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Nov. 22, 2016

Jeremiah Lopez: Connecting with an older population

Nov. 22, 2016

Jeremiah Lopez is an assistant professor in the Department of Family and Community Medicine in the College of Osteopathic Medicine. He specializes in geriatric medicine.

My residency in family medicine at McLaren-Flint Family Practice introduced me to geriatrics and planted the seed of interest in the sub-specialty. I was exposed to a two-month geriatrics block that included post-acute and long-term care management. In addition, participating in home visits for our patients who were home-bound provided crucial insight into an individual’s social and living situation. Barriers that limited a patient’s care may have been due to an environmental factor that was addressed during these visits.

Another rewarding experience that fostered my interest in geriatrics during my residency in Flint was the Geriatric Assessment Clinic. This was a multidisciplinary team of family medicine residents and health psychologists, moderated by our staff geriatrician. Patients were referred to the assessment clinic for various reasons, but the most common reasons were memory problems and caregiver/family concern for safety.

Evaluations were in-depth and patients were often accompanied by a family member or guardian. After residency, I noticed my patient panel shifted toward the septuagenarian and octogenarian demographic. I felt more comfortable talking and connecting with this older population. Listening to their life stories has always interested me. In addition, I continued to manage residents in a long-term facility.

Although my patient panel and schedule may reflect that of a geriatrician, I felt experience alone would be insufficient to cultivate my interest in gerontology. Once the seed of interest was planted during residency, I knew that pursing a fellowship would allow that seed to grow. I was fortunate to be involved with the geriatrics fellowship at Michigan State University.

Being involved with a Michigan State University-affiliated residency program, I was familiar with their quality to excellence and expectations of life-long learning. During the fellowship, I found the complexities of care and the subtle nuances that are needed for the care of the elderly very fascinating.

I had the fortunate opportunity to work with geriatricians that helped cultivate my enthusiasm for the field. I have learned to appreciate the intricacies of a health care team. Participating in multidisciplinary teams helps foster collaborative thinking and drives toward the same goal: patient care. Discussing potentially sensitive topics, such as dementia and end-of-life, are difficult conversations for some families.

With the help of one of my faculty mentors, Francis Komara, professor of family and community medicine, I was able to pursue quality improvement initiatives within the nursing home at the Medical Care Facility and Rehabilitation Services of Ingham County, often called Dobie Road. Our project, “Urinary Tract Infections in Long Term Care: Improving Quality Measures” was awarded an unrestricted grant for the American Medical Directors Association Foundation and we will present our study in March 2017 in Phoenix.