Care of the Elderly Program
This program offers a rich and exciting opportunity to further enhance your skills in caring for older adults. While the program is generally 12 months in duration, there is occasionally an option of an abbreviated six-month experience of core rotations. There is a strong commitment to teaching and learning tailored to individual needs.
The program includes a combination of block rotations with selected horizontal continuing clinical experiences. Experience in the following clinical settings is usually provided in block rotations:
- Acute Care Ward Consultation
- Geriatric Rehabilitation Unit
- Outreach
- Geriatric Psychiatry
- Geriatrics and Family Medicine
- Electives
The horizontal experiences include:
- Ambulatory clinics
- Seminars
- Resident project
- Rounds
- Developing teaching skills
- Experience in program planning, development, and administration
- Selected enrichment experiences
While there are specific goals and objectives for the program it is anchored broadly in the four principles of family medicine.
A. FOUR PRINCIPLES
- THE DOCTOR-PATIENT RELATIONSHIP IS CENTRAL TO THE ROLE OF THE FAMILY PHYSICIAN.
The resident must develop and demonstrate appropriate attitudes toward the elderly in providing care. The resident should be familiar with the role of and impact on the families/caregiver in the management of the elderly, and be able to recognize and manage effectively the problems of the family/caregiver caring for the elderly. The resident should demonstrate knowledge of and insight into common ethical and legal issues in the care of the elderly.
- THE FAMILY PHYSICIAN IS AN EFFECTIVE CLINICIAN.
The resident must have theoretical knowledge of and practical experience in common clinical problems and approaches in the elderly.
- FAMILY MEDICINE IS COMMUNITY-BASED.
The resident must actively use and interact with community resources to enhance patient management.
- THE FAMILY PHYSICIAN IS A RESOURCE TO A DEFINED PRACTICE POPULATION
The resident must be able to access appropriate materials and resources and apply them in the practice to the patient’s benefit. The resident will understand the unique position of the family physician to promote research that respects patient involvement. The resident will be able to select and access evidence from the medical literature to answer patients’ questions.
B. PROGRAM GOALS
- Defining the discipline in terms of knowledge and attitudes
- Refining and extending clinical skills appropriate to the discipline
- Creating an awareness of the services available in the community with utilization of a team approach
- Creating the skills for community leadership in the development of geriatric services and health promotion.
C. OBJECTIVES
KNOWLEDGE
- The physician shall be able to discuss the aging process.
- The physician shall discuss the disorders of old age.
- The physician shall demonstrate a high index of suspicion for treatable disease and dysfunction.
- The physician shall demonstrate expertise in the medical, functional, social, ethical and psychological dimensions of ill health in the elderly.
- The physician shall demonstrate skill in working cooperatively with other health professionals.
SKILLS
- The physician shall demonstrate the special skill required to take an accurate, relevant history from the patient and/or relative or friend.
- The physician shall demonstrate a physical examination technique modified to an appropriate scheme for the elderly patient.
- The physician shall demonstrate knowledge of the use of functional assessment methods in routine practice.
- The physician shall demonstrate expertise in risk assessment and management.
- The physician shall demonstrate expertise in diagnosing and treating the common disorders of old age, aiming for realistic goals.
- The physician shall assess the mental function and competency of the elderly patient.
- The physician shall demonstrate expertise in diagnosis and management of psychogeriatric disorders.
- The physician shall accurately assess the required levels of care for any particular patient.
- The physician shall manage the patient with multiple disorders and rank these in order of priority.
- The physician shall discuss the special problems of retirement.
- 11. The physician shall discuss the special problems of the terminally ill patient and the family.
- The physician shall discuss the special problems of drug therapy for the aging patient.
- The physician shall assess the patient’s suitability, for care at home against the background of family, mental capabilities, physical status, economic feasibility, and home facilities.
- The physician shall demonstrate expertise in managing the problems of the family in relation to elderly people.
- The physician shall use the team approach to the geriatric patient. (Experience at levels of team leader, team participant and as group facilitator shall be included. Post-meeting follow-up and evaluation of team function are to be emphasized).
- The physician shall appropriately utilize rehabilitation therapy.
- The physician shall demonstrate expertise in the recognition and management of elder abuse.
USE OF COMMUNITY RESOURCES
- The physician shall list and appropriately utilize the services offered in the community, e.g. legal advice, home care, nursing home, voluntary services, day hospital, etc.
- The physician shall list and appropriately utilize the facilities available in the hospital for the elderly patient, such as physiotherapy, speech therapy, pastoral counseling and social services.
- The physician shall demonstrate knowledge of the administrative role of a medical director of a Home for the Aged or Nursing Home. The physician shall be able to discuss the role of attending physicians and consultant physicians in such facilities.
PROJECT:
The physician shall complete a project on some aspect of health care of the elderly in family practice.