To all Geriatric Resource Nurse participants WELCOME BACK!!! To all Geriatric Resource Nurse participants

Thank you To Dr. David Gill who is contributing so much time, passion, and energy to make this an excellent semi-annual GRN training series. To all the participants, who care deeply about the older persons living in their communities.

Geriatric Resource Nurse Semi-Annual Updates for Community Nurses Sponsored by the Penn State Site of the Geriatric Education Center of Pennsylvania Consortium (GEC/PA) (Penn State University, University of Pittsburgh, & UPMC) in collaboration with the Pennsylvania Behavioral Health and Aging Coalition Principal Investigator: Melissa Hardy, PhD Project Coordinator: Carol Hancock Gold, PhD in the Center for Healthy Aging at Penn State

Project Support “This project is supported by funds from the Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS) under grant number # UB4HP19199. “Geriatric Education Center of Pennsylvania”. The information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by the BHPr, HRSA, DHHS, or the U.S. Government.”

Responsibilities of Participants After this training has concluded, you will be emailed a link to the evaluation form that includes the attestation of attendance and post-test; these must be completed no later than midnight on Wednesday, December 5, 2012. The post-test is ONE question! You will not be awarded your PSNA certificate unless you complete this evaluation form. You also need to complete a 2012-2013 Demographic Form in order to meet one of the requirements of our funder for this project if you have not already done so. You will not be awarded your PSNA certificate unless you have completed this new demographic form.

Geriatric Resource Nurse Semi-Annual Training Series for Community Nurses Linda Shumaker, RN-BC, M.A. Outreach Coordinator Pennsylvania Behavioral Health and Aging Coalition

Reminder: Aging of America Those 65 and older represent the fastest growing age group in America. Growth will be from 12% to 21% of the population by 2030 –estimated 70.1 million. Rapid growth is expected to occur among the oldest & frailest population groups. More diverse racially and ethnically Will live longer Will have multiple complex health problems Need for the inter-professional team model!!! Face higher healthcare and prescription drug costs Labor force likely to be proportionally smaller – the population support ratio (aged 18-64 vs. 65 plus) will decrease by approximately 40%

Behavioral Health Issues in the Older Adult Aging of Pennsylvania Fifth highest aging population in the country One of the highest population of rural aged The number of rural elderly is increasing faster than in the urban areas. By 2020 the elderly population in PA is expected to be approximately 3 million – more than one in four Pennsylvanians will be classified as elderly, an increase of more than 50 percent. The number of oldest old is projected to continue rising in PA, more than in the nation as whole. Linda K. Shumaker

Behavioral Health Issues in the Older Adult Aging of America Supply of healthcare workers does not address current demand and will fall short of the expected increase. The vast majority of health professionals have little geriatric training: 4% of social workers Less than 1% of physician assistants Less than 1% of registered nurses Less that 1% of pharmacists Linda K. Shumaker

Aging of America (cont.) Behavioral Health Issues in the Older Adult Aging of America (cont.) Institute of Medicine concludes that “the nation faces an impending healthcare crisis as the number of older patients with more complex health needs increasingly outpaces the number of healthcare providers with the knowledge and skills to adequately care for them.” Linda K. Shumaker

IOM 2003 Report – Health Professions: A Bridge to Quality “All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics.” IOM 2003 Report – Health Professions: A Bridge to Quality

Aging of America (cont.) In today’s health care system, services for older adults are often delivered by many different providers with little or no coordination among the various professions represented at the patient’s side. While health professionals are expected to work in inter-professional teams, they are trained in the silos of their respective schools and programs.

Reminder: Geriatric Resource Nurse: Key Position Provides and communicates standards for best, evidence-based care for older adults Assists with strategies for identifying older adults at risk of decline Assists with assessing the development of symptoms related to geriatric issues Coordinates team-based techniques for care across health professions Connects service providers and links community services

Geriatric Resource Nurse: Key Position (cont.) Team Leaders in their communities with the knowledge and skills to address the multiple needs of older people Leaders of community-based Inter-professionals in delivering care to community-residing older adults Educators across all levels of their community Professionals Service providers Family members Older adults The “Community” itself

Need for Inter-professional Approach at Community Level The challenges associated with aging, physical illness, increasing infirmity, dependency and limited financial resources place the older adult at high risk for behavioral and physical health issues. Proactively addressing these issues requires that we attempt to intervene at the community level, in order to prevent the older adult from having to be hospitalized or transferred to a nursing home for extended care.

Need for Inter-professional Approach (cont.) No single service agency has the skills and resources to effectively address all areas of need. Successful intervention requires a comprehensive and coordinated system of care!

Need for Inter-professional Approach (cont.) Effective and adequate treatment requires an inter-disciplinary approach that will address the multiple needs of persons as they age and decline in physical, cognitive, and emotional ways. More emphasis needs to be placed on the importance of cooperation and mutual respect among the professional and lay care-givers, and integration of the various levels and types of care.

Roles of Geriatric Resource Nurse: Summary Assess individual needs for community resources Explore options with client and family Take a multi-faceted approach Foster partnerships between agencies Give support and information to providers throughout referral process Ensure follow-up across systems Build inter-professional linkages in the community!

GRN GoogleGroup grn-pa@googlegroups.com is a communication resource for the GRNs who were trained in Spring 2011: All GRNs are members of the group (unless they unsubscribed) Any member of the group can send information to everyone in the group. Individuals receiving information can reply to everyone in the GoogleGroup or just to the sender.

GRN GoogleGroup (cont.) Examples for the use of the GRN GoogleGroup: Send out interesting, relevant, new information to update each other Requests can be sent to the GoogleGroup for ideas and suggestions from other GRNs on how to deal with a difficult case or client Share ideas or system approaches as in Best Practices

GRN GoogleGroup (cont.) Examples for the Use of the GRN GoogleGroup: Ask for special programmatic needs or referral sources (or details on) Share information about local or state-wide programs, seminars or conferences Penn State and PA BHAC use the Google Group to share offerings, updates, needs assessments, interesting and relevant news that may be helpful to GRNs, etc.

THE GRN GOOGLE GROUP is for you! Please use it!!!

Introduction of David J. Gill, MD MD, University of Florida Internship, Internal Medicine, University of Rochester, School of Medicine & Dentristry Residency, Neurology, University of Rochester Fellowship, Cognitive and Behavioral Neurology, University of Rochester Current Position: Practicing cognitive and behavioral neurologist who runs the Unity Health System Memory Center in Rochester. Has organized and taught courses on neural and behavioral science to students at Penn State Hershey and Rochester School of Med. & Dent.

Thank you, Dr. Gill!