Geriatric Research Education and Clinical Center (GRECC)
GRECC Education News: April - June 2018 (FYQ3)
- Birmingham/Atlanta GRECC: Engaging Diverse Older Adults in Research
- Bronx GRECC: Workforce Development Initiative to Prepare Associated Health Trainees to Effectively Care for Older Rural Veterans
- Durham GRECC: Caring for Older Adults and Caregivers at Home
- Greater LA GRECC: VA Greater Los Angeles GRECC
- Little Rock GRECC: VISN 16/Little Rock GRECC Education
- Miami GRECC: The “E” in GRECC means “Education”
- Palo Alto GRECC: Bringing Together Multiple Disciplines for Interdisciplinary Geriatrics Training
- Pittsburgh GRECC: VA Pittsburgh GRECC Develops Aphasia Rehabilitation Residency Program
- Puget Sound GRECC: Geriatric Scholars Program Supports System-Wide Distribution of Home Safety Workbook
- Salt Lake City GRECC: Associated Health Trainees (AHT) Program
DREAMS, a two-part educational intervention designed to increase opportunities for diverse older adults to participate in all phases of the research process, was conceptualized by GRECC investigators Drs. Madeleine Hackney and Molly Perkins.
Funded by Patient Centered Outcomes Research Institute (PCORI), Developing a Research Participation Enhancement and Advocacy Training Program for Diverse Seniors (DREAMS) addresses barriers to research participation among under-represented groups in two parts:
- Part I: An 8-week interactive research seminar, co-taught by Atlanta VA and Emory University researchers and medical students, educated 96 older adults (M age = 71.5 years) from under-represented groups (49% non-white - 16% with annual incomes < $20,000) about current translational and clinical aging research.
- Part II: The DREAMS Team program was implemented with a subset (n=24) of the Part I cohort who demonstrated commitment to further training to serve as patient – research advocates.
Bronx GRECC: Workforce Development Initiative to Prepare Associated Health Trainees to Effectively Care for Older Rural Veterans
The Hudson Valley Rural Geriatric Education Collaborative (HVRGEC) is an exciting, innovative program with the VISN 2 Geriatric Research Education and Clinical Center (GRECC) based at the James J. Peters VA Medical Center (JJP, and the VA Hudson Valley Health Care System (HVHCS). This Rural Health Training & Education Initiative prepares associated health trainees to provide high-quality healthcare to older rural Veterans. Trainees represent a variety of disciplines, including social work, psychology, pharmacy, nursing, audiology, and physician assistants. HVRGEC supplements trainees’ existing clinical experiences at the VA by offering exposure to various rural settings of care, telehealth, and curriculum content on critical rural health issues. Extensive clinical, didactic, and educational offerings are provided at the following locations:
- Castle Point and Montrose campuses of HVHCS
- Monticello, Port Jervis, and Pine Plains Community Based Outpatient Clinics (CBOCs) at HVHCS
Major program offerings include:
- A weekly geriatrics focused Associated Health Seminar
- Access to a VA SharePoint site which stores over 1,250 interdisciplinary resources in rural health and geriatrics monthly GRECC CBOC connection case conferences
- Free access to a geriatrics virtual learning community (www.gerischolars.org) which provides self-paced learning opportunities in geriatrics
- Annual rural health half-day conference for trainees, faculty, and staff
- rural health webinars
- faculty development
By the end of FY 2018, the HVRGEC program will have trained approximately 300 associated health trainees in rural geriatrics. The program has been funded by VHA’s Office of Rural Health (ORH) since FY2013 and has been recognized as an ORH “Best Practice.”
For more information about the HVRGEC program, contact Annette Hintenach, Program Manager at (718) 584-9000, ext. 3853.
The Caring for Older Adults and Caregivers at Home (COACH) model, developed by the Durham VA GRECC, is a home-based dementia care program serving Veterans with dementia living at home. It is an innovative model of care that provides support and education, including attention to behavioral symptoms, functional impairment, and home safety, on a consultation basis. The program has a holistic approach to enable veterans to live at home for as long as possible and help caregiver to reduce their level of burden.
Services: Provided by a geriatric social worker and a geriatric registered nurse with the support from an interdisciplinary team including a geriatrician, geriatric psychiatrist and geriatric pharmacist. The registered nurse and social worker perform a comprehensive medical and psychosocial assessment; including a home safety evaluation; assessments of patients’ behaviors, cognitive and functional abilities; medication review; caregiver stress and family resources, caregiver’s health literacy; and a plan to improve caregiver support.
Impact: Frail Veterans with dementia have a high risk of being institutionalized and that risk increases every year as the disease progresses. Their caregivers are often exhausted and isolated and struggle to manage those symptoms. Having access to a group of professionals that offer support, education, training in dementia care at home and assistance to obtain resources alleviates caregivers burden and decreases safety hazards. The program has increased access to dementia care and increased access to VA and community resources. COACH has served over 550 veterans and their caregivers over the past six years. Caregivers have expressed high level of satisfaction with the program reaching 100% of satisfaction.
- Increase access to care to older veterans with dementia
- Reduce cost of nursing home placement
- Reduce caregiver burden
- Reduce safety hazards in patients with dementia
For more information, contact Judith.Davagnino@va.gov at 919-286-0411 ext. 6258.
The Geriatric Research, Education and Clinical Centers (GRECCs) are a cornerstone in the Veterans Health Administration's strategy to focus attention on healthcare issues in the aging Veteran population, to increase basic knowledge of aging, to transmit that knowledge to healthcare providers and to improve the quality of care for older Veterans throughout the VA. The VA Greater Los Angeles GRECC, housed at the Sepulveda and West Los Angeles campuses, was among the first of these centers of excellence and is a national leader in research, education, and clinical demonstration activities. The three main areas of focus in our GRECC include:
- Cognitive disorders
- Vulnerable older adults
GLA GRECC Leadership:
- Cathy Alessi, MD (Director)
- Eliot Mitchell, VHA-CM (Administrative Officer)
- Greg Cole, PhD (Associate Director, Research)
- Josea Kramer, PhD (Associate Director, Education and Evaluation)
- Steven Castle, MD (Associate Director, Clinical)
- Jennifer L. Martin, PhD (Associate Director, Clinical and Health Services Research)
For more information, call (818) 891-7711, ext. 39311
The VISN 16/Little Rock GRECC education team has developed and implemented a monthly interdisciplinary training program for a variety of health professionals from medicine, pharmacy, social work, nursing, and occupational therapy. This face-to-face training provides trainees with a unique opportunity to learn to care for older Veterans in an inter-professional setting under the guidance of a broad array of training facilitators who are researchers, educators, and clinicians. Each month, a facilitator and trainees gather to discuss a geriatric-focused case study.During each case discussion, the learning and teaching technique called Concept Mapping is used to visually illustrate relationships between concepts and ideas.
It is our mission to provide healthcare staff and trainees with the geriatric-related knowledge required to provide high quality, Veteran-centric healthcare to our older Veterans. We accomplish this mission through innovative education activities as directed by quality metrics, needs assessments, and recent research. Each year the trainees form teams to collaborate and develop enduring educational materials. This past year, they developed several geriatric email blasts called “Did You Knows?” These email blasts on geriatric-related topics (suicide, dementia, falls, etc.) are sent out to VISN 16 healthcare clinicians to provide brief asynchronous with links for additional information.
For more information, contact the VISN 16 GRECC Education Team.
Our Geriatric Research, Education, and Clinical Center (GRECC) has education built into its name! It is part of the core mission. The education mission is targeted to VA staff and trainees at our facility, our network and nationwide. Over many years at Miami, the GRECC has sponsored a monthly grand rounds in geriatrics. Our geriatric medicine fellowship program has trained hundreds of board certified geriatricians, many of whom were recruited to leadership, research and clinical positions at this VA and at VA facilities throughout the nation. GRECC staff have taught thousands of medical students. GRECC staff teach graduate students in a population health and aging program. Office of Academic Affiliation funding to the GRECC has supported trainee positions in psychology, social work, speech therapy, physical medicine & rehabilitation and nutrition. Over the decades, GRECC staff have participated in education with many of our peers in other services such as research, primary care, nursing, medicine, surgery, and others.
Our VISN leadership has supported geriatric education for PACT providers by annually sponsoring both a 2-day conference and a mini-residency in geriatrics held at each facility within the VISN. These conferences, jointly designed and delivered by the Gainesville and Miami GRECCs, have been highly rated by learners.
Our educational efforts also extend to national conferences where posters of GRECC discoveries are exhibited and GRECC speakers present their findings to others. Recently, we have begun a collaboration with the VHA SimLEARN National Simulation Center in Orlando to produce content that will be available online nationwide to all VA staff in FY19.
For more information, contact:
- Hermes J. Florez, MD, MPH, PhD, Miami, GRECC Director
- Yvette Kendal, MA, Miami GRECC Research at 305-575-3388
In 2016, Dr. Philip Choe and Dr. Terri Huh of the VA Palo Alto Health Care System (VAPAHCS) GRECC developed an Interprofessional Team Training based on an educational activity developed at the University of Alabama-Birmingham. The Palo Alto GRECC training is geared toward geriatric medicine fellows and allied health trainees (optometry, pharmacy, physical therapy, psychology). The focus of the training is to model an interprofessional team assessment for a patient establishing care with the VA for the first time. A scripted simulation with a volunteer patient takes place with assessments from nursing, social work, psychology, geriatric medicine, pharmacy, physical therapy, and optometry. After the scripted simulation, the trainees are broken up into interprofessional teams and asked to develop a plan of care that takes into account the goals of the patient, the family, and the interprofessional team. Training evaluation results in 2016 and 2017 demonstrate a significant improvement in knowledge, abilities, and skills related to interprofessional team interactions. The annual training continues with the next training planned for July 2018 for the incoming Geriatric Medicine Fellows and allied health trainees.
In addition to the Interprofessional Team Training, the geriatric medicine and allied health trainees will come together on June 19th for the 1st Annual GRECC Allied Health Scholars’ Symposium. Geriatric Medicine fellows and Pharmacy residents will present their quality improvement projects conducted during their training year. Optometry residents will present case studies. Judges from each discipline will rate the presentations. All are invited to drop-in between 2:00 and 4:00pm on Tuesday, June 19th to view the presentations. The symposium will take place in the Palo Alto GRECC Conference Room (C-260) in Building 4 on the 2nd floor.
For more information, contact Christine Gould, PhD, Acting Assoc. Director for Education and Evaluation at 650-493-5000 Ext. 68899.
Aphasia is a communication disorder that is common in brain-injured Veterans and estimated to affect more than 100,000 US Veterans age 55 and older. The “Pittsburgh Aphasia Rehabilitation Training Network and Residency” (PARTNeR) program is an innovative, targeted workforce development initiative that leverages the expertise and infrastructure of VA Pittsburgh’s Program for Intensive Residential Aphasia Treatment and Education (PIRATE). Specifically, PARTNeR brings together scholarship awardees and GRECC clinical and research faculty recognized world-wide for their expertise in aphasia rehabilitation and research with Veterans undergoing treatment within PIRATE’s novel point-of-care environment. The 5-week residency program includes core curricula addressing assessment, intervention, counseling, and outreach/advocacy aspects of aphasia management, and case-based experiential learning activities grounded in current psycholinguistic and cognitive-neuropsychological approaches to aphasia therapy to provide specialized training in theoretically motivated and patient-centered aphasia rehabilitation services consistent with current best evidence.
The VA Pittsburgh Healthcare System has awarded six Aphasia Rehabilitation Residency Scholarships to Speech Language Pathologists from the Cincinnati, Martinez, Minneapolis, Nashville, Richmond, and Seattle VA Medical Centers. Upon completion of the program, PARTNeR residents will have improved knowledge and competencies in aphasia rehabilitation and will be prepared to serve as valuable resources and advocates for this underserved veteran population upon return to their home communities.
For more information, contact Patrick J. Doyle, Ph.D. at 412-360-6427.
Puget Sound GRECC: Geriatric Scholars Program Supports System-Wide Distribution of Home Safety Workbook
With the generous support of the Geriatric Scholars Program, the Puget Sound GRECC has printed and mailed 50,000 copies of A Guide for Families: Keeping the Person with Memory Loss Safer at Home workbook. Copies have been sent to each of the Community Based Outpatient Clinics (CBOCs) across the country. Based on initial feedback from Geriatric Scholars, there is great demand for this information in primary care settings. The workbook will do much to increase the safety of Veterans at home and to address the stressful burden of caregiving.
The Puget Sound GRECC plans to distribute a Brain Health and Aging card, also with the support of the Geriatric Scholars Program.
For more information, contact Stephen Thielke, MD MS MA, Associate Director for Education/Evaluation
The Salt Lake City GRECC hosts interdisciplinary learners through the GRECC Associated Health Trainees (AHT) program. We offer an interactive set of geriatrics trainings for Allied Health Trainees in fields including nursing, social work, physical and occupational therapy, psychology, audiology, and speech pathology. Trainees have field placements at the George E. Wahlen VA Medical Center in VISN 19. An innovative aspect of our training program is the use of peer teaching methods. In this approach, trainees present to each other, creating an interactive and interdisciplinary learning environment with deep investment from the learners.
Each month, in addition to their clinical experience, Associated Health Trainees have the opportunity to attend interdisciplinary presentations and other educational opportunities. During FY18, we have offered didactic and interactive sessions on topics including:
- Aging Veterans and Veteran Resources
- Physical and Occupational Therapy in Productive Aging
- The Aging Eye and Common Eye-Related Geriatric Pathologies
- and others
Both online and face-to-face presentations focus on gerontology, geriatric care, and interdisciplinary teamwork through various methods, including case analysis and interactive exercises. Our goal is to continue to provide new and relevant training that will continue to aid trainees in better understanding services available, understanding of their patients, and improve their assessment of veterans. AHT trainees have also been given the opportunity to attend the 16th Annual Rocky Mountain Geriatrics Conference, hosted by Denver GRECC in 2018, titled “Aging in Place: Promoting independence and planning for the future of our aging population.” Live streaming of the conference is offered to Salt Lake City AHT’s free of charge.
For more information, contact Jorie Butler, PhD, Associate Director for Education.