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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.
  • 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.

Practical details:

Monday Tuesday Wednesday Thursday Friday
AM
PM Kline Galland Kline Galland

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.