A Creative Way to Expand the Geriatrics Workforce

Journal of the American Geriatrics Society Research Summary

Geriatrics is the field of health care focused on care for older adults. Experts suggest that our current geriatrics workforce needs better preparation to care for the 5.7 million people living with dementia in this country. To help meet this challenge, the Institute of Medicine has called for enhancing educational and training programs for improving the competence of the workforce, and to ensure that our workforce reaches the level needed to serve the growing population of older adults with dementia.

Despite these ongoing efforts, the shortage of geriatricians makes it difficult to meet these urgent educational needs. For this study, a team of researchers looked “outside the box” to learn more about whether creative solutions could offer valuable opportunities for addressing these issues. In this new study, the researchers outlined the results and outcomes of an undergraduate service-learning course that used music and filmmaking to teach person-centered approaches to dementia.

The course, which included music, filmmaking, and reflective writing components, focused on service at local dementia care settings and was conducted in collaboration with Music & Memory, a non-profit organization dedicated to bringing personalized music playlists to people living with dementia or other serious medical challenges.

The three-credit undergraduate service-learning course was developed and taught by a music professor over three consecutive semesters with 16 to 18 students each term.

The students worked in pairs at one of two dementia care settings. Students received initial classroom training on dementia, ethnomusicology (music anthropology), ethnographic fieldwork methods (the technical term for expert research based on studying people and culture), filmmaking basics, and creative aging. Continue reading

Older Adults and Medication: A Geriatrician’s Experience

ST picStephanie Trifoglio, MD, FACP
AGS Member
Private Practice Internist & Geriatrician 

As a geriatrician, I see all of my patients myself, carefully take their history, and review all of their medications, both prescribed and over the counter (OTC).  One patient’s story highlights why this is still very important and worth the time and effort.

A new patient, Mrs. B, came to me for help in managing her dementia. Her husband was remodeling their home to make it accessible as she was now barely able to walk.  She was becoming more confused.  She had previously seen an internist and two neurologists.  Her husband gave a history of Parkinson’s disease, along with a several-year history of colitis and longstanding diarrhea.

The initial history revealed that Mrs. B. had progressive weakness, unsteady gait, and confusion.  She had muscle jerks at night.  She had three recent car crashes and subsequently stopped driving.  She had even lost her ability to do sudoku. This was significant as she had been a doctorate-level biologist.  A review of her medications showed that she had four years of taking Pepto-Bismol, two tablets, four times per day, prescribed for collagenous colitis.  She took this dose consistently.

The active ingredient in Pepto-Bismol is bismuth, and I have never before had a patient take this much bismuth.  Being naturally curious, and always looking for potentially reversible causes of dementia, I did a bit of research and ran basic blood tests on Mrs. B.  I also instructed her to stop taking the bismuth. Continue reading