WEBVTT

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So today I'm going to be
talking to you about the summer

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I spent at Baystate Medical
Center as a research assistant

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with their Acute Care
for Elders program.

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So what is an Acute
Care for Elders unit?

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It is kind of a
specialized model of care

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that is designed to try to
accommodate the unique health

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care needs that seniors have
in an inpatient setting.

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As you can imagine, seniors are
not like someone who is, say,

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20, 30 years old.

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They have some
issues when it comes

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to inpatient hospitalization.

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So for example, even with
short-term hospitalization,

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so if someone who
is a little older

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is in the hospital even
just for a couple of days,

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that bed rest can lead
to functional decline.

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Seniors are also prone to what
is known as delirium, which

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is an acute state of
confusion that seniors

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are particularly prone to.

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So an Acute Care for Elders unit
is kind of a different model

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that I will go into in
a minute that is trying

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to accommodate those needs.

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There are five major
components to an acute care

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for elders unit.

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As you can see, they focus on
really patient-centered care,

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frequent medical review,
early rehabilitation,

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discharge planning.

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And at Baystate,
the biggest things

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that I noticed that
were implemented there

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were what were called
grounds meetings, which

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they had every day.

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These were meetings attended
by myself, the research

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assistant, the
physician's assistant,

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pharmacist, the nurses--

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basically everyone from the
interdisciplinary aspects

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of patient care.

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And essentially,
every patient was

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discussed every day, so their
progress, how they are doing.

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There was also a
big focus on what

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are known as potentially
inappropriate medications,

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which, as you can imagine,
are medications that are not

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known to work too well
for seniors, that are all

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too often prescribed anyway.

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So there was a big focus on
trying to get seniors off

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of these unnecessary
medications that sometimes

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do more harm than good.

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So why does it matter?

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Why do these interventions
make a difference?

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Long story short, the results.

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For example, falls
were down by half.

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Delirium was reduced by 30%.

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People were being
discharged back home

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as opposed to skilled nursing
facilities more frequently.

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[INAUDIBLE] use
was down 50 folds.

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So basically,
people were staying

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for shorter periods of
time, coming back less,

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basically being
healthier for longer

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as a result of this model.

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So where did I come in?

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I was a research assistant.

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So my job consisted
of patient interviews.

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I was administering what was
known as a Frailty Scale.

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So it was a few
cognitive assessments,

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one of which I'm going to
go a little more in-depth

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on in a minute, a depression
screening asking about

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someone's activities
of daily living--

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so basically trying to see if
patients are having their needs

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met both inside and
outside of Baystate.

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So for example, trying to see
if, can you get into the shower

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without assistance?

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If you do need help with that,
do you have help with that?

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And reporting my findings
at grounds meetings.

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One particularly interesting
cognitive assessment

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that I would like to share with
you is known as a clock draw.

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So I would have the
patients try to draw a clock

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as it looked at ten past eleven.

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And these are some
of my actual clock

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draws that I got
from people listed

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with the person's diagnosis.

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So for example, this is someone
who had Parkinson's disease,

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and that is someone who was
suffering from delirium.

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I got the clearance
from the doctor

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at the head of the
program to go through,

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to share these
pictures with you.

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And here's some more.

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This is someone who had bipolar.

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And that's someone with
depression, possible dementia,

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altered mental status.

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And so you see people
who may be able to hold

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a conversation with you,
you wouldn't necessarily

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think they have
cognitive impairments,

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and little things like this,
you can really tell a lot.

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It's fascinating.

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So the biggest take aways
that I got were, obviously,

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my hands-on patient experience.

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You can't learn
that in a classroom.

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I got to work directly with
patients, interviewing them.

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I also got to form a valuable
professional network.

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So the physician's assistant
was my direct supervisor.

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The doctor heading the program,
I got to network with them.

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I got to shadow doctors
and, as I mentioned,

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understanding the unique
health care challenges

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that seniors face.

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I would highly
recommend this to anyone

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who's considering a
medical career, anyone

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who wants to work with seniors.

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Overall, I learned so much.

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And I would like to share
some acknowledgements.

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I would like to thank Heidi-Ann
Courtney, the physician's

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assistant who was my direct
supervisor, Dr. Erin Leahy, who

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was in charge of the program,
LYNK UAF 2017 for making this

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all possible, and Professor
Jared Schwartzer for being

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such an amazing moderator.

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[APPLAUSE]

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