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Comprehensive
Geriatric Assessment
Comprehensive Geriatric Assessment is designed to
complement the care provided by the primary care physician. Assessments are
frequently requested for concerns about general frailty, polypharmacy and other
common geriatrics conditions, including falls, pain and so-called "failure to
thrive". The evaluation is conducted where the person lives, be it a house,
apartment, assisted living center, nursing home, or other care facility, because
that is the best place to incorporate the entire spectrum of biomedical,
psychosocial and functional health needs. When conducted by GCS, Comprehensive
Geriatric Assessment is likely to include the following:
* detailed medical
and functional evaluation in the home
* review of medications, therapies and
compliance issues
* evaluation of mental status and decision-making
abilities
* recommendation of medical studies or therapies
* discovery of
and problem solving around unmet needs, and
* suggestions to optimize
functional health, including diet and exercise
Based on the evaluation,
a written report to the primary care physician provides recommendations that may
be incorporated into the patient's ongoing plan of care. A plan for periodic
follow up with the geriatrics consultant may be suggested. |
Specialized
Alzheimer's Disease Care
As part of Alzheimer's Disease diagnosis and
treatment, Dr. Haber has a great deal of experience managing the "challenging
behaviors" associated with Alzheimer's Disease and other dementias.
Interventions combine behavioral management strategies based on a detailed
understanding of specific behaviors and disease characteristics, with
medications that are carefully selected and monitored to target specific
symptoms, minimize negative side effects, maintain dignity, and preserve quality
of life for patients, their families and other caregivers. Assessments and
follow up are performed where the patient resides, be it a home or care facility
setting, in order to incorporate the full impacts of the environment on the
behaviors and their management. |
Assessment of
Decision-Making & Functional Status
Some changes in memory and
cognition are consistent with "normal" aging; others suggest disease.
Differentiating among these is not always easy, but the distinction may be very
important to the overall well-being of the individual and his or her family.
More broadly, Functional Assessment incorporates a detailed evaluation of
physical, sensory, cognitive and emotional functioning in the setting where the
patient lives. Included are assessments of the ability to manage basic daily
living tasks such as feeding, dressing, grooming, bathing and toileting, and to
accomplish more sophisticated tasks such as managing finances, transportation
and a safe home environment. Findings from this evaluation, including potential
problems in memory, judgment and other cognitive processes, coupled with an
understanding of medical needs, optimal therapies and regimens, caregiver
availability, environmental constraints, and projections about future needs,
enable Dr. Haber to make recommendations designed to optimize and preserve safe,
healthful, independent functioning. These may include suggestions for additional
assistance, therapy, or a different living environment (level of care), with
periodic follow up reassessments as indicated. Emphasis is placed on honest and
sensitive appraisal of potential deficits, minimizing their impacts,
preservation of strengths, anticipation of further declines, promotion of
quality of life, and protection of individual dignity. |
Medical Care
Management & Advocacy
There are times when a patient or family seeks
an advocate within the medical system, for medical care management, or for a
medical "second opinion" to ensure and reassure themselves that the best
possible care is being received by their loved one. This in fact may be the
primary rationale for requesting Comprehensive Geriatric Assessment or other
personalized Geriatric Consultation services. As a Board Certified Internal
Medicine and Geriatric Medicine specialist, with graduate degrees in Public
Health and Social Work and a great deal of management and clinical experience,
Dr. Haber is adept at providing and communicating geriatric consultation
services that assist patients, families, other care givers, and other care
providers to "get on the same page". Not only a skilled diagnostician, Dr. Haber
is also well-versed in oral and written communication, advocacy, and mediation,
to ensure the best possible health care and medical care management for patients
and clients. |
End-of-Life
Care
With the understanding that death is a natural part of life, there
comes a time when the focus of treatment may need to change from "cure" to
"care". Dr. Haber is highly experienced in assisting patients and families to
understand when aggressive medical intervention is no longer likely to be
helpful, and to understand and cope with a transition from curative to
palliative medical care. Equally importantly, she has a great deal of expertise
with the medical aspects of comfort care and symptom management to assure
comfort and dignity during this final stage of life. |
Forensic
Geriatrics
Forensic Geriatrics practice refers to work with attorneys and
the legal system. In this realm, Geriatrics Consulting Services conducts
assessments of cognitive and functional capacity, decision-making abilities, and
needs for functional supervision, and provides to attorneys and their clients
health-related input for general life care planning. Dr. Haber also conducts
chart reviews and serves as an expert witness around issues of elder neglect and
abuse. |
Organizational
Consultation & Staff Development
In an environment of changing
demographics, increasing costs, declining resources and tightening government
regulation, nursing homes and other facilities are under pressure to provide
care for persons with ever more challenging frailties. As conducted by
Geriatrics Consulting Services, Organizational Consultation services incorporate
the following:
* comprehensive needs assessment through observation, survey
reviews and staff interviews
* staff development through formal
in-service-training programs and individual and small group meetings
*
family and community education
* assistance in plans of correction, and
*
program development
Dr. Haber is a Certified Medical Director with
experience in a host of acute inpatient and outpatient medical, subacute,
skilled nursing and residential care settings. She is equipped to provide
direction to improve quality of care and identify efficiencies that positively
impact on all individuals involved in achieving a long term care organization's
mission and objectives. | |
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