Department of Family & Community Medicine

Enhanced Skills Program: Care of the Elderly Long Term Care Rotation Goals and Objectives

By the end of the rotation, the resident will be able to:

Medical Expert

  • Recognize, assess, investigate and manage common acute and chronic medical problems in long-term care, such as heart failure, diabetes, dementia, wounds, falls, pneumonia, osteoarthritis, osteoporosis and urinary incontinence.
  • Recognize, assess, investigate and manage behavioural and psychological symptoms of dementia (BPSD) using a PIECES template, with appropriate non-pharmacologic and if needed, evidence-based pharmacotherapy.
  • Recognize the potential role of other health issues in the presentation of decreased cognitive performance in older adults, including in delirium, and manages these factors appropriately.
  • Assess capacity of an individual to make treatment decisions. Appropriately seek consent from substitute decision makers when treatment decisions are required.
  • Perform a comprehensive pain assessment and appropriately treats pain in the older person, being mindful of the benefits, adverse effects and risks of various treatment approaches.
  • Review a medication list and optimally prescribes, incorporating an understanding of benefits and risks as well as patient’s goals, evidence and life expectancy.

 

Communicator

  • Develop rapport, trust and ethical therapeutic relationships with patients and families.
  • Accurately elicit and synthesize information from, and perspectives of, patients and families. Gather information about patient’s beliefs, concerns, expectations and illness experience.
  • Accurately convey needed information and provide explanations to patient and families in a way that is understandable and encourages discussion and participation in decision-making.
  • Develop a common understanding of issues, problems and plans with patients and families and provides and follows-up on a shared plan of care. Attempt to incorporate patient wishes even in situations of diminishing individual capacity.
  • Recognize and manage communication challenges with older patients, including hearing impairment, low vision and impaired cognition.

 

Collaborator

  • Participate in a collaborative team-based model and with consulting health professionals in the care of patients.

 

Leader

  • Allocate finite healthcare resources appropriately. Apply evidence and management processes for cost-appropriate care

 

Health Advocate

  • Advocate for individual patients around relevant health matters encountered in long-term care

 

Scholar

  • Critically evaluate medical information, its sources and relevance to an LTC population.

 

Professional

  • Demonstrate a commitment to their patients, profession, and society through ethical practice. Recognize and appropriately respond to ethical issues encountered in long-term care.
  • Fulfill the regulatory and legal obligations required of long-term care practice.
  • Demonstrate a commitment to physician health and sustainable practice.
  • Demonstrate a commitment to reflective practice. Gather information about personal performance, knows one’s own limits and seeks help appropriately. Reflect on practice events, especially critical incidents, to deepen self-knowledge.