26Th Annual Maine Geriatrics Conference Schedule June 2-3, 2016

26th Annual Maine Geriatrics Conference Schedule June 2-3, 2016

Revised: 1-10-16

Thursday June 2

8:00-8:15 am:Greetings and Introductions

Marilyn R. Gugliucci, PhD, Chair, Conference Planning Committee & MGS Co-Chairs

8:15-9:30 am:Life Gets Better: The Unexpected Pleasures of Growing Older

Wendy Lustbader, MSW

Nationally acclaimed speaker and author Wendy Lustbader will engage us in exploring what it means to flourish in later life. Drawing on her decades of experience as a social worker with people of all ages, Ms. Lustbader makes the case that as we get older we gain self-knowledge, confidence, and an increasing capacity to be true to ourselves. She debunks the myth that youth is the best time of life, instead showing how hard-earned lessons make our later years the most fruitful. Younger people will draw hope from her message, and those with length of days will feel affirmed and inspired. The lively presentation will be full of stories and audience dialogue, designed to awaken the heart and mind.

9:30-10:00 am:Break

10:00-11:00 am:Older Adults & Veterans: Traumatic Brain Injury and

Neurocognitive Disorders

William Bograkos, MA, DO, FACOEP, FACOFP

The DSM 5 updates will be reviewed and discussed in relation to neurocognitive disorders and the neurocognitive domains. Dr. Bograkos will utilize past experience in caring for the veteran population and older adults in this presentation that supports our current “Joining Forces” initiative. It will include discussion of veterans from WW II to current conflicts and provide information on substance induced neurocognitive disorders which is often associated with PTSD and other trauma stress reactions.

11:00-12:00 pm:Integrating Care for Medicare-Medicaid Beneficiaries: An Overview of the Duals Demonstrations

Elizabeth Gattine, JD

This presentation focuses on the unique characteristics of Medicare-Medicaid beneficiaries, often referred to as “dual eligible” beneficiaries. It provides an overview of this population in Maine and nationally, and describes approaches taken by states to better align Medicare and Medicaid and integrate the full range of medical, behavior health, and LTSS for Medicare-Medicaid beneficiaries, including the Financial Alignment demonstrations currently underway in several states. The Muskie School is part of the national evaluation team led by RTI for those demonstrations and has conducted data analysis for Maine’s Department of Health and Human Services on the service use of Maine’s duals.

12:00-1:15 pm:Lunch

1:15-2:30 pm:Workshops Session A

A1. Fireside Chat

Wendy Lustbader, MSW

Join Ms. Lustbader in a conversation with a relaxed yet exhilarating format. Session attendees have the opportunity to ask questions and dive deeper into topics related (or not) to Wendy’s morning session.

A2. Medication Review: Ways to Help the Older Adults you Work With

(Repeat Session B.1)

Nicolette R. Centanni, Pharm. D., BCPS, CGP& Lisa A. Wendler,

Pharm.D., BCPS

As individuals age, bodies undergo changes that alter the effect of certain drugs. These changes may alter how we metabolize these drugs; increasing sensitivity or toxicity especially to anticholinergic medications and psychotropics.With the many potentially dangerous medications that could be administered to older adults, it helps to have a few tools to assess their appropriateness. The American Geriatric Society published an updated 2015 BEERs criteria list that outlines potentially inappropriate medication use for older adults. Other more patient-friendly tools include the Anticholinergic Brochure, designed by Iowa CERT with the patient in mind; and Steadi (Stopping Elderly Accidents, Deaths & Injuries toolkit designed by the CDC's Injury Center for health care providers. This session will promise to enlighten and engage the audience on safe medication use for older adults.

A3.Keep Them Rocking at Home

Becky Hayes Boober, PhD: Moderator; w/ Dyan Walsh, MSW, Diana M.

Nadeau, Meg Callaway, MA, Anne Schroth

As the state with the oldest median age, Maine has a unique opportunity to create new options for keeping older Mainers and others with chronic health conditions at home instead of in institutions or hospitals. Thriving in Place communities are designing creative connections among health care providers, social services organizations, community and home-based services and community members to prevent unnecessary institutional-ization. Engage withrepresentatives from five of these innovative Thriving in Place (TiP) initiatives and hear what they’ve learned. These projects are in the communities of: Aroostook County; Greater Bangor Area; Blue Hill Peninsula; Bucksport Area; & Piscataquis County.

A4.The Spirituality of Aging

(Repeat Session B.2)

Marguerite Stapleton, MS

Every life stage has its own age-appropriate learnings, challenges and questions. These can be categorized as physical, emotional, intellectual and/or spiritual. In the last few decades gerontologists have become increasingly aware of the importance of spirituality to the well-being of seniors. Seniors themselves reveal that with more time to focus on being rather than doing, the issues of spirituality often take center stage. This session will explore the spiritual tasks of the elder, first by establishing some distinctions between religion and spirituality and then by examining various definitions of spirituality.Through reflective conversation, participants will investigate the twelve key spiritual tasks that seniors are invited to address at this final life stage.

2:30-3:00 pm:Break

3:00-4:15 pm:Workshops Session B

B1.Medication Review: Ways to help the Older Adults you Work With

(Repeat of Session A.2)

Nicolette R. Centanni, Pharm. D., BCPS, CGP& Lisa A. Wendler,

Pharm.D., BCPS

B2.The Spirituality of Aging

(Repeat of Session A.4)

Marguerite Stapleton, MS

B3.Being Mortal: Aging and Dying within the US Health Care System Fireside Chat on Atul Gawande’s Book

Marilyn R. Gugliucci, PhD & Lenard W. Kaye, DSW, PhD

This session is designed to encourage discussion regarding palliative and end of life care for older adults. A framework will be provided from Atul Gawande’s book, Being Mortal and a Hospice Home Immersion Project for Medical Students conducted at the Gosnell Memorial Hospice Home, Scarborough. Dr. Gawande’s ultimate goal of “a good life – all the way to the very end” will be juxtaposed to the goal of a good death. Grappling with this topic will promise to be thought provoking and (hopefully) enlightening!

B4.MCOA Policy Track – Aging Policy Year in Review

Meg Callaway, MA & Jessica Maurer, JD

The Maine Council on Aging is leading a broad coalition of organizations working to address the immediate needs of older adults in Maine. It is working on an initiative to re-imagine aging in a way that values all that older adults have to offer and support them across the continuum of needsas they age at home and in community. This workshop will explore the most pressing public policy issues that impact older adults and will offer clear approaches as to how these issues are being addressed at the federal, state and local level through various initiatives, task forces and legislative actions.

Friday June 3

8:00-8:15 am:Greetings and Introductions

Marilyn R. Gugliucci, PhD, Chair, Conference Planning Committee & MGSCo-Chairs

8:15-9:15 am:Serving At-Risk Older Adults with Compassion not Control

Susan Wehry, MD

Few late life issues are more troubling than the fear of loss of self-determination. The story usually goes something like this: “Despite increasing frailty, Eleanor has made it clear she doesn't want to leave her long-time home. When neighbors tell her children that Eleanor is increasingly forgetful and wandering at night, Sheila and her siblings begin to ask "Is mom safe?" "What should we do?” Professionals often suggest families ‘place' a parent in a facility, which can have serious unintended negative consequences. This presentation aims to aid professionals in how to strike a better balance between compassion and control.

9:15-10:00 am:Depression in Community Dwelling Older Adults: A Broad Brush

Stroke

Emily A.P. Haigh, Ph.D.

Depression is the most common mental health problem among older adults and significantly decreases quality of life. Late-life depression is often complicated by the presence of multiple comorbid conditions and increasing disability. Despite the availability of evidence-based treatments for depression, older adults are often underdiagnosed and/or receive inadequate care. Key points regarding the prevalence, course, and treatment of depression in older adults will be discussed. You will be provided with an overview of the challenges and opportunities associated with identifying and providing care for community dwelling older adults with depression.

10:00-10:30 amBreak

10:30-11:45 amWorkshops Session C

C1.Design Charrette: If you Build it…They will Come

Connie Jones, MSEvan Carroll, AIA, MLA, LEED AP BD&C

Your participation in this interactive and unique workshop will help determine what programs and interior building design to accommodate these programs are best suited for an anonymous older adult community center. Building structure and measurements will be provided. A design charrette is an intensive planning session where citizens, providers, service workers, designers and others collaborate on a vision for development. It provides a forum for ideas and offers the unique advantage of allowing everyone who participates to be a mutual author of the plan. Your experiences and creativity will contributeto the teamwork needed in designing a new community center for older adults that is a real possibility.

C2.Acute Care and the Person with Dementia: Chaos or Calm

(Session Repeated~D.1)

Jane Marks, CDP

Hospital care can be a time of chaos for a person with Alzheimer’s or a related dementia as well as for the caregiver and hospital staff. Dealing with an acute illness can be overwhelming and the risk of delirium and even death are increased. Hospitals provide acute care to individuals who are cognitively intact yet literature states that 45% of hospitalized elders may have cognitive impairment that is often not noted nor considered during treatment. These patients are at even higher risk of poor outcomes. This workshop will discuss the particular complications having a dementia exacerbates in an acute care setting as well as highlight innovative programs in hospitals in the United States and Europe including an idea presented at the Alzheimer’s Association International Conference in Copenhagen Denmark, 2014.

C3.Chaplaincy Training and Spirituality: Implications for Nursing Practices

Frank Macht, M.Div./MA, Laurie Harding, MS/RN, Janice Cundy, Terry Fuller, RN EllenThompson, MS, RN w/ Dennis McCullough, MD, Coordinator

Over the past 2 years The Upper Valley Community Nursing Project ( has developed a mutually supportive relationship with the Clinical Pastoral Education Program of the Dartmouth-Hitchcock Chaplaincy Department. This connection has enabled community and parish nurses to further explore the spiritual dimensions of the care they provide. The UVCNP has focused on using the parish nursing model of “holistic, but not hands-on” care to meet needs of predominately frail elders in our communities who fall into the gaps of care in our fragmented systems. This workshop will focus on case discussions and practical approaches to integrating spirituality into community nursing and other nursing contexts.

C4.Transportation Challenges & Opportunities

Connie Garber, MA, Marcia Larkin, Barbara Donovan, BS & Linda Belfiore

A panel of transportation experts will share information about a variety of transportation options currently available in Maine and New England, including some new and emerging opportunities. The panel members will review challenges and opportunities they see in the area of senior transportation, for both rural and urban seniors. A general discussion with workshop attendees will allow for additional information sharing and the identification of partnerships and future collaborations to address this critical area of need.

11:45-1:00 pm:Lunch

1:00-2:15 pmWorkshops Session D

D1.Acute Care and the Person with Dementia: Chaos or Calm

(Repeat ofSession C.2)

Jane Marks, CDP

D2.Responding to Depression in Community Dwelling Older Adult: Towards Evidence-based Identification and Treatment

Emily A.P. Haigh, Ph.D

Depression is the most common cause of emotional suffering in late life and is associated with total health care costs approximately 50% higher than nondepressed older adults (Katon et al., 2003). Caring for community-dwelling older adults with depression is challenging and generally complicated by comorbid chronic conditions. This workshop will provide an opportunity learn about the complexities associated with the identification of depression among older adults and opportunities for effective treatment. Attendees will learn about evidence-based psychological interventions, with an emphasis on behavioral activation, as well as the promising application of mindfulness-based approaches for older adults with depression.

D3.Assessing Decision-Making Capacity in Older Adults

Susan Wehry, MD

The convergence of our aging society, the growing population of older adults with cognitive impairment, the increase in blended families, and an enormous intergenerationaltransfer of wealth has magnified the importance of adequately assessing the capacity of older adults to make medical, financial and everyday decisions about their functional problems. Participants in this workshop will hear and learn how to apply the latest research and tools to improve capacity assessments.

D4.MCOA Policy Track - Hot Topics in Insurance & Benefits – Helping Seniors Navigate Through the Confusion

Ann Smith, BA, MS & Jess Maurer, JD

With nearly constant changes to health insurance and benefits programs at the federal and state level, it’s hard for older adults to keep up. This panel presentation will discuss current challenges for older adults who are transitioning from a Marketplace plan to Medicare and the tax and financial implications for those who get it wrong. It will also address federal and state changes to current entitlement programs like social security, Medicare, MaineCare and the Medicare Savings Program.

2:15-2:30 pm:Break

2:30-3:20 pm:Attendee Forum: What’s the Point of Aging: Word of God or

Crowd Control?

Marilyn R. Gugliucci, PhD, Moderator

This Attendee Forum guarantees to get your blood pumping! Those in attendance will address this important question, which can be viewed through a multitude of frameworks including historical, philosophical, sociological, theoretical, and medical perspectives.Actually, personal experiences and insights may be the best approach to grabbling with “What is the Point of Aging?”

3:20-3:30 pmWrap-up & Attendee Shout Out on Conference Rants and Raves