COURSE INFO

Practice Gap Summary
Course Description
Target Audience
Learning Objectives
Accreditation
Program Agenda
Faculty
Registration
Location
Accommodations for Disabilities


Geriatric Psychiatry for the Primary Care Provider 2010

5th Annual Course!

July 30 – August 1, 2010
Sheraton Sand Key
Clearwater, FL

Sponsored by:

    Tampa General Hospital

 

Practice Gap Summary


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 depression, dementia, Alzheimer’s disease, 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


As the number of older patients treated in primary care settings continues to increase, both psychiatrists and primary care physicians will jointly diagnose and treat the co-morbid mentally ill. Our mission is to provide physicians with the necessary competency to enhance and increase the quality of treatment of mental disorders in the elderly.

This course addresses evidence-based protocols for the diagnosis and treatment of 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 these conditions 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, Neurologists, Psychologists, Neurologists, Nurse Practitioners, Pharmacists, Long-Term Care Specialists, Social Workers, Mental Health Counselors, and Hospice Professionals.

 


Learning 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 comorbid medical disorders in patients with dementia illnesses;
  • Effectively screen and treat post-stroke depression;
  • Compare and contrast neuroimaging strategies in the evaluation of dementia;
  • Identify safety issues as they relate to ability to drive in the elderly;
  • Assess objective potential for stem cell therapies in dementia;
  • Identify relevant drug-drug interactions with psychotropic medications;
  • Diagnose the major psychiatric complications of elderly patients in medical and surgical units;
  • Analyze clinically relevant conditions and one’s responsibilities and authority to examine elderly patients involuntarily under the Florida Baker Act;
  • Assess and treat common pain conditions in the elderly;
  • Interpret the basic elements of communication and care at the end of life;
  • Identify and manage balance disorders in the elderly;
  • Effectively respond to the special needs of the elderly during possible flu outbreaks; and
  • Diagnose and treat common psychiatric complications of HIV/AIDS in the elderly.
 


Accreditation


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.

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 12.5 contact hours. Universal program number TBD.

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.

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: USF Health is approved by the American Psychological Association to sponsor continuing education for psychologists. USF Health maintains responsibility for this program and its content. This activity is for 12.5 credits.

Florida Licensed Clinical Social Workers, Licensed Marriage and Family Therapists, 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.

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

 


Syllabus materials will be available online prior to the course rather in paper format.

7/26/10 UPDATEALL AVAILABLE SLIDES HAVE BEEN E-MAILED TO PARTICIPANTS. IF YOU DID NOT RECEIVE THE ATTACHMENTS, PLEASE E-MAIL smakar@health.usf.edu.

Program Agenda

Friday, July 30, 2010
NEUROBEHAVIORAL CARE IN DEMENTIA

TIME

SESSION / EVENT

1:00 pm – 6:30 pm

Registration Desk Open

1:55 pm – 2:00 pm

Welcome & Introductions

2:00 pm – 2:15 pm
Pre-Activity Case Assessment Using Audience Response System

2:15 pm – 3:00 pm

Cognitive Assessment: Best Practices in the Real World
(Michelle Mattingly, PhD)
As we age, there are changes in how we think, how we process information and our emotional state. We continue to struggle screening and assessing mental status in clinical practice. This presentation will focus on diagnoses and instruments of practical value available to clinicians. It will serve as a training session for participants.

3:00 pm – 3:40 pm

Co-Occurring Conditions in Dementia (Vincent Perron, MD)
Studies reveal that individuals with dementia have a high number of concurrent medical illnesses. The most common are femur fracture, cardiovascular disease, diabetes, and musculoskeletal and genitourinary disorders.  These conditions increase the number of admissions to hospitals, SNFs, increase length of stays and are positive predictors of mortality. Lastly, they significantly affect the quality of life of individuals with Alzheimer disease and they also can affect the quality of life of their caregivers. This presentation will review the diagnosis and management of comorbid medical conditions in the care of patients with dementia and Alzheimer disease.

3:40 pm – 4:00 pm

Panel Discussion

4:00 pm – 4:15 pm
Break

4:15 pm – 4:55 pm

Monitoring for Safety: To Drive or Not to Drive – That is the Question (Michael R. Schoenberg, PhD, ABPP-CN)
Visual and cognitive declines in aging can alter driving safety. These age-related changes may lead to more accidents. Non-driving laboratory tests of visual acuity and cognition may be predictive of driving ability and safety. This presentation will address basic elements of driving safety, describe components of off-road and on-road driving assessments, review the Florida guidelines to determine medical fitness to drive and discuss the implications for clinical practice.

4:55 pm – 5:35 pm

Neuroimaging for Memory Disorders (F. Reed Murtagh, MD)
Non-invasive viewing of the brain inclusive of CT, MRI, fMRI, and MRS scanning are used routinely in the diagnosis of memory disorders and dementia. Neuroimaging methods are useful to track cognitive changes with a particular focus on early detection of AD or ongoing monitoring of disease progress and treatment. A PET scan is a unique imaging test that records organ and tissue function at a cellular level. Since 2005, Medicare decided to cover the cost of PET scans for the diagnosis of Alzheimer’s disease. But Medicare has decided to cover a PET scan for Alzheimer’s disease diagnosis only when, after a thorough clinical evaluation, the cause of dementia is still uncertain. This presentation will review the current imaging strategies to assist in the diagnosis of dementia. Special emphasis will be on establishing who the best candidate for PET scanning is and what the findings mean with respect to treatment.

5:35 pm – 6:15 pm

Hematopoieitic Growth Factors as Novel Therapeutic Agents for Alzheimer's Disease
(Juan R. Sanchez-Ramos, MD, PhD)
The search for trophic factors that impact the degenerating nervous system has expanded beyond the classical neurotrophins. There is increasing recognition that hematopoietic growth factors (HGFs) have neurotrophic properties. This  lecture will focus specifically on HGFs or cytokines that have direct and indirect effects on the brain and which may have therapeutic potential for neurodegenerative diseases, including Alzheimer’s disease (AD). These include stem cell factor (SCF), granulocyte colony-stimulating factor (G-CSF), monocyte colony-stimulating factor (M-CSF), granulocyte–macrophage colony-stimulating factor (GM-CSF) and erythropoietin (EPO). HGFs have the capacity to prevent neuronal death, stimulate the proliferation and differentiation of neural stem/progenitor cells (NSCs) into new neurons, enhance the formation of new synapses, modulate inflammatory processes, mobilize monocytes from the peripheral circulation and increase their infiltration into the brain, where they reinforce the endogenous microglial population. G-CSF has been safely and routinely administered to enhance hematopoiesis in bone marrow donors and is now being tested for therapeutic efficacy and safety in patients with stroke and AD. HGF receptors expressed on neurons and NSCs provide novel targets for drug discovery in the search for agents that can forestall or reverse the pathological progression of AD.

6:15 pm – 6:30 pm

Panel Discussion

6:30 pm – 8:00 pm

Welcome Reception

Saturday, July 31, 2010
PSYCHIATRIC CARE IN AGING AND DEMENTIA

TIME

SESSION / EVENT

7:00 am – 7:55 am

Continental Breakfast

7:55 am – 8:00 am

Welcome & Introductions

8:00 am – 8:40 am

The Good, the Bad, and the Ugly About the Baker Act and Dementing Patients in Your Emergency Room (Brian Keefe, MD, JD)
The Baker Act in Florida is a mechanism to provide emergency assessment and mental health services either on a voluntary or involuntary basis. Confusion seems to prevail on the use of the Baker Act in elderly patients. A significant number of Baker Acts in Florida are for persons over the age of 65 years because a significant number of patients may have cognitive impairment and wander at night, leave things unattended, don’t eat or sleep and doesn’t care adequately for their pets. Similarly, patients who sundown may be paranoid and even strike out at others if they feel threatened.  A report from the Florida Fairness Commission reviewed the use of the Baker Act and found that they can often affect Florida’s elderly in adverse ways and recommended revisions and overhaul. This presentation will focus on a review of the Florida Baker Act statutes and its impact on elderly patients and their families.

8:40 am – 9:20 am

Home Care, Day Care, and Long-Term Care: Making Appropriate Referrals (Ofelia Granadillo, MSW, LCSW)
There is a growing crisis in dementia care. Between now and 2020 we will experience a dramatic increase in the number of Floridians with dementia needing care. Clinicians need to be able to assess their patients and make appropriate referrals to help persons and their families receive the care they need in the place most appropriate for them. This presentation will review options for appropriate care, understand the differences in available types of care and their cost.

9:20 am – 10:00 am

Drug-Drug Interactions in Clinical Practice
(Angel L. Wolf, MBA, PharmD, BCPP)
The number one cause of iatrogenic disease in the elderly is related to drug-drug-interactions. Of potential drug interactions, psychotropic drugs lead the list.  Nearly one million elderly are evaluated in emergency rooms for an adverse drug event (ADE) every year. All active medications ordered for the elderly should be monitored. The detection and prevention of ADEs is the focus of attention of this presentation. The use of electronic medical records and clinical decision support networks to detect and prevent ADEs will be discussed.

10:00 am – 10:20 am

Panel Discussion

10:20 am – 10:40 am

Break

10:40 am – 11:30 am

Pain Management in the Elderly (Francisco Fernandez, MD)
The management of pain especially with opioids is under more scrutiny now than ever. While the American Pain Society and other organizations have well established protocols and guidelines, pain in the elderly is often managed inadequately. Pain is one of the most common reasons elderly patients seek treatment. This presentation will review a rational approach to assessment and treatment based on accepted principles in practice.

11:30 am – 12:10 pm

Psychiatric Complications in Medical-Surgical Units
(Barbara Lubrano di Ciccone, MD)
Anxiety, alcoholism, mania, depression and delirium are common psychiatric complications occurring in the general hospital. Elderly patients need a careful medical evaluation to exclude treatable causes of medical disorders masquerading as psychiatric disease. Similarly, psychiatric complications need equally aggressive management as the complications of systemic disorders. This presentation will review the common psychiatric complications of the elderly in the general hospital and address treatment issues.

12:10 pm – 12:30 pm

Panel Discussion

Sunday, August 1, 2010
POTPOURRI

TIME

SESSION / EVENT

7:00 am – 7:55 am

Continental Breakfast

7:55 am – 8:00 am

Welcome & Introductions

8:00 am – 8:40 am

What is New in End of Life Care (Ned H. Cassem, SJ, MD)
Modern medicine has prolonged living but also prolonged dying. Since the majority of people die at an older age, good end of life care is an important aspect of geriatric medicine. Understanding what constitutes a “good death” will be highlighted in this presentation along with basic principles of palliative care. Saunders components of suffering in the context of chronic illness, death and loss of a sense of meaning will be reviewed. The care of bereaved family members will be discussed. 

8:40 am – 9:20 am

Seasonal, Swine, and Avian Flu: Responding to Uncertainty, Rationing, and Distress (Lisa M. Brown, PhD)
Media reports of the potential threat of H1N1 (swine) and H5N1 (avian) to our personal well-being are growing. Patients want to know if these concerns are based on fact or fiction. During the 1918-1919 flu pandemic, the avian flu mutated into a highly infectious and deadly influenza A virus strain of subtype H1N1, which killed more than 675,000 Americans and resulted in significant societal disruption. Could a similar flu pandemic occur today in America? What are the consequences for you and your patients? This session will address the psychological and social impacts of a mild, moderate, or severe outbreak. Methods for addressing the concerns of patients who receive mixed messages from public authorities and are contending with rationing of medical services will be discussed.

9:20 am – 10:00 am

Post-Stroke Depression (Patrick Marsh, MD)
Depression is one of the most common and unrecognized complications associated with stroke. Post-stroke depression is associated with limited functional and cognitive recovery. Moreover, there is increased mortality in the presence of depression or any other psychiatric disorder. This presentation will review the risk factors, epidemiology, assessment and treatment strategies in post-stroke depression.

10:00 am – 10:15 am

Panel Discussion

10:15 am – 10:35 am

Break

10:35 am – 11:25 am

Honey, I’ve Fallen and I Can’t Get Up: Balance Testing in the Office (Kenton S. Tarver, AuD)
There are many types of balance problems in the elderly caused by different medical conditions. Causes of balance problems include medications, poor vision, vestibular dysfunction, gait and balance disorders and other medical conditions, from a drop in blood pressure to brain tumors. This has implications to prevent falls. This presentation will focus on the latest screening and diagnostic services for balance problems in the primary care setting. The most appropriate treatment interventions will be discussed.

11:25 am – 12:05 pm

I’m Too Old to Have AIDS: Psychiatric Complications
(Francisco Fernandez, MD)
The number of persons with HIV-1 infection in the United States has continued to rise, consistently increasing at an estimated 56,000 per year for the past decade. Thus, the HIV/AIDS epidemic cannot be considered “under control” at this time. In Florida, one of the fastest growing groups of new infections is the elderly. This presentation will focus on risk assessment in the elderly as well as a review off major psychiatric complications and their treatment in the older adult infected with HIV.

12:05 pm – 12:20 pm

Panel Discussion

12:20 pm – 12:30 pm Post-Activity Case Assessment Using Audience Response System
12:30 pm
Adjournment


Faculty
Course Director

Francisco Fernandez, MD
Professor and 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
Associate Professor
Department of Aging and Mental Health Disparities
Louis de la Parte Florida Mental Health Institute
University of South Florida
Tampa, Florida

Ned H. Cassem, SJ, MD
Professor of Psychiatry
Harvard Medical School
Chair of Psychiatry
Massachusetts General Hospital
Boston, Massachusetts

Ofelia Granadillo, MSW, LCSW
Department of Psychiatry & Behavioral Medicine
University of South Florida College of Medicine
Tampa, Florida

Brian Keefe, MD, JD
Chief of Psychiatry
Tampa General Hospital
Assistant Professor
Training Director
, Geriatric Psychiatry Program
Department of Psychiatry & Behavioral Medicine
University of South Florida College of Medicine
Tampa, Florida

Barbara Lubrano di Ciccone, 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

Michelle Mattingly, PhD
Assistant Professor
Coordinator, Memory Disorders Clinic
Department of Psychiatry & Behavioral Medicine
University of South Florida College of Medicine
Tampa, Florida

F. Reed Murtagh, MD
Professor of Radiology
Department of Oncologic Services
University of South Florida College of Medicine
Director, Division of Neuroradiology
Moffitt Cancer Center
University Diagnostic Institute
Tampa, Florida

Vincent Perron, MD
Assistant Professor
Division of Geriatric Medicine
Academic Director
Center for Hospice, Palliative Medicine and End of Life Studies
University of South Florida College of Medicine
Medical Director, ACE Unit
Medical Director, Palliative Services
Tampa General Hospital
Tampa, Florida

Juan R. Sanchez-Ramos, MD, PhD
Professor & Vice Chair for Research
Department of Neurology
Helen Ellis Endowed Chair for PD Research
Director
, Parkinson Research Foundation Center of Excellence at USF
Director, Huntington’s Disease Society of America Center of Excellence at USF
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

Kenton S. Tarver, AuD
American Institute of Balance
Adjunct Faculty, Department of Communication Sciences & Disorders
College of Behavioral & Community Sciences
University of South Florida
Tampa, Florida

Angel L. Wolf, MBA, PharmD, BCPP
Affiliate Assistant Professor
University of South Florida College of Medicine
Director, Medication Therapy Management
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 conflicts of interest are resolved, and also that speakers will disclose any unlabeled/unapproved use of drugs or devices during their presentation. Detailed disclosure will be made in the course syllabus.

 

 

Registration


Full Conference

$229

Single Day Fee

$99


Online and fax registration is no longer available for this course, but you are welcome to register onsite at the Sheraton Sand Key Resort at the start of the conference. Please e-mail smakar@health.usf.edu if you plan to register onsite .

Cancellations must be received in writing by July 2, 2010, and will be subject to a $35 processing fee. No refunds will be given for cancellations after July 2, 2010, 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.

 

 
 

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 1, 2010, so be sure to make your reservation early!

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 16, 2010 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.

 



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