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TEACHING NURSING HOME SERVICE (TNH):
This service consists of three groups of physicians and trainees providing patient care in several nursing homes on Oahu. The emphasis is on teaching medical care of nursing home patients, rehabilitation, palliative/end-of-life medicine, and Hospice care. Services include both primary care geriatrics and consultations. Trainees are also taught principles of nursing home administration, medical directorship, and state and federal regulations governing nursing homes.
There are several components:
- Nursing home patient care (primary care and geriatrics consultations): Nursing home residents represent a group of very old, very frail persons with multiple chronic illnesses and complex care needs. Trainees receive instruction and experience that help them to understand the medical, ethical, legal, administrative and financial issues surrounding their care.
- Program director's rounds (medical directorship of nursing homes): Many geriatricians and primary care physicians are asked to become medical directors of nursing homes, however most have had no training in this area. Our program provides hands-on experience for trainees.
- Hospice and palliative care: The basic goals of hospice and palliative care include attention to symptom control, quality of life, emotional, spiritual, and social needs of patients and families dealing with chronic, life-limiting illness.
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KUAKINI MEDICAL CENTER GERIATRICS AND FAMILY SERVICES PROGRAM:
This service includes the following:
- Inpatient care at Kuakini Medical Center
- Inpatient consultations at Kuakini Medical Center
- Outpatient consultation services
Older patients often have special medical, psychological and social needs. Common issues include dementia, depression, delirium, medical decision-making capacity and malnutrition. Trainees are taught principles of full geriatric assessment, including evaluation for common geriatric syndromes, nutritional/ elimination status, functional status, advanced directives and community referral needs. Trainees gain experience working in interdisciplinary teams, involving input from family, caregivers, nurses, medical social work, physical/occupational/speech therapy and the referring physician.
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LEAHI OUTPATIENT GERIATRICS CLINIC:
Older patients often have special medical, psychological and social needs. Common issues include dementia, depression, delirium, medical decision-making capacity and malnutrition. Trainees are taught principles of full geriatric assessment, including evaluation for common geriatric syndromes, nutritional/ elimination status, functional status, advanced directives and community referral needs. Trainees gain experience working in interdisciplinary teams, involving input from family, caregivers, nurses, medical social work, physical/occupational/speech therapy and the referring physician.
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Copyright 2005-06, Department of Geriatric Medicine
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