Geriatric Medicine

Our Mission: To Lead the Pursuit of Excellence in Geriatric Healthcare

Hackensack University Medical Center's Geriatric team led by Chief of Geriatrics Lisa Tank is committed to providing an exceptional geriatric patient experience through patient-centered care, education, research and community outreach.

 

Primary Care and Consultation Services for Older Individuals

The Geriatric Medicine Program has four physicians trained in geriatric medicine and an advanced practice nurse as well. It has been recognized as one of the nation’s leading geriatric programs by U S News and World Report every year that the rating has been in existence. The physicians provide both primary care and consultative services for older individuals at all levels of care.

 

The Acute Care for the Elderly Unit (The ACE Unit) and Multidisciplinary Rounds throughout Hackensack University Medical Center

Located on the fourth floor of the St. John Building, the Acute Care for the Elderly Unit is designed to address the special needs of elders when they require hospitalization.  Attention is directed to the new acute illness or, commonly, a flare-up of one of the individual’s chronic conditions when care within a hospital is required. Not only is the acute medical problem addressed but considerable effort is made to minimize the individual’s functional decline, so often seen during hospitalization. The ACE Unit is staffed by nurses with those skills so essential to assuring the best possible outcome of care. For example, to ensure patient satisfaction and the highest quality of care, all nurses on the unit carry portable telephones, allowing patients to contact them at any time. Additionally, a geriatrician  and a discharge planner participate in multidisciplinary rounds so as to maximize each individual’s function and quality of life both during the hospital stay and following discharge. At the time of discharge, patients and their families receive counseling directed to their post-hospital needs, such as dietary recommendations and the use of durable medical equipment, and are advised what to anticipate both immediately following discharge from the hospital and long into the future.

The physicians who are members of the Geriatric Service (Drs Lisa Tank, Manisha Parulekar, Arunima Sarkar) also lead multidisciplinary rounds on multiple other floors at Hackensack University Medical Center. The primary focus of these rounds is to ensure that each patient is provided with comprehensive care which addresses that individual’s unique needs both during the hospital stay and following discharge.

 

Consultation within the Hospital

Consultation by the Geriatric Service is available on all adult hospital units. Partnering with the hospitalists and the primary care provider, our physicians  offer comprehensive geriatric assessments initially and then follow these elders while they are in the hospital. If requested, they are able to provide ongoing care to almost all these patients after discharge, be it to their home or to a facility.

 

The Center for Healthy Senior Living

The Geriatrics Center for Healthy Senior Living is an ambulatory service that provides both a comprehensive assessment of an elder’s unique healthcare needs and a targeted program designed to address those specific needs. It offers both a primary care service and a consultative program, often coordinating the care provided by  multiple other specialists.

The emphasis is placed on diagnosing illnesses, both acute and chronic, and managing these conditions so as  to maximize the function and quality of life of that individual for the longest period of time. This undertaking is carried out with an appreciation of the physiologic changes associated with aging, which generally result in a decline in functional reserve capacity in most all organ systems.  By the time an individual reaches 65 years of age, likely that person  has one or more chronic diseases superimposed on the aging process. This makes each elder unique from a medical perspective and this requires a very individual care plan.

When the physicians at the Center provide ongoing comprehensive primary care they always take into consideration that individual’s physical functional capability and personal wishes. They also work with family members so as to coordinate care and support the caregivers when necessary. Educational materials about county and even national resources for in-home support are available as well.


 

Care in a skilled nursing facility, both long term and following an acute hospitalization.

The physicians who are members of the Geriatric Program visit patients who so often have multiple chronic illnesses requiring care in a skilled nursing facility. They evaluate each individual on a regular basis and coordinate the program of care with the other team members, addressing the very particular needs of each  resident. When the individual is in the nursing facility primarily to receive rehabilitation and sub-acute services the geriatrician makes frequent visits and is available to the staff of the facility so as to maximize the elder’s functional state as well. Presently, the physicians make regular visits at the following facilities: Maywood Center, Care One at Wellington, Care One at Oradell, Care One Pinerest and the Cupola and Sunrise Assisted Living of Paramus.

 

Care in an Assisted Living Facility

Residents of these facilities require continuity of care so as to address both chronic medical conditions and newly arising medical problems as well as to assure the maintenance of function to the maximal extent possible. To achieve these objectives, medication management and individually designed programs in physical therapy and recreation are so often required. 

 

The Heart Failure Program

In collaboration with Drs Robert Berkowitz and Louis Teichholz, Dr. Tank conducts Heart Failure Rounds at a number of sub-acute facilities. Working with the nurses at these locations, she directs her attention most especially  to maximizing the individual’s sense of well-being and preventing unnecessary re-admissions to the hospital. Because of its success, the program presently is being expanded to include a larger number of facilities and other physicians who are members of the Geriatric Program.

 

Geriatrics Oncology

The  Geriatric Oncology Program provides for the integration of  the expertise of medical oncologists, oncologic surgeons and geriatricians as well as other specialists so as to maximize the function and quality of life of patients 75 years of age and older. This Program offers cancer care designed to address the very individual medical and social needs of the person under care. For example, it highlights potential drug-drug interactions and optimizes the person’s nutritional state and rehabilitative capability. It also attempts to address the socioeconomic and family needs that likely are unique to the person under care. All new patients receive an extensive assessment using a comprehensive geriatric assessment tool. The treatment plan is then reviewed by the geriatric oncology team of physicians, nurses, social workers, dietitians, occupational and physical therapists, and pharmacists.

 

The Hospital Elder Life Program (The HELP Program)

The Hospital Elder Life Program is a service provided by Hackensack University Medical Center to improve the hospital experience of older patients. Designed by Dr Sharon Inouye at Harvard University this program is directed to preventing the onset of delirium, so very common in elders, and maximizing the elder’s function, both within the hospital and following discharge.  A team approach is used making use of an elder life Specialist, elder life nurse, a geriatrician, and a large number of carefully trained volunteers.  One or more members of this team make daily visits designed to keep the individual fully oriented. They provide assistance, when necessary, with feeding as well as companionship. In addition the staff offers range of motion exercises. Its supervisory staff has received a number of awards for their outstanding efforts. This program was recognized nationally when Hackensack University Medical Center received the Joint Commission’s Gold Seal of Approval and the first Certification for Geriatrics Delirium in the entire country.  

If you would like to become a volunteer please contact:
Nadine R. Benoit, the HELP Elder Life Specialist at 201-996-2542 or nbenoit@Hackensackumc.org.

 

Academic Programs: The Geriatrics Fellowship and Residency and Student Rotations

The Geriatric Fellowship Program at Rutgers-New Jersey Medical School at Hackensack University Medical Center allows physicians who have completed a residency in internal medicine to become more knowledgeable about geriatric medicine and to be eligible to take the Geriatric Medicine examination under the auspices of the American Board of Internal Medicine. These individuals care for patients at multiple sites of care, including one or more acute care, long term care, assisted living, and ambulatory settings.  In addition, each fellow carries out a research project. This is the only fellowship program which is completely under the administration of Hackensack University Medical Center. This fellowship program, which was established in 1996, has trained over 34  fellows who have become Board-certified geriatricians.

In addition, all students from St George’s Medical School and many students from Rutgers rotate on the service. In addition all the medical residents from UMDNJ do so as well.

The geriatric faculty and the fellows have been involved in a number of research projects which were presented as posters at the Annual Scientific Meeting of the American Geriatrics Society. The division also participated in the Josiah Macy Jr. and the ABIM Foundation study, ‘Improving Quality of Care of Elderly Patients in the Educational Setting.’

For further information about the fellowship or indeed any other issue, please contact the Chief of Geriatrics and Program Director, Lisa Tank, M.D. at 551-996-1140, or by email at ltank@HackensackUMC.org. Applications for fellowship may be made through ERAS.

 

  

Please call 551-996-1140

for more information or to book an appointment  

 


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