The focus of research for the faculty and staff of the Division of Geriatric and Palliative Medicine is vulnerable elderly patients. These include victims of elder mistreatment, elder victims of disaster and frail hospitalized elders.

Elderly Victims of Disaster

In 2005, there were a high number of older Katrina survivors evacuated to Houston.  Dr. Dyer, Ms. Beth Cloyd of the Harris County Hospital District, and Nancy Wilson of Care for Elders, in conjunction with other aging services providers; developed a tool that was used to triage vulnerable seniors out of the Astrodome shelter to more appropriate housing.  This term called Seniors Without Families Triage or SWIFT, was designed to quickly assess the special needs of elderly evacuees.  The AMA & AARP sponsored the SWIFT Team members to develop a best practices guide. 

• In 2005, TEAM conducted the Geriatric Nurse Practitioner (GNP) pilot project in the Houston Regional APS office. The nurse practitioner provided medical expertise to APS workers, supervisors and legal staff. She triaged patients for medical acuity, directed referrals to our interdisciplinary geriatric assessment team, responded to medical questions and provided medical follow up.
• In 2005, TEAM launched a Telehealth consultation project in West Texas to provide geriatric consultation services to rural and frontier areas of West Texas.
• In 2005, TEAM joined with a group of aging service providers to develop and implement a triage system. Seniors without Families Triage (SWIFT) to was created to accommodate the special needs of elderly Hurricane Katrina evacuees and relocate them from the Houston Astrodome shelter to more appropriate housing. The American Medical Association and the American Association of Retired Persons sponsored the development of a best practices guide based on the experience. It was entitled “Recommendations for Best Practices in the Management of Elderly Disaster Victims” and was published in 2006.
• Dr. Dyer's testimony after Hurricane Katrina

Harris County Elder Abuse Fatality Review Team (EFFORT)                                             

In 2003, with a small grant from the American Bar Association, TEAM formed the Harris County Elder Abuse Fatality Review Team, known as EFFORT, to review selected cases of unexpected adult deaths that were caused by interpersonal violence including family violence, suicide, neglect or abuse occurring in Houston and Harris County. Although funding ended in 2004, EFFORT has remained an active and dynamic entity in Harris County.  EFFORT operates as a sub-committee of the Harris County Domestic Violence Coordinating Council Adult Violent Death Review Team (AVDRT) in accordance with Chapter 672 of the Health and Safety Code.  EFFORT reports its findings and recommendations to the Harris County Commissioner's Office every two years.

EFFORT is administratively led by two co-directors.  Ms. Lynne Parsons is an Assistant District Attorney with the Harris County District Attorney's Office.  Dr. John Halphen is a geriatrician from The University of Texas Medical School at Houston.  Members include the Houston Police Department, the Harris County Sheriff's Office, the Harris County Medical Examiner's Office, Adult Protective Services, Director of the Geriatrics and Palliative Care Division at The University of Texas Medical School at Houston, a representative from the Harris County Victim's Assistance Office, a professor at The University of Texas School of Nursing Aging Institute, Director of the Harris County Ombudsmen Program, a PhD prepared nurse and EFFORT coordinator, a social worker from the BCM-HCHD Geriatrics Program and a geriatric nurse practitioner.

EFFORT strives to be inclusive in its membership and considers new members based on community resources and needs.  These members must reflect the geographical, cultural, racial, ethnic and gender diversity of the county or counties represented.  Also, members should have experience in abuse, neglect, suicide, family violence or elder abuse.

Reynolds Foundation:

Funded by the D.W. Reynolds Foundation and generous contributions from the late Roy Huffington, Huffington Endowed Lecture Series, Othello “Bud” and Nelwyn Hare, Memorial Hermann Foundation, Harris County Hospital District, and the Office of the Dean at the University of Texas Medical School at Houston

Effective January 2009, through a grant from the D.W. Reynolds Foundation, the UTH Medical School Division of Geriatrics and Palliative Medicine received funding to strengthen and promote geriatric education for medical students, faculty and practicing physicians.  This endeavor, titled TEXAS Training Excellence in Aging Studies, enables the development of new and innovative methods for teaching future and current physicians about geriatric medicine. 

The immediate goal of the TEXAS Program is to increase geriatric knowledge, skills and practice behaviors among medical students, residents, faculty and practicing physicians.

The long range goal of the TEXAS Program is to create an environment of excellence in geriatric care at UTH and throughout the community.

Receipt of the Reynolds provides an opportunity to accomplish several objectives over the next four years:

• Organize and integrate Geriatric content into the existing medical school curriculum using the Vanderbilt University Knowledge Map.
• Develop a 3-D virtual world whereby medical students profit from the advances in computer technology by interacting with "virtual" patients through their avatar, or virtual self.
• Create interactive email "sound bytes" and case studies for resident physicians whereby they receive brief and entertaining tidbits of geriatric information followed by case studies and team competitions.
• Provide hospitalists, non-geriatric physicians and geriatricians with training on how to teach geriatrics at the bedside by offering the Curriculum for Hospitalized Aging Medical Patients (CHAMPS) program developed by the University of Chicago.
• Invite renowned experts in geriatrics from across the nation to give intensive 1.5 day workshops and technical assistance for UTH medical students, residents, faculty and community physicians.

Frailty in Hospitalized Elders

Faculty and staff have become the study of a number of topics that impact frail hospitalized patients. These include the benefits of nursing run hospital programs for the elderly, the outcomes of ACE unit stays, and pain control in the elderly.

 

Dr. Dyer's Publications List