In primary care we are tasked with treating multiple conditions, therefore many of our patients are on numerous medications. Some of these medications are prescribed to deal with side effects of other medications. Often clinicians may not be aware that they are treating preventable drug side effects and wind up prescribing even more medications. This causes a cascade effect that results in significant polypharmacy. Join us while we discuss this common phenomenon and strategies to minimize or avoid it entirely.

Join us as we discuss falls: a clinical issue that warrants regular assessment in adults over the age of 65.

Falls in the older population are associated with significant morbidity and mortality yet little evidence exists to determine best practices for prevention. Join us while we discuss a recent RCT that examined Tai Chi versus more traditional exercising in older individuals and its impact on reduction in falls for those at greatest risk.

Genetic and lifestyle risk factors have been implicated in the development of Alzheimer’s dementia (AD) as well as other subtypes of dementia. Specific genetic protein mutations have been identified in individuals who develop AD. There is also an abundant amount of evidence that suggests the risk of dementia can be reduced by avoiding tobacco smoking, limiting alcohol consumption, keeping physically active, and maintaining a healthy diet. Join our discussion of a recent study that shows a healthy lifestyle is associated with decreased risk of dementia in those with both low and high genetic risk.

This episode focuses on older adults and caregivers/partners in relation to their intimacy and sexuality for patients experiencing changes in cognition.

Join us as we discuss deprescribing; the provider-supervised process of discontinuing inappropriate medication(s). We will review minimizing risk, improving quality of life and maximizing patient-centered care.

Dementia afflicts over five million Americans. Although no cure exists, symptomatic treatments can provide temporary benefits and improve quality of life. Several medications that are effective in reducing symptoms and slowing decline are available, and other medicines and innovative treatments are in development. Healthy lifestyle habits have been shown to reduce risk and delay onset of symptoms. This presentation will review the latest information on diagnosis and treatment of dementia and discuss new approaches in the pipeline. The speaker will also highlight healthy behaviors shown to reduce symptoms, compensate for age-related cognitive decline, and protect brain health. * What's New in Dementia? may meet the criteria of the Medical Board of California for 0.75 credit of Geriatrics. Visit www.mbc.ca.gov for details.

There is a well-recognized need to improve communication about end of life care between medical providers and patients. Advance care planning involves clarifying patients’ illness understanding and understanding their values, beliefs, and goals of care to ensure care at the end of life honors these goals. Unfortunately, simply increasing completion rate of advance directives does not impact care at the end of life. Strategies for successful advance care planning in primary care clinic will be discussed in this talk. Specifically, the talk will outline a framework for discussing care planning for healthy, chronically ill, and terminally ill patients.

This session aims to refresh your knowledge and stimulate interest in performing a thorough and focused physical exam (PE), particularly in the geriatric population. Whether part of a Medicare evaluation or a routine office visit, the PE provides an opportunity to develop rapport, trust, and potentially to discover clinically significant findings that might otherwise have gone unrecognized. A series of brief scenarios will be used to illustrate important yet basic concepts such as differentiation between normal age-related findings versus indicators of worrisome disease processes and atypical presentation of disease. Now, Let’s Get Physical!

Falls are a major cause of morbidity and serious health issues in older adults that can have devastating outcomes. Using real-world cases and audience participation, this lecture will discuss a hands-on approach to identifying fall risks, preventing falls, assessing patients post-fall, and treating older adults. Office-based balance and gait assessments that can be conducted in small spaces will be demonstrated. Evidence will be presented about updated recommendations on fall treatments, including simple recommendations to multi-level interventions that improve the care of older adults. Advice on selecting the right durable medical equipment (e.g., canes, walkers, rollators, wheelchairs, and scooters) and measuring for the correct size equipment will be provided. Very few people outlive their canes so many older adult patients use hand-me-downs, resulting in poor posture, gait instability, and additional falls. After attending this lecture, you will understand how to best care for your older adult patients who are prone to fall. Please note that any data, indications, and guidelines presented in this activity are current as of the recording/release on February 8, 2020, and they are subject to change as new information is published.

This session aims to refresh your knowledge and stimulate interest in performing a thorough and focused physical exam (PE), particularly in the geriatric population. Whether part of a Medicare evaluation or a routine office visit, the PE provides an opportunity to develop rapport, trust, and potentially to discover clinically significant findings that might otherwise have gone unrecognized. A series of brief scenarios will be used to illustrate important yet basic concepts such as differentiation between normal age-related findings versus indicators of worrisome disease processes and atypical presentation of disease. Now, Let’s Get Physical! Please note that any data, indications, and guidelines presented in this activity are current as of the recording/release on February 8, 2020, and they are subject to change as new information is published.

Now that the capabilities of medicine provide increasingly complex care and technology to keep patients alive in health states they might not desire, the clinician is responsible for anticipating future care needs and guiding treatments as patients become more ill and less functional. Advance care planning is an essential tool in the primary care practitioner’s armamentarium, and this skill set must be honed to ensure that patients receive care consistent with their informed preferences and appropriate to their prognosis. Clinicians must feel comfortable introducing advance care planning, carrying out serial discussions with patients about prognosis, using appropriate tools and practice structures, and coordinating care among the team of clinicians caring for their patients across care venues. Sometimes the process requires setting limits and addressing maladaptive coping. Building strong relationships with patients and families and a consistent focus on goals of care is key to high quality treatment for the complex patient and achieving optimal end of life care.