Geriatric Assessment and Consultation Clinic

Rotation Length: 12 months (longitudinal)
Location: Swedish Medical Center (First Hill)
Supervising Faculty: Rubenstein
Evaluation: direct observation, chart review, written competency-based evaluation.

	Monday	Tuesday	Wednesday	Thursday	Friday
AM				Geriatric Assessment Clinic
PM

Geriatric Assessment and Consultation clinic is held on Thursday mornings at Swedish Family Medicine.
The fellows’ own patients as well as patients of the residency clinic are seen for complete Geriatric Assessment.
The fellows also perform specialty Geriatric consultations for community physicians.
The clinic is precepted by the geriatrics faculty.

Patient Care

Learn to perform complete Geriatric Assessments, to include evaluation of nutrition, hearing loss, vision loss, fall risk, urinary incontinence, polypharmacy, depression, cognitive impairment, functional status, caregiver strain, and advanced care planning.
Become adept at providing specialist geriatric consultation to community physicians for a wide range of geriatric clinical questions.
Recognize when safety concerns require recommending that patients transition to a higher level of care, and know how to access available options.

Medical Knowledge

Develop expertise in functional and cognitive assessment, particularly in the diagnosis and management of dementia.
Identify common geriatric problems that are often missed in primary care, and develop specific treatment recommendations.

Practice-Based Learning and Improvement

Understand the appropriate use of screening tools, and the evidence behind them, in the assessment of geriatric patients.

Interpersonal and Communication Skills

Communicate sensitively and accurately with patients, caregivers, and families regarding the diagnosis of, natural history of, and treatment options for dementia.
Become expert in discussions of goals of care, including end of life care.
Provide succinct and expert written communication to referring physicians; provide appropriate follow-up plans.

Professionalism

Interact professionally with referring physicians, acting as a community resource.
Establish the role of the consultative geriatrician in the care of the elderly.
Work closely and collaboratively with the multidisciplinary team, including nursing, behavioral health, social work, and rehabilitation therapy.

Systems-Based Practice

Understand the available community resources for patients with cognitive impairment.
Develop knowledge of medico-legal issues relevant to geriatric medical care, including Durable Power of Attorney, Health Care Directives, and Guardianship.