So today I'm going to be talking to you about the summer I spent at Baystate Medical Center as a research assistant with their Acute Care for Elders program. So what is an Acute Care for Elders unit? It is kind of a specialized model of care that is designed to try to accommodate the unique health care needs that seniors have in an inpatient setting. 

As you can imagine, seniors are not like someone who is, say, 20, 30 years old. They have some issues when it comes to inpatient hospitalization. So for example, even with short-term hospitalization, so if someone who is a little older is in the hospital even just for a couple of days, that bed rest can lead to functional decline. 

Seniors are also prone to what is known as delirium, which is an acute state of confusion that seniors are particularly prone to. So an Acute Care for Elders unit is kind of a different model that I will go into in a minute that is trying to accommodate those needs. 

There are five major components to an acute care for elders unit. As you can see, they focus on really patient-centered care, frequent medical review, early rehabilitation, discharge planning. And at Baystate, the biggest things that I noticed that were implemented there were what were called grounds meetings, which they had every day. These were meetings attended by myself, the research assistant, the physician's assistant, pharmacist, the nurses-- basically everyone from the interdisciplinary aspects of patient care. 

And essentially, every patient was discussed every day, so their progress, how they are doing. There was also a big focus on what are known as potentially inappropriate medications, which, as you can imagine, are medications that are not known to work too well for seniors, that are all too often prescribed anyway. So there was a big focus on trying to get seniors off of these unnecessary medications that sometimes do more harm than good. 

So why does it matter? Why do these interventions make a difference? Long story short, the results. For example, falls were down by half. Delirium was reduced by 30%. People were being discharged back home as opposed to skilled nursing facilities more frequently. [INAUDIBLE] use was down 50 folds. So basically, people were staying for shorter periods of time, coming back less, basically being healthier for longer as a result of this model. 

So where did I come in? I was a research assistant. So my job consisted of patient interviews. I was administering what was known as a Frailty Scale. So it was a few cognitive assessments, one of which I'm going to go a little more in-depth on in a minute, a depression screening asking about someone's activities of daily living-- so basically trying to see if patients are having their needs met both inside and outside of Baystate. 

So for example, trying to see if, can you get into the shower without assistance? If you do need help with that, do you have help with that? And reporting my findings at grounds meetings. One particularly interesting cognitive assessment that I would like to share with you is known as a clock draw. So I would have the patients try to draw a clock as it looked at ten past eleven. And these are some of my actual clock draws that I got from people listed with the person's diagnosis. 

So for example, this is someone who had Parkinson's disease, and that is someone who was suffering from delirium. I got the clearance from the doctor at the head of the program to go through, to share these pictures with you. And here's some more. This is someone who had bipolar. And that's someone with depression, possible dementia, altered mental status. And so you see people who may be able to hold a conversation with you, you wouldn't necessarily think they have cognitive impairments, and little things like this, you can really tell a lot. It's fascinating. 

So the biggest take aways that I got were, obviously, my hands-on patient experience. You can't learn that in a classroom. I got to work directly with patients, interviewing them. I also got to form a valuable professional network. So the physician's assistant was my direct supervisor. The doctor heading the program, I got to network with them. I got to shadow doctors and, as I mentioned, understanding the unique health care challenges that seniors face. 

I would highly recommend this to anyone who's considering a medical career, anyone who wants to work with seniors. Overall, I learned so much. And I would like to share some acknowledgements. I would like to thank Heidi-Ann Courtney, the physician's assistant who was my direct supervisor, Dr. Erin Leahy, who was in charge of the program, LYNK UAF 2017 for making this all possible, and Professor Jared Schwartzer for being such an amazing moderator. 

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