or model and putting it into real‐world practice. We propose a new platform for sharing a broader range of healthcare quality improvement initiatives—successes and failures. We include several salient characteristics that could be measured and described in support of dynamic, sustainable, evidence‐based implementation of geriatrics programs.Item Occupational Therapy’s Role in Geriatric Primary Care: Helping Pave the Way(2025-05-05) Reyher, Whitney; Bednarski, Julie; Bednarski, Julie; Department of Occupational Therapy, School of Health and Human Sciences; Pritchard, SuzanneOlder adults often have complex healthcare needs that are managed by a primary care physician (PCP). As the amount of older adults rises in the coming years, in combination with a potential shortage of PCPs, occupational therapists can start to play an important role in assisting in their care in this practice setting, as the scope of OT aligns with the preventative and holistic nature of primary care. The aim of this project was to assist with occupational therapy joining the healthcare team at a geriatric outpatient clinic by identifying an OT population need and assessing the effectiveness of the current process to meet that need, while also educating interdisciplinary colleagues about OT’s scope of practice and the benefits of team-based care. The results of this study indicated that the current process of screening and referring to outside agencies is not effective at meeting the occupational needs of the patients.Item Optimizing Health for Complex Adults in Primary Care: Current Challenges and a Way Forward(Springer, Part of Springer Science+Business Media, 2014-06) Day, Hollis; Eckstrom, Elizabeth; Lee, Sei; Wald, Heidi; Counsell, Steven; Rich, Eugene; Department of Medicine, IU School of MedicineAs the population ages, the quantity and complexity of comorbidities only increases in the primary care setting. Health systems strive to improve quality of care and enhance cost savings, but current administrative and payment systems do not easily support the implementation of existing evidence and best practices for multimorbid adults in most primary care offices. This perspectives piece sets forth a research agenda in the area of implementation science at the intersection of geriatrics and general internal medicine. We challenge academic medical centers, medical societies, journals, and funders to actively value and support investigation in this area as much as traditional research pathways.Item Palliative care as a core component of geriatric medicine. [Part 1](2004-05-17) Meier, Diane E.Presentation about incorporating more palliative care into health care for the aged.Item Palliative care as a core component of geriatric medicine. [Part 2](2004-05-17) Meier, Diane E.Presentation about incorporating more palliative care into health care for the aged.Item Palliative care as a core component of geriatric medicine. [Part 3](2004-05-17) Meier, Diane E.Presentation about incorporating more palliative care into health care for the aged.Item Response to depression treatment in the Aging Brain Care Medical Home model(Dove Medical Press, 2016) LaMantia, Michael A.; Perkins, Anthony J.; Gao, Sujuan; Austrom, Mary G.; Alder, Cathy A.; French, Dustin D.; Litzelman, Debra K.; Cottingham, Ann H.; Boustani, Malaz A.; Department of Biostatistics, School of Public HealthOBJECTIVE: To evaluate the effect of the Aging Brain Care (ABC) Medical Home program's depression module on patients' depression severity measurement over time. DESIGN: Retrospective chart review. SETTING: Public hospital system. PARTICIPANTS: Patients enrolled in the ABC Medical Home program between October 1, 2012 and March 31, 2014. METHODS: The response of 773 enrolled patients who had multiple patient health questionnaire-9 (PHQ-9) scores recorded in the ABC Medical Home program's depression care protocol was evaluated. Repeatedly measured PHQ-9 change scores were the dependent variables in the mixed effects models, and demographic and comorbid medical conditions were tested as potential independent variables while including random effects for time and intercept. RESULTS: Among those patients with baseline PHQ-9 scores >10, there was a significant decrease in PHQ-9 scores over time (P<0.001); however, the effect differed by gender (P=0.015). On average, women's scores (4.5 point drop at 1 month) improved faster than men's scores (1 point drop at 1 month). Moreover, both men and women had a predicted drop of 7 points (>50% decline from baseline) on the PHQ-9 at 6 months. CONCLUSION: These analyses demonstrate evidence for the sustained effectiveness of the ABC Medical Home program at inducing depression remission outcomes while employing clinical staff who required less formal training than earlier clinical trials.