Older Adult Behavioral Health Initiative Events

Find information and slides from previous events and learn about upcoming events.

2020 Virtual Conference: Supporting Special Populations of Older Adults with Behavioral Health Needs

A conference held on August 25-26, 2020 presented by the Institute on Aging at Portland State University and Oregon Health Authority, Older Adult Behavioral Health Services.

This conference aimed to improve the knowledge and skills of professionals working with older adults and people living with disabilities who have behavioral health needs. Invitees included Behavioral Health Specialists, PASRR II Screeners, and Enhanced Care Services providers.

Conference sessions focused on four primary special population groups:

  • Chronically ill and disabled
  • Geographical communities
  • Low income and/or homeless populations
  • Ethnic populations

Note about CEUs:

CEUs are only available to conference attendees through September 30th.

You may receive up to 3 hours of CEU credit for watching recordings of the breakout sessions you did not attend during the conference. To earn CEU credit, you will need to watch the video recording and pass the corresponding quiz with a score of at least 80%. You will receive your certificate(s) within one week of completing the quiz.

Below you will find CEU details and links to take the quizzes in each of the breakout sessions.

Sessions:

Plenary 1: The Age-Friendly Health Systems Initiative - Marian Hodges, MD, MPH

This session is intended for all attendees with the goal of introducing them to the Age-Friendly model and how its 4M’s–What Matters, Medication, Mentation, and Mobility–can be applied in a behavioral health setting. “What Matters” is the foundation for the model, which is defined as “knowing and aligning care with each older adult’s specific health outcome goals and care preferences.” This session will also focus on the specific aspects of having “What Matters” conversations with older adults who are living with behavioral health challenges and how to incorporate their goals and preferences into a care plan.

At the end of this session, attendees will be able to:

  • Describe the Age-Friendly model
  • Discuss how the Age-Friendly model could be implemented in behavioral health settings
  • Identify opportunities for having “what matters” conversations with their respective clients

Download Slides (PDF) >

Plenary 2: Supporting Older Adults with Loneliness and Social Isolation - Ashwin Kotwal, MD
This session is intended for all attendees. Data show that perceived social isolation is linked with adverse health consequences including depression, impaired executive function, accelerated cognitive decline, poor cardiovascular function and impaired immunity at every stage of life. A recent study by the American Cancer Society found that social isolation increases the risk of premature death from every cause for every race. Their research showed that the magnitude of risk by social isolation is similar to that of obesity, smoking, lack of access to care and physical inactivity. This session reviews the current research on social isolation and loneliness. This session will also focus on promising practices for reducing their impact on older adults’ behavioral health, e.g., cognitive behavioral therapy, engagement in community or social activities, digital technology, and co-housing.

At the end of this session, attendees will be able to:

  • Discuss the effects of social isolation and loneliness on physical, mental and cognitive health
  • Describe how social isolation differs from loneliness
  • Discuss evidence-based interventions for combating social isolation and loneliness

Download Slides (PDF) >

Breakout Session 1: Conducting a Culturally Appropriate “What Matters” Conversation - Panel Presentation (1.5 CEUs)

Regina Koepp, PsyD, A.B.P.P., Atlanta VA Health Care System;
Joel Pelayo, C.H.W., Toña Sanchez, C.H.W., The Next Door;
Daniel Towns, D.O., Oregon Health & Science University, Intercultural Psychiatric Clinic

This session builds on information presented in the Age-Friendly Plenary. It is essential to consider the impact of race, ethnicity, culture and other identities on how older adults view health and illness and their preferences for treatment. Refugee and immigration status or intergenerational trauma can also affect their trust levels. This session describes unique protective factors of people in the Hispanic community, the drivers of mental health/behavioral health disparities (e.g., lack of trained interpreters) and best practices for providers working with this population. The session also focuses on different subpopulations among the Hispanic community. This session also reviews current Immigration and Customs Enforcement policies that affect behavioral health services to undocumented individuals. This presentation will provide an overview of mental health disparities related to African American older adults (including the accumulative effect of racism on African American older adults), recommendations for approaching care and support (including importance of provider self-awareness), and discussion of the essential role of resilience factors.

At the end of this session, attendees will be able to:

  • Summarize mental health disparities related to African American older adults
  • Discuss recommendations for approaching mental health care and support for African American older adults
  • Describe the important role of resilience factors among African American older adults
  • Discuss unique protective factors and drivers of mental health/behavioral health disparities among the Hispanic community
  • Explain best practices for providers working with the Hispanic population
  • Describe the legal rights extended to health care providers to protect their immigrant patients
  • Discuss recommended steps to conduct a culturally appropriate “What Matters” conversation
  • Explain the need for providers to recognize their unconscious biases and ways they may be communicated to the older adult

CEU Quiz Link

Download Regina Koepp Slides (PDF) >

Download Joel Pelayo & Tona Sanchez Slides (PDF) >

Download Daniel Towns Slides (PDF) >

Breakout Session 2: Trauma-Informed Care and Houselessness - Lydia Bartholow, DNP, PMHNP (1.5 CEUs)

A study published in 2019 showed that Oregon had a rate of 350 homeless individuals per 100,000 population, making the state’s rate the 4th highest in the United States. (The national average was about 168 per 100,000.) Homeless individuals with serious disabilities, severe and persistent mental illness, or long-standing substance use disorders are especially likely to experience chronic homelessness or to be shelterless. These populations are also likely to have experienced significant trauma. This presentation will provide an understanding of how trauma affects the human body at a neurobiological level and what are the best practices for working with homeless populations. This session will provide attendees:

At the end of this session, attendees will be able to:

  • Discuss the neurobiological impact of trauma
  • Apply trauma informed care practices to working with vulnerable populations
  • Understand the unique challenges of working to support unsheltered populations across Oregon

CEU Quiz Link

Download Slides (PDF) >

Breakout Session 3: The Interface between Primary Psychiatric Disorders, Aging and Dementia – A Primer for the Busy Clinician - Vimal Aga, MD (1.5 CEUs)

This session will focus on the overlap between serious mental illness and dementia. Serious mental illness is a risk factor for developing dementia. This session will cover what serious mental illness looks like as one ages – what is the prognosis? How do does one differentiate between the cognitive symptoms associated with serious mental illness and a new dementing illness? Is the onset of dementia at an earlier age more likely amongst individuals living with serious mental illness than the general public? Does long term use of anti-psychotics and other psychoactive medications have an impact on cognition long term? What are the risk factors for developing dementia for individuals with serious mental illness? How do significant medical comorbidities such as cardiovascular disease and diabetes and lifestyle such as smoking and physical inactivity impact cognition and overall functioning? While attendees at all levels will benefit, this session is best suited for clinicians who have some experience working in the field with older adults with mental health issues.

At the end of this session, attendees will:

  • Understand how clinical presentations of late-onset primary psychiatric disorders in older adults compare with neurobehavioral symptoms in the neurocognitive disorders, including in the prodromal stage; 
  • Be introduced to a recently-introduced framework for evaluating patients with neurocognitive disorders presenting as late-onset psychiatric disorders (Mild Behavioral Impairment or MBI); and 
  • Apply the above framework to the clinical work-up of a patient with MBI using a case-based approach, during which the importance of history-taking, office cognitive screening, and CSF and neuroimaging biomarker testing will be highlighted.

Download Slides (PDF) >

CEU Quiz Link >

Breakout Session 4: Substance Use Disorder Treatment: Access, Adaptability, and Aging - Liberty Martinez Bird, LPC, CADC-III & Sarah Holland, MSW, MPH (1 CEU)
This session will provide a better understanding of the impact of substance use treatment on older adults in Oregon. The intersection of substance use and older adults receives less attention than other age groups. However, older adults are more likely than younger adults to have multiple chronic health conditions and to use prescription medications that can interact with alcohol and other substances, which puts them at increased risk for adverse outcomes. As people age in long-term recovery, strategies to address cognitive decline and other emerging health concerns are of high significance.

At the end of this session, attendees will be able to:

  • Discuss the use of medication-assisted treatment (MAT) to support and maintain recovery amongst older adults
  • Understand age-specific challenges in terms of access to treatment and strategies to address and overcome those challenges
  • Apply strategies to address cognitive decline and other emerging health concerns as people age in long term recovery

CEU Quiz Link

Download Slides (PDF) >

2019 Forum on Behavioral Health Policy: Improving Outcomes for Older Adults and People with Disabilities in Oregon

An event to celebrate the accomplishments of the Older Adult Behavioral Health Initiative; share findings that emerged from evaluation data, discuss challenges and opportunities moving forward; and recommendations for next steps.

2019 Conference: Assessment and Risk Factors in Complex Cases

A conference presented by the Institute on Aging at Portland State University and Oregon Health Authority, Older Adult Behavioral Health Services.

This conference aimed to improve the knowledge and skill of professionals working with older adults and people with disabilities who have behavioral health needs. Invitees included Behavioral Health Specialists, PASRR II Screeners, and Enhanced Care Services providers.

Conference sessions focused on:

  • Assessing complex clinical issues.
  • Determining if an individual has the capacity to give informed consent and direct their care.
  • Best practices and tools of harm reduction.

Sessions:

Diagnosis Methods for Dementia and Impact of Cognitive Decline - Allison Lindauer

This session describes the best practices for medication therapy for dementia management, DSM-V Criteria for major neurocognitive disorder, and clinical decision-making methods in the differential diagnosis of dementia. This session includes a case conceptualization and practice, with a special emphasis on the functional assessment of IADL/ADL impairment. This session describes various etiologies, clinical presentations, and medication options for dementia and neuropsychiatric symptoms.

Download Slides (PDF) >

Capacity Assessment: The Why and the How - Nirmala Dhar

This session describes best practice methods and procedures for determining capacity across care settings. This session describes the definition of capacity; how to identify individuals at risk for impaired capacity; and how to implement a four-part framework for assessing capacity.

Download Slides (PDF) >

Download Capacity Eval Template (PDF) >

Download Practical Tool (PDF) >

Medical Diagnoses Complicated by Mental Health Symptoms - Y. Pritham Raj, MD

This session addresses psychiatric comorbidity in medical and neurological illness through the lens of a holistic conceptual framework focused on addressing the biological, psychological, and social components of frequently co-occurring medical and mental health conditions in older adults. Participants will further develop applied knowledge of complex clients who have cross-system medical and mental health needs. Specifically, this session convers mental and physical health symptoms that occur over the course of physical and neurological conditions, which might indicate a need for further intervention. This session describes medication classes that can cause or exacerbate mental health issues.

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Weighing the Risks and Benefits of Medications Among Older Adults - Helen Kao, MD

This session provides up-to-date information on the effectiveness and safety concerns of the short- and long-term use of opioids, benzodiazepines, and other potentially inappropriate prescription and over-the-counter medications among older adults. This session covers evidence-based recommendations in identifying polypharmacy concerns and inappropriate prescribing as risk factors for adverse drug reactions. This session provides an update on national and local opioid prescribing guidelines, with a discussion of the potential role of behavioral health professionals in identifying opioid misuse and related harms. More specifically, this session convers the concept of iatrogenesis, STOPP/START screening tools and the Beers Criteria, as well as gain awareness of the most common drugs (e.g., anticoagulants, antiplatelets, and diabetes medications) linked to hospitalizations in older adults.

Download Slides (PDF) >

American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults >

STOPP START Toolkit >

Harm Reduction in Caring for Incapable Older Adults in the Community: Ethical Implications for Health Care Providers - Nicholas Kockler, PhD, MS

This session focuses on ethically challenging situations often faced by community-based health care providers in caring for older adults. These issues sometimes stem from an adult’s diminished decision-making capacity or cognitive impairment, which puts them at risk of harm due to unsafe behaviors. At the same time, providers may be limited or uncertain about how to best support the adults they serve given the ethical implications of various decisions. Harm reduction has emerged as an ethically defensible strategy that can inform consideration of various options in caring for incapable older adults. The session presents a harm reduction philosophy of care and describe the ethical implications for health care providers as well as ethical considerations in a range of intervention options for a given situation.

Download Slides (PDF) >

Fostering Autonomy Among Older Adults Who Live with Compromised Mental Capacity - Lynda Crandall, RN, GNP

This session is targeted to professionals working with older adults living in care settings/communities. It offers practical guidance on how to support resident autonomy and self-directed living in spite of circumstances such as compromised capacity resulting from mental illness, including dementia. Case vignettes are used to consider approaches to support person-centered/self-directed daily living, as well as discuss ethical dilemmas such as with residents who may not be engaging in, or refusing, self-care, refusing services/activities, or experiencing other challenging behaviors.

Download Slides (PDF) >

2018 Forum on Behavioral Health Policy in Oregon: Improving Outcomes for Older Adults and People with Disabilities in Oregon

An event to celebrate the accomplishments of the Older Adult Behavioral Health Initiative; share findings that emerged from two years of evaluation data, discuss challenges and opportunities moving forward; and recommendations for next steps.

2018 Conference: Critical Issues and Promising Practices in Behavioral Health

A conference presented by the Institute on Aging at Portland State University and Oregon Health Authority, Older Adult Behavioral Health Services.

This conference aimed to improve the knowledge and skill of professionals working with older adults and people with disabilities who have behavioral health needs. Invitees included Behavioral Health Specialists, PASRR II Screeners, and Enhanced Care Services providers.

Conference sessions focused on:

  • Emerging issues and promising practices
  • Evidence-based assessment and care planning tools
  • Developing care plans in collaboration with other service providers

Sessions:

Moving Forward Together: Understanding Engagement - Connie Davis, MN

An evidence-based model for human behavior will be used to explore client and provider engagement. A helpful analogy is used to learn how to understand the factors that underlie a person’s choices. Improved understanding of these factors can help us be more effective helpers and guides.

Download Slides (PDF) >

Improving Health & Reducing Social Isolation through Technology - Cory Bolkan, PhD

This session focuses on technology interventions for reducing social isolation and strengthening community. Lessons learned from a telehealth program with remote patient monitoring that engaged community-dwelling, chronically ill older adults in their own care are shared.

Download Slides (PDF) >

Depression and Anxiety - Glenise McKenzie, PhD

This session provides an overview of the prevalence of and risk factors for depression and anxiety and how these conditions are contributing to poor health, poor quality of life, hospitalizations and early mortality. The session focuses on the role of community-based care and nursing home staff in identifying and addressing these issues.

Download Slides (PDF) >

Improving Health & Reducing Social Isolation through Technology - Cory Bolkan, PhD

This session focuses on technology interventions for reducing social isolation and strengthening community. Lessons learned from a telehealth program with remote patient monitoring that engaged community-dwelling, chronically ill older adults in their own care are shared.

Download Slides (PDF) >

Veterans Issues - Joshua Clark, PhD

This session focuses on older veterans who have post-traumatic stress disorder, traumatic brain injury, and/or physical disabilities. Using a person-centered care approach, similarities and differences among key diagnoses are described as will information about how to interact with the VA system.

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Improving Communication Between Assisted Living Unlicensed Staff & Emergency Medical Services & Emergency Department Staff - Juliana Cartwright, PhD

Faculty, assisted living staff, and students partnered to implement quality improvement (QI) practices surrounding residents’ change of condition and quality of life. This presentation highlights findings and shares a robust set of training and QI tools for use in community-based care settings.

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Frail Elders: A Comprehensive Assessment - Liz von Wellsheim, RN

Many older adults with behavioral health needs have age-related functional impairments and a range of health issues that complicate behavioral health and decisions about appropriate services. This session covers key elements of a comprehensive geriatric assessment, provides indicators for when assessments are needed, and common geriatric assessment tools.

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Dementia Assessment - Patrick Gillette, MD

Using a person-centered approach, this session covers dementia assessment and provides tips for conducting behavioral assessments when cognitive impairment is suspected. How to engage and partner with primary care providers and others around behavioral issues related to dementia are emphasized.

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Aging in Community: Housing Issues and Emerging Models - Paula Carder, PhD

The session describes innovative and promising models for aging in community, with an emphasis on efforts related to affordable housing with services. This session describes examples from the Housing with Services, LLC program in Portland, as well as examples from a learning collaborative on linking health and social services to vulnerable adults of all ages.

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The Opioid Crisis and Older Adults - Sarah Goodlin, MD

The opioid epidemic is affecting older adults; rates of deaths and hospitalizations related to prescription opioid use and misuse are alarming. This session will focus on appropriate and inappropriate uses of opioids, advocacy for appropriate use, unintended consequences for limiting use, and nonpharmacological alternatives for pain management.

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2017 Behavioral Health Call to Action

An event to celebrate the accomplishments of the Older Adult Behavioral Health Initiative; share data findings that emerged from the first year of the evaluation, discuss challenges and opportunities moving forward; and recommendations for next steps.