The Gero Practice Compendium is a collection of both clinical and community resources related to Dementia Care, Medication Management and Care Transitions pertaining to the care of vulnerable older adults residing in the community.
Senior PharmAssist’s Mission is to promote healthier living for Durham seniors by helping them obtain and better manage needed medications, and by providing health education, Medicare insurance counseling, community referral and advocacy.
25-minute staff training video produced by the Veterans Health Administration to demonstrate how a set of caregiving skills can be implemented in practice. A set of five, 5-minute video clips show the conventional way of approaching care that often provokes or worsens challenging behaviors, and then shows an alternative approach. The alternative approaches include the following skills:
Tool maintained by the Centers for Medicare and Medicaid Services to allow consumers to evaluate and compare skilled nursing facilities (SNFs) based on their quality metrics.
Users can identify nursing homes according to distance from a zip code, and compare up to 4 nursing homes on staffing, performance on inspections, and quality indicators such as falls prevention, immunization rates, success in controlling pain and restoring function.
Series of brief, professionaly produced training videos for dementia caregivers that cover a variety of common issues, including how to address hallucinations, refusal to bathe, refusal to take medications, repetitive questions, repetitive behaviors, sundowning, and wandering. Format is similar for each video. Each lasts about 5 minutes and is structured as follows:
Disasters strike without warning, and emergency situations often worsen symptoms of dementia. Living with Alzheimer’s disease and other dementias can make it hard to cope with disasters such as severe weather, fires, floods, earthquakes and other emergencies. The National Alzheimer’s and Dementia Resource Center, funded by the U.S.
ARMOR is a functional and interactive evidence-based tool that takes into account a patient’s clinical profile and functional status – its primary goal is to improve functional status and mobility. This tool also emphasizes quality of life as a key factor for making decisions on changing or discontinuing medications.
Toolkit developed in 2017 for primary care providers that describes how to deliver person-centered care for people living with dementia, including guidance about codes for billing for services (CPT codes).
AHRQ developed toolkit for outpatient care practices designed to enhance patient experience and improve safety for new patients transitioning into a practice. The toolkit is composed of the following components, each of which is extensively referenced.
RCT comparing effiacy of 3 approaches (2 non-pharm) to controlling itching among 23 hemodialysis patients to reduce anticholinergic load from antipruitic medications.
Sample size was small, but all showed statistically significant reductions in itching intensity.
This website sponsored by End Hunger Durham provides information about existing food distribution, facilitating collaboration among hunger fighting agencies, and advocating for food policies and initiatives aimed at ending poverty and hunger.
Initial screening tool for cognitive changes. The 3-item brief standardized cognitive measure “Mini-Cog” is a well validated starting point that can be done at the annual wellness visit or for patients
NTOCC is a group of concerned organizations and individuals who together address the safety and quality of care for transitioning patients. This is a tool that could be used for organizational planning to create targeted action plans toward improving transitions of care.
NTOCC completed a project to determine seven crucial elements that are involved in every quality transition of care.
The Medication Appropriateness Index (MAI) measures the appropriateness of prescribing for elderly patients, using 10 criteria for each medication prescribed. For each criterion, the evaluator rates whether the medication is appropriate, marginally appropriate, or in- appropriate.
Meals on Wheels of Durham, Inc. is a non-profit agency committed to enhancing the quality of life for eligible homebound adults in our community. Their mission is to serve the elderly, frail, disabled, convalescing and others who cannot provide proper nutrition for themselves with the objective of improving the nutritional status and health of these individuals.
Since 1986, the Memory Disorders Clinic has been treating a wide range of memory problems arising from diverse medical causes including neurodegenerative diseases (Alzheimer's disease), vascular problems, and other neurological disorders). As part of the Joseph and Kathleen Bryan Alzheimer's Disease Research Center at Duke University Medical Center, the clinic provides diagnostic expertise, cutting-edge treatment, and research for memory problems.
A state-wide resource for family members of patients with Alzheimer’s and other memory disorders. The Duke Family Support Program serves families and professionals concerned about or caring for persons with memory disorders in North Carolina, and Duke employees seeking help with elder care decisions. A point of contact for all North Carolina families to help navigate next steps in care and gain more information about resources and support in the community.
The National Institute on Aging’s ADEAR Center offers information and publications for families, caregivers, and professionals on Alzheimer’s disease research, diagnosis, treatment, patient care, caregiver needs, long-term care, education, and training. This Fact Sheet provides information on medication used to manage symptoms of Alzheimer's Disease.
Duke Connected Care (DCC) is a community-based, physician-led network that aims to improve the quality of healthcare while addressing the national challenge of rising healthcare costs.
Duke Connected Care is an Accountable Care Organization (ACO). An ACO is a group of doctors, hospitals and other healthcare providers who are working together with health plans, like Medicare, to give patients high-quality, coordinated service and care.
Canadian International Pharmacy Association (CIPA) is a Canadian association of licensed, retail pharmacies. These pharmacies sell pharmaceuticals and maintenance medications (but not controlled substances) in 90-day quantities to both Canadian and U.S. citizens. Each CIPA pharmacy member is licensed and regulated by the government for safety.
The Rapid Geriatric Assessment (RGA) is a new screening tool developed by the Geriatrics Division of Saint Louis University. The RGA includes assessment of Frailty, Nutrition, Loss of Muscle Mass (Sarcopenia), and Cognitive Function. It is part of the HRSA-funded Geriatric Workforce Enhancement Program (GWEP) to improve the health of older Missourians by training primary care health providers in Geriatric Medicine
NC MedAssist is a nonprofit pharmacy program providing access to lifesaving prescription medications, patient support, advocacy and related services to poor, vulnerable, and uninsured North Carolina residents.
A Helping Hand provides in-home assistance for people age 60+ with temporary or permanent disabilities or those recovering from accidents or injuries, paid companions provide respite care, companion care, transportation escort to medical appointments, meal preparation, light housekeeping, correspondence, laundry, and medication reminders.
A therapeutic service where the participants are often experiencing difficulties associated with dementia, stroke, isolation, and confusion. Approximately 79 percent of participants in the center maintained or improved their cognitive condition due to the structure and stimulation of activities within the center. Participants enjoy a safe and comfortable surrounding and are provided stimulating activities designed to meet the physical, social, emotional, and mental needs of the adults.
Information and Assistance (I&A) services empowers adults age 60 and over to find referrals, information and solutions for problems they face at the right time. Assistance is provided by nationally certified Information and Referral specialists and is completely confidential.
The Durham Center for Senior Life offers congregate meal services at three satellite Senior Centers in Durham. he Congregate Meal Services are intended to promote social, emotional, and physical well-being in older adults age 60 years plus. We do this by providing a nutritional lunch 5 days a week as well as socialization activities.
In order to participate in our the Congregate Meal Service, you must be 60 or older and complete a registration application.
The NC Community Pharmacy Enhanced Services Network (CPESN) includes community pharmacies that have volunteered to collaborate with Community Care of North Carolina to provide enhanced pharmacy services to Medicaid and dually eligible Medicare-Medicaid beneficiaries. All participating pharmacies will provide the following required services, in addition to the optional services indicated for each pharmacy.
The Anticholinergic Risk Scale (ARS) is a ranked categorical list of commonly prescribed medications with anticholinergic potential. The higher the score the higher the risk of anticholinergic adverse effects in older adults.
Rudolph JL, Salow MJ, Angelini MC, et al. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med. 2008;168(5):508-513
A state wide resource for families dealing with Alzheimer's in North Carolina. The website is useful for locating support groups, finding outreach activities, and helping families find information about various types of dementia and helping with caregiver stress.
ACT on Alzheimer's® has a collection of training videos for administering cognitive assessments and reviewing diagnostic pitfalls that can occur. The 3-item brief standardized cognitive measure “Mini-Cog” is a well validated starting point that can be done at the annual wellness visit or for patients with cognitive complaints.
The Saint Louis Mental Status Exam (SLUMS) was developed at the Saint Louis Veterans Affairs Medical Center as a tool for cognitive screening. It takes slightly less time to administer compared to the Montreal Cognitive Assessment (MoCA), 8 minutes as opposed to 12 on average.
Succinct two-page handout for clinicians from the Veterans Administration explaining “Dementia Warning Signs” and elements of the diagnostic evaluation. Delivers an explanation of warning signs, why they are important to document, and next steps for assessment and management. This is a nice teaching tool for learners and a good review regarding the initial outpatient management of patients who may have memory problems.