Geriatrics - Aging Across the Curriculum
Aging Across the Curriculum
Meet Mr. and Mrs. Springfield
At Southern Illinois University School of Medicine, many of the geriatric learning experiences are designed around this older couple. In Year One of medical school, students first meet Mr. and Mrs. Springfield when they are in their 60s. With each year of medical school the couple ‘ages’ a decade so that by Year Four, students are learning to deal with elders in their 90s. Normal aging processes as well as diseases commonly seen in older adults will be examined as students deal directly with this illustrative couple in their 60s, 70s, 80s, and 90s. Students encounter the couple throughout their four years of medical school through:
- Case-based learning modules
- Standardized Patient (SP) experiences; and
- Small group sessions exploring sensitive issues faced by the couple
Initially the couple represents the vast majority of elders in the population who lead healthy, socially active lives. With increasing age, Mr. Springfield begins to experience some of the chronic illnesses frequently seen in older adults, while Mrs. Springfield remains a model of healthy aging. Near the end of Year Four, Mr. Springfield experiences the problems of frailty and Mrs. Springfield becomes his caregiver.
Through encounters with Mrs. Springfield, students learn to appreciate the value of health promotion activities that maintain functional status and independence. Through the encounters with Mr. Springfield, students become sensitive to the elder who experiences numerous, confounding health problems. These older patients present great challenges for medical students who may be overwhelmed with the complexity of the case and may feel unable to make a difference in the patient’s health. Physicians in almost every practice are dealing with many frail elders who have multiple problems. When the medical condition cannot be cured, other aspects of the person’s functional status can be targeted in order to create a better quality of life. Students are taught to recognize and capitalize on the older adult’s strengths.
- Demonstrate appropriate communication techniques and sensitivity in interacting with aging couples.
- Recognize the impact of chronic health problems on both the older patient and the spouse.
- List health promotion/illness prevention interventions associated with healthy aging.
- Recognize factors that contribute to frailty and approaches to maintaining functional status.
Year One Objectives
- Improve understanding of health promotion activities, illness prevention activities, and appropriate immunizations and screenings for elders.
- Analyze the pathophysiology of the most common chronic illnesses associated with aging.
- Develop an understanding of the impact of living with a chronic illness.Appreciate the value of non-pharmacological approaches to managing common chronic illness.
- Develop a comprehensive, multidisciplinary approach to managing the complex aging patient
Year Two Objectives
- Improve ability to communicate with elders and their families
- Increase understanding of sensitive issues in elder care such as hearing loss, memory loss, sexuality, and depression
- Recognize that most elders have many issues, that many are not due to "old age" and positive changes can be made in their treatment plan.
- Recognize that the interdisciplinary team can help the physician to provide the best care for elders
Year Three Objectives
- Recognize the causes of falls, potential for fractures, and the psychosocial impact of frequent falling in the older adult.
- Identify appropriate drugs and therapies to manage chronic pain.
- Recognize the importance of promotion of functional status and the appropriate use of assistive devices and adaptive equipment.
- Appreciate the role of the caregiver and the interdisciplinary team in assistance and restoration of activities of daily living functioning.
Year Four Objectives
- Appreciate the older patient and spouse's feelings about various issues associated with the latter years of life, such as giving up driving and facing end of life.
- Identify the range of support services and living arrangements for elders having difficulty maintaining IADLs (traveling, shopping, cooking, doing housework, medication management, and managing money).
- Identify impact of 24 hour/7 day caregiving and associated issues.