Clinical Programs

Dorothy Adler Geriatric Assessment Center

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.

Elder Horizons Program

The Yale Geriatrics Faculty have developed a number of interventions to prevent delirium and maintain the function and independence of older individuals during acute hospitalization. The Elder Horizons Program, under the direction of Dr. Susann Varano, utilizes a number of these interventions to assist older persons on Yale-New Haven Hospital units. The program makes innovative use of hospital volunteers and college interns in these interventions. The ultimate goal of this program is to assist nurses, patient care associates, and physicians to maintain the highest level of function of their elderly hospitalized patients.

VA Connecticut Healthcare System

In-Patient and Out-Patient Geriatric Consultation (Lisa Walke, MD): Working closely with surgical, medical, neurology and psychiatry in-patient housestaff, an interdisciplinary team will help to assess the special needs of elderly patients and to implement an appropriate plan of care. An out-patient consultation clinic assists in the pre-operative assessment of elderly patients and the management of difficult patients from the primary care clinics.

Homecare and Hospice (Margaret Drickamer, MD): Home visits with members of the interdisciplinary home care team (nurses, social worker, pharmacist, and dietician), see patients needing urgent intervention for a diverse array of problems including rehabilitation, disease management for congestive heart failure, diabetes, and other chronic diseases in exacerbation, wound care, and palliative care. The VA Connecticut Advanced Illness Management Team see both inpatient and home hospice patients for evaluations, palliative therapies, and end-of-life decision-making.

Yale Acute Care for the Elderly (ACE) Unit (8/8)

The Yale Geriatrics Faculty provides medical direction for the Yale New Haven Hospital Acute Care for the Elderly (ACE) Unit, a 12 bed acute medical ward for patients over the age of 65. The interdisciplinary team, consisting of a geriatrician, housestaff and medical students, nurses, rehabilitation therapists, a social worker, a care coordinator, a nutritionist, and a pharmacist, provides medical, functional, and psychosocial care for these geriatric patients. The goals of the unit are to prevent functional decline and iatrogenic complications, achieve patient and family goals and preferences, and deliver coordinated care in the hospital and upon discharge. The unit also serves as an environment in which residents and medical students learn the approach to geriatric care and a place where models of interdisciplinary care can be developed to use across the hospital.

Yale New Haven Geriatric Services, P.C.

The Yale New Haven Geriatric Services, led by Drs. Leo Cooney and Margaret Drickamer, 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) to provide high quality subacute, transitional care to patients discharged from Yale-New Haven Hospital and other area hospitals; 2) to provide excellent models of care for residents in long-term care; and 3) to 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.