Clinical Geriatrics

I’ve had the privilege of knowing Barbara Resnick, PhD, CRNP, FAAN, FAANP, for many years, and I, like the rest of the members of the American Geriatrics Society (AGS), am looking forward to getting to know her in her new capacity—as the president of the AGS. Dr. Resnick, who has a PhD in nursing and is a professor in the Department of Organizational Systems and Adult Health at the University of Maryland School of Nursing, begins her term as AGS president this month, during the AGS 2011 Annual Scientific Meeting.

I recently ran across an article in The New York Times about a subject that has long been an important and pressing issue in geriatrics and long-term care: the use of tube feeding in patients in the final stages of dementia. Eating problems are frequent complications in patients with advanced dementia, and this complication is associated with high mortality.¹ The Times article, “Feeding Dementia Patients with Dignity,”² opens with an anecdote about 75-year-old Rosemary DeFelice, who, in the last stages of Alzheimer’s disease, has lost the ability to eat. Her daughter, Cyndy Viveiros, must decide whether her mother should have a gastric feeding tube inserted.

More seniors are unhappy than happy with healthcare reform, according to a recent Gallup poll that also reflects what I’m hearing from older adults. Aware that the new healthcare reform law calls for Medicare cuts, many seniors are concerned that the cuts will chip away at their benefits. But the truth of the matter is that reform legislation will actually enhance Medicare benefits—and the practice of geriatrics.

The new reform law calls for significant future cuts in Medicare outlays, but these cuts focus on inefficiency, waste, and fraud that together cost Medicare billions each year. Basic Medicare benefits are guaranteed by law. And under healthcare reform, greater care coordination and support for care within a broader context of wellness will improve both the quality of care that beneficiaries receive and its cost-effectiveness. By accomplishing the latter, the legislation will make Medicare more sustainable.

Encouraging Patients to Get H1N1 and Other Vaccinations Is
Imperative; AGS’ New Immunization “Pocket Card” and FHA’s Vaccine “Tip Sheets” Can Help Seniors Understand Why

This flu season, about 36,000 Americans are expected to die of complications from seasonal influenza, and most of these deaths will be among older adults. Although the flu vaccine has been conclusively shown to lessen both the risk and the severity of influenza, one-third of older adults don’t get it, according to the Centers for Disease Control and Prevention (CDC), which also estimates that one-th

The 2009 H1N1 virus (“swine flu”) may be back in force earlier this fall than the seasonal flu, the Centers for Disease Control and Prevention (CDC) reported in mid-summer, as this issue of Clinical Geriatrics went to press.

Though the summer is usually flu-free, the new virus was continuing to cause illness, hospitalizations, and deaths in the United States throughout the summer months, and the World Health Organization (WHO) declared a worldwide pandemic. In light of this, the CDC warned that we could well see increases in H1N1 cases starting in September—when children head back to