Geriatric Medicine

Medical Education, Geriatrics, and the Humanities

The education of today’s physicians cannot be regarded as complete or adequate without substantial exposure to geriatrics.  It is not just the facts of geriatric medicine, but the humanistic aspect of its practice that is important.  Medicine is taught as a cut-and-dry collection of information, taking

  3.10.2011

New Rules for Pressure Ulcer Risk Assessment in Nursing Homes

MDS version 3.0, the mandatory assessment tool for residents of skilled nursing facilities, was finally implemented October 2010 after years of planning.  Section M: Skin Condition has been completely revised and expanded.  This blog post will address MDS 3.0 sub-section M0100: Determination of Pressure Ulcer Risk, which approaches

  17.08.2011

Pressure Ulcer Prevention for Patients in Wheelchairs

In most cases pressure ulcer prevention can be accomplished by risk assessment followed by common sense choices for pressure reduction.  In these days of evidence based medicine, health care providers need to listen to the evidence and implement best practices to reduce the incidence and prevalence

  16.05.2011

The Faces of a Generation Deserve Attention

An Essay by Dr. Jerry Winakur [This essay written by author and physician Jerry Winakur is reprinted with permission from Caring for the Ages, a publication of the American Medical Directors Association.  Dr. Winakur is Clinical Professor of Medicine at University of Texas Health Science Center

  25.04.2011

The Myth of the Mechanical Fall

Recently on hospital teaching rounds a medical resident presented an elderly man who fell.  The patient suffered no fall-related injuries but was diagnosed with pneumonia and congestive heart failure.  The resident called the event a “mechanical fall,” and the interns and residents nodded in agreement regarding the

  21.04.2011

Free Online Training for MDS 3.0 Section M: Skin Condition

  This is the video of the pressure ulcer assessment and coding training session for MDS 3.0 Section M: Skin Condition that I delivered in Las Vegas on August 10, 2010.  It was posted online by the Centers for Medicare and Medicaid Services (CMS) on January 20,

  14.03.2011

White House Backtracks on Payment for End-of-Life Counseling

Medical doctors are trained to understand and administer powerful technologies which can prolong life.  They get paid to do this.  But should they also get paid to inform patients of alternatives if they do not want these technologies?  The Obama administration has said no to this question.  During

  17.01.2011

Geriatrics by Legislation: The Trend Continues

In a recent blog post I pointed out some legislative initiatives that essentially make certain principles of geriatric practice required by law.  I noted how these laws can be interpreted as an effort to make up for the scarcity of practicing geriatricians, and the lack of

  28.12.2010

Brief Reprieve from Congress for Medicare Cuts to Doctors

Earlier this month the Senate voted to postpone for one year the impending Medicare pay cuts to doctors that would have gone into effect January of 2011.  This is the latest postponement for a measure that will have deep impact on care of the elderly in

  13.12.2010

Does MDS 3.0 Section M Avoid the Unavoidable?

The revised Resident Assessment Instrument (RAI) with the new MDS 3.0 Section M: Skin Conditions radically expands the assessment process for pressure ulcers in Medicare certified skilled nursing facilities.  In contrast to the prior version, there are data fields for improving or deteriorating pressure ulcers, ulcer

  8.11.2010

Dr. Jeffrey M. Levine has authored numerous articles on topics related to healthcare of the elderly. These include medical history, prevention and treatment of chronic wounds such as pressure ulcers, elder neglect and abuse, and physical restraints. He has also edited a book on legal and regulatory aspects of nursing homes.