Integration Foundation

• Upon completion of this problem, students should be able to describe the impact of dementia on older adults and their caregivers, and how integrated, interdisciplinary community care is essential to meet their care needs.
• Describe the functional, behavioural, and psychosocial impacts of dementia upon older adults who are living with this diagnosis, as well as their caregivers.
• Explain the approach to cognitive impairment, including differential diagnosis, and bedside tests of cognition.
• Review the diagnostic criteria for Alzheimer’s disease.
• Describe the clinical course of dementia, the important safety considerations at each stage, and which professionals and resources are available in the community to provide care under these circumstances.
• Review the legal entities of substitute decision makers and power of attorney.
• Explore the significance and frequency of caregiver fatigue, and strategies employed to address it.
• Describe the legal obligations of physicians to report concerns regarding driving safety, with a focus on the importance of cognition.
• Recognize the importance of integrated primary care in the care of our aging population, and the different settings (including home and LTC) in which this care is provided.
• Upon completion of this problem, students should be able to describe the physiological, psychosocial, and functional impacts of the aging process, framed within the context of the periodic health examination for older adults. They should be able to explain the role of the interdisciplinary, community-based primary care team in maintaining the function and wellness of older adults. They will explore the concept of “successful aging”.
• Develop an approach to the periodic health examination in older adults, including the scheduling and interpretation of recommended screening tests and vaccinations.
• Identify the common physiologic changes which accompany the aging process, and how these changes may be associated with geriatric syndromes such as mild cognitive impairment, gait/balance disturbance, falls/fracture, urinary incontinence, mood disturbance, and polypharmacy.
• Describe protective factors and coping strategies which enable older adults to thrive despite complexity and multi-morbidity.
• Explain how the concept of frailty impacts decision-making, goals of care, and care recommendations in older adults.
• Explore how to prioritize issues within the context of complexity and multi-morbidity, while considering the goals and priorities of each patient, or “what matters most”.
• Develop an approach to assessment and prevention of falls in older adults in the community, and in LTC.
• Describe how interdisciplinary community-based programs and resources support the health, function, and wellness of older adults.
• Explore the various living environments in which older adults reside including home, assisted living, residential home, long term care.
• Recognize that the majority of older adults in Canada are living well and independently in their communities and continue to contribute in multiple ways to society.
• Upon completion of this problem, students will be able to demonstrate the integration of cardiac, respiratory, hematology and renal core concepts in critical management of a patient with complex sepsis.
• Describe the management of a patient presenting with acute cardiac and respiratory pathology.
• Review the assessment and management of cardiac murmurs and associated pathology.
• Review interpretation of electrocardiograms, with a focus on tachyarrhythmias (atrial fibrillation (SVT)).
• Review interpretation of chest radiographs in identifying cardiac and respiratory diagnosis.
• Review interpretation of abnormal laboratory values such as thrombocytopenia and disseminated intravascular coagulation.
• Discuss possible differential diagnosis for a patient presenting with respiratory and cardiac pathology with septic shock.
• Evaluate risk factors for Methicillin Resistant Staphylococcus Aureus infections and associated complications.
• Upon completion of this problem, students will be able to demonstrate the integration of cardiac, respiratory, hematology and renal core concepts in critical management of a patient with complex sepsis including ethical issues with social issues and chronic drug use.
• Review pathophysiology in the development of septic emboli in the lung.
• Review management of a patient with Methicillin-resistant Staphylococcus aureus including risk factors for other pathology and antibiotic stewardship.
• Evaluate indications for valve replacement in cardiac surgery.
• Review management of acute renal failure and indications for dialysis.
• Review indications for methadone use - (NG tube for administration).
• Discuss the ethical considerations of repeat heart valve surgery in a PWID who is actively using drugs.
• Discuss a team based approach to management of opioid withdrawal and associated stigma.