GERIATRIC PSYCHIATRY FOR THE PRIMARY CARE PROVIDER 2009

COURSE INFO

Course Description

Faculty Disclosure

Target Audience

Objectives

Accreditation

Program Agenda

Faculty

Registration

Location

Accommodations for Disabilities

Geriatric Psychiatry for the Primary Care Provider 2009

July 31-August 2, 2009
Sheraton Sand Key Resort
Clearwater Beach, FL

Sponsored by:

Needs Assessment / Gap Analysis

The increasing demand for geriatric psychiatric care requires that general practitioners and their staff acquire specialized skills pertaining to the unique circumstances of the elderly patient and the role of family or caregiver. Despite a broadening literature base, it has been noted that many cases of dementia, delirium, and other mental health issues continue to be missed. Reasons for this under-recognition are varied but may include the absence of routine, systematic screening. There are pressing needs for clinicians to better detect and manage complex or poorly responding patients, encourage collaboration with mental health specialists, and increase treatment completion. The care of every patient with conditions like dementia must be individualized to meet the unique needs of that patient and his or her caregivers. Therefore, good communication between the patient’s psychiatrist, primary care physician, and other mental health professionals ensures maximum coordination of care, can minimize polypharmacy, and can improve patient outcomes.

Course Description

This course addresses evidence-based protocols for the diagnosis and treatment of behavioral and mental health disorders in the elderly. All content will be aligned with the Geriatric Psychiatry Core Competencies of the American Board of Psychiatry and Neurology, as well as the Practice Parameters and Guidelines of the American Psychiatric Association, American Academy of Neurology and American Psychological Association.

Correctly diagnosing conditions such as cognitive impairment and memory disorders early in the treatment continuum will optimize patient function, improve caregiving, prevent premature long-term care placement, and the enhance safety and quality of life of the patient, as well as that of the caregiver.

Collaborative care, involving both primary care physicians and mental health specialists, has been shown to enhance quality of care and improve outcomes. This course provides an opportunity for important dialogue between PCPs, Specialists, Nurses, and Allied Health Professionals.

Target Audience

This program has been developed to meet the educational needs of healthcare practitioners involved in the evaluation and treatment of aging individuals, including Primary Care Physicians, Family Practice Physicians, Psychiatrists, Psychologists, Neurologists, Nurse Practitioners, Pharmacists, Long-Term Care Specialists, Social Workers, Mental Health Counselors, and Hospice Professionals.

Objectives

Upon completion of this activity, the participant will be able to:

Utilize evidence-based practice parameters in the evaluation and management of dementia;
Effectively screen and differentiate age-associated cognitive decline and early Alzheimer’s disease;
Compare and contrast anti-dementia medications;
Identify distinguishing features of vascular changes and dementia in the elderly;
Assess specific pharmacogenomic strategies and how these will be used in behavioral health to map out innovative treatment strategies;
Identify complementary and alternative treatment strategies for memory and cognitive enhancement;
Diagnose the major psychiatric complications of cancer in the elderly and its treatment
Implement behavioral and pharmacological treatment strategies for anxiety, psychosis, delirium, and sexual dysfunction;
Assess and treat common hearing problems in the office;
Identify and manage compulsive hoarding, picking, and related disorders in the elderly; and
Diagnose and treat the more common symptoms of mental distress following traumatic events and naturally-occurring disasters.

Accreditation

Physicians:

AAFP
This activity has been reviewed and is acceptable for up to 11.75 Prescribed Credits and 0.75 Elective Credits by the American Academy of Family Physicians.

AMA/ACCME
USF Health is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

USF Health designates this educational activity for a maximum of 12.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurses: The University of South Florida College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. This activity is for 12.5 contact hours.

Psychologists: The University of South Florida College of Medicine is approved by the American Psychological Association to sponsor continuing education for psychologists. The University of South Florida College of Medicine maintains responsibility for this program and its content. This activity is for 12.5 credits.

Florida Licensed Clinical Social Workers, Florida Licensed Marriage and Family Therapists, Florida Licensed Mental Health Counselors: USF Health is an approved provider (BAP#433 – Exp. 3/31/11) of continuing education credits for clinical social work, marriage and family therapy, and mental health counseling. This program has been reviewed and approved for up to 15 contact hours.

Pharmacists: The University of South Florida College of Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program has been approved for 12 contact hours. Universal program number is as follows: 230-000-09-001-L04-P.

To receive continuing education credit, a pharmacist must attend the accredited sessions and must return the program evaluation instrument. In order to receive full credit, registrants must register no later than 10 minutes after the start of the meeting and must attend the entire meeting.

All participants who are requesting pharmacy credit should expect to receive their statement of credit either on-site or within 4 weeks by U.S. Mail upon the conclusion of the activity.

Others: Certificates of attendance are available for all other participants.

Program Agenda

Friday, July 31, 2009
TIME	SESSION / EVENT	LOCATION
1:00 pm – 6:30 pm	Registration Desk Open	Lobby 2
1:55 pm – 2:00 pm	Welcome & Introductions (Francisco Fernandez, MD)	Beach/Gulf
2:00 pm – 2:40 pm	Easy Diagnosis of Dementia in the Office (Michael W. Hoffmann, MD) The prevalence of dementia is expected to increase dramatically in future years as life expectancy continues to increase and the baby-boomer population ages. The cumulative incidence of Alzheimer's disease has been estimated to be as high as 4.7% by age 70, 18.2% by age 80 and 49.6% by age 90. Proposed risk factors for dementia include a family history of it, previous head injury, lower educational level and female sex. Alzheimer's disease is the most common cause of dementia; many of the remaining cases of dementia are caused by vascular disease and Lewy body disease, as both diseases often occur in combination with Alzheimer's disease. This presentation will focus on the clinical signs and symptoms of dementia that may indicate the need for a full neurobehavioral evaluation and subspecialty consultation.	Beach/Gulf
2:40 pm – 3:20 pm	Age-Associated Cognitive Decline and Mild Cognitive Impairment (MCI) (Michael R. Schoenberg, PhD, ABPP-CN) Psychologists can play a leading role in the evaluation of the memory complaints and changes in cognitive functioning that frequently occur in the later decades of life. Although some healthy aging persons maintain very high cognitive performance levels throughout life, most older people will experience a decline in certain cognitive abilities. This decline is usually not pathological, but rather parallels a number of common decreases in physiological function that occur in conjunction with normal developmental processes. For some older persons, however, declines go beyond what may be considered "normal" and are relentlessly progressive, robbing them of their memories, intellect and eventually their abilities to recognize spouses or children, maintain basic personal hygiene, or even utter comprehensible speech. This presentation will focus on the clinical parameters of the more benign versus the more malignant forms of cognitive deterioration that are caused by a variety of neuropathological conditions and dementing diseases. Secondarily, this presentation will assist the primary care provider in determining when to refer to a subspecialist for a neuropsychological evaluation.	Beach/Gulf
3:20 pm – 3:40 pm	Panel Discussion	Beach/Gulf
3:40 pm – 4:20 pm	A Genomics Primer for Geriatric Psychiatry (Lynn Wecker, PhD) In the era of the human genome project, the primary care provider needs to do more than genetic screening and counseling. This presentation will focus on the unmet needs of primary care provider today with respect to more targeted, individualized prevention and treatments. It will also discuss the opportunities of the genome, proteome, metabolome discovery to change medical practice as it exists today and will address how changes and advances in technology are rapidly ushering in a whole array of new pathways for individualized medicine of the future. Moreover, this presentation will explore specific strategies in behavioral health and pharmacogenomic futuristic interventions.	Beach/Gulf
4:20 pm – 4:40 pm	Break	Palm
4:40 pm – 5:30 pm	Therapeutic Advances in Dementia (Maria T. Caserta, MD, PhD) Drug therapies are an important component of management programs for the care of growing populations of dementia patients. Drugs can be used synergistically with caregiver education to improve management of functional disability and behavioral symptoms, with the potential to lessen the need for the patient to be institutionalized in nursing homes or other healthcare facilities. This presentation reviews the findings using cholinesterase inhibitors for improving symptoms of cognitive and ADL dysfunction in patients with Alzheimer's disease and other dementias and concludes with an analysis of the potential pharmacological benefits that may occur with these therapies as well as those currently in clinical trials.	Beach/Gulf
5:30 pm – 5:50 pm	Panel Discussion	Beach/Gulf
5:50 pm – 6:30 pm	Case Presentations (Maria T. Caserta, MD, PhD, Michael W. Hoffmann, MD, and Michael R. Schoenberg, PhD, ABPP-CN) This interactive presentation will focus on applying practical clinical updates to everyday dementia patient care. Speakers will provide case vignettes and collaborate with participants to determine the best diagnosis and/or treatment plans.	Beach/Gulf
6:30 pm – 8:00 pm	Welcome Reception	Poolside Grass
Saturday, August 1, 2009
TIME	SESSION / EVENT	LOCATION
7:00 am – 8:00 am	Continental Breakfast	Lobby 2
7:55 am – 8:00 am	Welcome & Introductions (Francisco Fernandez, MD)	Beach/Gulf
8:00 am – 8:40 am	Geriatric Psycho-Oncology (Barbara Lubrano, MD) Psycho-oncology is a relatively new scientific discipline which combines the study of the biological and psychological aspects associated with cancer. One area of interest has focused on identifying the needs of the elderly, the psychiatric complications of cancer and its treatment, and the possible relationship between psychosocial factors and the etiology or progress of cancer. This presentation will focus on assessment and treatment strategies for the elderly cancer patient.	Beach/Gulf
8:40 am – 9:20 am	Vascular Dementia and Depression (Harold W. Goforth, MD) Vascular dementia is a degenerative cerebrovascular disease that leads to a progressive decline in memory and cognitive functioning. Vascular dementia generally affects people between the ages of 60 and 75, and affects more men than women. The most common type of vascular dementia is multi-infarct dementia (MID), which is caused by a series of small strokes, or “mini-strokes,” that often go unnoticed and cause damage to the cortex of the brain—the area associated with learning, memory, and language. Similarly, the "vascular depression" hypothesis is supported by the comorbidity of depression, vascular disease, and vascular risk factors and the association of ischemic lesions to distinctive behavioral symptoms. Disruption of prefrontal systems or their modulating pathways by single lesions or by an accumulation of lesions exceeding a threshold are hypothesized to be central mechanisms in vascular depression. Treatments for vascular dementia & depression will be reviewed.	Beach/Gulf
9:20 am – 10:00 am	Complementary and Alternative Treatments for Cognition (Angel Wolf, MBA, PharmD, BCPP) Preventing cognitive decline and dementia are important goals for our aging population. The recent results with of the lack of effect of standardized ginkgo biloba extract (GBE) on preventing or delaying cognitive decline in people age 85 years or older is an example of why this information is critically important for all seniors. Finding a distinct compound with advantage for primary prevention studies is critically important especially because of the risk for developing mild cognitive impairment (MCI), a known precursor to dementia. This presentation will focus on best available evidence for alternative or complementary therapy in enhancing cognition as well as identifying treatments that have a disease modifying effect on the brain.	Beach/Gulf
10:00 am – 10:20 am	Panel Discussion	Beach/Gulf
10:20 am – 10:40 am	Break	Palm
10:40 am – 11:30 am	Antipsychotic Use in Alzheimer’s Disease: Implications from CATIE Alzheimer’s Disease Findings (Maria T. Caserta, MD, PhD) Second generation antipsychotics (SGA aka atypical antipsychotic drugs) have increasingly been prescribed off-label in recent years to patients with dementia to help calm agitation and aggression or treat delusions and hallucinations, as well as other behavioral disturbances commonly associated with various forms of dementia, including Alzheimer's disease. Recent studies confirm that a statistically significant increase in risk of death associated with the use of SGAs in elderly patients especially those with dementia. Concern over the use of SGAs in elderly patients has been steadily growing based on the FDA revisions to the labels of all SGAs inclusive of specific language on the increased risk of death in elderly demented patients requiring a black-box warnings. This presentation will review the available literature and provide clinically relevant approach based on the CATIE-AD findings.	Beach/Gulf
11:30 am – 12:10 pm	Treatment of Anxiety in Older Adults (Francisco Fernandez, MD) Anxiety disorders in the elderly are prevalent and disruptive of all functions interfering with both functional performance and quality of life. These disorders often occur comorbidly with other psychiatric disorders, such as dementia and Alzheimer’s disease. This presentation will focus on treatment options in the elderly patient with anxiety inclusive of alternative therapies.	Beach/Gulf
12:10 pm – 12:30 pm	Panel Discussion	Beach/Gulf
Sunday, August 2, 2009
TIME	SESSION / EVENT	LOCATION
7:00 am – 8:00 am	Continental Breakfast	Lobby 2
7:55 am – 8:00 am	Welcome & Introductions (Francisco Fernandez, MD)	Beach/Gulf
8:00 am – 8:40 am	Assessment and Prevention of Delirium (Ned H. Cassem, SJ, MD) Delirium or acute confusional state is a transient global disorder of cognition. In the elderly, this condition is a medical emergency associated with increased morbidity and mortality rates. Early diagnosis and resolution of symptoms are correlated with the most favorable outcomes. This presentation will focus on the correct diagnosis and treatment of delirium in the elderly.	Beach/Gulf
8:40 am – 9:20 am	Disasters: Impact on Mental Health in an Elderly Population and Practical Suggestions for Preparation, Response, and Recovery (Lisa M. Brown, PhD) Different cohorts of older persons have different characteristics and life experiences that shape their vulnerability and resilience to disasters. Although a sudden, threatening, traumatic event can induce feelings of fear, helplessness, and vulnerability in everyone directly affected, older adults who have health problems, limited mobility, sensory loss, or cognitive impairment encounter unique challenges during disasters. Social support is often mobilized when an older person's life or health is threatened after a disaster, but assistance may be less available when property is damaged or destroyed, electricity or phone communication is lost, or daily routines are disrupted. It is the responsibility of the mental health clinician to differentiate between normal and abnormal reactions to disaster. During each phase of a disaster (mitigation, preparation, response, and recovery) specific assessment and intervention strategies (resilience programs, psychological first aid, crisis counseling, psychotherapy) should be used and modified if necessary for use with older adults. This presentation will provide an overview of evidence-based practices and share the findings of longitudinal research examining mental health functioning, service use, and recovery in a sample of community-dwelling older Floridians who were adversely affected by the 2004 Florida hurricanes.	Beach/Gulf
9:20 am – 10:00 am	Cat Lovers, Pickers and Hoarders in Late Life (Patrick Marsh, MD) Compulsive hoarding, picking and associated behaviors are a specific group of disorders that have been accepted as psychiatric disorders in the elderly. In many, they can be life-long patterns of behaviors while in others they are a reaction to stress or loss. In either case, they can be harmful to self and may require emergency treatment. The relationship of these disorders to obsessive compulsive and impulse control disorders will be reviewed. Recognition of the problem, formal assessment and available treatments will also be addressed.	Beach/Gulf
10:00 am – 10:20 am	Panel Discussion	Beach/Gulf
10:20 am – 10:40 am	Break	Palm
10:40 am – 11:30 am	Honey, Did You Hear Me? Testing for Hearing in the Office (Theresa Chisolm, PhD) Because of their increased incidence of illness and disability, geriatric patients require extra time and diligence to assess and track medical problems. One function that often interferes with their ability to interact in a more positive health related manner is their ability to hear well. This presentation will describe a comprehensive hearing assessment for elderly patients that can be used in the office as part of a general medical and functional problem oriented assessment.	Beach/Gulf
11:30 am – 12:10 pm	Sexuality Late in Life (Francisco Fernandez, MD) While regular sexual activity helps maintain sexual ability, changes associated with the aging process may interfere. This presentation will review relevant changes for both men and women and focus on strategies for sexual satisfaction in old age.	Beach/Gulf
12:10 pm – 12:30 pm	Panel Discussion	Beach/Gulf
12:30 pm	Adjournment

Faculty

Course Directors
Francisco Fernandez, MD Professor & Chair Department of Psychiatry& Behavioral Medicine Director, Institute for Research in Psychiatry Principal Investigator, Memory Disorders Clinic University of South Florida College of Medicine Tampa, Florida
Course Faculty
Lisa M. Brown, PhD Assistant Professor Department of Aging and Mental Health Disparities Louis de la Parte Florida Mental Health Institute Memory Disorders Clinic Department of Psychiatry & Behavioral Medicine University of South Florida College of Medicine Tampa, Florida Maria T. Caserta, MD, PhD Professor & Chief Geriatric Psychiatry Program Medical Director Memory Disorders Clinic Department of Psychiatry & Behavioral Medicine University of South Florida College of Medicine Tampa, Florida Ned H. Cassem, SJ, MD Professor of Psychiatry Harvard Medical School Psychiatrist Massachusetts General Hospital Boston, Massachusetts Theresa Chisolm, PhD Professor and Chair Department of Communication Sciences & Disorders College of Arts & Sciences University of South Florida Tampa, Florida Harold W. Goforth, MD Assistant Professor of Psychiatry Duke University Medical Center Co-Director, Consultant-Liaison Psychiatry Service Durham VA Medical Center Durham, North Carolina Michael W. Hoffmann, MD Professor of Neurology Director, Cognitive Neurology Associate Dean, Academic Assessment Assistant Vice President, USF Health University of South Florida College of Medicine Director, Stroke Center James A. Haley VA Medical Center Tampa, Florida	Barbara Lubrano, MD Assistant Professor Director, Medical Student Clerkship in Psychiatry Department of Psychiatry & Behavioral Medicine University of South Florida College of Medicine Tampa, Florida Patrick Marsh, MD Assistant Professor Department of Psychiatry & Behavioral Medicine University of South Florida College of Medicine Tampa, Florida Michael R. Schoenberg, PhD, ABPP-CN Associate Professor Chief, Neuropsychology Services Clinical Director, Memory Disorders Clinic Department of Psychiatry & Behavioral Medicine University of South Florida College of Medicine Tampa, Florida Lynn Wecker, PhD Distinguished University Professor Director, Neuropsychopharmacology Laboratory Department of Psychiatry & Behavioral Medicine University of South Florida College of Medicine Tampa, Florida Angel Wolf, MBA, PharmD, BCPP Affiliate Assistant Professor Department of Psychiatry & Behavioral Medicine University of South Florida College of Medicine Manager, Clinical Pharmacy – Behavioral Health WellCare Health Plans, Inc. Tampa, Florida

Faculty Disclosure

USF Health adheres to the ACCME Standards regarding commercial support of continuing medical education. It is the policy of USF Health that the faculty and planning committee disclose real or apparent conflicts of interest relating to the topics of this educational activity, that relevant conflict(s) of interest are resolved, and also that speakers will disclose any unlabeled/unapproved use of drug(s) or device(s) during their presentation. Detailed disclosure will be made in the course syllabus.

Registration

Full Conference – Early Fee (by 7/6/09)	$179
Full Conference – Late Fee (after 7/6/09)	$249
Single Day Fee	$75

Fees include the course content, syllabus, certificate of attendance, reception, continental breakfasts, and breaks.

Cancellations must be received in writing by Monday, July 13, 2009, and will be subject to a $35 processing fee. No refunds will be given for cancellations after July 13, 2009, but you may transfer your registration to a colleague.

USF Health reserves the right to cancel this activity due to unforeseen circumstances, in which case a full refund will be given to participants. USF Health will not be responsible for travel expenses incurred by the participant in the unlikely event that the activity is cancelled.

Online registration requires Credit Card payment. If you are paying via check or purchase order, please download and complete this printable registration form and send it in according to the instructions therein.

DOWNLOAD PRINTABLE REGISTRATION FORM

Location

Sheraton Sand Key Resort
1160 Gulf Boulevard
Clearwater Beach, FL 33767
727-595-1611
www.sheratonsandkey.com

Sink your toes into 10 acres of sugar-white sands at this exclusive beach resort located in Clearwater Beach, Florida. Enjoy pool and beach activities, tennis, spa services, fitness center, shopping, casual and fine dining, and more. You can also hop on a trolley to explore the scenic Clearwater Beach area.

A limited number of rooms have been reserved for this meeting at the following special group rates:

$154 plus tax for Beach/Gulf Side
$125 plus tax for City/Street Side

As an added bonus, the group rates above come with a complimentary internet access code, which will be provided at check-in.

For reservations, please call 727-595-1611 and identify yourself as a participant of the USF Geriatric Psychiatry Conference to receive the special group rate. Group rates cannot be guaranteed after July 3, 2009, so be sure to make your reservation early! Note that the number of available City/Street Side rooms is very limited.

PARKING – The Sheraton Sand Key Resort offers complimentary self-parking; however, parking is limited, so it is recommended that attendees arrive early to allow sufficient time to locate a space.

DIRECTIONS - Click HERE for directions to the Sheraton Sand Key

Accommodations for Disabilities

Please notify the USF Health CPD Office by e-mailing smakar@health.usf.edu or calling 813-974-4296 by July 13, 2009 if a reasonable accommodation for a disability is needed.

Equal Opportunity

Events, activities and facilities of the University of South Florida are available without regard to race, color, sex, national origin, disability, age, or Vietnam veteran status as provided by law and in accordance with the University's respect for personal dignity.