[1]

Welcome!

The annual Rocky Mountain Geriatric Conference is a great tradition. Our planning committee is excited about the enthusiasm for this year’s Rocky Mountain program in geriatrics. We have a full conference this year and are making every effort to make attendees comfortable.

Our goal is to maximize the safety of older patients. Discussions will highlight the inter-connection between faints and falls unique to older patients and describe medical, social, rehabilitative, psychological, and health systems interventions that can help older patients safely maintain independence.

Topics are organized around two parallel tracks. One track will address the clinical evaluation and management of faints and falls targeted at health care providers. This track will include a review of appropriate cardiac testing and outpatient monitoring, timing of referrals, and an overview of neuropathies, movement disorders, and vestibulopathies. A separate track will emphasize multi-disciplinary approaches to maximizing safety and independence at home and will include such topics as addressing visual impairment, rehabilitative needs, elder mistreatment, transportation barriers, technology needs, health literacy, and medication management. Together, the two tracks span clinical care starting with clinical medicine to the provisions of ancillary services to health systems and program development.

Please take the time to enjoy the beauty of the Wasatch Mountains in early fall. Walking, hiking, biking and simply gazing at the scenery are encouraged. It is a perfect place to network with like-minded colleagues.

Special thanks to our 2011 Conference Planning Committee: Natalie Sanders (Chairman), Mohamed Hamdan (Co-chairman), Mark Supiano, Charlene Weir, Tim Farrell , Bret Hicken, Marilyn Luptak, Karey Johnson, Jack

Christensen

9th

Annual Rocky Mountain Geriatrics Conference

“““SSSaaafffeeetttyyy iiinnn ttthhheee BBBaaalllaaannnccceee::: FFFaaaiiinnntttiiinnnggg,,, FFFaaalllllliiinnnggg,,,

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Snowbird Ski and Summer Resort ~ Salt Lake City, Utah

[2]

Attend one of the following morning break-out sessions:

Cottonwood A

Track 1: Faint and Fall/Didactic Sessions for the

Health Care Provider

Initial evaluation of patients with fainting spells

Overlap Between Faint and Fall - Natalie

Sanders, DO

General Approach to Patients With Transient Loss

of Consciousness - Brian Olshansky, MD,

FACC, FAHA, FHRS

Risk Assessment in Patients With Syncope

Assessment of Short-term Risk and Need for

Admission - Mohamed H. Hamdan, MD, MBA,

FACC, FHRS

ECG Findings You Do Not Want to Miss -

Mohamed H. Hamdan, MD, MBA, FACC,

FHRS

Tilt Table Testing and CSM

Indications and Treatment - Mohamed H.

Hamdan, MD, MBA, FACC, FHRS

Cottonwood B

Track 2: Multi-disciplinary Approach to

Maximizing Safety and Independence at Home

Maximizing Safety for Our Patients with Visual

Impairment – In their Personal Environments

and in Our Clinics - Julia Kleinschmidt, PhD,

LCSW

Identifying and Treating Elder Mistreatment

Vulnerable Adult Abuse in Community Care

Settings - Rebecca A. Mabe, MSW, LCSW

Issues Relating to the Support of Caregivers -

Marren Eberle Grant, MSW, LCSW

Physical Therapy - Using Gait and Balance

Assessment Tools to Predict Fall Risk -

D. James Ballard, PT, DPT

4:00 p.m. Keynote Address: Mobility and Aging for Clinicians - Cottonwood C & D

Stephanie Studenski, MD, MPH

5:00 p.m. Plenary Session: Home Sweet Home: A Global Perspective of the Why and What of

Evaluation - JoAnne Wright, PhD, OTR/L, CLVT

7:00 a.m. Breakfast Buffet Rendezvous

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Detailed information found on pages 5-7

Attend one of the following afternoon break-out sessions:

Cottonwood A

Cardiac Testing

Cardiac Testing - Indications for Various Stress

Tests – Frank G. Yanowitz, MD Ambulatory ECG Monitoring – T. Scott Wall, MD

Cottonwood B

Aging in Place: What Technology Can Offer to

You - Jeanette Koski MS, OTR/L

1-2:00 p.m. Plenary Session: Care Transitions - Complex Patients in a Complex System - Cottonwood C & D

Caroline S. Blaum, MD, MS

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Detailed information found on page 5

8-9:00 a.m.

9:15-10:15

a.m. Break

10:30-11:30

a.m.

2:15-3:15

p.m.

2:00 – 4:00 p.m. Registration Cottonwood Lobby

6:00 – 7:30 p.m. Reception Rendezvous

11:30 a.m-1:00 p.m. Lunch Buffet Rendezvous

[3]

Attend one of the following morning break-out sessions:

7:00 a.m. Breakfast Buffet Rendezvous

1-2:00 p.m. Plenary Session: Unique Safety Issues in Rural Settings - Cottonwood C & D

Linda Edelman, PhD, RN

2:15-3:15 p.m. Plenary Session: Examples of Programs Successfully Integrated in the Community

(Overview of the Faint and Fall Clinic and Home-Based Primary Care at VAMC) - Natalie

Sanders, DO and Gwenda S. Mitchell, MS, FNP-C

3:15 p.m. Adjourn

8-9:00 a.m. Plenary Session: Decision Making Capacity - Maureen Henry, JD Cottonwood C & D

Track 1: Faint and Fall/Didactic Sessions for the

Health Care Provider

Cottonwood A

Neurological Causes of Falls

Movement Disorders as a Neurologic Cause of

Falls - Leland E Dibble, PT, PhD, ATC

Neuropathies - J. Robinson Singleton, MD

A Practical Approach to the Common Causes of

Vertigo in the Primary Care Setting - Kevin

Wilson, MD

Track 2: Multi-disciplinary Approach to

Maximizing Safety and Independence at Home

Cottonwood B

Transportation Issues

Staying on the Road: Tips for Safe Driving as We

Age - Marc A. Rosello, MS, OTR/L

Alternative Transportation Modalities: Veterans

Transportation Accessible Skills Program -

Veterans On The Move – Troy L. Roper, AA

Drugs, Alcohol and Substance Abuse

Substance Abuse Among Older Adults: An

Invisible Epidemic – Dee Dee Lobato, BS

Medication Safety - Moving Beyond Just

Polypharmacy - Karen M. Gunning, PharmD

BCPS FCCP

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ccoonnttiinnuueedd Detailed information found on page 8

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Detailed information found on pages 9-10

9:15-10:15

a.m.

10:30-11:30

a.m.

4:45-5:45 p.m. Plenary Session: Interactive Case Presentations - Natalie Sanders, DO Cottonwood C & D

5:45 p.m. Adjourn

Cottonwood A Indications for Referrals

Syncope Evaluations: Indications for EP

(electrophysiology)Referral –

Nazem Akoum, MD

Indications for a Neurologic Evaluation in a

Patient Presenting with Faint - Pegah Afra, MD

Attend one of the following afternoon break-out sessions:

Cottonwood B

Health Literacy - Timothy W. Farrell, MD

3:30-4:30

p.m.

11:30 a.m-1:00 p.m. Lunch Buffet Rendezvous

[4]

Onsite Dining Options The Cliff Lodge The Atrium Espresso Bar Daily, 7 - 11 a.m. El Chanate Restaurant Monday - Saturday, 11 a.m. - 9 p.m El Chanate Cantina* Monday - Saturday, Noon - 9 p.m. Lodge at Snowbird The Lodge Bistro Thursday - Saturday, 5:30 - 9 p.m. The Lodge Bistro Lounge Thursday - Saturday, 5 - 10 p.m. Snowbird Center Baked and Brewed Daily, 8 a.m. - 6 p.m. The Forklift Breakfast, Daily, 7:30 a.m. - 11 a.m. Lunch, Daily, 11:30 a.m. - 2:30 p.m. Steak Pit Daily, 6 - 9 p.m. Tram Car Pizza Daily, 11 a.m. - 8 p.m. Snowbird deliveries, 5 - 8 p.m. Iron Blosam Wildflower Restaurant Wednesday - Saturday, 6 - 9 p.m.

Snowbird Conference Center Meeting Locations

All sessions are in the Cottonwood

Ballrooms, second level

1st-floor Conference Center

[5]

Presentation Abstracts

For an interactive program with links to the presentations, go to: www.tiny.utah.edu/RMGCLogin

Wednesday, 14th

4:00 pm Cottonwood C & D

Keynote Address: “Mobility and Aging for Clinicians”- Stephanie Studenski, MD, MPH

The capacity to move is critical for functional independence. Movement control, which reflects stability in motion,

influences multiple aspects of gait and balance. The purpose of this talk is to examine how gait and balance interact,

how simple indicators can be used clinically, and to explore known and novel age-related factors that influence gait

and balance. At the end of this presentation, participants will be able to:

Describe the trajectory of mobility status in health and disease, from function to impairment in relation to aging.

Describe how mobility is maintained and restored in older adults and the impact of behavior, prevention,

intervention.

Incorporate measurement tools, and technologies to improve assessment.

Integrate supportive designs to enhance mobility in aging: housing, communities, and transportation.

5:00 pm Cottonwood C & D

Plenary Session: “Home Sweet Home: A Global Perspective of the Why and What of

Evaluation” - JoAnne Wright, PhD, OTR/L, CLVT

Where one lives is much more than just a structure to keep the weather away. As we discuss home situations there are

many layers that can give us clues into the safety and functional independence supports that are either in place or can

be added to allow people to age-in-place. This presentation will explore the many areas that professionals working

with older adults need to consider for a complete evaluation. At the end participants will be able to:

Recognize the complexity of home evaluations.

Integrate the physical, psychosocial, safety and functional aspects that need to be assessed--formally and

informally--during an evaluation.

Identify methods to assess a living situation and relevant consults to refer to for further assistance if necessary.

Thursday, 15th

Attend one of the following morning breakout sessions:

8:00 am Cottonwood A

“Overlap Between Faint and Fall” - Natalie Sanders, DO

This session will explore the relationship between faint and fall. Specifically, it will highlight the prevalence of these

conditions in the State of Utah. We will review the mechanisms whereby patients with faint can present with fall.

We will discuss neurally mediated syncope as a cause of non-accidental falls in cognitively intact and impaired

patients. Finally, we will review the cost and safety implications if the overlap between faint and fall is not

considered when evaluating patients. At the end of this presentation, participants will be able to:

List mechanisms underlying the conceptual overlap between faint and fall.

Recognize the relationship between neurally mediated syncope as a cause of non-accidental falls in older adults.

Interpret the importance of the overlap between faint and fall in understanding and evaluating patients.

“General Approach to Patients With Transient Loss of Consciousness” - Brian Olshansky, MD, FACC, FAHA, FHRS

Syncope is a common and concerning problem that most physicians need to face with their patients on a regular basis.

This lecture will be addressing the initial evaluation of patients who have fainting spells. I will;

Define the problem of fainting and the initial approach in its evaluation.

Raise issues regarding the risks of patients who have fainting spells.

Teach the audience a method to develop a contemplative approach to the patient who passes out.

Address the issue regarding who needs to be admitted to the hospital.

[6]

Thursday, 15th

continued

8:00 am Cottonwood B

“Maximizing Safety for Our Patients with Visual Impairment – In their Personal Environments and in Our Clinics” -

Julia Kleinschmidt, PhD, LCSW

This session will help attendees appreciate the graying of the American population and the resultant growth in numbers

of individuals that are at risk for blinding conditions. As a result, addressing blindness is an urgent safety issue in

this population. The different types of vision loss, and what they mean for patients, will be explored. The functional

impact of vision loss will be addressed with a focus on mobility and activities of daily living. Basic concepts in

helping patients use remaining vision optimally will be presented with examples of how these concepts can be

incorporated in patients’ homes and in our practice settings. Services, resources, and referral strategies will be

discussed.

Attend one of the following morning breakout sessions:

9:15 am Cottonwood A

“Assessment of Short-term Risk and Need for Admission” - Mohamed H. Hamdan, MD, MBA, FACC, FHRS

The attendees will be able determine the clinical markers of short term risk in patients presenting with faints and/or falls.

To define and understand the specific management and indication for admission in faint and fall patients.

Identify clinical markers to identify patients at risk for faints.

Discriminate the patient characteristics predictive of patients and falls.

“ECG Findings You Do Not Want to Miss” - Mohamed H. Hamdan, MD, MBA, FACC, FHRS

Review ECG findings and guidelines addressing short-term risk in patients presenting with syncope.

Recognize causes of bradycardia.

Recognize cause of tachycardia.

Discuss risk factors that require hospital admissions in patients with syncope.

9:15 am Cottonwood B

“Vulnerable Adult Abuse in Community Care Settings” - Rebecca A. Mabe, MSW, LCSW

Safety issues in the older adult population include abuse by caregivers, intimate partners, and at times, family members.

This session will include a discussion of the demographics, warning signs, and resources for responding to older

adult abuse. At the end of this presentation, participants will be able to:

Recognize vulnerable adult abuse.

Understand reporting requirements of abuse.

Plan for response to vulnerable adult abuse.

“Issues Relating to the Support of Caregivers” - Marren Eberle Grant, MSW, LCSW

This presentation describes the issues that health care providers should be mindful of when providing clinical

consultation to chronically ill clients and their family members. The plight of the caregiver will be noted with a

highlight of the complexities involved in caregiving. The varied circumstance and conditions of the care recipient’s

environment will be addressed. How human development is connected to the act of caregiving. Promoting "Active,

Healthy Aging" (in connection to last year’s conference focus) for both the care recipient and caregiver. Heighten

awareness that support of caregivers does not need to be time intensive, but caregivers should not be ignored. This is

a system perspective and it is helpful for clinicians to know how to promote well-being, and finally, be able to

provide helpful information to the caregiver to increase a proactive stance towards providing care to chronically ill

and declining loved ones.

Identify key issues relevant to consult with chronically ill patients.

Increase awareness of the experience of the caregiver of a chronically ill patient.

Promote a systems perspective in the generating solutions.

[7]

Thursday, 15th

continued

Attend one of the following morning breakout sessions:

10:30 am Cottonwood A

“Tilt Table Testing and CSM: Indications and Treatment” - Mohamed H. Hamdan, MD, MBA, FACC, FHRS

Review the methodology of tilt table testing and CSM and interpretation of results. At the end of this presentation,

participants will be able to:

Understand the indications and methods used during tilt tabled testing.

Recognize the treatment options for vasovagal syncope, POTS and OH.

Understand how and when to perform CSM.

Understand the indications for pacing in patients with positive CSM.

10:30 am Cottonwood B

“Using Gait and Balance Assessment Tools to Predict Fall Risk” - D. James Ballard, PT, DPT

Unintentional falls are common in older adults. Fall-related injuries can result in disability, nursing home admission, or

even death. Falls have multiple causes and predisposing risk factors. Most falls are the result of the interactions

between intrinsic risk factors and environmental hazards. As the number of risk factors increases, the risk of falling

increases. Older adults who have fallen are more likely to fall again. Fear of falling is a major issue among older

adults who have fallen, but also among individuals who have not fallen. Medical providers should ask older adults if

they have fallen and should perform assessments identifying fall risk. The majority of risk factors, if not all, respond

to targeted intervention. Multi-factorial exercise programs can reduce fall rates in older adults.

1:00 pm Cottonwood C & D

Plenary Session: Care Transitions – “Complex Patients in a Complex System” -

Caroline S. Blaum, MD, MS

Dr. Blaum will discuss care transitions experienced by many patients, particularly older adults with multiple chronic

conditions. She will review adverse events and patient safety challenges associated with poor transitions, and

interventions that have been tried to improve transition outcomes. At the end of this presentation, participants will

be able to:

Understand types of care transitions and characteristics of patients undergoing transitions.

List adverse events and patient safety issues that happen in poor transitions.

Become more familiar with the literature about transitional care interventions and level of evidence regarding

methods to improve transitional care.

Attend one of the following afternoon breakout sessions:

2:15 pm Cottonwood A

“Cardiac Testing - Indications for Various Stress Tests” – Frank G. Yanowitz, MD

The focus of this presentation will be on the use of stress testing modalities for identification of risk factors for

cardiovascular events including arrhythmias, conduction abnormalities and ischemic manifestations that predict risk

of acute cardiac events that might contribute to falls and syncope.

“Ambulatory ECG Monitoring” – T. Scott Wall, MD

The session will provide an overview of technologies available for ambulatory ECG monitoring. Particular focus will be

given to the indications and utility of these ambulatory ECG for evaluating patients with syncope.

The learner will be able to describe available technologies for ambulatory ECG monitoring and to describe the

indications for and utility of these technologies for evaluating patients with syncope.

[8]

Thursday, 15th

continued

2:15 pm Cottonwood B

“Aging in Place: What Technology Can Offer to You” - Jeanette Koski MS, OTR/L

This interactive session will include information and samples of technologies that are available to support people who

want to stay as independent and safe as possible in their own homes. The presentation will include interactive

discussions, video and demonstrations, and hand-outs about technologies and resources that are available to achieve

this goal. At the end of this presentation, participants will be able to:

Understand the term technology as it applies to aging in place.

Identify several high and low technology options that support aging in place.

Identify resources to obtain technology solutions.

Attend one of the following afternoon breakout sessions:

3:30 pm Cottonwood A

“Syncope Evaluations: Indications for EP (electrophysiology) Referral” - Nazem Akoum, MD

Presentation will describe the cardiac causes of syncope and common presentations with findings where a cardiac and

electrophysiological evaluation is recommended.

“Indications for a Neurologic Evaluation in a Patient Presenting with Faint” - Pegah Afra, MD

The symptomatology of the neurological causes of faint will be discussed. Differential diagnosis of neurological causes

of syncope and syncope mimickers will be reviewed followed by a brief review of their diagnosis and available

treatment modalities.

Review the cardiac causes of syncope.

Summarize the common presentations forms.

Synthesize the differential diagnosis of neurological causes of syncope.

3:30 pm Cottonwood B

“Health Literacy” - Timothy W. Farrell, MD

Low health literacy presents a significant barrier to older adults’ ability to maintain safety and independence at home.

This lecture will present criteria for determining patients’ health literacy level along with tools which health care

providers may use to assess the reading level of patient handouts. In addition, this lecture will present evidence

regarding the relationship of low health literacy to adverse outcomes including medication errors and poor transitions

of care.

Levels of health literacy: Criteria for classifying patients as having low health literacy will be described.

Health literacy calculators: Tools such as the SMOG calculator will be demonstrated.

Health literacy as a barrier to safety and independence at home: Evidence from the literature will be cited

regarding the contribution of low health literacy to adverse medication events and poor transitions of care.

4:45 pm Cottonwood C & D

Plenary Session: “Interactive Case Presentations” - Natalie Sanders, DO

During this session, we will present a number of clinical cases. Each case will have a number of teaching points.

Participants will have an opportunity to discuss and comment on the cases. They will use their background clinical

knowledge as well as information they had learned in previous sessions to analyze each teaching case and formulate

a treatment plan based on the clinical history presented.

Integrate key clinical characteristics associated with falls from case presentations.

Analyze teaching cases and integrate research findings into discussion.

[9]

Friday, 16th

8:00 am Cottonwood C & D

Plenary Session: “Decision Making Capacity” - Maureen Henry, JD

The session will address traditional elements of the legal approach to capacity assessment, the variety of approaches to

capacity assessment, concerns about capacity assessment, and alternative approaches to addressing the decision

making needs of older adults with cognitive impairment. At the end of this presentation, participants will be able to:

Identify the four commonly cited elements of decision-making capacity, a variety of approaches to evaluating

capacity, and the drawbacks of traditional views of capacity and capacity assessment.

Explore alternative approaches to addressing the decision-making needs of older adults with cognitive

impairment.

Attend one of the following morning breakout sessions:

9:15 am Cottonwood A

“Movement Disorders as a Neurologic Cause of Falls” - Leland E Dibble, PT, PhD, ATC

Movement disorders, such as Parkinson’s disease, are a strong contributor to falls with some research estimating that

70% of persons with PD will fall annually. This presentation will briefly discuss the sensorimotor characteristics

that create the significant postural instability in these individuals. In addition, specfic clinical characteristics,

comorbidities, and disease variations / subtypes will be addressed as they relate to falls and response to medical and

rehabilitative treatment. At the end of this presentation, participants will be able to:

Understand the sensory systems necessary for normal postural control.

Understand the components of the motor responses to postural adjustments.

Discuss fall risk reduction treatments targeted at sensory input and motor output.

“Neuropathies” - J. Robinson Singleton, MD

Peripheral neuropathy affects 10% of people over 65 years old, due to diabetes, vitamin deficiency, gammopathy or as an

idiopathic entity. Sensory loss occurs early in most neuropathies, and can lead to reduced kinesthetic sense, leading

to risk for falls, orthopedic injury, and when severe, foot ulceration. Neuropathic pain frequently limits ambulation

or alters gaits, again increasing fall risk. Early evaluation for reversible or treatable causes, neuropathic pain

management, and prompt referral for gait evaluation can improve prognosis, reduce fall risk and improve quality of

life. At the end of this presentation, participants will be able to:

Describe characteristics of patients with major peripheral and central nerve impairment.

Recognize common neuropathy phenotypes and causes.

9:15 am Cottonwood B

“Staying on the Road: Tips for Safe Driving as We Age” - Marc A. Rosello, MS, OTR/L

At the end of this presentation, participants will be able to:

Identify the three key functions of safe driving.

Be able to indentify good driver traits.

Understand resources available in the community to assist aging drivers with driving rehabilitation or driving

retirement.

“Alternative Transportation Modalities: Veterans Transportation Accessible Skills Program - Veterans On The

Move” – Troy L. Roper, AA

Troy developed the Veterans Transportation Accessible Skills (VTAS) Program at the Salt Lake City VA. Join Troy as

he describes the program from inception to current day, including the challenges and successes faced by his clients.

At the end of this presentation, participants will understand the:

Understand the basic building blocks of the VTAS program.

Identify key challenges faced by clients.

Increase awareness of the benefits of a Transportation Accessible Skills Program.

[10]

Friday, 16th

continued

Attend one of the following morning breakout sessions:

10:30 am Cottonwood A

“A Practical Approach to the Common Causes of Vertigo in the Primary Care Setting” - Kevin Wilson, MD

The prevalence of dizziness increases steadily with age. With a practical approach to both the history and physical exam,

the primary care practitioner can usually identify the cause and institute appropriate treatment, significantly

improving the older patient's quality of life. At the end of this presentation, participants will be able to:

Understand the different causes of dizziness.

Differentiate the causes based on history and physical examination.

Institute appropriate treatment or make the appropriate referral based on this evaluation.

10:30 am Cottonwood B

“Substance Abuse Among Older Adults: An Invisible Epidemic” – Dee Dee Lobato, BS

The learner will be able to explore reasons why substance abuse among older adults remains underestimated, under

identified, under diagnosed and under treated. At the end of this presentation, participants will be able to:

Identify the myths surrounding older adults and substance abuse, what do you believe?

Elucidate reasons for “Why do we care?”

Identify barriers to identifying and treating older adults.

“Medication Safety - Moving Beyond Just Polypharmacy” - Karen M. Gunning, PharmD, BCPS, FCCP

Patients and providers often think of medication safety in older patients as being a “numbers game” - in that the more

medications the patient is on - the greater at risk patients are for medication misadventures. While this is true, it is

important to move toward an environment of rational pharmacotherapy and the provision of medication therapy

management is a start in this process. This session will review the latest information in medication safety for older

patients and introduce the value of medication therapy management in an interdisciplinary health care team. At the

end of this presentation, participants will be able to:

Understand that a higher prevalence of multiple, chronic disease states must be managed concurrently.

Address appropriate use of medications for multiple diseases and avoid risks associated with multiple medication

use such as adverse effects, drug/drug interactions, drug/disease interactions, and inappropriate dosing.

1:00 pm Cottonwood C & D

Plenary Session: “Unique Safety Issues in Rural Settings” - Linda Edelman, PhD, RN

Rural older adults are vulnerable to injury. Lifestyle and sociodemographic factors, as well as geographic isolation,

influence perceptions of injury and injury risk. Limited community resources and access to health care further impact

injury risk and outcomes. This talk will explore injuries occurring to older adults in rural Utah in the context of the

communities in which they occur. Implications for further research and prevention efforts will be addressed. At the

end of this presentation, participants will be able to:

Name factors associated with increased injury risk in rural older adults.

Compare injury risks and outcomes between rural and urban older adults living in Utah.

Discuss sociodemographic and geographic factors associated with injury risk in rural older adults living in Utah.

Explore future areas of injury research and prevention tailored to older rural adults.

[11]

Friday, 16th

continued

2:15 pm Cottonwood C & D

Plenary Session: Examples of Programs Successfully Integrated in the Community

“Overview of the Faint and Fall Clinic” - Natalie Sanders, DO

During this session, information regarding the University of Utah Faint and Fall Clinic will be presented. Specifically,

we will review the background behind establishing a faint and fall clinic, the patient mix the clinic sees, and walk the

audience through a typical visit to the faint and fall clinic. We will describe the different services available to

patients at the clinic as well as describe how the clinic uses a web-based application to assess each patient according

to published clinical guidelines. Data supporting the success of the clinic, including the improved yield to diagnosis,

decreased utilization of tests, and decreased hospital admissions will also be highlighted.

“Home-Based Primary Care at VAMC” - Gwenda S. Mitchell, MS, FNP-C

The Home-Based Primary Care Program provided a multi-disciplinary approach to fall prevention and injury reduction.

A guide for Fall Risk Assessment as well as suggestions for intervention will be presented.

A brief review of research pertaining to fall reduction in community-dwelling older adults will be presented.

Evaluation of Fall Risk in older adults will be presented.

Areas of interventions to reduce falls and injury will be discussed

At the end of this presentation, participants will be able to:

List the components of a fall risk assessment.

Recognize interventions that can reduce falls and injuries from falls in community-dwelling older adults.

SAVE THE DATE

10th Annual Rocky Mountain Geriatrics Conference

September 12-14, 2012

Salt Lake City, Utah

[12]

Presenter Information Pegah Afra, MD - Dr. Pegah Afra received her

medical training in Albert Szent Gyorgyi

Medical University in Szeged, Hungary. She

then completed her internship in internal

medicine of Southern Illinois University, three

years of neurology residency at University of Wisconsin,

and two years of fellowship in epilepsy and clinical

neurophysiology at Johns Hopkins Hospital.

She is currently an Assistant Professor of Neurology and

Associate Director of Clinical Neurophysiology Fellowship

Program in the Department of Neurology of the University

of Utah. She focuses on diagnosis and treatment of seizures

and epilepsy. Her specific interests include presurgical

evaluation and treatment of intractable epilepsies, invasive

intracranial EEG monitoring and Magnetoencephalography

(MEG). Dr. Afra is investigating the use of MEG in

presurgical evaluation of intractable and surgically

amenable epilepsies. She also uses

magnetoencephalography to investigate the basis of

variations of human cognitive function including

synesthesia.

Nazem Akoum, MD - Medical School:

American University of Beirut, Lebanon, MD,

1997-2001. Residencies: American University

of Beirut Medical Center, Internal Medicine

Residency, 2001-2002. Indiana University SOM,

Indianapolis, IN, Internal Medicine Residency, 2002-2005.

Fellowships: University of Utah SOM, Salt Lake City, UT,

Cardiology Fellowship, 2005-2008. University of Utah

SOM, Salt Lake City, UT, Electrophysiology Fellowship,

2008-2009. Clinical Specialties: Ventricular and

supraventricular arrhythmias; Device therapy for sudden

cardiac arrest and heart failure. Research Interests: Clinical

research in arrhythmia induced cardiomyopathy. Clinical

research in magnetic resonance imaging of the

arrhythmogenic substrate. Basic research in cellular

electrophysiology: conduction and permeability of cardiac

gap junction channels

D. James (Jim) Ballard, PT, DPT - Jim has

been a faculty member in the Department of

Physical Therapy at the University of Utah since

2004. He is a clinical assistant professor and the

co-director of the University Rehabilitation and

Wellness Clinic. In the physical therapy curriculum he

teaches: management in geriatrics, men’s and women’s

health and wellness, and assists in teaching vestibular

rehabilitation.

Jim’s chief clinical interests are balance training, vestibular

rehabilitation and male and female pelvic floor muscle

rehabilitation. He is a member of the Movement Disorders

Team at the University Health Sciences Center. In this

capacity, he assesses the motor effects of levodopa in

individuals with Parkinson’s disease before and after deep

brain stimulation surgery and performs pre-operative

assessments for individuals with essential tremor and

dystonia.

Caroline S. Blaum, MD, MS - Caroline Blaum

is a professor and practicing geriatrician at the

University of Michigan and a research scientist

at the VA Geriatrics Research and Education

Center in Ann Arbor. She earned her medical

degree and a Master’s degree in clinical research design and

statistical analysis from the University of Michigan. Her

specialty is care delivery models for older adults and she is

currently leading U of M’s “Pay for Performance” Medicare

Demonstration Project. Her research on geriatric syndromes

and frailty, diabetes in older adults, disability, and long-

term care is supported by the National Institute on Aging,

the VA Centers for Medicare and Medicaid Services, and

the Agency for Healthcare Research and Quality. Dr.

Blaum’s extensive national policy service includes

membership on the expert panel for Assessing Care of the

Vulnerable Elderly, and service as a U.S. Public Health

Services Primary Care Policy Fellow. She sat on the panel

that developed the American Geriatrics Society

(AGS)/California Health Care Foundation Guidelines for

the Care of Diabetes in the Elderly, and is the AGS

Representative to the Physician Consortium for Practice

Improvement. She chairs the AGS Quality Practice

Management Committee, is a member of the National

Quality Forum’s Steering Committee on Hospital Outcomes

and Efficiency, and a member of the Executive Committee

of the AMA’s Physician Consortium for Quality

Improvement.

Lee Dibble, PT, PhD, ATC - Dr. Dibble

received a PhD from the University of Utah and

his PT degree from Duke University and is

currently an Associate Professor within the

Department of Physical Therapy. Dr. Dibble

currently co-directs the Balance and Fall Prevention

Program within the University of Utah Rehabilitation and

Wellness Clinic. His current research agenda is focused on

accurately characterizing fall risk in persons with

neurologic deficits and on exercise interventions (resistance

training and balance training) for persons with

Parkinsonism and other neurodegenerative diseases. This

research has received funding from NIH, the American

Parkinson’s Disease Association, the Parkinson’s disease

Foundation, and the University of Utah. He is one of a team

of co-investigators examining the progression of mobility

loss in PD and the potential influence of physical activity in

minimizing or reversing this decline.

Linda Edelman PhD, RN – Linda has

experience in both basic science and

clinical/nursing research. She received a

Masters of Philosophy in Experimental

Pathology at the University of Utah in 1993

where she specialized in molecular immunology. She then

earned a BSN from the University of Utah College of

[13]

Nursing in 1995. For the next 17 years she utilized her basic

science and nursing backgrounds as the Research

Coordinator for the University of Utah Burn Center. During

that time she was involved with the design, conduct, and

analysis of multidisciplinary clinical research studies

pertaining to burn injuries.

Dr. Edelman's dissertation used probabilistic linkage and

GIS mapping to describe burn injuries in Utah. Since

joining the faculty at the University of Utah College of

Nursing in 2008 her research focus has been on injuries

occurring to older adults living in rural Utah. She is a 2010

John A. Hartford and Atlantic Philanthropies Claire M.

Fagin Fellow.

Timothy W. Farrell, MD - Dr. Farrell is

Assistant Professor of Medicine (Clinical) and

Adjunct Assistant Professor of Medicine at the

University of Utah School of Medicine, and a

Physician Investigator, VA SLC GRECC. Dr.

Farrell received an A.B. in philosophy from Dartmouth

College in 1998 and earned his MD from the University of

Massachusetts Medical School in 2004. He then completed

a family medicine residency at Brown University/Rhode

Island Hospital in 2007, followed by a geriatric medicine

fellowship at Brown University/Rhode Island Hospital in

2009. Dr. Farrell is board-certified in family medicine,

holds a CAQ in geriatric medicine, and is a member of the

American Academy of Family Physicians and the American

Geriatrics Society. He is a recipient of a Geriatric

Academic Career Award (GACA) from HRSA focused on

interdisciplinary education in transitions of care. He is also

an investigator on an AHRQ grant, “Primary Care Practice

Redesign – Successful Strategies.”

Marren Eberle Grant MSW, LCSW – Marren

graduated from Weber State University and the

University of Utah, School of Social Work. She

began her career working in mental health in

2000. She has worked with adolescents utilizing

equine therapy. She has advocated for women to educate

themselves. She assisted with development and promotion

of the PEER program at Weber State University advocating

for awareness toward sexual assault. She has worked with

both victims and perpetrators of sexual assault. Her most

extensive work has been working with clients suffering

from chronic mental illness. She frequently facilitates

individual, family and group therapy. She is knowledgable

with clients seeking stabilization when in crisis. Most

recently, Marren has been involved in the VA SCORE

project (Supporting Caregivers of Rural Veterans

Electronically), currently providing support and guidance to

caregivers of Veterans suffering from cognitive decline.

She has enthuastically assumed the role of Caregiver

Advocate, and promotes active, healthy aging with her

clients.

Karen Gunning, PharmD, BCPS, FCCP -

Graduated from Oregon State University in

1995 with a BS in Pharmacy, then received

her PharmD from the University of Utah, and

completed an Advanced Pharmacy Residency

in Family Medicine and Primary Care at the University of

Washington Family Medicine Residency Program and

School of Pharmacy. Dr. Gunning has been the clinical

pharmacist at the University of Utah Sugarhouse Family

Health Center for the past 12 years, is on the curriculum

committee and director of grand rounds for the Family

Medicine Residency Program, and the Director of

Continuing Education at the College of Pharmacy. She has

also been extensively involved with the Utah Medicaid

program, as a member of the FUR board for 8 years, and

currently as the Chair of the Utah Medicaid Pharmacy and

Therapeutics committee. She has received numerous

awards for her teaching, including Teacher of the Year from

the College of Pharmacy students and faculty (2000, 2009)

and also from the Family Medicine Residency Program. In

2007, she was named the Utah Society of Health System

Pharmacists (USHP) Pharmacist of the Year, and in 2008,

she was named a fellow of the American College of Clinical

Pharmacy. She is the faculty advisor of the Beta Epsilon

chapter of Rho Chi at the University of Utah, and the

Region VII Councilor for the National Rho Chi society.

Her special interests include women’s health, the

pharmacist’s role in disease prevention, transitions of care,

and public health, and curriculum development in both

family medicine residency and pharmacy education.

Mohamed H Hamdan, MD, MBA, FACC,

FHRS - Dr. Hamdan is a Professor of Internal

Medicine; John and June B. Hartman Professor

of Internal Medicine; Associate Chief, Division

of Cardiology; Director, Clinical Cardiac

Electrophysiology

College: Carmel St. Joseph, Baccalaureate; American

University of Beirut, BS

Medical School: American University of Beirut, Beirut,

Lebanon

Residency: University of Iowa Hospitals and Clinics

(Internal Medicine 7/89-6/92)

Fellowship: Stanford University Hospital (Cardiology

7/92-6/94); University of California - San Francisco

(Cardiac Electrophysiology 7/94-6/96)

Faculty Positions: Associate Professor of Internal

Medicine, University of Texas Southwestern Medical

Center (2001); Director, Clinical Cardiac

Electrophysiology, University of Texas Southwestern

Medical Center (2002); Professor of Internal Medicine,

University of Utah (2005); Associate Chief, Division of

Cardiology Director, Clinical Cardiac Electrophysiology

Clinical Specialties: Electrophysiology Cardiology

Research Interests: Electrophysiology Cardiology

[14]

Maureen Henry, JD - Maureen Henry has been

the Executive Director of the Utah Commission

on Aging since August 2005. In that position,

she was instrumental in facilitating the process

that led to a new Advance Health Care Directive

law. She has served as Director of Utah’s Aging and

Disability Resource Connection since 2009. In addition, she

is currently a student in the University of Utah, College of

Nursing’s Hartford Center for Geriatric Nursing Excellence

PhD Geriatric Specialty Cohort. Her research interest is in

health care decision making capacity in older adults with

cognitive impairment. Maureen is a graduate of Berkeley

Law School, UC Berkeley. She is a current member of the

Attorney General’s HIPAA Task Force and the National

POLST Paradigm Task Force Board.

Julia J. Kleinschmidt, PhD, LCSW - Dr.

Kleinschmidt is a Clinical Professor in the

Department of Ophthalmology and Visual

Sciences, John A. Moran Eye Center at the

University of Utah. Dr. Kleinschmidt has

developed and directs an ophthalmology-based Patient

Support Program for individuals with visual impairment and

for their families. Services include crisis counseling,

information and referral services, support groups, and an

Orientation to Vision Loss program. Dr. Kleinschmidt has

conducted research and published in numerous professional

journals, and she has published a book, The Impact of

Vision Loss in the Elderly. Dr. Kleinschmidt has

presented papers and lectures across the U.S. and in Israel,

South Africa, Canada, Sweden, and England.

Jeanette Koski MS, OTR/L - is a licensed

Occupational Therapist who is currently an

assistant professor (clinical) at the University of

Utah, Division of Occupational Therapy.

Jeanette graduated from University of

Indianapolis with a Master of Science degree in OT. She

has been a clinician for 13 years and has worked with adult

clients in several settings including rehabilitation and home

health during that time. She particularly enjoys working

with people recovering from spinal cord injuries and stroke.

She has also been a team leader at the University of Utah

hospital inpatient rehab.

Dee Dee Lobato, BS - Dee Dee Lobato is

currently the program manager for Salt Lake

County Aging Services Healthy Aging Program.

She has worked for SLCO for 8 years. Prior to

SLCO she worked at Salt Lake Community

College for 7 years as the Director as the Health & Wellness

Services and as a prevention specialist for the Drug and

Alcohol Education Program. She has a BS from

Westminster College in Sociology.

Rebecca A. Mabe, MSW, LCSW – As the

Social Work Services Field Education

Coordinator at the Salt Lake City VA HCS, and

a Geriatric Social Worker with a Criminology

Certificate, she collaborates with and provides

clinical social work support regarding the issues of aging

and vulnerable veterans. She received her BS in Sociology

in 1999, at the University of Utah, and, MSW in 2001, from

University of Utah Graduate School of Social Work.

Rebecca has held many positions in clinical practice and

education, currently University of Utah and Brigham Young

University Field Practicum Instructor. She serves on a

number of boards and councils including; National Alliance

for the Mentally Ill for Salt Lake, University of Utah

Practicum Advisory Council, SLCVAHCS Women

Veteran's Advisory Board, Social Work Services Executive

Council.

Gwen Mitchell, MS, FNP-C – Gwen is a

primary care provider, in the Home Based

Primary Care, VA Medical Center, SLC, UT.

She has worked in HBPC providing in-home

primary care for the past 19 years. In this

capacity she works with a multi-disciplinary group that

includes NP, SW, OT, dietetics, and psychology, to

maximize the health and safety of homebound veterans. For

the past 6 years she has also focused on fall prevention and

injury reduction in community - dwelling frail adults.

Gwen received her Bachelor of Science (Nursing) in 1980,

from Westminster College, Salt Lake City, and a Master of

Science (Nursing-FNP) in 1992, University of Utah.

Brian Olshansky, MD, FACC, FAHA, FHRS

Dr. Olshansky is a board certified clinical

cardiac electrophysiologist, and is a tenured

Professor of Medicine at the University of Iowa

Hospitals. Dr. Olshansky graduated from

Carleton College and completed his MD at the University of

Arizona, completed residency training in Internal Medicine

at Bellevue/NYU Hospitals, Cardiology Fellowship training

at the University of Iowa, and Electrophysiology Fellowship

training at the University of Alabama, Birmingham. He has

been in academic medicine all his career and has been on

the staff at the University of Alabama Case Western

Reserve University and Loyola University before returning

to the University of Iowa in Iowa City. He has directed

Electrophysiology Laboratories and Training Programs at

Loyola University Medical Center and University of Iowa

Hospitals. Dr. Olshansky has expertise in the evaluation and

treatment of cardiac arrhythmias. He is recognized for his

work regarding the assessment of arrhythmia mechanisms,

autonomic effects on cardiovascular physiology, treatment

of atrial and ventricular arrhythmias and evaluation of

syncope. He is known for his diverse interests ranging from

technological and mechanistic aspects of cardiac

[15]

electrophysiology to holistic issues regarding medical care

and the doctor-patient relationship

Troy Roper, AA - Troy sustained a TBI as a

result of a serious motorcycle accident in 2005.

Unable to drive, Troy was faced with staying

home every day or learning to ride public

transit. After his personal journey of finding

freedom through the use of public transit, Troy developed

the Veterans Transportation Accessible Skills (VTAS)

Program at the Salt Lake City VA, with over 1,000 Hours

Volunteer Service.

Troy received the Brain Injury Survivor of the Year, Brain

Injury Assoc. in 2009, and is a decorated Vietnam War

Veteran trained in Avionics. He has an Associate of Arts

Degree: Advertising/Marketing from Pasadena City

College. Troy is a member of: LCPD, UCB, NFB, Utah

Brain Injury Council; Blind and Visually Impaired

Veterans; Veterans Transportations Accessible Skills

Program, (VTAS) Instructor; Peer Specialist Core Recovery

Training, SLC VA; Person Centered Planning for Peer

Support Whole Health, SLC VA

Marc A. Rosello, MS, OTR/L - Marc is a

Clinical Instructor in the Occupational Therapy

Department, University of Utah. He is also a

Level I and II supervisor for the University of

Utah Occupational Therapy School and

Advisor to Occupational Therapy Master Students. Marc

received his Baccalaureate Degree in 1993, Augustana

College in Rock Island Ill., Biology and his Masters Degree

in 1995, Washington University School of Medicine in St

Louis, MO. (Occupational Therapy). Marc has worked 11

years for the University of Utah Hospital and Clinics at the

Sugarhouse Rehabilitation Clinic in the Out Patient and

Community Rehabilitation Service programs, and is on the

CVA team at University Hospital.

Natalie Sanders, DO - Dr. Sanders is a

Clinical Instructor with the Division of

Geriatrics at the University of Utah. She

completed her undergraduate medical education

at the College of Osteopathic Medicine of the

Pacific in Pomona, CA. She subsequently graduated from

the Internal Medicine Residency program from the

University of Utah and was selected as a Chief Medical

Resident. After practicing for three years as a General

Internist with this same institution, Dr. Sanders formalized

her training in a Geriatrics Fellowship. Her current clinical

practice is the Faint and Fall Clinic at the University of

Utah where she also serves as Associate Director. She

educates Internal Medicine residents and performs clinical

research highlighting the cardiovascular mechanisms behind

the overlap between faint and fall.

J. Robinson Singleton, MD – Dr. Singleton is

Professor of Neurology at the University of

Utah, Director of the NCRR Utah Center for

Clinical and Translational Sciences Clinical

Services Core, and Director of the

Neurophysiology Laboratory at the Salt Lake City

Veterans’ Administration Hospital. He trained at the

University of Colorado and the University of Michigan

before joining the University of Utah faculty in 1996. Dr.

Singleton is a clinical neuroscientist who has helped

develop the concept that early insulin resistance and

dsylipidemia damage distal peripheral nerves. He has

research expertise in small fiber and autonomic function,

and clinical, electro diagnostic and histological measures of

neuropathy and its progression. His current NIH and

American Diabetes Association funded projects address the

effects of diet, exercise and lipid modifying drugs on

neuropathy risk and cutaneous nerve regeneration in

patients with diabetes, prediabetes or metabolic syndrome.

He teaches neuromuscular disease diagnosis and electro

diagnostic techniques to Neurology and Physical Medicine

and Rehabilitation residents at both the Veterans

Administration Hospital and the University of Utah and has

helped to train 18 Neuromuscular Fellows.

Stephanie A. Studenski, MD, MPH - Dr.

Studenski is a geriatrician and rheumatologist

whose practice, teaching and research focus on

mobility, balance disorders and fall in older

adults. Through her research, she strives to

understand balance and mobility problems that occur with

obvious conditions such as stroke, as well as those of more

insidious onset that may be related to subclinical losses in

multiple organ systems. She has been continuously funded

by NIH, the VA, and other sources for over 25 years and

has published over 200 articles and book chapters. Dr.

Studenski is currently the Principal Investigator of the

Claude D. Pepper Older Americans Independence Center at

University of Pittsburgh, whose thematic focus is gait and

balance in the aged. She is Associate Editor of “Hazzard’s

Textbook of Geriatrics and Clinical Gerontology”, co-

author of the Geriatrics chapter in the Textbook on Clinical

and Translational Science. She currently serves on the NIA

council of Advisors.

T. Scott Wall, MD – Dr. Wall has Eleven

years experience as a practicing

cardiologist/clinical electrophysiologist and

currently holds a faculty appointment as

Assistant Professor of Medicine in the Division

of Cardiology at the University of Utah. He received his

MD at the University of Texas Southwestern Medical

School, Dallas, Texas in 1996; his BS in Physics,

University of Texas at Austin in 1992; Fellowships:

University of North Carolina at Chapel Hill, Cardiology;

University of Utah School of Medicine, Cardiology. His

[16]

Clinical Specialty is Cardiology / Electrophysiology. Dr.

Wall is a Fellow of the American College of Cardiology,

and member of Heart Rhythm Society.

Kevin F. Wilson, MD – Dr. Wilson joined the

University of Utah faculty as an assistant

professor of Otolaryngology – Head and Neck

Surgery in 2010. He fulfilled a residency at the

University of Michigan and received his

medical degree at Washington University

School of Medicine in St. Louis. Dr. Wilson enjoys caring

for both adult and pediatric patients with a variety of

problems, including allergies, sinus-related disorders,

hearing loss, voice disorders, head and neck cancer, and

facial plastic and reconstructive surgery. He has received

advanced training from the American Academy of

Otolaryngic Allergy and provides allergy testing and

treatment. He has done research in cystic fibrosis, hearing

loss and its restoration, head and neck cancer, rhinitis, and

pediatric airway reconstruction. He sees patients both at

University Hospital Clinic 9 and South Jordan Health

Center.

JoAnne Wright, PhD, OTR/L, CLVT – Dr.

Wright is a Gerontologist, an Occupational

Therapist, a Certified Low Vision Therapist

and a Clinical Professor at the University of

Utah. Her passion throughout her career has

been quality-of-life and sharing the knowledge she has

gained through client interaction, schooling and research

with others. Raised in Salt Lake City, she returned to the

mountains that she loves in 1997 and was the

Developer/Chair of the only entry level OT program in

Utah. When not working, she hunts fossils (there is an old

theme here), sapphires, minerals and gems. Her newest life

adventure (in addition to her current faculty role) is

providing low vision evaluation and treatments at the Life

Skills Clinic.

Frank G. Yanowitz, MD - Dr. Yanowitz is a

Professor of Medicine in Cardiology,

Geriatrics at the School of Medicine,

University of Utah; Cardiology Director at the

Intermountain Health and Fitness Institute,

LDS Hospital. He has been a member of the University of

Utah School of Medicine faculty for 38 years. Frank

received his degree in medicine at the State University of

New York Upstate Medical School, Syracuse. He

completed an Internship at Straight Medical, University of

Chicago Hospitals, Chicago. Residency in Internal

Medicine at University of Chicago Hospitals. Fellowship in

Cardiology at University of Chicago Hospitals, completing

his training in 1971. From 1971-1973 he was a Major in the

USAF working at the School of Aerospace Medicine in San

Antonio, Texas. In August of 1973, he started his work at

the University of Utah School of Medicine, primarily

located at the LDS Hospital.

Planning Committee

Natalie Sanders, DO - Clinical Instructor, Division of Geriatrics; Associate Director, Faint and Fall Clinic; University of Utah;

Conference Chairman

Mohamed H. Hamdan, MD, MBA, FACC, FHRS - John and June B. Hartman Professor of Medicine, Associate Chief,

Division of Cardiology; Director, Arrhythmia Service, Director, Faint and Fall Clinic, University of Utah School of Medicine,

Division of Cardiology; Conference Co-Chairman

Mark A. Supiano, MD - Marjorie Rosenblatt Goodman and Jack Goodman Professor of Geriatrics; Chief, Division of

Geriatrics, University of Utah School of Medicine; Director, VA Salt Lake City Geriatric Research, Education, and Clinical

Center; Executive Director, University of Utah Center on Aging

Timothy W. Farrell, MD - Assistant Professor of Medicine (Clinical), Adjunct Assistant Professor of Family Medicine,

University of Utah School of Medicine; Physician Investigator, VA SLC GRECC

Bret L. Hicken, PhD, MSPH - Health Science Specialist, Veterans Rural Health Resource Center - Western Region

Marilyn Luptak, PhD, MSW - Assistant Professor and Director, Social Work in Aging Emphasis; Hartford Geriatric Social

Work Faculty Scholar, University of Utah College of Social Work

Charlene R. Weir, PhD, RN - Associate Director for Education and Evaluation, VA Salt Lake City GRECC – VISN 19;

Associate Professor, Biomedical Informatics, University of Utah; Investigator, VA Salt Lake City IDEAS Center

Karey Johnson, MSN, RN - Clinical Manager, Center for Learning Excellence; Assoc. Chief, Nursing Service for Education,

VASLC HCS

Jack Christensen, BS - Education Specialist, VA Salt Lake City GRECC – VISN 19

[17]

Conference Sponsors

Utah’s older population is growing rapidly. By 2025, it is projected Utah will have the nation’s fastest growth rate in

its population above age 65.

In response to this need, the Division is actively expanding its research, education, and clinical programs. The

Division is the academic home for Geriatric Medicine within the University of Utah School of Medicine. It is one

component of the campus-wide Center on Aging, and is closely interconnected with the VA Salt Lake City Geriatric

Research, Education, and Clinical Center (GRECC), as well as with other Center on Aging affiliated programs.

Geriatrics Division faculty and staff are devoted to:

Expanding the Geriatric Medicine knowledge base;

Providing Geriatric Medicine education and training programs;

Providing outstanding consultation and management services in the inpatient, outpatient, and long-term care

settings.

Visit us at; www.medicine.utah.edu/internalmedicine/geriatrics

Geriatric Research, Education and Clinical Center

The VA Salt Lake City Health Care System Geriatric Research, Education and

Clinical Center (GRECC) is one of twenty-one "Centers of Geriatric Excellence"

located throughout the United States. GRECCs are the cornerstone of the Veterans

Health Administration (VHA) strategy to focus attention on the aging veteran

population, to increase the basic knowledge of aging, to transmit that knowledge to

health care providers, and to improve the quality of care to the aged.

Our Mission

To conduct geriatric research, educate providers and the public, and develop state of the art clinical demonstration

projects to improve the quality of care of elderly veterans.

Our Purpose

To serve as local, regional and national resources for geriatric education and training and to integrate new and existing

geriatric knowledge and skills into clinical practice.

Visit us at; www.saltlakecity.va.gov/slc_grecc

The Center on Aging provides the focal point uniting aging-related research,

education, and clinical programs at the University of Utah. By linking its

faculty and programs, the Center synergizes the growth and progress of

interdisciplinary research to help people lead longer and more fulfilling lives

and supports the development of multidisciplinary clinical and training

programs.

Visit us at; www.aging.utah.edu

[18]

Conference Sponsors

Utah Geriatrics Society

The purpose of the Utah Geriatrics Society is to carry out the mission of American Geriatrics

Society (AGS),and “to improve the health, independence and quality of life of all older people” in

the State of Utah. More specifically the purpose of state affiliates as defined by AGS is threefold:

1- to recruit local leaders who can promote clinical geriatrics

2- to establish a local presence for AGS across the country, and

3- to identify future national leaders.

There are currently 24 AGS affiliates and other states are preparing to add to that number. In Utah, we are

experiencing a population that is aging much faster than the national average - by 2030 there is projected to be

482,593 people over 65 years in Utah (17.14% of the population). In order for us to be able to meet the needs of this

growing population of older adults, we will have to be well organized, up to date with current practice standards and

be able to attract other professionals into geriatric practice. Developing an active Utah affiliate of AGS will be an

important step in meeting these goals.

Visit us at; www.utahags.org

Veterans Office of Rural Health

The ORH mission is to improve access and quality of care for enrolled rural and highly

rural Veterans by developing evidence-based policies and innovative practices to support

the unique needs of enrolled Veterans residing in geographically remote areas.

Vision –

a) expand its collaborative working relationship with internal VA offices and field units and external rural

health experts, leveraging expertise and resources to build on current programs;

b) develop new methods to provide the best solutions to the challenges facing the nation’s rural and highly

rural Veterans; and

c) develop innovative solutions to increase access to health care for rural and highly rural Veterans in order to

improve the health of rural and highly rural Veterans.

Areas of Focus - ORH provides a centralized office structure for ensuring the effective delivery of high quality

accessible services to rural and highly rural Veterans. A key factor in achieving this aim is the vetting of methods,

pilots and policies within ORH’s areas of focus. ORH benefits from Veterans Health Administration (VHA)

institutional support, as well as robust and constructive congressional inputs, making it well-positioned to effectively

support the interests of rural and highly rural Veterans across a number of key focus areas. These areas of focus are:

Access and Quality

Technology and Telehealth

Studies and Analyses Studies and Analyses

Building Collaborations

Workforce Recruitment and Retention

Visit us at; http://www.ruralhealth.va.gov/

[19]

9th Annual Rocky Mountain Geriatrics Conference Safety in the Balance: Fainting, Falling, and Maintaining Independence

September 14-16, 2011

Speaker and Planning Committee Disclosure Summary

The University of Utah School of Medicine Continuing Medical Education Office meets the Accreditation Council for Continuing Medical Education

expectations regarding the identification and resolution of conflicts of interest that arise from financial relationships with commercial interests. Financial

relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria,

ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial

benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting,

speaking and teaching, membership or advisory committees or review panels, board membership, and other activities from which remuneration is

received, or expected. We consider relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.

Everyone in control of content, including all speakers and planners are expected to disclose any relevant financial relationships in any amount within the

past 12 months. Speakers are also expected to openly disclose intent to discuss any off-label, experimental, or investigational use of drugs, devices, or

equipment in their presentations.

Speaker(s) Name

or

Planner(s) Name

Speaker (s)

or

Planner (P)

Grants/Research

Support

Consultant Stock

Shareholder

(directly

purchased)

Honorarium Other

Financial or

Material

Support

Pegah Afra, MD S No No No No No

Nazem Akoum, MD S No No No No No

D. James Ballard, PT, DPT S No No No No No

Caroline S Blaum, MD, MS S No No No No No

Jack Christensen, BS P No No No No No

Leland E Dibble, PT, PhD, ATC S No No No No No

Linda Edelman, PhD, RN S No No No No No

Timothy W Farrell, MD P, S No No No No No

Marren E. Grant, MSW, LCSW S No No No No No

Karen M Gunning, PharmD, BCPS,

FCCP

S No No No No No

Mohamed H Hamdan, MD, MBA,

FACC, FHRS

P, S No No No No No

Maureen Henry, JD S No No No No No

Bret L Hicken, PhD, MSPH P No No No No No

Karey Johnson, MSN, RN P No No No No No

Julia Kleinschmidt, PhD, LCSW S No No No No No

Jeanette Koski, MS, OTR/L S No No No No No

Dee Dee Lobato, BS S No No No No No

Marilyn Luptak, PhD, MSW P No No No No No

Rebecca A Mabe, MSW, LCSW S No No No No No

Gwenda S Mitchell, MS, FNP-C S No No No No No

Brian Olshansky, MD, FACC, FAHA,

FHRS

S No No No No No

Troy L Roper, AA S No No No No No

Marc A Rosello, MS, OTR/L S No No No No No

Natalie Sanders, DO P, S No No No No No

J Robinson Singleton, MD S No No No No No

Stephanie Studenski, MD, MPH S No No No No No

Mark A Supiano, MD P No No No No No

Scott Wall, MD S No No No No No

Charlene Weir, PhD, RN P No No No No No

Kevin Wilson, MD S No No No No No

JoAnne Wright, PhD, OTR/L, CLVT S No No No No No

Frank G. Yanowitz, MD S No No No No No

No one in The University of Utah Continuing Medical Education Office in control of content for the 9th Annual Rocky Mountain Geriatrics Conference:

Safety in the Balance: Fainting, Falling, and Maintaining Independence conference has any relevant financial relationship with commercial products or

services discussed during this conference.

[20]

Accreditations

Accreditation: This activity has been planned and implemented in accordance with the Essential Areas

and policies of the Accreditation Council for Continuing Medical Education through the joint

sponsorship of The University of Utah School of Medicine and The Salt Lake Geriatric, Research,

Education, and Clinical Center (GRECC). The University of Utah School of Medicine is accredited by

the ACCME to provide continuing medical education for physicians.

AMA Credit: The University of Utah School of Medicine designates this live activity for a maximum of

14 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their

participation in the activity.

ANCC - The VA Salt Lake City Health Care System is an approved Provider of Continuing Nursing Education by the Utah

Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on

Accreditation. This program is approved for 14 contact hours.

AAFP - This Live activity, 9th Annual Rocky Mountain Geriatrics Conference: Safety in the Balance: Fainting, Falling, and

Maintaining Independence, with a beginning date of 09/14/2011, has been reviewed and is acceptable for up to 14.00

Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit

commensurate with the extent of their participation in the activity.

AGS GRA - This CME activity is endorsed by the American Geriatrics Society. Credits earned from this activity may be

counted toward the AGS Geriatrics Recognition Award.

APTA - This activity is approved for 14 Continuing Education Credit hours by the Utah Physical Therapy Association

NASW - This activity is approved for 14 CEU credit hours.

Nondiscrimination and Disability Accommodation Statement: The University of Utah does not exclude, deny benefits to

or otherwise discriminate against any person on the basis of race, color, national origin, sex, disability, age, veteran’s status,

religion, gender identity/expression, genetic information, or sexual orientation in admission to or participation in its

programs and activities. Reasonable accommodations will be provided to qualified individuals with disabilities upon

request, with reasonable notice. Requests for accommodations or inquiries or complaints about University

nondiscrimination and disability/access policies may be directed to the Director, OEO/AA, Title IX/Section 504/ADA

Coordinator, 201 S President’s Circle, RM 135, Salt Lake City, UT 84112, 801-581-8365 (Voice/TTY), 801-585-5746

(Fax).

Every effort has been made to assure the accuracy of the data presented at this meeting. Physicians may care to check

specific details such as drug doses and contraindications, etc., in standard sources prior to clinical application.