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Reasons older individuals are turning to marijuana
An article published in the April 2020 issue of The American Journal of Geriatric Psychiatry, written by UCSD medical student Kevin Yang, and co-authored by division members, Alison Moore, MD, Khai Nguyen, MD, Reva Nafsu, RN, and Christopher Kaufmann, PhD, explores the reasons older individuals are turning to marijuana. Read more here.

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Welcome our Newest Member, Aireen Gutierrez, MD!

When did you know you wanted to be a Geriatrician?

It was in August of 1972, when my family and I arrived in America to escape the martial law during Marcos’ regime.  Being the oldest of 5 daughters, I had to start earning a living early to help support my family’s needs. So as early as high school I worked as a phlebotomist, telemetry technician, which led me to be interested in the medical field.  However, it was my job as a nurse’s aide in a “convalescent home” that opened my eyes to how desperately the quality of care of our older patients needed to be improved. As I later pursued my nursing career,  and worked in Critical Care unit at Good Samaritan Hospital for 5 years, again I witnessed how my patients with dementia kept  coming back to ICU on a ventilator, with  tube feedings., and I thought to myself, someday, “ I would like to be have a profession which can bring back quality of life and dignity, especially towards the end of life of my patients “.

How did your education, training and experience contribute to your growth and passion in Geriatrics?

After obtaining my Medical Degree from St. Louis University, I proceeded to finish my Internal Medicine Residency at Jersey Shore University Medical Center. This is where I met my mentor who had introduced me to a whole spectrum of Geriatrics from caring for active, healthy older adults all the way to the most frail, vulnerable patients, and realized that this is, indeed, my calling. 
So I then pursued my fellowship from the Harvard Multi-Campus Geriatric Program.  Since then, for the past 18 years, I have had vast experience in Geriatrics, which has included subacute care, home visits, wound care, and providing care in an outpatient senior clinic.  I was also the first physician when the PACE program was introduced in San Diego.  PACE provides all-inclusive care for frail seniors with complex medical issues to help them continue to live at home.  Later on, I became passionate about end-of-life care, which led me to my work at Vitas Hospice and later obtaining board certification in Hospice and Palliative Medicine.
However, post-acute/long-term care had always been my passion for most of my career, which I was able to practice at the Veterans Home of CA and now at UCSD Population Health. I learned to value the importance of a cohesive, interdisciplinary team to ensure a patient-centered care approach.  I find it challenging and yet fulfilling to care for our elderly patients, who not only have end-stage multiple disease states, but complicated also by psychosocial needs.  The quote which I try to apply in my daily practice is from Maya Angelou, “people will forget what you said, people will forget what you did, but people will never forget how you made them feel".

How has joining the UCSD Division of Geriatrics and Gerontology and Population Health impacted your career?

It is a  both a privilege and inspiring to be given the opportunity to work with and learn from the leaders in this field, who are dedicated, and share my passion of improving the quality of care for the most vulnerable members of our society.  This is also where I feel our voices are heard and our opinions respected.
Through research and seminars, I am learning more evidence-based concepts, which I can apply in improving the care I deliver to my patients.
Population Health has given me the opportunity to be member of a collaborative team, which takes care of the high risk patients, through their transitions of care, at home and in a long-term care setting.  It is exciting to be part of this program during its early stage and to be able to contribute to its continued growth and success.

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Senior living facilities restrict readmission to prevent coronavirus

April 2, 2020 in San Diego, California.
(Eduardo Contreras/The San Diego Union-Tribune)
Our Clinical Services Chief, Dr. Khai Nguyen has been featured in an article from the San Diego Union-Tribune regarding senior living facilities restricting readmissions to prevent COVID-19 spread. Click here to read the article.

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We don’t know enough about Latinos and Alzheimer’s, and that’s a huge problem. 

by Hector Gonzalez, Associate Professor of neurosciences at UC San Diego to L.A. Times. Feb 19,2020. Click here to read the article.

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10 Priorities for a Decade of Action on Healthy Ageing, by the World Health Organization. 

The 10 Priorities provide the concrete actions that are needed to achieve the objectives of the WHO Global strategy and action plan on ageing and health. WHO carried out a series of consultations with experts, WHO staff and key stakeholders to identify those actions that would be transformative. Each priority is crucial for getting the world to the point where it can take on a decade of concerted action. Many are inextricably linked and all will require collaboration with many key partners. Healthy Ageing will not become a reality without focused global action. These 10 priorities  provide the path forward.

Infographic


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UC San Diego Health Part of National Initiative to Improve Senior Patient Care

First in San Diego to implement evidence-based approach to provide high quality of care to seniors
December 02, 2019  |  Michelle Brubaker

According to the National Council of Aging, approximately 92 percent of seniors have at least one chronic disease and 77 percent have at least two. As a rapidly growing demographic, experts say seniors require particularly high quality care and attention in areas such as independence, medication use, fall and dementia risk and co-occurrence of disease conditions.

UC San Diego Health is at the forefront of addressing the complex needs of seniors, recently becoming the first health care system in San Diego to join the Age-Friendly Health Systems initiative  and be recognized as Committed to Care Excellence by the Institute for Healthcare Improvement (IHI). The designation acknowledges UC San Diego Health’s implementation of a set of evidence-based interventions designed to improve care for older adults.

UC San Diego Health joins more than 100 health systems across the nation that are part of the initiative. The goal of IHI is for 20 percent of hospitals and health systems in the United States to be recognized as age-friendly by 2020.

“We look forward to both sharing our best practices and learning what’s working at other health care systems,” said Alison Moore, MD, MPH, chief of the Division of Geriatrics and Gerontology at UC San Diego Health. “Through raising awareness, education and collaborations, we can make a profound shift in how we define the future of care for a large and incredibly valuable portion of our society. We are dedicated to meeting our senior patients where they are in life.”

The initiative is based on a series of practices known as the four Ms, which focus on addressing essential elements of care for senior patients: 
What Matters: Knowing and aligning care with each older adult's specific health outcome goals and care preferences across all settings of care.
Medication: Prescribing appropriate medications in doses that do not interfere with quality of life.
Mentation (Cognitive Function): Preventing, identifying, treating and managing dementia, depression and delirium.
Mobility: Ensuring older adults are able to move safely every day, both to maintain normal, healthy functions and to prevent injury.

“The initiative provides health care systems with the tools needed and creates new standards of care to ensure conditions, such as delirium and depression, are identified while falls and adverse effects of medications are prevented in older patients,” said Khai Nguyen, MD, clinical services chief of senior medicine at UC San Diego Health.

Both cognitive function and mobility can decline significantly for older adults during hospitalization. In an Age-Friendly Health System, evidence-based protocols, such as physical exercises and daily cognitive stimulation, are used to prevent decline and may reduce the length of a person’s hospital stay, plus increase the likelihood that an individual can return home versus transferring to a skilled nursing facility.

“Our care team is not only concerned with figuring out ‘what’s the matter with you,’ but also figuring out ‘what matters to you,’” said Lindsey Yourman, MD, primary care physician at UC San Diego Health.

Hospitals and health care practices recognized by the IHI as being Committed to Care Excellence have shown exemplary alignment with the elements of the four Ms over at least a three-month time period. UC San Diego Health has spearheaded the four Ms at the Medicine for Seniors clinic in La Jolla and Senior Behavioral Health program in Hillcrest, with the goal of implementing the four Ms care approach in other areas of the system.

“We are building a framework of care that can one day be rolled out across our hospitals and clinics,” said Nguyen. “We are fortunate to be early adopters in this national movement. These efforts are historic in the care of seniors in our country.”