Geriatrics

Montefiore Einstein geriatricians begin with a complete patient evaluation, including physical health and ambulation, memory, medication usage and nutrition. The assessment and recommended plan are discussed with the patient, caregivers and the patient’s primary care provider. A Montefiore Einstein geriatrician coordinates care, which may include:

• Recommendations for management of medical problems and age-related conditions
• Medical evaluation and treatment of Alzheimer’s disease, other dementias and depression
• Social work consultations for supportive counseling and coordination of community services and entitlements
• Coordination of home care and rehabilitation services
• Evaluation for nursing home placement

Our preoperative medical assessments for older adults who are undergoing orthopedic surgery are comprehensive evaluations that go beyond traditional medical screening to assess functional reserve and identify age-related risk factors that may affect surgical outcomes.

When surgery is recommended as part of your care plan, we’ll also coordinate scheduling with our world-renowned surgeons at one of the many locations within our health system.

Our multidisciplinary team, including geriatricians, nurse practitioners, social workers and geropsychiatrists, specializes in the medical and psychosocial evaluation and ongoing care of older adults with dementia. Our physicians consider the patient’s family life when evaluating and determining a care plan for memory loss, depression, Alzheimer’s disease and other dementias.

Physicians address common issues that families face, including:

• How do we get help?
• How do we manage our loved one’s behavior?
• How should we handle decision-making, including medical, financial and legal decisions?
• What should we do when a patient starts wandering at night?
• Should we consider new drugs and clinical trials?

Information about support programs is provided to assist patients and their families. We’ll coordinate any additional care or specialized services you may need, bringing together experts from across our health system to ensure your care is fully integrated and comprehensive.

It can be difficult for patients with chronic conditions to think about the type of healthcare they’d like to receive in the event they can’t make their own decisions. We’re here to help develop an advance directive that clearly states their wishes and preferences. The directive can include a living will that details any medical interventions and life-sustaining treatments (such as cardiopulmonary resuscitation—CPR, mechanical ventilation, feeding tubes, intravenous—IV fluids or antibiotics) the patient wants or does not want under specific circumstances. It also clarifies preferences for pain management and organ donation. In addition, the directive can include a durable power of attorney for healthcare that designates a trusted person to make healthcare decisions on the patient's behalf if the patient is unable to communicate.

The Guiding an Improved Dementia Experience (GUIDE) Model is a voluntary, nationwide Medicare alternative payment model specifically designed to deliver comprehensive, coordinated care for Medicare beneficiaries with dementia and support their unpaid caregivers. Patients receive 24/7 access to a care team that includes a dementia-proficient clinician and trained care navigator who provide continuous, proactive support beyond brief office visits.

To see if you are eligible for the GUIDE program, please call: 855-662-4843 (855-MMC-GUID) or email: GUIDE@montefiore.org.