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Martha Hays, left, works July 19 with nurse Sandy Miller

A nurse and patient work together during a balance evaluation at the Hays home in Columbus, Ohio, in 2017.

Participants in Madison’s Successful Aging Project — who hail from both the community and academia — made the case in a recent op/ed for the importance of geriatric team care for successful aging. Primary health care delivered by well-functioning teams leads to better access, patient outcomes, efficiency, and patient and provider satisfaction. Collaboration among providers will improve to care for seniors, which is currently in short supply due to a scarcity of geriatricians and other primary care physicians committed to senior care.

The Successful Aging Project is creating and demonstrating a model in Madison to improve collaboration and outcomes for geriatric patients.

Unfortunately, training of team members by their academic home currently is a challenge. Time needed to convey the required knowledge is difficult to come by in an already-overburdened curriculum, and there is minimal opportunity for trainees to pursue interprofessional education in the real-world clinical setting.

Interprofessional education is key to the success of team care and occurs when members of two or more professions learn about each other and each other’s areas of expertise, thereby enabling effective collaboration and improved health care outcomes.

The Madison community is fortunate to have the opportunity to use two unique clinical campuses to serve as the foundation for interprofessional education of geriatric team care health providers as part of the academic/community collaborative program of our developing Successful Aging Project. Both campuses, located in senior housing communities, offer unique opportunities to pursue interprofessional education and address current deficiencies in those efforts. 

Our developing campus at the Northport/Packer housing project in northeast Madison provides a unique opportunity for trainees to experience the social determinants of health. This project, which includes the neighboring developments of Northport and Packer, is home to approximately 750 residents who qualify for Section 8 housing. A significant number are seniors of diverse cultural origin with limited English proficiency. These two adjacent housing developments are affiliates of the American Baptists Homes of the Midwest and have been successfully managed for years, with all profits devoted to resident benefits. Both developments have well-developed community learning centers, with extensive computer resources and video production capabilities.

Social determinants of health are non-medical factors that can affect a person’s health outcomes. They are responsible for most health inequities. The United States, despite ranking among the 10 richest countries in the world per capita, experiences sizable health disparities that are rooted in social, economic, and environmental factors. Socioeconomic status is major social determinant of health. Neighborhoods with concentrated poverty are associated with a variety of conditions that often contribute to increased hospitalization and emergency department use by seniors, as well as to  an extensive need for expensive nursing home care.

It is important for trainees to encounter and be involved in addressing these problems in the cohort of Medicare residents at Northport/Packer and the surrounding neighborhood. A particularly important one is health literacy, which can be addressed effectively at Northport/Packer using the facilities' outstanding educational resources.

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Capitol Lakes is a comprehensive continuing care retirement community that provides independent and assisted living, nursing home, and memory care facilities. The integration of these facilities provides continuity of care as residents age. It is located adjacent to the Square in downtown Madison. It is a highly desirable destination for residents who have the financial resources to support apartment living with substantial associated benefits relating to food, exercise, education, and entertainment. Many of the 200 independent living residents have expressed interest in successful aging projects that provide benefits to residents as well as educational opportunities for trainees. Ongoing projects include medication review by pharmacy trainees, advance care planning with medical social work trainees, prevention initiatives, mental fitness including "aerobics of the mind," and respite care for residents with cognitive decline. Also, some trainees will participate with an Agrace hospice team providing home end-of-life care. These pilot projects also will be implemented on the Northport/Packer campus.

The schedule of clinical interaction for trainees does not allow time to attend lectures or scheduled discussion groups on these topics. This challenge can be addressed by virtual group-learning sessions via laptop computers. UW's School of Education software facilitates participation by up to 16 trainees at various times during the day based on the trainees' availability. These sessions will be available for viewing by all trainees.

The Madison Successful Aging Project has unique resources given the community campuses' ability to collaborate with the trainees' academic home, UW-Madison. This will allow an effective curriculum for interprofessional education in training geriatric team-care providers who will be in demand by the rapidly proliferating senior living communities throughout the U.S.

Richard Rieselbach, M.D., is professor emeritus of medicine, UW School of Medicine and Public Health in Madison. Tim Conroy is executive director of Capitol Lakes Retirement Community. Jay Noren, M.D., M.P.H., is associate dean, College of Medicine, University of Illinois-Chicago, where he is professor of medicine and public health. Rev. Carmen Porco, PhD, is the CEO of Housing Ministries of American Baptists in Wisconsin.

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