December 2010/January 2011
The Home hosts Hollanders
Dr. Jay Luxenberg, the Home’s medical director, recently coordinated an international exchange visit of a group of nursing home physicians and administrators from the Netherlands. Their program included a tour of the Home and visits to many other Bay Area long-term care facilities.
Senior Roundtable group will have the Home as their monthly meeting site
Community liaison director William Foster successfully lobbied for the Home to host the January – June 2011 San Francisco Senior Roundtable meetings. Membership in this group includes case managers, fiduciaries, social workers, doctors, dentists, financial planners, physical therapists, healthcare professionals from retirement housing, assisted living, hospitals, nursing homes, dementia/Alzheimer’s care facilities, home health, caregivers, those involved in elder law, etc. These meetings therefore provide valuable networking opportunities, while useful information is disseminated by an educational component, usually in the form of a guest speaker.
Hosting these monthly meetings will enable William to increase the Home’s exposure to a variety of agencies, promote awareness of STARS (short-term and rehabilitation services) and our acute geriatric psychiatry hospital, with the goal of obtaining referrals to these short-stay programs and strengthening our community partnerships.
CPMC meets with JH staffers regarding short-stay programs
In the interests of further cementing the partnership between California Pacific Medical Center and the Jewish Home, and promoting the Home’s short-stay programs, community liaison director William Foster and chief nursing officer Edwin Cabigao met with CPMC’s department of outcomes management at their Pacific campus last month. Case managers and social workers learned about STARS and our acute geriatric psychiatry hospital, and how CPMC patients can benefit by being referred to these programs.
Changes to income tax rules for LGBT couples
New federal income tax rules apply for LGBT (lesbian, gay, bisexual and transgender) couples who are California-registered domestic partners. Beginning with the 2010 tax year, the rules apply specifically on how to report each party’s income on their individual returns. The opportunity also exists to amend prior tax returns where a refund might be available. With special thanks to Daniel Hoebeke, planned giving officer, who took the initiative to provide this information for staff, highlights of the law changes are now available from our Human Resources department.
Taking the ancient road to pioneering science
To reach his cutting-edge destination, the International Psychogeriatric Association’s meeting in Santiago de Compostela, Spain, in September, medical director Dr. Jay Luxenberg, and his wife, Jan, did it in the medieval manner. They walked the pilgrims’ way, a path that has been traveled for almost eight centuries.
IPA brings to its meetings geographically diverse, world-renowned experts in the field of psychogeriatrics. With its focus on new research, IPA’s program is designed to provide these professionals with innovative science and practical tools that can immediately be put to use when they return to their workplace. Once in attendance at the meeting, Dr. Luxenberg embraced IPA’s 2010 theme, Diversity/Collaboration/Dignity, when he participated in a symposium on testamentary capacity and undue influence.
Dr. Allison publishes in the Journal of Aging, Humanities and the Arts
Associate medical director Dr. Theresa Allison has published an article in the Journal of Aging, Humanities and the Arts, vol. 4, no.3 (in press), entitled The Nursing Home as Village: Lessons from Ethnomusicology. Based on her doctoral dissertation in musicology, the article discusses the ways in which music helps to create neighborhoods, allows for the creation of meaningful relationships after the development of end-stage dementia, and enables elders to give back to the facility that houses them. As quoted from the article: “When we listen closely to our research participants, and observe how they act and respond in creative activities, we begin to comprehend why music and the arts are of such value to them. Most importantly, it is through the understanding of how and why creativity is important in nursing homes that we can begin to develop more humane models of custodial care for our elders.”
The Journal of Aging, Humanities, & the Arts (JAHA) is the official publication of the Humanities & Arts Committee of the Gerontological Society of America. Their aim is to foster dialogue between the humanities and arts and the bio-medical, psychological, behavioral, and social sciences to challenge stereotypes, further our understanding of the aging process, and provide creative approaches to the exploration of issues pertaining to aging.
Music and memory experts gather at Stanford
The Jewish Home’s Dr. Theresa Allison was invited to participate in the invitation-only Longevity, Music and Memory conference at Stanford University in October. The goal of this interdisciplinary conference (the Stanford Center on Longevity, along with the Stanford Center for Computer Research in Music and Acoustics) was to bring together experts on music and memory in order to examine the possibility of using music to improve memory in older adults and to establish a collaborative research agenda.
HIV and aging: Dr. Schwartz joins others to identify areas for future research
Dr. Janice Schwartz, Research director, attended the 1st International Workshop on HIV & Aging in Baltimore, Md., October 4-5. With an aging HIV-infected population – and suggestions that HIV itself may cause conditions normally associated with aging – the workshop presented a unique and much-needed platform for international scientific exchange on the increasingly recognized problems of HIV and aging. Gathering a cross-disciplinary team of experts and trainees in an interactive and science-focused setting, the latest developments were reviewed and evaluated in order to identify important topics for future research, develop better approaches to treatment, and create a strategic agenda for future management problems associated with HIV and aging.
Edwin Cabigao distinguishes himself at SFSU
Edwin Cabigao, chief nursing officer, was recognized by San Francisco State University on October 2 when he received the 2010 Kenji Murase Distinguished Alumni award. Dr. Murase taught at SFSU for over two decades and was among the first professors at the university’s Graduate School of Social Work and Social Research.
Rabbi Marder spreads the written and the spoken word
Having devoted significant time to the writing of a chapter for a book that followed on the groundbreaking work of the 2009 conference Midrash and Medicine: Imagining Wholeness, Rabbi Shelly Marder looked forward to the publication of his contribution. Psalms, Songs & Stories: Midrash and Music at the Jewish Home of San Francisco was recently published in the book, Midrash & Medicine. It is paired with a chapter written by the volume’s editor, Rabbi William Cutter of Hebrew Union College and the Kalsman Institute.
On November 12, Rabbi Marder will teach a session at a conference on spirituality, Day of Spirit: Spirited Aging, sponsored by the Northern California Presbyterian Homes & Services. Entitling his session Poetry and the Inward Pilgrimage, Rabbi Marder will invite participants to explore poetry as a creative resource for elders’ spiritual reflection. “Good poets ask hard questions, articulate uncertainty, embrace ambiguity, do not preach, and most important of all, are imaginative,” notes Rabbi Marder. “These qualities make poetry a strategy for reflecting on the complex experience of aging, as older adults seek hope and wisdom.”
Good Grief: A Mo(u)rning Conference in the Morning, a program alliance between Bay Area Jewish Healing Center and Sinai Memorial Chapel, takes place on December 1. In addition to providing networking opportunities for synagogue clergy, staff, and lay leaders who support the mourners in the community, the conference offers an excellent educational program, exposing attendees to new ways to support those in grief. This year is no exception, as Rabbi Marder is the keynote speaker.
In I have lost you … Giving Voice to Grief through Poetry, Rabbi Marder will talk about how professionals engaged in grief work can effectively utilize poems in their practice and reflection. What are specific qualities and elements of poetry that make it a valuable tool for helping and serving persons in grief, he will ask. Are there commonalities between the experience of grief and the experience of writing or reading a poem? Attendees have been asked to bring along a short poem that relates to loss, grief and/or mourning. “As we read and explore poems,” Rabbi Marder explains, “we will ask: What does this particular poem encourage in terms of ideas about grief, healing, new orientation to life, and relationships?”
Japanese corporation’s management team tours the Home to get ideas
Heartwell is a Japanese corporation that provides medical equipment and offers services for the refurbishment of homes or healthcare facilities to accommodate the needs of disabled or elderly persons. It also provides food vendor services to hospitals and other geriatric long-term care programs. In the country to get ideas on how the United States is meeting the needs of its aging population, and researching what services, vendors, and accommodations are provided at healthcare facilities, Heartwell’s president and four members of its management team made the Jewish Home one of the stops on their tour in September.
On hand to take them around our facility were chief nursing executive Edwin Cabigao, William Foster, community liaison director, and Mark Friedlander, director of Resident Programs & Services/Customer Service. As the group was shown the Home (they were most impressed by the size of our campus, our on-site clinics, and rehab equipment designed to facilitate and increase mobility), they shared information about changes in elder care in Japan. Traditionally, elderly parents have been taken care of within the home by the entire family, but with adult Japanese children now more independent and career-orientated, caregiving roles have shifted as more children work outside the home. When they are no longer able to manage the higher levels of care their parents may require, these elders are moving into nursing facilities. To that end, more long-term care facilities are being established in Japan to satisfy this growing need, while home health accommodations and board and care services are expanding.
Community liaison director does the rounds
In his community liaison role, William Foster keeps Bay Area professionals informed about the Home’s short-stay programs – STARS and our acute geriatric psychiatry hospital. Recent presentations included one at the Mental Health Association of San Francisco, a networking opportunity at the monthly meeting of the San Francisco Senior Roundtable, and an overview of our short-stay programs to Network for Elders.
Planned giving officer populates his calendar
The second half of September was a busy time for planned giving officer Daniel Hoebeke, as he attended and participated in a number of seminars and Webinars. These included an accountants-led roundtable of new and pending legislation entitled Tax Changes: It’s Not Pretty at the Estate Planning Breakfast Club; a charitable giving Webinar by Roy Adams and Christopher Hoyt, nationally recognized authorities on charitable giving and retirement planning; a gathering of the Northern California Planned Giving Council, where an attorney discussed The Facts of Life (Estates): Remainder Interests in Residences and Farms; and the Kasner Estate Planning Symposium at Santa Clara University. Writes Daniel: “The latter’s one-day estate planning seminar for attorneys, accountants, certified life underwriters, bank trust and investment officers, financial advisers, and other wealth-planning professionals provided the most current information regarding the tax, legal, and financial issues concerning estate planning, and trust and estate administration.”
Students get the facts and feeling from CNE
The Gerontological Society of America and American Health Care Association Student Chapter benefited from hearing from chief nursing executive Edwin Cabigao. Invited to address this group at San Francisco State University in September, Edwin spoke about his professional experience as a gerontologist, industry standards and expectations, and offered directions/advice on what classes or trainings students should take. Attendees mentioned that they not only appreciated getting the particulars from Edwin, but were inspired by his passion for his work and his ability to connect with his audience.
Age March shows that age is a spirit not a number
As an exponent of celebrating aging as a positive experience, the Home was pleased to be a supporter of the Age March. On Sunday, August 8, people of all ages, races, genders, sexualities, and economic walks of life gathered for a one-mile march at San Francisco’s Crissy Field. Founded by Barbara Rose Brooker, a 73-year-old native San Franciscan, author and teacher of creative writing at SFSU/OLLI, Age March aims to raise age awareness and begin to break down the myths, stereotypes, and social pressures causing age discrimination, shame and negative attitudes towards aging in our culture. Those who participated in this community building activity included community liaison director William Foster and H.R. director Chana Anderson, who took this opportunity to share information about the care, services, and programs offered by the Home.
Jewish Home shares ideas for Redwoods’ revitalization project
One of the places The Redwoods, a senior living community in Mill Valley, looked to for ideas for its planned revitalization project was the Jewish Home. To that end, William Foster, community liaison director, was delighted to give their board vice president, a member of the board, executive director, and program and volunteer coordinator a tour of our campus in June. Their visit was enhanced by recreation therapist Lisa Dale O’Donell, fitness center manager Tony Yu, Gary Tanner, director of Creative Arts, Jim Weslow, director of Rehabilitation Services, and Laura Nieberding, interim director of Nutritional Services, talking about their programs as the group viewed the relevant areas. Administrator Sandra Simon provided good company and further information as they enjoyed lunch in our garden café. Comments on the Home from The Redwoods’ executive director included “It was the perfect tour”; “wonderful facility”; “many wonderful ideas that we took with us”; “a great organization.”
Professionals get the low-down on STARS and the Home’s acute psych hospital
The Jewish Home’s community liaison director William Foster continues to inform Bay Area professionals about the Home’s short-stay programs, STARS and our acute geriatric psychiatry hospital.
When the patient management team, made up of directors of case management (discharge planners) from San Francisco’s acute hospitals, held their July meeting at St. Francis Hospital, William presented these services in detail. Nelson Galang, the Home’s director of Utilization Management, was on hand to answer any questions related to his area of expertise. Comments from Ron Smith, senior vice president of the Hospital Council of Northern and Central California, included “sensational presentation”; “kept everyone’s attention … questions afterwards indicated great interest”; “thank you for offering such an important service.”
The Home’s psychiatric services were at the forefront of William’s presentation to San Francisco General Hospital’s director of psychiatric emergency service, Dr. Eric Woodard and his team, as they were when he addressed Dr. Mason Turner, chief of the department of psychiatry at Kaiser Permanente San Francisco Medical Center, and related staff. Both short-term rehab and psychiatric services were communicated at a clinical collaborative with On Lok and the Department of Aging and Adult Services.
The Jewish Home’s Garden Unit begins transformation into specialized unit
The Home’s Garden Unit is embarking upon a transformation into a specialized dementia unit, reports unit manager Jean Santo. To better serve these residents, “we will be redoing the garden and changing the environment to be more homelike,” she says. “Pictures of residents will decorate the hallways, and activities will be available 24 hours a day.”
A day-long in-service was recently conducted in preparation for the Garden Unit’s certification as a special care unit. Led by Bonnie Bollwinkel, professional training/education specialist for the Alzheimer’s Association, attendees learned the importance of according respect and effectively managing difficult behaviors.
“I learned a lot of new approaches,” says Jewish Home CNA Amy Castillo. Nancy Dudley, a graduate student from Stanford currently interning at the Home, found that having the in-service taught from the residents’ perspective was effective; it is important for caretakers to remember that they are working with individuals; in other words, focus on delivering person-centered care. Jewish Home recreation coordinator Dana Rosenberg concurs: “The training was informative and team-building. I especially enjoyed learning about helpful techniques for communicating and connecting with people who have dementia. Singing is a particularly beneficial medium.”
Medical director lends his voice and expertise to media in health care
Dr. Jay Luxenberg, medical director, was featured on Advances in Long-Term Care Medicine, a weekly radio program run in partnership with the American Medical Directors Association. Broadcast on ReachMD XM 160, Dr. Luxenberg was interviewed by the program’s host, Dr. Eric Tangalos. He spoke about managing depression in long-term care, and included a discussion of light therapy.
ReachMD has been on the air on XM satellite radio since 2007. The station invites physicians, researchers, policymakers and other experts in their specialty areas of health care and medicine to speak about important issues and developments in their fields of interest.
NIH’s Aging Systems and Geriatrics Study Section, Center for Scientific Review, gets Dr. Janice Schwartz as a member
Research director Dr. Janice Schwartz has accepted the prestigious National Institutes of Health’s (NIH) invitation to serve as a member of the Aging Systems and Geriatrics Study Section, Center for Scientific Review, for the term beginning July 1, 2010 to June 30, 2014. Members are selected on the basis of their demonstrated competence and achievement in their scientific discipline, as evidenced by the quality of research accomplishments, publications in scientific journals, and other significant scientific activities, achievements, and honors.
Membership on a study section represents a unique opportunity to contribute to the national biomedical research effort. Study sections review grant applications submitted to the NIH, make recommendations on these applications to the appropriate NIH national advisory council or board, and survey the status of research in their fields of science. These functions are of great value to medical and allied research nationwide. Dr. Schwartz’s participation will assure the quality of the NIH peer review process.
UCSF symposium seeks insights into HIV and aging
Dr. Janice Schwartz joined leading researchers from around the world investigating the role of HIV and immunosenescence (aging of the immune system), and many of the HIV and aging conditions such as renal disease, cardiovascular disease, osteoporosis and declining cognitive function at a daylong symposium at UCSF last month. There is a growing consensus that, even among HIV patients who are responding well to anti-retroviral therapy, there is something causing death at an earlier age, perhaps by as much as 10 to 15 years. Researchers are trying to understand the processes underlying this emerging problem.
Dr. Jay Luxenberg focuses on factors that make a patient/client “difficult”
Having just returned from his attendance at the American Geriatrics Association national meeting in Orlando, Fla., Dr. Jay Luxenberg, medical director, prepares to join other leaders in the field of geriatric mental health on June 23 to discuss how to work with patients/clients whose behaviors are challenging.
Understanding and Managing Clients Who Challenge Us as Professionals forms part of the Institute on Aging’s Mind, Body, Spirit: Pathways to Improving Health educational series. Entitled Medical Factors That Contribute to Making the Difficult Client Difficult, Dr. Luxenberg’s presentation will focus on medical factors such as psychiatric syndromes, dementias, hearing impairment, urinary urgency and incontinence, and strategies to manage them. It will include a discussion on the importance of access to care; for example, how to find a physician who will make house calls.
Dr. Lynn Flint lectures in Los Angeles
Jewish Home physician Dr. Lynn Flint makes her way to Los Angeles in July to attend and participate in the California Association of Long Term Care Medicine’s (CALTCM) 36th Annual Meeting, Creating a Culture of Patient Safety. This two-day conference highlights critical strategies to improve nursing home patient safety and provides techniques and tools for the interdisciplinary team to adapt to their own facility needs. Dr. Flint will lecture on A Holistic Approach to Palliative Care in the Nursing Home and will serve on a panel entitled Integrating Palliative Care into Long Term Care.
Norwegian Journal of Nursing interviews CNE Edwin Cabigao
Barth Tholens, editor in chief of the Norwegian Journal of Nursing (Sykepleien), was at the Home last month to interview CNE Edwin Cabigao for a special issue highlighting those who have extensive experience in nursing in the U.S., and featuring nurses in a range of different areas, such as prison, home health, acute hospital, and nursing home environments. Edwin was asked to describe a typical day’s work at the Home, to talk about the challenges of working in a nursing home, the Home’s demographics, and to offer his opinion on the U.S. healthcare system. Edwin tells us that Mr. Tholens was most impressed by the Home, our facilities, and the people. Their hours-long interview concluded with an invitation to Edwin to visit Norway’s version of nursing homes.
Our community liaison, William Foster, took part in the Excelsior Resource Fair on April 24, put on by Rebuilding Together San Francisco and the Excelsior Action Group. RTSF is a local affiliate of Rebuilding Together, a national organization that mobilizes thousands of volunteers each year and includes 205 affiliates serving more than 500 communities nationwide, with the goal of supporting positive changes that have already been initiated by neighborhoods and increasing the neighborhoods’ capacity for growth and change through collaborative efforts.
RTSF’s new campaign, Changing Neighborhoods, Changing Lives, is focusing heavily on revitalizing the Excelsior District this year, the area in which the Jewish Home is located. Armed with information about STARS and our newly renovated acute geriatric psychiatry hospital, William told attendees about these excellent community resources that exist right in the neighborhood.
Making the case for research in aging
A number of past chairs of the Jewish Home’s board gathered for a luncheon at the Home last month – to socialize, to hear Daniel Ruth, president & CEO, address important issues facing the Home, and to listen to Dr. Janice Schwartz, our Research director, trace the development, progress and successes of the research center from its formation in 1997 through 2010.
Dr. Schwartz began by presenting the rationale for research at the Home. The goal is to discover and spread information that will result in improved care of older people. Research increases the Home’s visibility not only locally but nationally. It raises the level of professionalism, and provides an infrastructure for collaborating with research colleagues. She then summarized progress made in each of these areas, such as the recent grant awarded by the National Institutes of Health that will address problems of multiple medications in the elderly, and publications that have come from research projects that cite the Home.
“Essential elements to ensure a sustainable research center can be defined by the four P’s,” Dr. Schwartz went on to tell the guests. “A critical number of People involved in research at the Jewish Home, a Place for them to work, support for their Programs, and an academic Partner.” Progress made to date in each of these areas include the UCSF Harris M. Fishbon Distinguished Professorship for Clinical Translational Research, to be based at the Jewish Home; the current Rosenberg Family Center’s research facilities, and the proposed expansion and pledged funds from the Herbst Foundation to help create a clinical research center; the Julian S. Davis Memorial Lecture series, and the necessary continued support for programs and a professorship to explore new and improved therapies for aging adults; and our affiliation with the UCSF Clinical Transitional Research Institute.
Help for hoarders
William Foster, our community liaison, shares some of what he learned at the session he recently attended on clutter addiction and compulsive hoarding in older adults, put on by the Institute of Aging.
An underreported problem that rarely becomes known until an accident happens, clutter addiction and compulsive hoarding tends to be more common in older adults. This may be attributable to lifestyle changes or isolation, for instance. Or the feeling they have no purpose in life and so hoarding offers a sense of security and control. The good news is that health care and mental health workers are becoming more educated about what hoarding means and hence treatment is more readily available.
When it comes to any kind of intervention, don’t overwhelm or threaten, never remove belongings without the person being present, and avoid doing a surprise or forced clean-up. Treatment and assistance may include collaborating with mental health agencies, adult protective services, fire protection, building and safety, and animal control.
Staff shares their savvy with SFSU gerontology students
A group of graduate students from San Francisco State University’s masters in gerontology program visited the Home on Friday, March 19 for a full day’s program. CNE Edwin Cabigao started off by providing them with invaluable information about both the federal and state’s survey process, which he entitled Survey Management 101. The students were then taken on a tour of our facility, followed by Edwin leading a Q&A session. In the afternoon, the group was treated to a varied round of experts – our staff, of course! Joan Accarino spoke about pain management and end-of-life care. Rabbi Shelly Marder invited the students to a Shabbat service where they experienced Jewish life in action. Laura Nieberding filled them up with facts about dining at the Home, and Mark Friedlander gave the lowdown on customer service. Lisa Dale O’Donnell brought activities and recreational programs into play. Daniel Hoebeke told them everything they needed to know about fundraising in 12 minutes, and Kyle Fredrickson shone the spotlight on STARS.
The students’ professor, Dr. Cristina Flores, commended Edwin on his professionalism, and noted how good it was for the students to see “the happy side of long-term care.” Comments from the students themselves included “very informative tour and wonderful presentation” and “I have done an extensive research on the Jewish Home and I know that people always talk about how good the care is and how wonderful the place. The environment, the staff, and the residents make the place unique and just magnificent! It was amazing to see everything connect right in front of my eyes.”
Doorways of Hope offered by the rabbi
When the annual rabbinical convention of the Central Conference of American Rabbis gathers at San Francisco’s Fairmont Hotel on March 10, attendees will have the benefit of hearing Rabbi Shelly Marder speak on a Jewish view of dementia. He will be sharing the presentation he originally made at Temple Chai in Phoenix, Ariz., in April 2009. Entitled Doorways of Hope, excerpts from his inspiring, evocative address were published in the latest issue of Jewish Senior Living magazine 2009/2010.
Community liaison learns ways to improve elder health care
William Foster, our community liaison, represented the Home when he attended the first of a three-part educational series entitled Mind, Body, Spirit put on by the Institute of Aging on February 24. Exploring pathways to improving elder health care, the first session covered how to recognize and respond to clutter addiction and compulsive hoarding in older adults. He will also be in attendance at the next two programs in the series. On May 4, he will learn about integrating mental, emotional and spiritual health, while on June 23, the topic covers understanding and managing clients who challenge us as professionals.
Rabbi Marder to co-edit new prayer book
Along with his wife, Rabbi Janet Marder, and two other rabbis, Rabbi Shelly Marder has been appointed to the editorial core team assigned to co-edit a new Reform Judaism machzor (prayer book) for the High Holy Days, to be published by the Central Conference of American Rabbis. This ambitious undertaking is projected to take the team four or five years to complete.
Open forum on federal estate taxes yields intriguing results
Planned giving officer Daniel Hoebeke participated in an open forum on federal estate taxes at the Estate Planning Breakfast Club meeting held in San Jose on February 9. The results of the forum were intriguing, Dan reports. He explains that “sometimes it is worse when Congress doesn’t act. The rules about whether you might owe federal estate tax are uncertain because existing laws were allowed to expire. Even complex plans may be affected. The rule of thumb has always been to review your will or trust every five years. Since nobody knows what future laws may provide, now is a prudent time to conduct that review.”
And on another note, Dan informs us that he has been accepted as a member of the San Francisco Estate Planning Council. Membership is limited to individuals who conduct substantial estate planning work in the city and county of San Francisco.
Research director speaks to Medical Friends …
Director of Research Dr. Janice Schwartz was invited to address Medical Friends of Rossmoor (made up of residents of Rossmoor, a senior adult community located in Walnut Creek) on Tuesday, January 12. As a sponsor of evidence-based talks of interest to the senior population by experts in their field, Medical Friends benefited from hearing Dr. Schwartz talk about research in geriatrics and the significance of Vitamin D in geriatric health. Attendance for Dr. Schwartz’s talk was the largest in the association’s four-year history. Dr. Clair Weening, president of Medical Friends, reported that he received many positive remarks and feedback, attesting to the high level of Dr. Schwartz’s talk and her skilled handling of questions.
… and will advise on committee at UCSF
As an appointee to UCSF’s Clinical Translational Research Institutes Regulatory Knowledge and Support Advisory Committee, Dr Schwartz will participate in helping this group develop the following goals:
- Educating and assisting researchers with UCSF and federal regulations for clinical research and therapy development
- Identifying processes and areas of clinical research administration that could be improved and performed more efficiently at UCSF
- Identifying specific improvement initiatives proposed for the next National Institutes of Health application for funding for the Clinical Translational Research Institute
Results of study conducted at the Jewish Home published
Pressure ulcers (“bed sores”) are a common clinical concern among nursing home residents, and there is much interest in improving strategies for pressure ulcer prevention and treatment. Nancy Stotts, RN, Ed.D., a researcher from the Department of Physiological Nursing at UCSF, and her colleagues recently completed a study in which ten of the 64 study participants were residents of the Jewish Home.
Following up on work done in California nursing homes that showed that residents unable to get out of bed on their own often did not get enough fluid intake, Dr. Stotts wanted to see if giving more fluids to patients would improve the oxygen supply to the skin and help skin heal. The study involved giving an extra 10 ml/kg water per day for 5 days – about a pint of water extra each day to a resident weighing 100 pounds, who either had, or was at risk of getting, a pressure ulcer. Results of this study were published in 2009 in the journal Wound Repair and Regeneration.
The researchers concluded that the increased fluid intake in the trial did not improve factors that would ameliorate pressure ulcer risk and enhance healing potential. Specifically, the deposition of collagen, a vital component of skin structure, was not increased, nor was total body water or tissue oxygen increased. The researchers urge that additional work be done to evaluate pressure ulcer prevention in nursing home residents.
Medicare boot camp for Rehab Services director
Jim Weslow, director of Rehabilitation Services, attended the HCPro Medicare Boot Camp – Long-Term Care Version in Pasadena, Calif., January 18-21. Covering the Medicare rules and regulations applicable to skilled nursing facilities, the objective of this four-day course was to provide participants with a detailed understanding of these rules, with a particular emphasis on their operational application. By following a Medicare patient from pre-admission through discharge, the function of each department was addressed and the pitfalls that might be encountered along the way were uncovered.
Jim says that the course solidified his understanding of Medicare and prepared him for implementation of the new MDS 3.0 (which deals with standardized assessment and facilitates care management) and RUGS IV systems (Resource Utilization Groups, which refers to quality indicators, quality measures, and payment). He noted that many of the recommendations made by the instructor are already in place at the Home.
Julian S. Davis Memorial Lecture
Education, research, and the exchange of knowledge related to improving care and life for the elderly are essential to the welfare of our society. It is also part of the mission of the Jewish Home, and of our colleagues in gerontology and geriatric medicine at the University of California, San Francisco.
The Julian S. Davis Memorial Lecture was created to provide enhanced opportunities for both the Home and UCSF’s Division of Geriatrics to be exposed to leaders in the world of gerontology and geriatric medicine. It is also an avenue for academic visitors to UCSF to share their expertise with a broader audience committed to improving life for the elderly; for the Jewish Home to benefit from such expertise and have access to local and academic colleagues; and for programs and facilities at the Home to receive increased exposure.
Thursday, January 21 is the date to hear Julian S. Davis Memorial lecturer Terri Fried, M.D., professor of medicine, Yale School of Medicine, and co-director of The Claude D. Pepper Older Americans Independence Center, speak on Overcoming Obstacles to Planning for End-of-Life Care. Staff, residents, family members, volunteers, and friends are invited to attend this on-site address, 2:00 p.m. in the Home’s synagogue.
A more healthcare-worker oriented lecture, Patient-Centered Decision-Making for Older Persons: Promoting Greater Choice, will take place the same day, 6:00 p.m. at UCSF’s Millberry Union Conference Center, Golden Gate Room, 500 Parnassus Avenue. This lecture is open to the public, and will be followed by a reception.
A dedicated educator and compassionate physician who was committed to ensuring that the elderly in our community receive the best care, regardless of social circumstances, Dr. Julian Davis served as president of the Home’s board of directors from 1983 to 1985. He was also instrumental in the development of the Home’s Koret Center. His son, James, followed in his footsteps, both by becoming a physician and chairing the Home’s board of trustees from 2002 to 2004.
Saving Bubbie & Zadie – topic of discussion at teen “issues” fair
Director of Social Services Catherine Reid accepted an invitation to serve on a panel covering aging concerns and issues in November. Put on by the Marin/San Francisco Jewish Community Teen Foundation of the S.F.-based Jewish Community Federation, Catherine, a member from Federation and one from Jewish Family and Children’s Services engaged a group of enthusiastic and interested teen philanthropists when they discussed independent living and skilled nursing, as well as transportation and economic issues facing seniors in the community.
Growth through mindfulness
Social worker Danielle Gallant took a two-day continuing education credit course in December, run by Terry Fralich, a clinical counselor and the author of Cultivating Lasting Happiness: A 7-Step Guide to Mindfulness, an exploration of a practical, accessible path for nurturing growth through mindfulness.
“The course included integrating mindfulness meditation and neuroscience in the treatment of anxiety, anger, and depression,” Danielle reports. “Recent research reveals evidence that the brain is more malleable (referred to as neural plasticity) than previously thought. By exercising our thoughts, that is, engaging in ‘mindfulness meditation,’ we can regulate and change our emotional responses to negative thoughts. We can strengthen the process of our brain’s frontal cortex with positive thoughts.” This can be compared to the cognitive behavioral therapy that Danielle does with her residents.
“Learning that the brain is not rigid is great news,” Danielle says. “Studies done with individuals in their 70s show that seniors can actually change the make-up of their brains.”
Mind-body medicine: eating well, living vibrantly
The 21st International Psychology of Health, Immunity & Disease Conference, held in South Carolina in December, was attended by social worker Ann Rovere. Presenters covered a range of topics, from micronutrient deficiency and digestive wellness, to the systemic consequences of imbalance, emotions, and chronic musculo-skeletal pain. Goals of the conference included determining the role of psychosocial distress and/or well-being in shaping health outcomes; the application of techniques, such as current mind-body and integrative medicine therapies, to change behaviors; and integrating issues of aging and other life transitions with newer positive therapy approaches.