University of Utah - Registration Form 6thAnnual RockyMountain … · 2019-11-21 · Cancellation...
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Cancellation Policy: The full course tuition is refundable, less $100 administrative fee, if your cancella- tion is received, in writing, prior to August 10, 2008. The $100 administrative fee is non-refundable regardless of the reason for cancellation. No refunds will be granted after this time for non-attendance. The conference committee re- serves the right to cancel this conference in the event of un- foreseen circumstances or if the minimum acceptable registra- tion is not met. In the event of conference cancellation, regis- tration fees will be refunded. 6th Annual Rocky Mountain Geriatric Conference “The Science and Practice of Caregiving” September 3 - 6, 2008 Red Lion Hotel Salt Lake Downtown, Salt Lake City, Utah Presented By: Division of Geriatrics, University of Utah School of Medicine Center on Aging, University of Utah VA Salt Lake City Health Care System VA Salt Lake City Geriatric, Research, Education, and Clinical Center (GRECC – VISN 19) Utah Cooperative Healthcare Education Program, Inc. 500 Foothill Drive Salt Lake City, Utah 84148 NON-PROFIT ORG. U.S. POSTAGE PAID SALT LAKE CITY UT PERMIT No. 7081 Fees include continental breakfast, lunch, refreshments, syllabus materials, and a non- refundable administrative charge of $100. All fees are due in advance; reg- istrations will NOT be accepted without payment. Payments will be accepted by check via mail, or with a credit card via fax, phone or mail-in. Conference information and regis- tration forms are available online at: www.uchep.com For more information, please email Jack Christensen at [email protected] Fees and Information Please print or type and fax or mail to UCHEP (05HL), 500 Foothill Drive, Salt Lake City, UT 84148, (801) 584-5600, Fax: (801) 588-0414 Registration Fees Received on Received Check or before after Payment Aug 10, 2008 Aug 10, 2008 □ □ Physicians (All) $450 $500 □ □ Allied Health Professionals $325 $375 □ □ Residents (need letter) $250 $300 □ □ Allied Health (VA) $250 $300 Last Name: First Name: ___________________ ______________________ Degree(s)/License(s) ( check all that apply): □ □ MD □ □ DO □ □ PhD □ □ PA □ □ Student □ □ VA Employee; Facility______________ □ □ RN □ □ MSN □ □ APRN □ □ MSW □ □ Other: ______________________ Organization: _______________________________________ Street Address_____________________________________________ City: ______________________________________ State: ________ Zip: ___________ Telephone: ______________________ FAX: ____________ Email: _______________________________________________ SPECIAL DIETARY /PHYSICAL CONSIDERATION : Dietary Restrictions? ____________________________ Special Accommodations? ____________________________________ Send your completed registration form to: UCHEP (05HL) VA SLC Health Care System 500 Foothill Drive, Salt Lake City, UT 84148 Registration Contact: Holly 801-584-5600 / Annette 801-584-2586 Email: [email protected] Fax Number: 801-588-0414 TOTAL Amount Enclosed / Authorized Charge: $ Method of Payment □ □ Check - Please make checks payable to UCHEP □ □ Credit Card □ □ Visa □ □ MC □ □ Am Ex # _____________________________________________ exp date: _____/_______ Name on the card _______ Signature ___________________________________________________ Registration Form
Transcript of University of Utah - Registration Form 6thAnnual RockyMountain … · 2019-11-21 · Cancellation...
Cancellation Policy:
The full course tuition is refundable, less$100 administrative fee, if your cancella-
tion is received, in writing, priorto August 10, 2008.
The $100 administrative fee isnon-refundable regardless ofthe reason for cancellation.
No refunds will be granted afterthis time for non-attendance.
The conference committee re-serves the right to cancel thisconference in the event of un-foreseen circumstances or if theminimum acceptable registra-tion is not met. In the event ofconference cancellation, regis-
tration fees will be refunded.
6th Annual Rocky Mountain Geriatric Conference
“The Science and Practice of Caregiving”September 3 - 6, 2008
Red Lion HotelSalt Lake Downtown,
Salt Lake City, Utah
Presented By:
Division of Geriatrics,University of Utah School of Medicine
Center on Aging,University of Utah
VA Salt Lake City Health Care System
VA Salt Lake CityGeriatric, Research, Education,
and Clinical Center (GRECC – VISN 19)
Utah Cooperative Healthcare EducationProgram, Inc.500 Foothill DriveSalt Lake City, Utah 84148
NON-PROFIT ORG.U.S. POSTAGE
PAIDSALT LAKE CITY UT
PERMIT No. 7081Fees include continental breakfast, lunch,refreshments, syllabus materials, and a non-refundable administrative charge of $100.
All fees are due in advance; reg-istrations will NOT be acceptedwithout payment.
Payments will be accepted bycheck via mail, or with a creditcard via fax, phone or mail-in.
Conference information and regis-tration forms are available onlineat:
www.uchep.com
For more information, pleaseemail Jack Christensen [email protected]
Fees and Information
Please print or type and fax or mail to UCHEP (05HL), 500 Foothill Drive,Salt Lake City, UT 84148, (801) 584-5600, Fax: (801) 588-0414
Registration FeesReceived on Received
Check or before afterPayment Aug 10, 2008 Aug 10, 2008
□ □ Physicians (All) $450 $500
□ □ Allied Health Professionals $325 $375
□ □ Residents (need letter) $250 $300
□ □ Allied Health (VA) $250 $300
Last Name: First Name: ___________________ ______________________
Degree(s)/License(s) ( check all that apply): □ □ MD □ □ DO □ □ PhD □ □ PA □ □ Student
□ □ VA Employee; Facility______________ □ □ RN □ □ MSN □ □ APRN □ □ MSW □ □ Other: ______________________
Organization: _______________________________________ Street Address_____________________________________________
City: ______________________________________ State: ________ Zip: ___________
Telephone: ______________________FAX: ____________Email: _______________________________________________
SPECIAL DIETARY /PHYSICAL CONSIDERATION:
Dietary Restrictions? ____________________________ Special Accommodations? ____________________________________
Send your completed registration form to:UCHEP (05HL)VA SLC Health Care System500 Foothill Drive, Salt Lake City, UT 84148
Registration Contact:Holly 801-584-5600 / Annette 801-584-2586Email: [email protected]
Fax Number: 801-588-0414
TOTAL Amount Enclosed / Authorized Charge: $
Method of Payment
□ □ Check - Please make checks payable to UCHEP□ □ Credit Card □ □ Visa □ □ MC □ □ Am Ex # _____________________________________________ exp date: _____/_______
Name on the card _______ Signature ___________________________________________________
Registration Form
A c c r e d i ta t i o nThis activity has been planned and implemented in accordance with the Essential Areas and Policies ofthe Accreditation Council for Continuing Medical Education through the joint sponsorship of The Univer-sity 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 continuingmedical education for physicians.
The University of Utah School of Medicine designates this educational activity for a maximum of 17.5AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent oftheir participation in the activity.
The VA Salt Lake City Health Care System is an approved Provider of Continuing Nursing Education bythe Utah Nurses Association, an accredited approver by the American Nurses Credentialing Center'sCommission on Accreditation. This program is approved for 17.5 contact hours.
CEUs have been applied for with Utah NASW and are pending.
The University of Utah complies with the Americans with Disability Act by providing qualified individualswith disabilities access to University programs, services and activities. A request for accommodation canbe made by calling 582-1565 x2435. Reasonable prior notice is required.
Course DirectorRandall W. Rupper, MD, MPH - Assistant
Professor, University of Utah School of Medi-cine, Div. of Geriatrics; Physician Investiga-tor, VA Salt Lake City GRECC and Salt LakeIDEAS Center
Guest FacultyChristopher M. Callahan, M.D. - Cornelius
and Yvonne Pettinga Professor in AgingResearch, Professor of Medicine, IndianaUniversity & Hospital; Regenstrief HealthCenter
Margy Campbell, LCSW, CMC, CFP, MG -Owner, Age Connections, Inc and Guardian& Conservator Services, LLC
David W. Coon, Ph.D. - Associate ProfessorASUW Social/Behavioral Science Faculty,Arizona State University
Elizabeth B. Fauth, Ph.D. - Research Assis-tant Professor, Department: Family, Con-sumer, and Human Development, Utah StateUniversity
Barbara Given, Ph.D., RN, FAAN - AssociateDean for Research and Doctoral Program ,University Distinguished Professor, MichiganState University College of Nursing
Kenneth M. Langa, M.D., Ph.D. - Assoc. Prof.of Medicine, Div. of General Medicine, Univ.of Michigan Medical School; Research Inves-tigator, Center for Practice Management andOutcomes Research, Ann Arbor VA MedicalCenter; Faculty Associate, Institute for SocialResearch, University of Michigan
Kathleen W. Piercy, Ph.D. - Associate Profes-sor, Department of Family, Consumer, andHuman Development, Utah State University
Lucy A. Savitz, Ph.D., MBA—Senior Scientist,Institute for Health Care Delivery Research,Intermountain Healthcare; Associate Profes-sor, Clinical Epidemiology, Medicine, AdjunctAssociate Professor, Nursing, University ofUtah
Richard Schulz, Ph.D.- Professor of Psychia-try, Psychology, Epidemiology, Sociology,and Director, University Center for Socialand Urban Research, University of Pitts-burgh
University & VA FacultyCynthia Berg, Ph.D. - Professor of Psychol-
ogy, Department of Psychology, University ofUtah
Nancy K. Dailey, MSN,RN-BC Clinical Instruc-tor, University of Utah College of Nursing;Program Director, VA Nursing Academy, VASalt Lake City Healthcare System
Dale A. Lund, Ph.D. - Professor, College OfNursing and Associate Director Research ofthe University of Utah Hartford Center ofGeriatric Excellence
Katherine P. Supiano, MS, LCSW, F-GSA, CT - Director, Caring Connec-tions: A Hope and Comfort in GriefProgram; Assistant Professor(Clinical); Clinical Social Worker:University of Utah Hospitals-Palliative Care Services
Charlene Weir, RN, PhD - AssociateDirector for Education and Evalua-tion, VA Salt Lake City GRECC
The Science and Practiceof Caregiving
PROGRAM DESCRIPTION:
The conference is specifically designed to ad-dress the communication and collaboration issuesassociated with improving caregiver support. Byexamining the knowledge base provided by theresearch/literature and translating those findingsinto practice, we have the best chance of meetingcaregiver needs.
Providing effective support for caregivers is apervasive and difficult problem for clinicians caringfor chronically ill patients in our aging society.This conference brings together prominent care-giver researchers and expert clinicians with thegoals of improving caregiver and patient outcomesand enhancing provider satisfaction and effective-ness. The final day of the conference will presentmethods for incorporating these findings into localQI activities.
Topics will focus on understanding caregivers’decision-making processes, as well as improvingcommunication and collaboration among the care-giver, the patient and the interdisciplinary healthcare team. Assessment and intervention tools willbe presented to enhance the clinician’s ability toprovide emotional and informational support tostruggling caregivers.
Content is appropriate for physicians, physicianassistants, psychologists, nurses, social workers,and other medical personnel working with caregiv-ers.
PROGRAM OBJECTIVES:
1. Identify the predictive factors associated with effec-tive caregiving from epidemiology and clinical re-search.
2. Describe the current research on decision-making incaregivers.
3. Integrate up to date assessment techniques thateffectively tailor support to the individual caregiverand their family.
4. Demonstrate critical communication content that isthe most effective in enhancing collaboration.
5. Increase awareness of resources and keysupports for caregiving among service pro-viders in the aging and disability networks.
6. Foster greater collaboration and resource sharingamong providers to address caregiving issues moreeffectively at the community level.
7. Integrate key principles of Quality Improvement intoeffective program support for caregivers.
Program Overview / Schedule G e n e r a l I n f o r m a t i o nLocation
Red Lion Hotel Salt Lake Downtown161 West 600 South, Salt Lake City, Utah 84101Tel: 801-521-7373; Fax: 801-524-0354;E-mail: [email protected]
Complimentary parking is available adjacent to the hotel.Downtown Salt Lake City is within the Free Ride Zone for UTA bus or TRAX.
Downtown Location With Spectacular Mountain Views
Guests enjoy exceptional, private balcony views of downtown and moun-tains from each of our 392 deluxe guest rooms and suites. “Just-like-home” room ameni-ties include free Net4Guests high-speed wireless Internet access, large workstations, in-room movies and room service.
Relax and unwind in our heated outdoor pool and oversized whirlpool or workout in ourstate-of-the-art fitness center. Our Café Olympus serves family favorites for breakfast,lunch and dinner while the elegant Charcoal Room Restaurant and Sky Bar nightclub letyou enjoy the height of fine dining and spectacular views.
The hotel offers 24-hour courtesy shuttle. Upon arrival in the baggage claim area, callthe hotel at (801) 521-7373 to arrange for pickup.
AccommodationsA block of rooms is being held at the Red Lion Hotel for arrival on Tuesday,September 3 and departure on Saturday, September 6, 2006. Please callfor reservations at 1-800-733-5466 or the hotel direct at 1-801-521-7373.
First night stay must be guaranteed with a credit card. The room rate isthe prevailing Federal Government rate of $94.00 single or $104.00 doubleoccupancy plus local taxes and fees of 12.7%. Additional rates apply fortriple or quad occupancy. To receive the special conference rate,please be sure to indicate that you are associated with the “6th An-nual Rocky Mountain Geriatrics Conference. The cut-off date for thisroom block is August 13, 2008. Any reservations requested after thisdate will be accepted on a space and rate availability basis. Check-in timeis 3:00 p.m. Check-out time is noon. Hotel cancellation policy is 24hours prior to arrival date and cancellation number must be obtained byguest.
Americans with Disabilities Act Policy:
Thursday, September 4th0700 Registration and Continental Breakfast0800 Welcome - Rand Rupper, M.D., M.P.H.0800 “Intervening to Support Caregivers of Persons with Dementia” -
Richard Schulz, Ph.D.900 “Caregiving Considerations for Special Populations” -
David W. Coon, Ph.D.1000 Break1030 “Daily Interventions to Reduce Caregiver Stress” -
Elizabeth B. Fauth, Ph.D.1130 Panel Discussion and Questions for Morning Presentations1200 Lunch (Provided)1300 “Helping Caregivers Plan Respite” - Dale A. Lund, Ph.D.1400 “Supporting Caregivers of Cancer Patients” - Barbara Given,
Ph.D., RN, FAAN1500 Break1530 “Guardianship and Legal Issues That Arise for Caregivers” -
Margy Campbell, LCSW, CMC, CFP, MG1630-1700 Panel Discussion and Questions for Afternoon Presentations
Wednesday, September 3rd
1600-1800 Registration—Convention Center Hall1600-1800 Reception and Ice-breaker
Friday, September 5th0700 Continental Breakfast0800 “Caregiving in the United States: Economic and Health Implica-
tions” - Kenneth M. Langa, M.D., Ph.D.0900 “The Natural History of Becoming a Caregiver: Cache County
Aging Study” - Kathleen W. Piercy, Ph.D.1000 Break1030 “Using Technology to Reach Rural Caregivers” - Nancy K.
Dailey, MSN,RN-BC1130 Panel Discussion and Questions for Morning Presentations1200 Lunch (Provided)1300 “Effective Communication and Joint Problem Solving Between
Patients and Caregivers”- Cynthia Berg , Ph.D.1400 “Facilitating Effective Communication Between Providers and
Caregivers” - Katherine P. Supiano, MS, LCSW, F-GSA, CT1500 Break1530 “Assisting Primary Care Providers to Interact Effectively With
Caregivers” - Christopher M. Callahan, M.D.1630-1700 Panel Discussion and Questions for Afternoon Presentations
Saturday, September 6th0700 Continental Breakfast0800 Case Study & Implementation Workshop - Christopher M. Calla-
han, M.D.; Lucy A. Savitz, Ph.D., MBA; Charlene Weir, Ph.D., RN;University Faculty“Community Practices Can Contemplate and AccommodatePatients With Dementia”
0840 “Individual/Clinic Quality Improvement”0920 “Organizational Level Change”1010 Break1040 “Community Involvement”1130-1200 Questions, Evaluation/ Adjournment
