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Primary Care: Addressing Issues of Aging Patients
Holland America's ms Ryndam

7-Night Western Caribbean Cruise Conference
from Tampa, Florida
January 22 - 29, 2012
All social events are complimentary for guests traveling with conferee and whose cabins are booked in the meeting group.
BIAS FREE CME - No Commercial Support was provided for this CME activity.
14 AMA PRA Category 1 Credit(s)™
14 Contact Hours
Course Fees
Physicians - $695.00
Other Professionals - $450.00
Course Fee Cancellation Policy:
30 days from sailing-None; 7-29 days-50%; Less than 7 days-100%
IMPORTANT NOTE: All conferees, their families, and guests must book their cruise within the
CME meeting group through Continuing Education, Inc./University at Sea® at
800-422-0711 or by
registering online. This ensures our company can provide conference services and
complimentary social amenities to all meeting participants
and their guests. Thank you for your cooperation.
Robert Louis Dickman, M.D. Dr. Dickman was the founding Chair of Family Medicine at Tufts University School of Medicine and the inaugural Jaharis Family Chair of Family Medicine from 2001-2009. Dr Dickman has also been very active in Geriatric Medicine since its inception in the US in the mid 1980's. He has been a fellow in the American Geriatrics Society since
1985 and been certified in geriatrics since 1988. Dr Dickman has lectured and published widely in the areas of geriatric medicine and medical ethics with a particular interest in overmedication in the elderly. He is currently an attending physician at Hebrew Senior Life, a large Harvard affiliated geriatric care program with multiple sites in the Boston area.
Eric G. Tangalos, M.D., FACP, AGSF, CMD, Dr. Eric Tangalos is Professor of Medicine at the Mayo Clinic in Rochester, Minnesota. He was Chair of Primary Care Internal Medicine from 1997 to 2006. Dr. Tangalos received his undergraduate training from the University of Michigan, is a graduate of the Loyola University Stritch School of Medicine in Chicago, and was a resident and fellow in Internal Medicine at Mayo.
He is a past president of the American Medical Directors Association (AMDA) and is a fellow and past governor of the American College of Physicians. He is a past director of the American Geriatrics Society and served on their Foundation for Health in Aging. He served eight years on the national board of the Alzheimer’s Association and was a member of their executive committee. He is a delegate to the AMA and is the immediate past chair of the AMDA Public Policy Committee.
He continues as Co-Director of Education for the Mayo Clinic Alzheimer’s Disease Research Center and has been continuously funded by the NIA since 1987. He is active with NCQA, JCAHO, AMA/PQRI and most recently was appointed to an NQF Steering Committee on Serious Reportable Events.. Dr. Tangalos also serves as Chair of the Omnicare P&T Committee.
Our staff can assist you with all your travel arrangements.
Physicians, Nurses, Nurse Practitioners, Physician Assistants
| Program Purpose / Objectives |
- Atrial Fibrillation (Dr. Dickman)
Objectives: After this session, the learner will be able to:
- Be able to use evidence based data to decide between rate and rhythm control in your patient
- Be able to utilize the CHAD score to decide about anticoagulation in your patient
- Be able to advise your patient about the pros and cons of ablation as a treatment
- Falls Prevention and Management (Dr. Dickman)
Objectives: After this session, the learner will be able to:
- Define falls
- Understand gait and balance disturbances in the elderly
- Implement a falls management program for long-term care residents
- Apply quality measures to benefit patient care and practice reimbursement
- Describe four age related changes which may contribute to falls in your elderly patient
- Be able to assess environmental changes that may contribute to falls in your patients
- Be aware of strategies to reduce the incidence of frequent falling in your patients
- Osteoporosis (Dr. Dickman)
Objectives: After this session, the learner will be able to:
- Understand the Institute of Medicine report on vitamin D
- Review definitions of osteoporosis by DEXA and FRAX
- Know which of your patients need to be screened, when and how often
- Know how to interpret the T score on a DEXA scan and its limitations
- Utilize therapies that include bisphosphonates, PTH and inhibitors of the RANK/RANKL/OPG system
- Recommend appropriate vitamin D therapy
- Council patients on calcium supplementation and cardiovascular risk
- Summarize the various dental guidelines on osteonecrosis
- Mild Cognitive Impairment (Dr. Tangalos)
Objectives: After this session, the learner will be able to:
- Define Mild Cognitive Impairment in both amnestic and non-amnestic disease states
- Understand the potential implications of early diagnosis of dementia for patient care outcomes
- Describe progress in biomarker research for Alzheimer’s disease
- Dementia (Dr. Dickman)
Objectives: After this session, the learner will be able to:
- Evaluate patients for symptoms of cognitive and functional loss
- Know the clinical manifestations of Alzheimer's disease and how to work up this problem in your patients
- Be able to diagnose Frontotemporal dementia and distinguish it from Parkinson’s disease in your patients
- Apply appropriate drug and non-drug interventions for patients with dementia
- Counsel families and caregivers at all stages of disease
- Anemia and CKD in the Elderly ( Dr. Tangalos)
Objectives: After this session, the learner will be able to:
- Discuss prevention methods for anemia in CKD with a healthcare team and older patients
- Identify patients who are at-risk of developing anemia of CKD
- Develop therapy courses for older people with CKD that combine healthy lifestyle choices and medication
- Describe best practices in the management of anemia and CKD
- Management of Constipation (Dr. Tangalos)
Objectives: After this session, the learner will be able to:
- Evaluate interdisciplinary strategies to overcome common barriers that hinder the optimal management of chronic constipation in health care settings
- Discuss the key components of a facility-wide approach to managing chronic constipation
- Describe the implementation of appropriate bowel protocols in health care settings
- Outline the elements of treatment plans that can be tailored for individual residents for chronic constipation to prevent severe complications
- Depression in the Elderly (Dr. Dickman)
Objectives: After this session, the learner will be able to:
- Recommend primary and adjuvant therapy for the depressed elderly patient
- Utilize the PHQ-9 in all practice settings
- Identify opportunities for non-drug interventions for depression including cognitive behavioral therapy
- Know three ways to distinguish Late Life Depression from Major Depressive Disorder in your older patients
- Recognize three "trigger diseases" which are associated with Late Life Depression
- Be familiar with four classes of anti-depressant medications and when to utilize them in your patients
- Delirium (Dr. Dickman)
Objectives: After this session, the learner will be able to:
- Be able to apply the confusion assessment method in diagnosing delirium in your older patients
- Know at least four major causes of delirium in your patients
- Be able to develop a plan to prevent and when not possible to effectively treat delirium
- Management of Chronic Non-malignant Pain in the Elderly (Dr. Tangalos)
Objectives: After this session, the learner will be able to:
- Understand the pathogenesis of pain
- Evaluate pain in elderly patients
- Apply recent guidelines in pain management
- Choose appropriate drug therapy and multimodal interventions for the relief of pain
- Improving Safety and Reducing Medication Errors (Dr. Tangalos)
Objectives: After this session, the learner will be able to:
- Identify medications that place long term care residents at high risk of medication misadventure
- List mechanisms available to decrease the risk of medication errors in select environments
- Identify the major areas of medication risk in the elderly residents
- Outline strategies to improve medication safety
- COPD and the Management of Respiratory Disease in the Elderly (Dr. Tangalos)
Objectives: After this session, the learner will be able to:
- Evaluate interdisciplinary strategies to overcome common barriers that hinder the optimal management of COPD in health care settings
- Discuss the key components of a facility-wide approach to managing respiratory illness
- Implement the appropriate use of nebulizers, MDIs and oxygen for long-term care residents
- Medical Ethics and the End of Life (Dr. Dickman)
Objectives: After this session the learner will be able to:
- Understand 3 ethical principles which may be utilized in decision making at the end of life
- Know when and how to utilize hospice care for your patients
- Know how to discusss the issue of parenteral feeding with patients and families who are no longer taking food by mouth
- Transitions in Care (Dr. Tangalos)
Objectives: At the end of this session the learner will be able to:
- Apply the principles of INTERACT in long term care environments
"Interventions to Reduce Acute Care Transfers”
- Consider Project BOOST for hospital transitions
“Better Outcomes for Older adults through Safe Transitions”
- Understand the principles underlying Project RED
“Re-Engineered Discharge”
- Case Discussions (both)
Objectives: At the end of this session the learner will be able to:
- Address any additional discussion items not previously reviewed
- Present cases for all to consider
- Review information not clearly stated
Key Applications
- Apply geriatric care quality indicators into every day practice
- Effectively manage common geriatric syndromes and conditions in different settings of care
- Re-engineer clinical practice to improve quality, efficiency, and safety in geriatric patients
- Participate in innovative models of geriatric care that will evolve as Medicare changes its reimbursement policies
- Apply the updated Beers Criteria in deciding about medication use in your patients
- Utilize the CHAD score when deciding about anticoagulation in your patients with atrial fibrillation
- Utilize the Geriatric Depression Scale to screen for depression in your older patients
Conference Sessions generally take place during the days at sea (as cruise itinerary allows) to avoid conflicts with Ports of Call or evening entertainment.
Accreditation: Continuing Education, Inc is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Designation: Continuing Education, Inc designates this live activity for a maximum of
14 AMA PRA Category 1 Creditstm. Each physician should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Education, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
Accredited status does not imply endorsement by Continuing Education, Inc/University at Sea or ANCC of any commercial products displayed or used with an activity.
Continuing Education for Psychologists
Approval: Continuing Education, Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. Continuing Education, Inc. maintains responsibility for this program and its content.
Designation: As an organization approved by the American Psychological Association, Continuing Education, Inc. is offering this activity for a maximum of 14 hours of continuing education credit. APA Standards for Awarding Credit require 100% attendance in all educational sessions to receive any CE credits.
EXCLUSIVE SHORE EXCURSIONS Please note that our shore excursions are operated separately and independently of those offered by the cruise line.
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Questions? Call us at 800-422-0711.
We can assist you with all your travel arrangements. We'd be happy to help you plan your flights, hotels or tours before and/or after your cruise conference.
DATE |
PORT OF CALL |
ARRIVE |
DEPART |
Sun Jan 22 |
Tampa, Florida |
- |
5:00pm |
Mon Jan 23 |
Key West, Florida Lectures 9:00am-11:00am |
1:00pm |
6:00pm |
Tue Jan 24 |
At Sea Cruising Lectures 9:00am-12noon; 1:00pm-4:00pm |
- |
- |
Wed Jan 25 |
Belize City, Belize |
8:00am |
5:00pm |
Thu Jan 26 |
Mahogany Bay, Honduras |
7:00am |
5:00pm |
Fri Jan 27 |
Costa Maya, Mexico |
7:00am |
3:00pm |
Sat Jan 28 |
At Sea Cruising Lectures 9:00am-12noon; 1:00pm-4:00pm |
- |
- |
Sun Jan 29 |
Tampa, Florida |
7:00am |
|