Monday, February 20, 2012

Forging the Future of Geriatrics and Palliative Care


This month the Journal of the American Geriatrics Society is e-publishing ahead of print a special article you should read, “Report of the Geriatrics – Hospice and Palliative Medicine Work Group: American Geriatrics Society and American Academy of Hospice and Palliative Medicine Leadership Collaboration.”

In 2009, the leadership of the American Academy of Hospice and Palliative Medicine (AAHPM), the American Geriatrics Society (AGS), and the John A. Hartford Foundation brought together leaders in geriatrics and hospice and palliative medicine to identify areas of synergy between the two subspecialties and to work together in areas of common interest. While regular readers of GeriPal should have no problem articulating the overlap between the two specialties, the article nicely summarizes similarities and differences and includes a nice figure adapted from Sean Morrison which will be a great visual resource for presentations (see Figure 1 in the article.)

Focus groups were held in 2009 at the Annual meetings of the AAHPM and AGS and the work group then summarized the key areas of focus in areas of workforce, research, education, policy, and communication to members. Then, at a retreat the leadership of the organizations came to consensus on the following initiatives and recommendations:

Workforce

(1) Continued dialogue between the leadership of both subspecialties on ways to train mid-career providers since fellowship training will not meet workforce needs
(2) Better understanding of the current workforce issues in hospice and palliative medicine and geriatrics through incorporation of questions into the AGS annual workforce study and the proposed academic hospice and palliative medicine survey and communication of these findings to both organizations
(3) Identification of areas of resistance to collaboration between both subspecialties
(4) Delineation of unique and overlapping competencies for both subspecialties
(5) Support by both organizations for Geriatric Academic Career Awards and Palliative Academic Career Awards

Research

(1) Joint advocacy for research in advanced illness / multimorbidity / symptom burden and symptom management in older adults
(2) Increased communication to relevant stakeholders regarding the vacuum in geriatrics / hospice and palliative medicine research
(3) Initiation of a joint strategic initiative to increase funding in these areas through NIH State of the Art conferences, potential Institute of Medicine conferences for targeted topics, and interaction by the workgroup together with other AGS/AAHPM leaders and key research and policy stakeholders

Education

(1) An exhibit booth exchange during both Annual Meetings allowing each organization to have a presence at the other’s national conference
(2) Development of a pre-conference session at both the AGS and AAHPM conferences
(3) Discount offerings of educational materials to memberships (AGS has provided Geriatrics at Your Fingertips to AAHPM members at the AGS member price, and AAHPM has provided the Primer for Palliative Care to AGS members at the AAHPM member price)

Policy

(1) Confer (and hopefully concur!) on matters of mutual clinical and policy import
(2) Share policy and advocacy initiatives regularly to highlight areas of mutual interest and emphasis
(3) Share “talking points” related to (2)
(4) Prepare statements and political approaches to “hot button” issues, including but not limited to rationing, healthcare reform, end-of-life care, Medicare cost-cutting initiatives
(5) Share mechanisms of mobilizing membership to accomplish shared goals of the AAHPM and AGS

Communication to Memberships

(1) Ongoing communication between both organizations’ members and leaders regarding collaboration of the two organizations
(2) Regular updates in the AGS and AAHPM newsletters
(3) Development of a joint position statement and issue brief addressing the need for integration of geriatric and hospice and palliative medicine, the importance of funding the care provided, and the need for training programs that facilitate training at the intersection of the fields


The working group in a letter to the editors of the Journal of Pain and Symptom Management acknowledge that it would be helpful to include other disciplines such as nursing (and I would add the American Medical Directors Association (AMDA!)) but this is a great first step. Be sure to thank both organizations for their work on this, and offer to help out.

And be sure to mark your calendars:

  • The Geriatrics SIG at AAHPM’s meeting is scheduled to meet Thursday March 8, 2012 from 5:30 PM – 6:30 PM
  • The Long-Term Care SIG at AAHPM’s meeting is scheduled to meet Friday March 8, 2012 from 4:45 PM – 5:45 PM
  • The Palliative Care SIG session at AGS’s meeting is scheduled for Thursday May 03, 2012 at 7:30 AM - 9:00 AM


by: Paul Tatum (@doctatum)

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