Geriatric Research Education and Clinical Center (GRECC)
Little Rock GRECC
The Little Rock GRECC has been serving older Veterans in Arkansas, Louisiana, Mississippi, Oklahoma and East Texas since 1987.
Research Focus Areas
Biology of aging outcomes in skeletal muscle, central nervous system and cardiovascular system
Exercise and Nutrition Interventions
Positive Changes in Mental Health and Behavior
Advance Care Planning
GRECC studies use laboratory, clinical, and health services research methods. Our programs seek to define the mechanisms underlying aging and disease, conduct trials to test effects of interventions for age-associated disease, and translate the interventions into effective clinical care. Examples of the research being conducted by GRECC investigators include:
- Steve Barger, PhD: defining basic mechanisms of Alzheimer's disease and neurodegeneration including the role played by disruption of insulin and glucose regulation similar to diabetes
- Rich Dennis, PhD: understanding the role of the immune system, nutritional supplementation, and resistance training in older adults seeking to maintain or improve muscle mass, strength, and function
- Kim Garner, MD: improving communication between patients, family members and care providers with respect to the decision making required for end-of-life care so that patient wishes are honored
- Sue Griffin, PhD: characterizing events and molecules involved in Alzheimer's disease and related disorders with an emphasis on genetics and inflammation in disease causation and progression
- Kalpana Padala, MD: decreasing fall risk and increasing mobility for older adults, particularly individuals with Alzheimer’s disease through technology-based exercise programs
- Prasad Padala, MD: using drug and non-pharmacological treatments for apathy in older adults to slow the progression of dementia and improve self-management of other health conditions
- Dennis Sullivan, MD: understanding the causes and consequences of poor nutrition and lack of ambulation for older adults particularly the effects on recovery from illness and mortality
Education and Evaluation
Each year, the Little Rock/Veteran Integrated Service Network 16 GRECC Education program provides clinical training experiences to VA providers, staff, students, medical residents and fellows, and allied health professionals at the Central Arkansas Veterans Healthcare System. Using virtual and asynchronous methods, the GRECC also provides many didactic and self-learning opportunities for an even wider spectrum of health professionals and students from across the country. The goal of all GRECC educational initiatives is to improve the knowledge and clinical competence of learners to care for older adults in a wide array of clinical settings. In determining the focus of each education initiative, our GRECC places special emphasis on interdisciplinary team training, cognitive impairment/dementia, nutrition, rehabilitation of frail older and advance care planning. Including all of the newest knowledge obtained through research and successful clinical initiatives into each educational program ensures that learners are brought up-to-date on what represents the state-of-the-art in caring for older adults. The GRECC also conducts extensive evaluations of all education programs; one goal of the evaluation process is to develop a better indication of how well students and trainees translate their educational experiences into improved clinical practice provided to older adults.
Specific Examples of Recent Education and Training Projects: National Webinar Series: All of these webinar series included presentations from some of the nation’s top experts in the field and were broadcast nationally in multiple weekly sessions.
- Palliative Care Essentials for Older Adults Webinar Series
- Advance Care Planning via Group Visits Webinar Series
Brief In-Service Series: For each series, topics were divided into 3 to 5 brief (10-15 minute) in-services, each of which was presented on multiple hospital wards and shifts over a period of several weeks.
- Dementia Care for Older Adults
- Recognition and Management of Delirium
- Catheter Associated Urinary Tract Infection Prevention In-services
Team-Based Self-Learning Series: For each series, students were taught the principles of self-learning and taught each other in groups under the close supervision of a faculty member:
- Palliative Care Team-Based Learning
- Geriatric Gait/Balance Team-Based Learning
- Delirium Team-Based Learning
“Did You Know” Email Blasts: These are short email messages that highlight and raise awareness on a particular geriatric clinical issue and long-term services and support. These emails go out to a national audience of VA staff.
Partnerships with Other National Educational and Training Programs
- Geriatric Scholars Program Clinical Practica
- Co-sponsored National Webinar Series
- Rural Interdisciplinary Team Training
- GRECC Connect Case Conferences
The VISN 16/Little Rock GRECC clinical program uses quality improvement and implementation science methods to develop, evaluate, refine, and disseminate innovative, evidence-based methods of caring for older adults that are in direct alignment with VHA’s Blueprint for Excellence. Projects developed to date span the entire geriatric care spectrum and range from promoting a cultural transformation among sedentary older adults to become more physically activity, to adopting lean models to engage Veterans in advance care planning. Several of these programs have been disseminated regionally and nationally while others have been fully integrated into routine clinical practice locally. Over the last four years, the VISN 16/Little Rock GRECC program initiatives have received over ten million dollars in funding, predominantly from the Offices of Rural Health, Geriatrics and Extended Care, and Health Equity within the VHA.
Nationally Disseminated Programs:
- Advance Care Planning via Group Visits
- The Tele-Geriatric Walking Clinic
Regionally Disseminated Programs:
- Engaging Rural Veterans in Planning for Future Medical Decisions via Group Visits
- The Geriatric Walking Clinic
- Preventing Institutionalization and Supporting Caregivers through Expanded Services (PISCES)
Totally implemented clinically
- Tele-health and Technology to Promote Mind and Body Wellness – ActiVets
- Multidisciplinary Memory Clinic
Exciting projects currently being rigorously evaluated
- Implementing Innovations in Rehabilitation to Promote More Rapid Goal Attainment