Geriatrics at Mount Sinai

Geriatrics

AT MOUNT SINAI Spring 2022

Brookdale Department of Geriatrics and Palliative Medicine:

Advancing Care for Older Adults for 40 Years In 1982, Mount Sinai was the first hospital in the United States to establish a department of geriatrics. Under the leadership of Robert N. Butler, MD, considered the father of modern geriatrics, the Department of Geriatrics and Adult Development, as it was then called, transformed the field, both in terms of specialized care for older adults, as well as medical training for the clinicians who treat them.

Our Proud History Dr. Butler laid the groundwork for what would become one of the most progressive geriatrics departments in the world. He recruited many of the early leaders on aging and

Diane E. Meier, MD; Christine K. Cassel, MD; and Albert L. Siu, MD

established the first geriatrics

Administration hospital in the Bronx to create the Geriatric

fellowship program in the

Research Education and Clinical Center. The Center continues to

country, creating a national

conduct research in geriatrics and palliative care and to provide

model for training geriatrics

acute and palliative care to older veterans.

specialists. Today, the fellowship has more than 30 fellows across seven Mount Sinai hospitals.

Among Dr. Cassel’s legacies were innovations and support of Robert N. Butler, MD

palliative care. Diane E. Meier, MD, established the Lilian and

The faculty has grown from a few to more than 75. Dr. Butler was

Benjamin Hertzberg Palliative Care Institute in 1997, which provides

also a strong advocate for policies that improved health care for

care to seriously ill patients and their families throughout Mount

older adults around the world and was one of the

Sinai, with Dr. Cassel’s support. Drs. Cassel and Meier were also

first geriatricians to recognize the importance of palliative care.

the founding co-directors of the Center to Advance Palliative Care,

Christine K. Cassel, MD, who succeeded Dr. Butler in 1995, has credited him with “creating an entire field of medicine” and

a national organization devoted to increasing the number and quality of palliative care programs in the United States.

changing attitudes so that aging could be perceived positively.

Dr. Cassel’s commitment to education was evident in her

During her tenure, the Department reaffirmed its commitment

recruitment of Rosanne Leipzig, MD, PhD, an internationally

to geriatrics research and education, and became one of the

recognized leader in geriatrics, who significantly advanced the

first five academic medical centers in the country to develop a

level of fellowship training in the field. Today, Dr. Leipzig is the Vice

palliative care program. Dr. Cassel was one of the first geriatrics

Chair Emertix for Education in the Brookdale Department.

attending physicians in the fledgling department before becoming

In 2002, Albert L. Siu, MD, who had previously served as Deputy

an internationally known geriatrician and ethicist. Later, she was

Commissioner of the New York State Department of Health and

instrumental in establishing a partnership with the Veterans

Division Chief of General Internal Medicine at Mount Sinai, became Continued

Advancing Care (Continued) Chair of the Department. His focus on palliative care was reflected in the renaming of the department to the Brookdale Department of Geriatrics and Palliative Medicine. He helped

American Geriatrics Society Recognizes the Work of Three Outstanding Brookdale Faculty

to establish the first Martha Stewart Center for Living and

Every year, the American Geriatrics Society (AGS) honors

the Wiener Family Palliative Care Unit.

researchers, clinicians, educators, and health professionals who

Under Dr. Siu’s leadership, the National Palliative Care Research Center was created to connect the community of palliative care researchers and influence health policy and clinical practice. Research in the field more than tripled during his tenure.

have made outstanding contributions to high-quality, patientcentered care for older adults. This year, they will honor three specialists from the Brookdale Department of Geriatrics and Palliative Medicine, marking the first time that a single institution has received more than one of these prestigious awards.

Claire K. Ankuda, MD, Assistant Professor

Dr. Siu oversaw the expansion of the Department from

of Geriatrics and Palliative Medicine, is the

serving one hospital to six throughout the Mount Sinai Health System. He also expanded Mount Sinai Visiting Doctors to include home-based hospital-level care, complex symptom management, and palliative care.

recipient of the Dr. Harold and Golden Lamport

As part of an ongoing effort to provide

In addition to coordinating their care with

Additional services under the ALIGN

Research Award. Since completing her

comprehensive, high-quality care, the

other physicians, the team makes sure

umbrella include the Transitional Care

palliative care fellowship at Mount Sinai

Brookdale Department of Geriatrics

patients and caregivers have the resources

Management Program, which cares for

in 2018, Dr. Ankuda has demonstrated an

and Palliative Medicine has instituted

they need to carry out their doctor’s

patients recently discharged from the

innovative programs designed to address

recommendations.

the unique health needs of older adults

The team monitors

and their caregivers. These programs

medications, helps

improve care coordination, reduce

establish a health care

the number of emergency room visits

proxy if appropriate,

Looking Ahead

impressive track record of prolific research and has proven to

For more than a decade, Mount Sinai has consistently

be an emerging leader in the field.

ranked among the top five hospitals nationwide for

Amy S. Kelley, MD, MSHS, Vice Chair of

geriatrics. R. Sean Morrison, MD,

Health Policy and Faculty Development and

the Ellen and Howard C. Katz Chair

Professor of Geriatrics and Palliative Care,

of the Brookdale Department since 2017, is building on the legacy of his predecessors to herald a new era in the care of older adults. Looking R. Sean Morrison, MD

ahead, his vision for the Brookdale

Department is to expand its ambulatory practices, create new programs to improve surgical, cancer, and HIV care for older adults, and enhance access to community-based palliative care services.

Dr. Morrison would also like to see the expansion of the Brookdale Department’s population-based research, which focuses on addressing disparities in access to care for people with serious illness and older adults. And finally, the Brookdale Department will continue its commitment to creating health care leaders within the Mount Sinai Health System and beyond. “We can create system-level change to make the American health care system a better match for the patients we’re caring for,” says Dr. Morrison.

and hospital admissions, and enhance

will receive the 2022 Thomas and Catherine

improves their health

patients’ experiences with our health

Yoshikawa Award for Outstanding Scientific

literacy, and provides

care system. Since 2016, ALIGN (Aging,

guidance to caregivers.

Achievement in Clinical Investigation. Her work

Life, Innovations, Goals and Needs) has

ALIGN also offers its

focuses on advancing the quality of care in older adults with serious

ensured that older adults with complex

patients a 24-hour

illness and promoting health care services and policies that help

medical illness have a comprehensive

telephone hotline to

them. Dr. Kelley is the second Brookdale faculty member to

health care plan that addresses all their

answer any questions,

receive this award.

unique needs.

provide coaching when necessary, and

hospital wh o are at risk for readmission,

allay patient and family concerns.

and the Surgery Co-Management

To date, more than 350 older adults have

Program, which optimizes outcomes for

benefited from ALIGN.

older, frail adults undergoing surgery.

Audrey K. Chun, MD; Lizette Andrango, LMSW; Stephanie Chow, MD, MPH; Jodi Payne; Danialle Coyne, NP; and Susana Lavayen, CC

Dr. Ravi Ramaswamy, MD, is the Director of

The ALIGN team assists patients,

Medical Student Education for the Department

caregivers, and their medical teams to

of Geriatrics and Palliative Medicine. He will

achieve a shared understanding of a

receive the 2022 AGS Outstanding Mid-

patient’s health care goals and creates a

ALIGN Director Stephanie W. Chow,

Career Clinician Educator Award for his

care plan to match those expectations.

MD, MPH, Assistant Professor of

contributions as a teacher and mentor. Among

Primary care providers identify and refer

Geriatrics and Palliative Medicine, leads

his accomplishments is the development of an outcome-based

older adults who would benefit from

a team comprised of physician fellows

geriatrics curriculum for all students enrolled in the Icahn School of

ALIGN’s specialized services, including

specializing in geriatrics and palliative care,

“Traditional models of primary care

Medicine at Mount Sinai.

those with highly complex medical

a geriatrics nurse practitioner, a geriatrics

often fail to meet the unique needs of

conditions, frequent hospital visits, or

social worker, a care coordinator, and an

older adults who have multiple complex

inadequate caregiver support. The ALIGN

administrative assistant. ALIGN outcomes

concerns, cognitive and functional

team works with individuals for several

are impressive. ALIGN has led to increased

impairment, and inadequate social support

months to stabilize their acute medical and

patient and provider satisfaction, has

at home,” says Dr. Chow. “The goal of

social work challenges and enable them to

reduced caregiver burden at home, and

ALIGN is to make sure that they receive

transition back to their primary care team

reduced emergency department visits and

the comprehensive care that they need

at the outpatient Martha Stewart Center

the need for hospitalization.

and deserve.”

“It speaks to the kind of work we do and to the talented people we have working at Mount Sinai,” says Helen M. Fernandez, MD, MPH, Vice Chair of Education and Professor of Geriatrics in the

The Mount Sinai Hospital is ranked number one in the care of older adults by U.S. News & World Report.

Supporting Medically Complex Aging Populations With Innovative Health Care Programs

Brookdale Department of Geriatrics and Palliative Medicine. “This year’s honorees are always thinking about how they can improve the care of patients and caregivers and, more broadly, what they can do to make the health care system better meet the needs of our aging population.”

for Living-Uptown.

The team currently collaborates with general, renal transplant, oncologic, urologic, and vascular surgeons and their primary care providers.

Provider Spotlight: Siobhan Sundel, DNP, GNP-BC, ANP Her grandmother lived until the age of 98

Dr. Sundel joined Mount Sinai as a geriatrics nurse practitioner

and was active until the last year of her

23 years ago, and currently serves as the nurse manager in the

life. Siobhan Sundel, DNP, GNP-BC, ANP,

unit, still seeing patients. “I get a lot of satisfaction in determining

Clinical Director of the Martha Stewart

the cause of my patients’ illnesses,” she says. “Very often, an older

Center for Living at Mount Sinai-Union

person presents very differently than a younger person. That

Square, thinks that her grandmother

investigation is something that I’ve always found very intriguing.”

inspired her to specialize in the care of

In 2014, Dr. Sundel went back to school to get her doctorate

older adults.

degree in nursing. Her years of clinical experience and advanced

“My patients have lived remarkable lives and seen tremendous

degree offered Dr. Sundel a unique position to mentor nurse

changes in society. I really enjoy talking with them, listening to their

practitioner students starting their careers, another aspect of

stories, and getting to know who they are,” Dr. Sundel says.

her work that she really enjoys.

The Barbara and Maurice Deane Healthy Brain Initiative Mount Sinai Health System has launched a collaborative, interdisciplinary care program called the Barbara and Maurice Deane Healthy Brain Initiative. The program was developed by three of Mount Sinai’s departments: the Brookdale Department of Geriatrics and Palliative Medicine, the Estelle and Daniel Maggin Department of Neurology, and the Department of Psychiatry. The Healthy Brain Initiative is designed to help people living with cognitive symptoms achieve the best possible quality of life for themselves, their families, and their caregivers. More information on how to request an appointment at the Barbara and Maurice Deane Center for Wellness and Cognitive Health can be found at: https://icahn.mssm.edu/healthybrain.

Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place, Box 1070, New York, NY 10029 (212) 659-8552 mountsinai.org/care/geriatrics @MSHSGeriPalCare