Long-Term Care

• Rotation length: 12 months (longitudinal)
• Location: Caroline Kline Galland Home
• Supervising Faculty: Rubenstein, Ainsworth, Babineau
• Evaluation: direct observation, chart review, written competency-based evaluation.

Practical details:

• Fellows spend one half-day per week at Kline Galland, and one half-day per week at WCC.
• Attending supervision is provided by our geriatrics faculty.

Rotation Goals and Objectives:

Patient Care

• Provide longitudinal care to a panel of frail, institutionalized elderly with a wide range of medical and social issues.

Medical knowledge

• Develop expertise in the common medical conditions of the long term care setting, including infections, dementia and behavioral disturbances, pressure ulcers, falls, polypharmacy, and pain management.
• Recognize acuity in the LTC patient; know when and how to recommend hospitalization.
• Become expert in palliation and in providing comfort care, including care at the end of life.

Practice based learning and improvement

• Provide supervision and teaching to resident physicians in the care of nursing home patients.

Interpersonal and communication skills

• Communicate sensitively and accurately with patients and families regarding prognosis and appropriateness of aggressive medical care.
• Gain expertise in running family meetings
• Respond appropriately to the concerns of nursing staff.

Professionalism

• Interact closely and professionally with nursing home staff to provide excellent multi-disciplinary care.

Systems-based practice

• Understand available practice models for the provision of long-term care.
• Supervise mid-level providers, and educate them in the practice of long term care.