Geriatric Fellowship Program with Model Senior Citizen Home for the Aged Needed

Nursing homeI have practiced general internal medicine and geriatric medicine in the South Palm Beach County, Florida area since 1979. I have seen the growth of the medical community from a sleepy seasonal coastal distribution of hospitals east of I-95 to a sprawling plethora of corporate and not for profit facilities sprouting in areas of population growth. While cardiac, stroke and trauma centers have evolved to meet the needs of the community; there has been no development of state of the art care for our aging and infirm seniors.

Yes there are many skilled nursing facilities in the area receiving patients from local hospitals following an acute illness or injury and attempting to rehabilitate the patients so they can eventually resume their lives. These facilities are paid primarily with Medicare funds if the patient has spent three nights in the hospital. The staffs of these facilities are numbered based on federal and state requirements. It is not unusual to see one registered or licensed practical nurse with a patient load of 20 or more patients. The nurses are assisted by aides, many of whom are paid minimal wages and who lack the language and training skills to recognize changes in their patients’ health conditions until those conditions have advanced to a critical level. They are not able to care for many of the simple day to day medical emergencies that we deal with at home on a daily basis such as cuts and abrasions, simple upper respiratory tract or gastrointestinal infections. Their mantra is “call 911 and send them to the ER while we copy the chart for transfer “(not always in that order). They are doing what they are told to do by administration and legal counsel and, frankly; their training and staffing does not allow them to do much else even if their hearts and souls feel differently.

We need the FAU Charles Schmidt College of Medicine or the University of Miami Miller School of Medicine or Nova Southeastern School of Medicine to partner with the Lynn School of Nursing at FAU and organize a geriatric fellowship program in medicine, nursing and care giving. The program would be taught at a model senior geriatric care center staffed by medical students, interns, residents, fellows in geriatrics, nursing students and graduate nursing students plus appropriate representatives of the other allied health supportive fields such as physical, occupational and speech therapy, nutrition and dietary and social services. Funding would come from philanthropic donors, federal and state grants, Medicare and Medicaid funds. The goal would be to train care givers to go out into the community and raise the bar and standard of care available to our senior citizens requiring acute rehabilitation or chronic custodial care while providing a local example of how excellent care can really be delivered. By raising the bar locally at a model facility we will be raising the bar throughout the region.

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