海角社区

Louisiana ranks fifth in the nation for Alzheimer鈥檚 disease, which mostly impacts older adults and is among the leading causes of death.

With only 50 certified geriatricians in the state鈥攑hysicians who specialize in the treatment of older people鈥攊t is often difficult to diagnose and treat dementia as well as other diseases and injuries, from heart problems to broken bones, in patients with dementia.

But thanks to a growing partnership between 海角社区 and Ochsner Health, dementia care is improving. Recently, Ochsner Health鈥檚 MedVantage Clinic in New Orleans became recognized as an by the Institute for Healthcare Improvement in partnership with the American Geriatrics Society and the American Hospital Association, getting the highest recognition of its kind, 鈥淐ommitted to Care Excellence.鈥� This achievement was a direct result of teaming up with 海角社区 to implement the 鈥�4Ms framework,鈥� which are four core principles of high-quality care: what matters most, medication, mentation, and mobility.

鈥淚deally, we want every healthcare provider to think about the 4Ms every time they encounter an older adult,鈥� said Dr. Erika Diaz-Narvaez, a geriatrician at Ochsner Health New Orleans and co-lead for the project with 海角社区. 鈥淒oes this person have memory problems? Do they have delirium or depression? Is their medication causing any side effects? How is their mobility? And what matters most to them? Asking questions like these leads to better outcomes for our patients and their families, and the hope is that we鈥檙e making more treatment plans based on our patients, not just guidelines.鈥�

Dr. Diaz-Narvaez sees patients and educates residents at Ochsner Medical Center in New Orleans. In collaboration with 海角社区 and Ochsner colleagues, she participates in multidisciplinary clinics and monthly online trainings for doctors, nurses, social workers, and other healthcare professionals.

鈥淥ur project has grown exponentially, and a lot has changed,鈥� said Matthew Estrade, project manager at Ochsner Health. 鈥淣ow we鈥檙e reaching other clinics and providers in Louisiana, Mississippi, and beyond. There is never going to be enough geriatricians, so we鈥檙e working with 海角社区 to make sure primary care providers know how to address these things for older adults.鈥�

A core component of the project is to train primary care doctors, since many patients with dementia, especially in rural areas, rarely see a specialist such as a neurologist. Since 2019, the 海角社区-Ochsner team has educated and trained more than 500 doctors and medical students, over 600 nurses and nursing students and faculty, and close to 1,500 social workers and social work students and faculty on how to better diagnose and treat people with dementia.

Team leader for the effort is Scott E. Wilks, professor of social work and director of the Healthy Aging Research Center at 海角社区. In 2019, he earned an award of nearly $4 million from the Health Resources and Services Administration, a federal agency under the U.S. Department of Health and Human Services, for the ongoing collaboration with Ochsner, called the Louisiana Geriatrics Workforce Education Program. Then, in 2024, the partners received a second grant of $5 million from the same agency to expand their efforts into what is now the .

鈥淏y 2030, older Americans will account for nearly 30 percent of the nation鈥檚 population, so the need for this work is dramatic.鈥�

Scott E. Wilks, 海角社区 Professor of Social Work

In Louisiana, there is one certified geriatrician for every 8,000 older adults. Meanwhile, only one in every 25 social workers and one in every 100 registered nurses are specialized or certified in geriatrics.

鈥淥ur main goal is to try to bridge the gap between the care people with dementia get from their primary care providers and the care they would be getting if they went to a specialist,鈥� Wilks said. 鈥淲e鈥檝e seen a significant number of misdiagnoses, neglected diagnoses, and too-broad diagnoses, which then lead to a whole host of issues with medication and treatment plans. That鈥檚 why we train medical professionals and caregivers on the symptoms to look for and on proper testing for dementia, including the type and stage, because if there鈥檚 a disconnect in primary care practice, we鈥檙e getting one or both wrong.鈥�

Dementia is not just one disease but a group of conditions that affect the brain and therefore impact memory, thinking, behavior, and emotion. Collectively, dementias are the leading cause of disability and dependency among older adults, and they鈥檙e phenomenally costly. If dementias were a country, it would be the 17th largest economy in the world. The unpaid work families do to provide in-home, daily care for loved ones with dementia is equivalent to $300 billion annually.

The monthly trainings 海角社区 and Ochsner provide use an educational model called ECHO, short for Extension for Community Healthcare Outcomes. Starting in November 2021 with about 20 healthcare providers in attendance, the trainings鈥�36 to date鈥攏ow regularly attract 100 professionals who want to learn about older adult care.

In addition to ECHO, 海角社区 and Ochsner host four in-person dementia trainings each year: the Alzheimer鈥檚 Services Educational Conference, as well as three other virtual trainings. They also organize a multidisciplinary panel where experts on Alzheimer鈥檚 disease and related dementias鈥攊ncluding a physician, nurse, social worker, and family caregiver鈥攁nswer questions. The partnership has led to the first dementia-focused curriculum requirements being implemented for nursing students at Chamberlain University in New Orleans, physician assistant students at Xavier University, and for medical students at the University of Queensland-Ochsner Clinical School at Ochsner Medical Center.

Another direct outcome of the 海角社区-Ochsner collaboration is how Ochsner physicians now access 4M-type data in their patients鈥� electronic medical records.

鈥淪omeone鈥檚 medical record usually contains a lot of 4M data, but it tends to be spread out throughout the record and difficult to find,鈥� Dr. Diaz-Narvaez said. 鈥淪o, we worked to create an algorithm, a dot phrase, that pulls all the relevant geriatric information into our notes. This helps us see at a glance how functional a person is, if they鈥檝e been prescribed inappropriate medications, and more. We鈥檝e now served hundreds of patients using this new capability, and we continue to reach more providers.鈥�

The team鈥檚 work is wholly supported by Ochsner Health trailblazers in improved care for older adults, Dr. Susan Nelson, a geriatrician, and Dr. Kathy Jo Carstarphen, an internal medicine doctor who leads Ochsner Health鈥檚 MedVantage Clinic. They have big plans for the future in collaboration with 海角社区.

鈥淲e want to expand use of the 4M data and educate more clinics, including Ochsner clinics in Louisiana and Mississippi, to help them achieve Age-Friendly Health System status where we also can track how many older adults are seen using this framework,鈥� Dr. Diaz-Narvaez said, with Dr. Nelson, Dr. Carstarphen, and Estrade all agreeing. 鈥淚t鈥檚 been a great partnership.鈥�

 

Read more about the 2024-2029 Louisiana-Mississippi Geriatrics Workforce Education Program: /chse/news/2024/harc-grant-for-dementia-care.php

Read more about the 2019-2024 Louisiana Geriatrics Workforce Education Program: /chse/socialwork/news/wilks_la-gwep_grant2019.php

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