Name: Abd-Manaaf Bakere

Rotation 3: Long term Care/Geriatric

Reflection on Long term Care/ Geriatric Rotation

During my third geriatric rotation at Metropolitan Hospital, from March 11 to April 12, 2024, I gained invaluable insights into the complexities of caring for elderly patients. One key lesson I learned is that effective geriatric care extends beyond addressing immediate medical concerns. For instance, Mrs. Ortiz, an 80-year-old patient with multiple chronic conditions, taught me the importance of understanding her social support system. Despite her physical limitations, Mrs. Ortiz thrived with the support of her daughter who ensured she attended appointments and adhered to her treatment plan. This experience highlighted the significance of considering patients’ social circumstances when devising care plans.

Managing multiple chronic conditions in elderly patients requires a nuanced approach. Mr. Mendez, a 75-year-old gentleman with hypertension, diabetes, and osteoarthritis, exemplified the challenges of prioritizing treatment goals. Collaborative decision-making with Mr. Mendez and his family allowed us to tailor his treatment plan, focusing on interventions that improved his quality of life while minimizing adverse effects.

Geriatric syndromes, such as frailty, fall, pressure ulcers, polypharmacy, and cognitive impairment, are prevalent among elderly patients and can significantly impact their well-being. Mrs. Rodriguez, an 85-year-old woman with frailty and recurrent falls, underscored the importance of a multidisciplinary approach to management. Working closely with physical therapists, social workers, and pharmacists, we developed a comprehensive care plan that addressed Mrs. Rodriguez’s mobility issues, ensured home safety modifications, and optimized her medication regimen to reduce fall risk.

Effective communication is essential in geriatric care, particularly when addressing sensitive topics such as end-of-life care. End-of-life care discussions are often challenging but essential in geriatric medicine. During my rotation, I gained experience in initiating conversations about advance care planning, discussing goals of care, and providing support to patients and their families as they navigated complex decisions surrounding terminal illness and palliative care. By actively listening to patients’ wishes and involving their families in the decision-making process, we were able to ensure their preferences were respected and their end-of-life care were aligned with their values.

Interdisciplinary collaboration is fundamental in providing holistic care for elderly patients. Through my rotation, I had the opportunity to work closely with nurses, social workers, pharmacists, and other healthcare professionals to coordinate care and optimize outcomes for patients. Overall, my geriatric rotation provided me with a deeper understanding of the unique challenges and rewards associated with caring for elderly patients. By incorporating a comprehensive care approach, prioritizing treatment goals, addressing geriatric syndromes, communicating effectively, and collaborating with interdisciplinary teams, I am better equipped to meet the diverse needs of elderly patients in my future practice as physician assistant.