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Teacher’s Manual Theme-Based Journal Five journal activities provided by: TEXAS Training Excellence in Aging Studies Division of Geriatric and Palliative Medicine The University of Texas Health Science Center at Houston School of Medicine and funded by: the Donald W. Reynolds Foundation Enter your journal entry below. Day 1 Many physicians have pre-conceived ideas about caring for older adults. Write a “surprise” or “a-ha” moment that you experienced when caring for an older adult. Enter your journal entry below. Day 2 Elder abuse, first described in 1975 as “granny battering,” affects 2-10% of the aging population in the United States. According to the best available estimates, between one and two million Americans aged 65 and older have been injured, exploited or otherwise mistreated by someone on whom they depended on for care and protection. Health care professionals in a variety of settings are encountering increasing numbers of older victims and their perpetrators. Reports of elder abuse and mistreatment to Adult Protective Services and law enforcement are rising. 1. In your journal today, please reflect on elder abuse and mistreatment and provide us your thoughts. 2. It has been recommended that management of elder mistreatment should be done through an interprofessional team approach. How would you manage an elder self-neglect patient? Enter your journal entry below. Day 3 1. Present a patient who either was on multiple medications or identified as having polypharmacy issues. What were the key red flags to make you suspect polypharmacy? What is your plan of care moving forward? Be specific. 2. The Pharmacist is an integral part of the interprofessional team. As a physician, provide two specific situations where the pharmacist would be instrumental in assisting with care for medically complex older adults in your geriatric internal medicine or primary care practice. Enter your journal entry below. Day 4 1. Write about a patient you have seen with dementia. As a physician, what will be your patient care challenges and how will you work with the family caregivers? 2. The Baby Boomer generation is growing older. Some call the aging of America a "health care tsunami." As a physician, how will you manage large percentages of older adults in your practice? Do you have any initial thoughts or strategies on how to effectively manage these complex medical patients? Will you use an interprofessional team? How could advanced practice nurses or physician assistants help you with the chronic management of these patients? Enter your journal entry below. Day 5 1. Describe a patient that you worked with that you thought might be socially isolated. What risk factors were present that made you suspicious of social isolation? How was it addressed, or in retrospect, how do you wish you had addressed it? 2. How would you describe the patient’s social network and social cohesion? Was he/she experiencing social exclusion and/or social isolation? Would a referral to another member of the interprofessional team be appropriate? Journal content created by Kathleen Pace Murphy, PhD Layout designed by Beth Watson in the Multimedia Scriptorium at The University of Texas Health Science Center at Houston. Photo Credit: Photographs used are allowed by the MorgueFile free photo agreement and the Royalty Free usage agreement at Stock.xchng. They appear on the first page in this order: Wallyir at morguefile.com/archive/display/221205 (also used in additional journal pages) Mokra at www.sxc.hu/photo/572286 Clarita at morguefile.com/archive/display/33743 The Training Excellence in Aging Studies (TEXAS) program promotes geriatric training from medical school through the practicing physician level. This project is funded by the Donald W. Reynolds Foundation to the division of Geriatrics and Palliative Medicine within the department of Internal Medicine at the University of Texas Health Science Center at Houston (UTHealth).