Integrated Care for Older Adults

Grace Pratt hosts the Integrated Care podcast with Monica Williams and Jen Thomas, sharing their backgrounds and years in integrated care and noting a shift back to a clinical topic after recent policy and implementation episodes. They discuss integrated care considerations for older adults, including cognitive decline that can mimic behavioral health symptoms, the need for differential diagnosis among depression, delirium, and dementia, and ruling out medical causes such as UTIs. The conversation emphasizes measurement-based care, protocols and workflows, and screening tools like the Mini-Cog and MMSE, including use during Medicare annual wellness visits. They highlight the importance of communication across multiple specialists, engaging family and social supports, and team-based care to address loss, function changes, grief, and care coordination challenges, ending with encouragement for new clinicians to rely on the team and use geriatric-specific assessments. 00:00 Finding Integrated Care 00:50 Meet the Hosts 05:45 Why Geriatrics Now 07:24 Upcoming Specialty Episode 09:31 Conference Preview 10:19 Geriatric Care Focus 11:13 Key Clinical Considerations 17:31 Screening and Protocols 19:21 UTIs and Delirium Clues 23:21 Wellness Visits and Mini Cog 27:22 Engaging Family Supports 30:28 Team Based Care Benefits 31:52 Clinical Pearls and Wrap Up