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Clinical Programs

Clinical initiatives at Yale include the Dorothy Adler Geriatric Assessment Center, a special Acute Care for the Elderly Unit at Yale New Haven Hospital (YNHH), a innovative co-treatment program in General Surgery at the VA Connecticut Healthcare System (VACHS), and a number of consultative programs at VACHS. The Northeast Medical Group YNHH Geriatric Services cares for individuals in life care centers, assisted living facilities, and skilled nursing facilities.

Yale New Haven Hospital Services

Dorothy Adler Geriatric Assessment Center: Appointments, Cancellations, and Information: 203-688-6361

Under the direction of Dr. Richard Marottoli, the Dorothy Adler Geriatric Assessment Center at Yale New Haven Hospital is an outpatient consultative service that provides comprehensive assessment of older persons. The Adler Center uses a team approach to work with persons who have medical, psychological, cognitive, or social problems impeding function or threatening independent living. The staff at the Adler Center includes geriatricians, geriatric psychiatrists, nurse case managers, patient care assistants, physical therapists, and neuropsychologists. The staff works closely with the patient and the family, the patient's physicians, and other care providers to develop a comprehensive plan to help optimize function, independence and quality of life. The Adler Center helps patients and families by developing linkages with appropriate community services such as home health care agencies, adult day care centers, and volunteer support groups. Moreover, the staff at the Center provides ongoing case management and clinical care as necessary for individual patients, in conjunction with the patient's physician. Finally, the Adler Center serves as an important educational site for interns, residents and fellows in geriatric medicine, as a leading model for other institutions who are developing geriatric programs, and as an important site of patient oriented research in geriatrics.

Yale Center for Restorative Care (CRC)

The Center for Restorative Care at Yale New Haven Hospital's Saint Raphael Campus provides a model of interdisciplinary care for older patients. It is a major site for teaching resident physicians and medical students about the care of the frail elderly. Two teams are localized on this Unit, the Cooney medical team, which consists of two resident physicians, two interns, and two medical students working with one Geriatric attending physician; and a Hospitalist team, in which two physicians and physician associates manage the Hospitalist patients on this Unit. Interdisciplinary Rounds are held twice a week for both of these teams. A team of physicians, nurses, physical and occupational therapists, care coordinator, dietician, and social worker meet to review the goals and status of all the patients on the Unit. The goal of this Unit is to develop clinical interventions which can be implemented throughout the hospital to improve the care of the frail elderly patients. The first initiative on delirium has been implemented throughout the medical units. The approach on this Unit is focused on the function of older individuals and to review daily the “geriatric vital signs” of mobility, mental status, continence, nutrition, and integrity of the skin. The attending physicians review daily with the resident physicians and nursing staff the goals of care of each individual. This Unit has become a major teaching site for geriatrics for resident physicians in Internal Medicine at YNHH.

NEMG Yale New Haven Geriatric Services

The Yale New Haven Geriatric Services, led by Drs. Leo Cooney and James Lai, provides primary care for residents in four local nursing homes. Yale New Haven Hospital, in conjunction with the Section of Geriatrics, developed this program in order to fulfill three goals:

  1. Provide high quality subacute, transitional care to patients discharged from Yale-New Haven Hospital and other area hospitals;
  2. Provide excellent models of care for residents in long-term care; and
  3. Create a new environment for teaching medical students, resident physicians, and fellows care of these complex older patients.

Physicians on the full-time and part-time faculty, working in conjunction with nurse practitioners and physician assistants, care for 450 short and long-term nursing home residents. Physicians in this practice are working with Yale Geriatric Investigators in studies to improve nursing home care.