Enhanced Skills Program: Care of the Elderly Long Term Care Rotation Goals and Objectives

By the end of the rotation, the resident will be able to:

Recognize, assess, investigate and manage common acute and chronic medical problems in long-term care, such as heart failure, diabetes, dementia, wounds, falls, pneumonia, osteoarthritis, osteoporosis and urinary incontinence.
Recognize, assess, investigate and manage behavioural and psychological symptoms of dementia (BPSD) using a PIECES template, with appropriate non-pharmacologic and if needed, evidence-based pharmacotherapy.
Recognize the potential role of other health issues in the presentation of decreased cognitive performance in older adults, including in delirium, and manages these factors appropriately.
Assess capacity of an individual to make treatment decisions. Appropriately seek consent from substitute decision makers when treatment decisions are required.
Perform a comprehensive pain assessment and appropriately treats pain in the older person, being mindful of the benefits, adverse effects and risks of various treatment approaches.
Review a medication list and optimally prescribes, incorporating an understanding of benefits and risks as well as patient’s goals, evidence and life expectancy.

Develop rapport, trust and ethical therapeutic relationships with patients and families.
Accurately elicit and synthesize information from, and perspectives of, patients and families. Gather information about patient’s beliefs, concerns, expectations and illness experience.
Accurately convey needed information and provide explanations to patient and families in a way that is understandable and encourages discussion and participation in decision-making.
Develop a common understanding of issues, problems and plans with patients and families and provides and follows-up on a shared plan of care. Attempt to incorporate patient wishes even in situations of diminishing individual capacity.
Recognize and manage communication challenges with older patients, including hearing impairment, low vision and impaired cognition.

Participate in a collaborative team-based model and with consulting health professionals in the care of patients.

Allocate finite healthcare resources appropriately. Apply evidence and management processes for cost-appropriate care

Advocate for individual patients around relevant health matters encountered in long-term care

Critically evaluate medical information, its sources and relevance to an LTC population.

Demonstrate a commitment to their patients, profession, and society through ethical practice. Recognize and appropriately respond to ethical issues encountered in long-term care.
Fulfill the regulatory and legal obligations required of long-term care practice.
Demonstrate a commitment to physician health and sustainable practice.
Demonstrate a commitment to reflective practice. Gather information about personal performance, knows one’s own limits and seeks help appropriately. Reflect on practice events, especially critical incidents, to deepen self-knowledge.