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ClosingSession2005

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Information about ClosingSession2005
Education

Published on January 7, 2008

Author: Tarzen

Source: authorstream.com

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The Katrina Disaster:  The Katrina Disaster Charles A. Cefalu MD, MS Professor and Chief, Section of Geriatric Medicine LSUHSC, NO, La. Facts About Hurricane Katrina/Rita:  Facts About Hurricane Katrina/Rita Worst natural disaster in US History New Orleans was second worst City for Crime New Orleans has little crime now. Baton Rouge doubled in size overnight from 400,000 to 800,000 population 180,000 homes declared a complete loss It is projected that about 25% of the population will eventually return-currently estimated at 250,000. Political experts predict that New Orleans will cease to be a stronghold for the Democrats Facts!:  Facts! 400,000-450,000 workers from La. currently living in Texas, half plan on moving back to La. 80,000 homes in NO a total loss and will not be rebuilt 1/3 of Oil and Seafood nationwide come from NO Metro area Juggling Personal and Professional Issues After Katrina:  Juggling Personal and Professional Issues After Katrina Personal-major damage to personal dwelling Marital Stress-losses of Home and possessions Spouse personal stress of care giving for aging in-laws and dealing with their losses and stresses Stabilizing the Academic Program ACGME Issues for LSU and the Program MCL/LSUHSC Geriatric Patient Population:  MCL/LSUHSC Geriatric Patient Population Principally minority Principally low income Principally low socioeconomic status This population mostly displaced to areas outside of Louisiana during the evacuation process MCL “Charity” and “University” Hospital primarily served the indigent minority socioeconomically disadvantaged Metro NO population-25,000 inpatient admissions, 400,000 outpatient visits, and 140,000 emergency visits per year Shocking Statistics About How The Elderly Faired after Katrina:  Shocking Statistics About How The Elderly Faired after Katrina 75% of those who died were over the age of 75. A majority could not be definitely identified At last count, approximately 1050 dead 40 nursing home patients in St. Bernard Parish abandoned by staff 40 inpatients at NO area Acute Care Hospital abandoned Comprehensive Geriatric Assessment:  Comprehensive Geriatric Assessment March 2004 Medical Center of Louisiana New Orleans, LA Contact with MCL Patients after Katrina:  Contact with MCL Patients after Katrina One patient from Georgia called the mobile-referred to Grady Hospital One patient from Houston-referred to Carmel Dyer MD One patient in Baton Rouge-referred to Earl K. Long Hospital (70 miles from NO) for medical care One patient referred to Kenner Regional Medical Center to the LSU FP Program there Other calls involved prescription referrals and advice on where to go. Mental Disorders in the NO Metro area as a result of Katrina:  Mental Disorders in the NO Metro area as a result of Katrina Depression-a risk factor for earlier onset of Alzheimer’s disease Anxiety states PTSD-Post Traumatic Stress Disorder Psychosis Support Services provided to Caregivers of Seniors After Katrina:  Support Services provided to Caregivers of Seniors After Katrina University of Monroe Gerontology Department-Jim Bulot MD-Internet Communication Alzheimer’s Association of La-Christy Fredric-coordinated Alzheimer's Support Services for Caregivers with the assistance of the La. Geriatrics Society and the Governor’s Office of Elderly Affairs-Seminars provided at key areas around the state Infection Control Issues for Evacuees Returning to NO after Katrina:  Infection Control Issues for Evacuees Returning to NO after Katrina Diptheria Tetanus Hepatitis A and B S:  S Silent Heroes:  Silent Heroes Carmel Dyer MD-Houston Geriatric Program-provided volunteer emergency triage and intermediate support for evacuees arriving from NO in Houston James Pacala MD-Geriatrics, the Mayo Clinic, provided volunteer emergency assistance to evacuees in the NO Metro Area and particularly outlying areas (Pecan Island) Many other Volunteer Medical Groups from all over the US The Physician/Patient Mismatch After Katrina:  The Physician/Patient Mismatch After Katrina 5,000 displaced physicians from NO Metro area Volunteer medical groups providing medical care Early on not enough patients to treat in N O Metro area suburbs Many physicians and other healthcare workers moved to other parts of state or nearby states to begin a practice Status of Nursing Home Evacuations in NO Metro area:  Status of Nursing Home Evacuations in NO Metro area Not known at this time and data being accumulated on what went wrong and what went right The Nursing Home Evacuation Plan :  The Nursing Home Evacuation Plan La. Nursing Home Assn had recently formulated an evacuation plan for its 300 plus members Roughly 120 homes affected by Katrina in NO Metro area LSU TV Broadcast to the NO Metro area to discuss the plan occurred several weeks before Katrina. Future Research:  Future Research Working with the La. Health Care Review (La. organization that works with Medicare relative to acute and long-term care issues) to determine nursing home evacuations and specifics Formal request made to work with AMDA on a grant application to do the same Fertile ground for gerontological research in the NO Metro area on the physical, emotional and mental effects of Katrina on the elderly population NO Hospitals That Closed after Katrina as a result of major damage:  NO Hospitals That Closed after Katrina as a result of major damage Baptist Hospital-Tenet Mercy Hospital-Tenet Charity and University Hospital Touro Hospital-reopened after one month Tulane Hospital Methodist Hospital Kenner Regional Hospital East Jefferson Hospital ? Communications a Major Problem for affected persons :  Communications a Major Problem for affected persons Cell phones in the NO Metro area with 504 area code was a major problem due to damaged and wet cell towers Cell phones with other area codes often busy with poor reception due to overload of calls All radio stations broadcasted from Associated Broadcasters-WWL Radio to national audience for 10 weeks after Katrina Lack of mail service and Fedex early on Depending on specific area Temporary Post :  Temporary Post Dealing With Professional Issues During First Month After Katrina-:  Dealing With Professional Issues During First Month After Katrina- Problem-moving the Clinical and Training Geriatric Program from “Charity” Hospital to another teaching Hospital LSU/MCL Geriatric Clinical and Training Program the only state supported or community program in the state and small and very new-two trainees began fter July 1. Tulane/VA Geriatric Program currently in disarray at last report Advised by LSU Health care Division of Hospitals to seek out another public state teaching hospital to prevent loss of funding. -Salvaging a Geriatric Academic Program:  -Salvaging a Geriatric Academic Program All LSU employees granted special emergency leave to take care of personal issues LSU Geriatric Clinical and Training Program- Trainees provided with concentrated nursing home experience in Kenner, La. during first month after Katrina Negotiations with private practice geriatricians in Baton Rouge proved unsuccessful during the first month after Katrina Salvaging a Geriatric Academic Program:  Salvaging a Geriatric Academic Program Negotiations with private practice geriatrician in Shreveport proved unsuccessful Negotiations with private Hospital on Northshore (located 25 miles from NO in home town) proved unsuccessful Discussions with LSU Healthcare Division of Hospitals and Medical Director of UMC (Lafayette Charity Hospital) allowed transfer of services 120 miles to the west-also affected by Rita Funding Issues for LSU Geriatric Clinical and Training Program:  Funding Issues for LSU Geriatric Clinical and Training Program $20,000 from the American Geriatrics Society-provided housing assistance for faculty and fellows A match of $20,000 from the John A. Hartford Foundation-provided housing assistance for faculty and fellows Applied to Disabilityfunders.org-rejected Funding Issues:  Funding Issues Application submitted to AARP Foundation Application forthcoming from Grant makers in Aging-New Program Announcement in process and waiting for announcement-would provide intermediate and long-term support of the Program over ten next 3-5 years assuming state Budget cuts that is a definite possibility due to a $900,000 state budget deficit Silent Heroes:  Silent Heroes The American Geriatrics Society-emergency funding The John A. Hartford Foundation-emergency funding Associate Fellowship Director-Lainie Moncada MD, who provided assistance in stabilization of the Geriatric Medicine Program-a ”trial by fire” apprenticeship Glen Mire MD-Residency Director at Lafayette Charity Hospital where the Program was transferred and accepted responsibility for the Program A supporting LSU and LSU Healthcare Division administration Accreditation Issues-LSU Geriatric Program:  Accreditation Issues-LSU Geriatric Program All Programs had to submit new agreements to ACGME by November 14 indicating new affiliation agreements with hospitals or other institutions for training residents and fellows (geriatric psychiatry, physical medicine and rehabilitation, nursing home, hospice, palliative care, major teaching hospital, etc) Future of the LSU Geriatric Clinical and Training Program-Options for the Future:  Future of the LSU Geriatric Clinical and Training Program-Options for the Future Permanent status in Lafayette at UMC (Lafayette Charity Hospital) Temporary status until New University Hospital is built or alternate Hospital options become available with time frame of 3-5 years as an estimate Develop new Clinical and Training Program in NO starting immediately Accreditation Issues-LSU Geriatric Program:  Accreditation Issues-LSU Geriatric Program All Programs had to submit in writing clinical rotations and experiences and written agreements with various new training sites by November 14 Site visit for all Clinical Programs occurred on November 21 in Baton Rouge (current site for first and second year medical students) with each program represented by: Program Director Faculty member Resident or fellow representative Making the Most of a “Once in a Lifetime Event”:  Making the Most of a “Once in a Lifetime Event” Doing for yourself rather than waiting for the Parish, state or federal government to come to your rescue Staying busy to avoid dwelling on the negative Keeping It Positive:  Keeping It Positive Finding any little positive news to lift peoples hopes Finding the 90 plus year old patient 5 days after Katrina in an attic of a house who was alive and had not had food or water since Katrina A Little Humor Goes A Long Way:  A Little Humor Goes A Long Way A House gutted in a Slidell (Northshore) with a sign out in front with debris stacked neatly from one end of the property to the other----------- The ”Yard of the Month” A Little Humor:  A Little Humor Hurricane Evacuation Instructions for Houston Texas- Hispanics take I-10 to San Antonio Cajuns take I-10 East to Lafayette Rednecks take Hwy 59 North to East Texas Yankees take I-45 South to Galveston Longhorns take Hwy 290 West to Austin Aggie take 610 Loop A Lost Culture?:  A Lost Culture? Not likely Central Louisiana-the heart of Boudin and Cracklins Southwest La-the heart of Crawfish farming Lake Ponchatrain-the best fishing in the last 15 years, just not enough boats in the water yet to harvest The “French Quarter” remained dry and was the first part of NO that was operational Six day Mardi Gras planned for 2006!

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