Please provide a brief background of your training and practice setting and years in practice.

I received my medical degree at University of Missouri-Kansas City and trained in internal medicine at Washington University-Barnes Jewish Hospital. I completed my clinical geriatric fellowship at Stanford-VA Palo Alto and then a geriatric clinical-educator fellowship at University of California-San Francisco. I previously worked as a geriatrician and palliative care physician at Santa Clara Valley Medical Center for 6 years and served as Chief of Geriatrics. I care for frail, older adults in a variety of settings including skilled nursing facility, hospital, and clinic. I recently joined the Palo Alto Division of Palo Alto Medical Foundation this year and will be lead physician in developing a community palliative care program.

Dan Osterweil, MD, CMD, FACP | CALTCM President

Dear friends,
Another year has winded down and it is time to report back to you all on the status of our organization. I want also to make a point why now more than ever it is very important to belong to the California Association of Long Term Care Medicine.

First, the status of the organization; we are 370 members strong, the only multidisciplinary organization of health professionals dedicated to long-term care medicine. This is more than a 100 percent growth! We are undergoing an administrative reorganization that will make us stronger and more self-sustaining in the future. I would like take this opportunity to thank the staff of the California Geriatric Education Center for all their hard work helping us build our organizational capacity.

As an internist with a long standing interest in Gerontology, I have seen the necessity for SNF, Custodial Care, RCFE, and Home Care. However, most of my patients have not seriously considered the possibility that they might become dependent. Neither have they prepared for its potential financial impact.

SCAN Health recently conducted a focus group survey in which they asked "Baby Boomers" about their parents' health in the last years of life. They acknowledged that most of their parents had a prolonged period of declining health and function that required a great deal of support from the family. However, when these "Boomers" were asked how they thought their last years would go, most thought they would be healthy and functional up until a very short time prior to their death.

Jay S. Luxenberg, MD

I don't usually write book reviews for the Wave, but this book sent to me by the author, a friend, surprised me so much by how it changed my thinking about an under-addressed aspect of long-term care that I want to share it with our readers. It is called "Poor oral health, a potential new geriatric giant" and it is subtitled "Significant oral health (care) issues in frail older people." It was a result of the PhD thesis work of its author, Gert-Jan van der Putten, an Elderly Care Physician (what we would call a geriatrician) and researcher at Radboud University Nijmegen Medical Centre in the Netherlands. Gert-Jan's book reports many studies that he has done in care homes and nursing homes in the Netherlands, looking at the provision of oral health care and the correlates of poor oral health. In particular, he looks at screening tools for xerostomia and hyposalivation. He reports on how frequently nursing home residents are on medications that diminish salivation. He found lower rates of resting, chewing stimulated and acid stimulated saliva secretion in women in nursing homes compared to men, and found that polypharmacy correlated with a very acidic saliva production.