by Janice Hoffman, PharmD, CGP, FASCP

As most of you are aware, CURES is a data information system that tracks Class II through V controlled substances dispensed in California. Online access to CURES, allows authorized prescribers and pharmacists to review information of dispensing via Patient Activity Reports (PAR) in an effort to identify drug abuse and/or diversion through accurate and rapid tracking of Schedule II through IV controlled substances.⁽¹⁾  In 2014, over 3.5 million PAR requests were processed. ^(1,2) The upgraded software should make it faster and easier to investigate a PAR in a more “real-time” basis and computer systems will need to be compatible with this data system. All pharmacists and prescribers must register by 1/1/2016.

The recent case in Iowa, where 78-year-old Henry Rayhons, a former Iowa State legislator, was accused of raping his wife Donna, is the tip of the iceberg when it comes to the challenges our society will face with the growing number of people who have Alzheimer’s disease.  If you’re not familiar with the case, the nursing facility roommate of Mr. Rayhons' wife, thought she heard “sexual” noises in the bed next to hers.  Nothing was ever proven, and Mr. Rayhons was found not guilty by a jury in April.  

Numerous issues came to light from this case.  Her doctors testified that she had severe dementia and was unable to consent to anything, let alone sexual relations.  The facility medical director said that any response that she had to her husband’s hugs and kisses was just a “primal response.”  There had been some guidance by the care team previously on the issue and the husband had signed a document acknowledging that his wife lacked the capacity to consent to sex.

Tim Gieseke is a general internist who has been a Medical Director of a CCRC since 1986 and subsequently of a hospital post acute unit and four community SNFs.  Dr. Gieseke has been CMD certified since 1996 and was a hospice Medical Director from 2006-2012.  He is a past president of CALTCM and recently finished his second 2-year term as Chair of Education for CALTCM in April 2015.  He is a frequent contributor to the CALTCM WAVE electronic newsletter.  He was a member of AMDA’s Public Policy Committee from 2008-2014. Dr. Gieseke is an active member of the California INTERACT initiative, California Dementia Partnership, the Coalition for Compassionate Care of California, and the Sonoma County My Care, My Plan initiative for improving palliative care.  He is an Associate Clinical Professor for UCSF in Family and Community Medicine teaching geriatrics, palliative care, and PA/LTC medicine at the Sonoma County FP residency.   

CALTCM Interview with Dr. Gieseke:

CALTCM is proud to issue a CALL FOR NOMINATIONS for the 2016 CALTCM Leadership Award! Do you know someone who should be recognized for his or her achievement in Post-Acute and Long-Term Care Medicine? Nominate them today for the 2016 CALTCM Leadership Award. Over the last few years, CALTCM has proudly recognized the following leaders: