Interdisciplinary Care: Together We Can Do Something Wonderful

The care of older adults in PALTC settings is complicated and requires us to address the co-occurring physical, behavioral, social, functional challenges our patients. Twenty years ago, Institute Medicine recommended that team-based was needed minimize fragmentation health delivery improve quality patient (Crossing Quality Chiasm: A New Health System for 21st Century, 2001). Additionally, since 1990s, federal regulations nursing homes require an interdisciplinary approach development implementation planning process. Despite these recommendations mandates, there still room grow when it comes PALTC. It easy say we provide care, but what do really mean? I asked members editorial advisory board Caring Ages a past president AMDA – Society Post-Acute Long-Term Care share some their best experiences with so could reflect on truly means be interdisciplinary. Some use terms multidisciplinary interchangeably; however, they are quite different. team consists from different disciplines who draw individual disciplinary knowledge separate, parallel fashion meet needs. Multidisciplinary teams may have advantage efficiency tend lack communication problem solving result redundancies assessment care. Alternatively, includes family working collaborative toward common goal. patient’s needs at forefront. Interdisciplinary support shared leadership decision making. To highly effective, trust, communication, collaboration, consensus building mutual respect disciplines. There evidence more effective than produce better outcomes (JAMDA, 2013; 14, 471-478). lot hard work, several barriers overcome effective. For many us, time spent meetings not reimbursable carving out schedules multiple remains persistent obstacle (The Consultant Pharmacist, 2014; 29, 149-153). COVID-19 pandemic has resulted greater technology among should continue utilized traditional face-to-face feasible. interpersonal professional had adequate opportunities learn (JAGS, 62, 961-965). education helps reinforce discipline-specific siloes. We make assumptions about other based exposure, incomplete information or previous unsatisfactory relationships. geriatrics gained increased popularity recent years; schools programs focus time-limited days rather integration into curricula clinical experiences. Team processes such as decision-making, consensus-building, ability resolve conflict critical improving cohesiveness (Medical Care, 2004; 42, 472-481). Travis Neal, PA-C, member Caring’s board, described focused psychotropic medication included nurses, social services professionals, pharmacists, physicians, advanced practice providers. Strategies open decision-making helped work this team. According Mr. “what makes meeting good tone, which forum challenge each seek other’s opinions. They all felt like voice meeting…. One key features creating real collaboration trying remain flexible. Recognizing my preferences biases, try flexible enough change mind front everyone openly admit something prior working.” Paige Hector, LMSW, associate editor Ages, her patterns daily stand-up operations. “We robust discussions wide variety topics including pre-admission screening, medical changes condition, psychosocial needs, discharge goals barriers, general coordination operational tasks. While residents families did attend meeting, connected them information, follow-up issues report back team.” function well strive maintain patient-centered perspective. Keeping allows discuss decide might implement interventions Phyllis Famularo, DCN, RD, dietician she worked “always resident’s interests heart” expertise help solve challenging problems solved by one discipline. Ms. Famularo partnering recreational therapist nutrition concerns. knew “the behaviors food activity events.” Cari Levy, MD, PhD, CMD, president, describes nature fulfilling wishes end life. “The nurse practitioner saw learned his lived state where he most His daughter very much wanted him during precious time. Commercial air option given status conditions. worker obtained charter flight developed plan comfort arrived morning family.” In world PALTC, complexities delivering high many, humble contributions. remind myself Mother Teresa’s wise words, “None me, ever great things. But can small things, love, together wonderful.” Dr. Galik chief Ages. views express own necessarily those any entity. LTC- community-based through Sheppard Pratt System. She professor University Maryland School Nursing, teaches Adult-Gerontology Primary Nurse Practitioner Program conducts research practices dementia caregivers long-term