Aging / Alzheimer's
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30429
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Browsing Aging / Alzheimer's by Author "Hadley, Lesca"
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Item Assessing Benzodiazepine Use in the Elderly(2021) Wickramage, Pavithra; Gibson, John; Hadley, LescaChronic benzodiazepines are frequently prescribed to patients above the age of 65 for anxiety and/or insomnia. They are listed in the Beer's criteria as medication that should not be prescribed to the geriatric population. In order to understand prescribing habits and limit the use of benzodiazepines in this demographic, a protocol following the Patient Monitoring Program (PMP) Narx Score was studied. Patients about the age of 65 who have a sedative score about 200 according to their PMP report were identified and recommended for tapering of medication and/or referral to psychiatry. Willingness to taper off medication was considered a positive result and compared to data gathered before this enhancement. After the implementation of the above-mentioned enhancement, 100% of patients were willing to be tapered off medication. This is in contrast to the 67% that were willing to be tapered off before. Significance for the terms of this study was set to be if greater than 50% of patients were willing, which was a success rate present before and after the enhancement. In conclusion, the utilization of the sedative NARX proved to be an effective method to identify patients who are at great risk of chronic benzodiazepine use. The age of the patient is used to calculate said score. Although the use of this score was beneficial to improving patient outcomes in the studied clinic, future studies should be implemented in clinics who did not have a prior history of geriatric patient education already implemented into the clinic culture.Item Improving Fall Risk Assessments in Elderly Rural Populations(2021) Johnson, Jordyn; Gold, Vanna; Gibson, John; Hadley, LescaPurpose This QI project was implemented to improve the screening for fall risks in patients over 65 who were not already using a walking assistive device. The town of Lampasas has a population of 19.4% over the age of 65 and there is currently little being done to identify fall risks. Methods Fall risks were identified using the "Get Up and Go" test in which patients were asked to go from a seated position to standing, walk across the room, and return to their chair. The administrator of the test was to watch for any difficulty standing, unsteadiness, or difficulty walking. Ideally, if a fall risk was identified, the administrator should then discuss preventative measures. Results Data collection was done on two separate days. The first day recorded how many screenings were done without intentional implementation of the project. Zero fall risk assessments were done during that day. The second was running the project and including the Get Up and Go test as part of the physical exam. Of the nine possible patients who could have been screened, seven were for an overall increase of 75%. Conclusions A key lesson learned was planning screenings in a way that is practical and easy. The get up and go test is easy to include in physical exams and provides a sampling of a patients mobility. The next steps would be to include the screening as part of the physical exam template in order to que providers to do the assessment.Item Incorporating Medical Students into the Development of Age Friendly Healthcare Systems through Quality Improvement Projects(2021) Murphy, Joshua; Philip, Timothy; Severance, Jennifer; Gibson, John; Hadley, LescaPurpose: The world is aging. Health systems are often not prepared for the number or complexity of geriatric patients. Caring for this vulnerable population through age-friendly health systems is imperative for our future. With the universal lack of geriatricians, family physicians primarily care for the elderly population and are therefore ideally placed to lead changes to improve the lives of geriatric patients. The Rural Osteopathic Medical Education (ROME) Program partnered with UNTHSC's Center for Geriatrics to create geriatric-focused quality improvement projects (QIPs) for medical students to complete in their family medicine clerkships. Methods: ROME students surveyed rural family physicians regarding geriatric needs in their patient population. The results were analyzed to determine patient clinical needs as well as physician educational needs. Geriatric QIPs were developed from the survey results and implemented into the clinics. Results: 100% of the students stated that they are better able to analyze, collect, and communicate data about quality improvements in practice. 100% of the students stated that they would integrate QIPs into their practices. 67% of the family physicians strongly agreed that QIPs were useful to their practice. Conclusions: Students identified best practices to address the health needs and concerns of older adults and their caregivers. The QIPs improved care for the elderly in addition to providing experience in implementing quality improvement methods that can be used in the students' future medical practices. Incorporating medical students into QIPs in family medicine clinics is valuable for the patients, students, and physicians.