"The patient" by Dr. Matthew Weiss, an elderly man who plays the role of an 80-year-old diabetes patient, told Weiss that he recently fell on the way to the bathroom and hit the salon.
"I shot down and I hit my head in it on the way down," said the man.
Weiss suggested that a man is sitting on the bed when he first starts to stabilize his blood pressure. He checks the man's legs and asks for medicines and throws rugs. When a man said he was drinking two beers every night, and sometimes more, Weiss warned that alcohol could increase the risk of falling.
Dr. Steven Barthi, UW Health geriat, who oversaw a training session for Weiss, a resident of the first year, praised Weiss's performance, including his gentle stimulus to drink. But Barci said Weiss should have been asked about human glasses, because obsolete recipes can also cause falls.
"Do not forget about vision," he said.
The session, featuring Richard Russell, 74, from Madison, who works as a ridiculous patient to help young doctors learn – is part of the growing effort in UW-Madison and around the state to better prepare health workers for serving them the aging of the population.
Wisconsin's 65-year-old, estimated at 895,000 in 2015, is expected to grow to 1.5 million by 2040. That is a 72% increase, compared to expected growth in all ages of just 12%.
The state report this year predicts a shortage of 745 primary doctors by 2035. Last year, the national report predicted a shortfall of 27,000 geriatricians – doctors specialized in the treatment of elderly – by 2025, including 3,430 in the Midwest.
Given the predictions, it became clear that all doctors, nurses, pharmacists and other providers need at least some training in geriatric diseases, said Barci, a clinical director of UV on geriatrics.
"There will never be enough geriatrics to care for a large group of older Americans," he said. "We need to be more intense to ensure that everyone has the basic exposure to nursing care for the elderly."
This is the goal of the recent initiatives of the UW School of Medicine and Public Health, the Madison Hospital for Veterans and a group led by Market University, which shares a grant from a federal geriatric workforce.
Older adults "have complex health needs that are not equipped with all service providers," said Stacy Barnes, a professor of medicine at Market, who heads the federal grant project. Recently, training of paramedics has begun to recognize signs of dementia and ways to calm the patients who have it.
Talk to older patients
UV began to demand medical students this year to take over the two-week unit for geriatrics. A monthly geriatric rotation for residents of internal medicine, long available as an elective, became mandatory about five years ago, said Barci.
In addition to the instructions of students and residents about falls, dementia, depression and other topics that particularly affect older people, the programs emphasize communication with older adults, he said.
Doctors should first talk to older patients, even if they have dementia, when they take care during clinical visits, Barci said. With elderly patients, doctors may need to speak louder and slower and to highlight several key issues, rather than mentioning each point.
"You will not be able to get through 10 items in 25 minutes," he said.
In Madison VA, nurses, pharmacists, social workers, psychologists and speech pathologists can receive certificates in geriatrics. A program for geriatric scientists, which is also available in some other VAs across the country, provides intensive training to a dozen providers annually and includes workshops for others in rural clinics.
Dr Paul Mannino, a family medicine physician at the Rockford Clinic, Illinois, last year last year last year last year spent at Madison's geriatric clinics through a geriatric science education program. Through the program, he wrote some of his Rockford patients in the follow-up of bodily medicine to try to keep them out of the hospital.
Now, "I have less fear in the management of complex geriatric patients," Manino said.
German labor grant
UW and Market together with Wisconsin Medical College, Aurora Health Care and Alzheimer's Association are partners in a 4-year grant for a federal US $ 3.4 million workforce improvement program that will last until next year.
Through a grant – one out of 44 at the national level – The College of Medicine developed online drug interaction courses and advanced directives that lenders can take to meet the demands for continued education.
Sixteen nurses at two hospitals in Aurora received intensive training to work with older adults, Burns said.
Reference guidelines for treating insomnia, interpreting heart changes, diagnosing osteoporosis and other topics are available for geriatricfastfacts.com providers.
The South Wisconsin chapter in the Alzheimer's Association trained the first responsible officials from the city and the Milwaukee, Milwaukee, and North Korean Department of Fire Protection on how to recognize aggression and other challenging behaviors as signs of dementia.
Such training, in order to prevent people with dementia from unnecessarily entering the criminal justice system, could extend to other parts of the country if the coalition receives another federal grant next year, Barnes said.
At UW, the recent Weiss training under the guidance of Barci was also supported by the grant. UW and VA designed a virtual version that could make such training available in rural areas, Barci said.
Dr Emily Owen, also a resident of internal medicine, first ranked a 87-year-old patient – played by John Smith (82) from Madison – for dementia.
He said he had left the stove several times and forgot to pay some bills, causing him to move with his son and daughter-in-law. Aries asked a series of questions and said he would relate the family to a social worker.
Dr. Sanjay Astana, head of geriatrics at UV and director of the Wisconsin Alzheimer's University in Wisconsin, welcomed her evaluation.
But he said it's important to determine whether memory damage is short or long. One way is to ask whether patients are taking sleeping pills, such as Tylenol PM, which can cause temporary cognitive impairments, he said.
"I always remember drugs," Astana said.
This article was supported by a scholarship for journalism from the Gerontology Society of America, the Network of Journalists for Generations and the John A. Hartford.