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The Importance of Multidisciplinary Teams
The gold standard in geriatric care is that multidisciplinary teams are brought together to provide best possible service over time. This is treatment that follows a recognized Biopsychosocial and/or Integrated Care model (e.g., as outlined by The World Health Organization or WHO).
Evidence based integrated services that address all biopsychosocial aspects of the patient experience are fundamental to successful management and maximizing positive outcome for the older adult.
Prior to meeting with Dr. Schechterman you may have been seen by healthcare professionals from a range of expertise (e.g., Internal Medicine, Neurology, Rheumatology). Based on review of all your records, and your time with Dr. Schechterman, you may also be referred to these professionals as part of a team approach. If so, we're happy to help insure that your records, where authorized, are sent to all team members, and that on-going communications are kept up to date.
Care provided across disciplines is usually centralized and coordinated by your Primary Care Provider (PCP). That provider is critical in bringing together the clinical data and diagnostic and treatment recommendations from the multidisciplinary team, and then defining your primary course of care.
A tip to keep in mind: Make sure all your providers are in touch with each other and have consensus about your care!
We see patients when there is suspicion of dysfunction or decline related to memory, concentration, attention, speech and language function, problem-solving, mood or personality change, and/or ability to function independently.
This is often first noticed by family members, friends, primary care (Internal Medicine, Family Practice), and specialty care (e.g., Neurology, Cardiology) providers, sometimes attorneys and accountants.
We also see many patients who evidence age-appropriate changes, or benign normal change, which is every bit as helpful to know about and document.
Subtle, or not-so-subtle changes in independent functioning such as organization and follow-through may be of increasing concern. Those closest may notice apathy or impulsivity, atypical for that individual and their usual way of functioning at home, in family relationships, and with others.
To maximize independence, individual and interpersonal success, we can:
Evaluate Cognitive, Affective, and Behavioral functions and capacity.
Sensitively assess memory, attention, focus, learning, language, perceptual, motor, and visual-spatial skills, as well as problem-solving, social cognition, functional daily living, and life satisfaction.
Clarify the impact of medical co-morbidity related to, for example, Autoimmune, Cardiac, Endocrine, Metabolic, Neurologic, Orthopedic, and/or Pulmonary concerns that are acute, intermittent, or chronic.
Measure and monitor quantitative and qualitative neurocognitive base rates and change specific to pre-and post-surgery, medical procedures, and therapies.
Define and differentiate what is happening (diagnosis), prioritize the focus of attention (triage), and help predict realistic outcomes (prognosis).
Work closely with Caregivers to maximize support, self-care, and care for patients.
Once the above is clarified we can then outline and coordinate a range of options that align with the healthcare team, patient, and family preferences, specific to capability. In doing so, care is often focused on effective management of the health condition and functional limitations, while maximizing quality of life in the context of what is most valued to the patient.
Unique patient and family needs
To serve our increasingly diverse patients and families, many of our services can be adapted to meet the needs of those who are Blind, Deaf (ASL), or Non-Verbal.
For patients who have limited or no English language skills, e.g., the primary language is, for example, Spanish, Mandarin, Hindi, many of the above services can be provided through a trained medical interpreter.