The Geriatrics rotation at the University of Chicago is a longitudinal curriculum throughout residency, which aims to develop residents’ knowledge and skills caring for older adult patients across a spectrum of care settings. 



  • Interns and Residents will receive their schedule from Raquel Ochoa and Dr. Lauren Gleason prior to the rotation. It is expected that you review this document and reach out to Raquel, Dr. Gleason, or the ambulatory chief if you have any questions regarding your schedule.
  • Interns are expected to attend all clinics listed on their schedule (remember you also have subspecialty and primary care clinics scheduled during this rotation)
  • Residents should expect to be at the hospital from 8am – 5pm for inpatient consults. Residents can plan to see 1-2 new consults and 1-2 follow-ups daily. Rounding time will be coordinated with the attending on service. On your first day of the rotation you can page the Geriatric Consult Service, at pager 9002, to learn about new patients.


  • If Interns or Residents are unable to attend any part of their consult block, they are expected to notify the attending and/or fellow prior to that day (i.e. for MROC and primary care/subspecialty clinic)


Specific Rotation Objectives by Year

PGY1: Outpatient & Nursing Home Care of the Older Adult

 — Diagnose and treat geriatric syndromes encountered in the outpatient setting

 — Recognize how outpatient care of older adults may differ from that of younger adults

 — Practice functional and cognitive assessment in frail older adults

 — Identify common medical errors that may occur during transitions of care

PGY2: Inpatient Care of Older Adult/Transitions of Care

 — Manage and coordinate care and care transitions across multiple delivery systems, including ambulatory, subacute, acute, rehabilitation and skilled nursing

 — Diagnose and treat geriatric syndromes encountered in the inpatient setting

 — Consult on patients with complex clinical problems requiring risk assessment

 — Assess and treat pain and non-pain symptoms in hospitalized older adults

 — Participate in a family meeting to address goals of care


Overall Rotation Objectives

Knowledge: By the end of the rotation, the resident will be able to recall or describe the key evaluation and management concepts related to the following geriatric syndromes: 

  • Dementia
  • Urinary Incontinence
  • Depression
  • Management of Hypertension in the Older Adult
  • Falls
  • Delirium
  • The Hazards of Hospitalization for frail, older adults
  • Pressure Ulcers
  • Assessment of Physical Function
  • Polypharmacy
  • Advance Directives
  • Palliative Care
  • Assessment of Decision Making Capacity
  • Health Promotion and Disease Prevention

Attitudes: By the end of the rotation, the resident will gain a greater appreciation of the following concepts, as assessed by supervising attendings during their clinical interactions with patients:  

  • The importance of individualized decision making,  reflecting the heterogeneity found among older persons with respect to physiologic function, health status, belief systems, values and personal preferences
  • The importance of negotiating goals of care with the patient and family and taking into consideration both the individual’s values and preferences as well as the physician’s professional judgment.
  • The importance of seeking out and considering the observations and opinions of family and other concerned individuals in evaluating an older patient. It is also important to remember that the primary obligation is always to the patient.
  • The function and importance of a multidisciplinary approach to caring for older persons, including appropriate respect for other health professionals and paraprofessionals and their roles in the provision of services.
  • The resident must understand that maintenance of function and quality of life are more often goals of care than cures of disease.

Skills: By the end of the rotation, the resident will demonstrate competency through direct observation in the following skills

  • The ability to perform screening assessments of basic and Instrumental Activities of Daily Living (ADL and IADL), cognitive function, and gait and mobility. 
  • The ability to facilitate medical decision-making for elderly patients, incorporating medical assessment as well as patient values and preferences. The resident should display respect for older adults and effective communication skills.
  • The ability to diagnose and manage acute and chronic multiple illnesses in older adults.
  • The ability to coordinate care of patients between ambulatory settings and long-term care, including home care, nursing homes, and hospice care.
  • The ability to effectively conduct discussions regarding goals of care and end-of-life care.
  • The ability to ask a focused clinical question and to use the techniques of evidence based medicine to find the answer.
  • The ability to compose a Critically Appraised Topic in Geriatric Medicine.


Selected Optional Readings

Advanced Care Planning

  • Hickman SE, Keevern E, Hammes BJ. Use of the physician orders for life-sustaining treatment program in the clinical setting: a systematic review of the literature. Journal of the American Geriatrics Society. 2015;63(2):341-350.

Care transitions

  • Coleman EA, Parry C, Chalmers S, Min SJ. The care transitions intervention: results of a randomized controlled trial. Archives of internal medicine. 2006;166(17):1822-1828.
  • Gillespie SM, Gleason LJ, Karuza J, Shah MN. Health care providers’ opinions on communication between nursing homes and emergency departments. Journal of the American Medical Directors Association. 2010;11(3):204-210.
  • Gill TM, Allore HG, Gahbauer EA, Murphy TE. Change in disability after hospitalization or restricted activity in older persons. Jama. 2010;304(17):1919-1928.

Chronic disease management

  • Moreno G, Mangione CM, Kimbro L, Vaisberg E. Guidelines abstracted from the American Geriatrics Society Guidelines for Improving the Care of Older Adults with Diabetes Mellitus: 2013 update. Journal of the American Geriatrics Society. 2013;61(11):2020-2026.

Decision-making Capacity

  • Assessing Patient’s Capacities to Consent to Treatment. Appelbaum, Paul and Grisso, Thomas. NEJM 1988; 319:1635-1638.
  • Assessment of Patients’ Competence to Consent to Treatment. Appelbaum, Paul. N Engl J Med 2007;357:1834-40.


  • Inouye SK, Bogardus ST Jr, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, Cooney LM Jr. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999 Mar 4;340(9):669-76. PubMed PMID: 10053175.
  • Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990 Dec 15;113(12):941-8. PubMed PMID: 2240918.
  • Marcantonio ER. Delirium in Hospitalized Older Adults. New England Journal of Medicine. 2017;377(15):1456-1466.
  • Oh ES, Fong TG, Hshieh TT, Inouye SK. Delirium in older persons: Advances in diagnosis and treatment. JAMA. 2017;318(12):1161-1174.


  • Mitchell SL. Advanced Dementia. New England Journal of Medicine. 2015;372(26):2533-2540.
  • Tube Feeding in Patients With Advanced Dementia: A Review of the Evidence Thomas E. Finucane; Colleen Christmas; Kathy Travis JAMA. 1999;282(14):1365-1370.


  • American Geriatrics Society & A. Pomidor, Ed. (2016, January). Clinician’s guide to assessing and counseling older drivers, 3rd edition. (Report No. DOT HS 812 228). Washington, DC: National Highway Traffic Safety Administration


  • Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. J Am Geriatr Soc 2011:59:148–157.
  • Grossman DC, Curry SJ, Owens DK, et al. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. Jama. 2018;319(16):1696-1704.
  • Kwan E, Straus SE. Assessment and management of falls in older people. CMAJ 2014;186(16):E610-621.


  • Finances in the Older Patient With Cognitive Impairment. Widera et al. JAMA. 2011;305(7):698-706.


  • Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA – Journal of the American Medical Association. 2011;305(1):50-58.
  • Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. The journals of gerontology Series A, Biological sciences and medical sciences. 2001;56(3):M146-156.
  • Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clinics in geriatric medicine. 2011;27(1):17-26.
  • Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752-762.

Hip fracture

  • Prestmo A, Hagen G, Sletvold O, et al. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet. 2015;385(9978):1623-1633.
  • Berry SD, Rothbaum RR, Kiel DP, Lee Y, Mitchell SL. Association of clinical outcomes with surgical repair of hip fracture vs nonsurgical management in nursing home residents with advanced dementia. JAMA Internal Medicine. 2018.
  • Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of a comanaged Geriatric Fracture Center on short-term hip fracture outcomes. Archives of internal medicine. 2009;169(18):1712-1717.

Hospitalized older adults

  • Creditor MC. Hazards of hospitalization of the elderly. Annals of internal medicine. 1993;118(3):219-223.
  • Gill TM, Allore HG, Gahbauer EA, Murphy TE. Change in disability after hospitalization or restricted activity in older persons. Jama. 2010;304(17):1919-1928.


  • Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Journal of the American Geriatrics Society. 2012;60(10):E1-e25.

Palliative Care

  • Temel JS, Greer JA, Muzikansky A, et al. Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer. New England Journal of Medicine. 2010;363(8):733-742.
  • Prognosis and Communication Website:


  • By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Apr;67(4):674-694. doi: 10.1111/jgs.15767. Epub 2019 Jan 29. PMID: 30693946.
  • Budnitz, D, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. The New England journal of medicine. 2011;365(21):2002-2012.

Pressure Ulcers

  • Smith ME, Totten A, Hickam DH, et al. Pressure ulcer treatment strategies: a systematic comparative effectiveness review. Annals of internal medicine. 2013;159(1):39-50.

Urinary Incontinence

  • Goode PS, Burgio KL, Richter HE, Markland AD. Incontinence in older women. Jama. 2010;303(21):2172-2181.


  • Pilkinton MA, Talbot HK. Update on vaccination guidelines for older adults. Journal of the American Geriatrics Society. 2015;63(3):584-588.