Long-Term Care: “Three Words” That Defined Geriatrics at AGS 2016
“If you were asked to describe geriatrics using just three words, what would they be?” With that thought provoking question, Heather Whiston, MD, MPH—program chair for the 2016 American Geriatrics Society (AGS) Annual Scientific Meeting (#AGS16)—called the conference to order. More than 2,700 geriatricians, geriatrics nurses, social workers, physician assistants, pharmacists, geriatrics trainees, and members of the media gathered in Long Beach, CA, to share their “three words” amid the research and clinical highlights on tap at #AGS16. Not surprisingly, “long-term care” was heard quite often not only in response to Dr Whitson’s question but also across hundreds of presentations and events that informed the meeting program.
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For Henderson State-of-the-Art Lecturer Christopher M Callahan, MD, three words rang true throughout his presentation on “Alzheimer’s Disease: Individuals, Dyads, Communities, and Costs”: caregivers, caregivers, caregivers. Dr Callahan reinforced that the future population living with Alzheimer’s disease is not a distant reality but already present among the millions of people who have reached age 50. As Dr Callahan eloquently noted: “Technology will allow [these] people to live at home for longer, but robots aren’t ready to give your mom a bath. In fact, mom probably doesn’t want a bath from a robot.” In this context, Dr Callahan stressed that integrating family caregivers into the ever-expanding long-term care system will be critical. This level of coordination is “plausible,” as Dr Callahan noted, but it will require “rebalance[ing] resources…while still coordinating health care with community services.”
Across a similar line of thought, Outstanding Scientific Achievement for Clinical Investigation Awardee Mara A Schonberg, MD, MPH, discussed the complexity of decision-making around mammography screening for older women. Noting the trajectory of breast cancer prevention and research since the mid-twentieth century, Dr Schonberg addressed the challenges of helping older women understand the complexity of mammography: not only how screening factors into care decisions but also how it can bring up complex care discussions about future care preferences and end-of-life expectations. Concluding her presentation, Dr Schonberg reiterated that the long-term outlook for improving health care decision-making in the context of mammography means bringing three core components of long-term care into concert: life expectancy, risk of disease, and preferences and values.
Personal preferences and values were certainly front-and-center at #AGS16. Kenneth Brummel-Smith, MD, AGSF, moderated a discussion about seeing the person, not the patient. Alexis M Coulourides Kogan, PhD, and Bruce A Chernof, MD, provided a definition of “person-centered care” and discussed how lower care costs are at the core of this approach. As Dr Chernof indicated, operationalizing person-centered care isn’t just about cost avoidance; it’s an opportunity to strengthen everything from staff and provider engagement to the reputation of a health facility. Amy J Berman, BS, RN, gave a touching personal account of the value of person-centered care. She reinforced that the approach is about more than a long-term struggle between quality and quantity, reflecting instead the need to bring the quantity and quality of long-term care together by making care about the person.
These were but several of the long-term care highlights on display at #AGS16. Elsewhere, Sean P Jeffery, PharmD, CGP, FASCP, FNAP, moderated a panel on medication targets and evidence-based approaches to deprescribing in older adults with cognitive impairments. Laurence Z Rubenstein, MD, MPH, AGSF, and a panel of other experts assessed falls epidemiology and protocols for falls risk assessment, as well as compelling new evidence from a study of the Systolic Blood Pressure Intervention Trial (SPRINT). Members of the AGS Public Policy Committee provided an update on the 2015 Medicare Access and CHIP Reauthorization Act (MACRA) and its implications for provider payment.
Speaker handouts from these and many other #AGS16 sessions already are available for free at GeriatricsCareOnline.org. Additionally, proposals are now being reviewed for the AGS 2017 Annual Scientific Meeting in San Antonio, TX, where the AGS will toast its 75th anniversary championing the needs of older adults, caregivers, and health care professionals. Visit AmericanGeriatrics.org for more information. —AGS
