CoxHealth Education Center is pleased to present the 33rd Annual Geriatric Conference.  This one-day conference  is designed to enhance the knowledge of physicians, physician assistants, nurse practitioners, nurses, nursing home administrators, physical and occupational therapists, social workers, case managers and other interested health care providers.

The number of people worldwide age 65 and older is expected to triple between 2010 and 2050—from 524 million to 1.5 billion.1 In the United States, there will be approximately 72.1 million people (19 percent of the total U.S. population) over age 65 by 2030, more than twice the amount in 2000. Missouri shows a similar trend in the projected growth of older adults. In 2011, there were 854,652 Missourians age 65 or older (14.2 percent of the population). This age demographic is projected to reach 1.4 million people (21 percent of the population) by 2030.  Older adults account for the largest percentage of health care spending. The Centers for Medicare and Medicaid Services (CMS) report that health care spending by older adults grew 3-times that of 18 to 64 year olds in 2010.  As Missouri continues to age, attention must be given to the health needs of this population, as well as the availability and cost of services.


(Older Adult Health Disparities in Missouri – Health Equity Series, MO Foundation for Health, 2014)

April 12, 2019

DoubleTree Hotel

7:00 – 7:20 am Registration/Refreshments/Vendor Displays
7:20 – 7:30 Welcome and Announcements
7:30 – 8:30 Treatment of Chronic Pain in the Elderly in the Era of the Opioid Crisis: Implications for our Vulnerable Elders

    Randall D. Huss, MD, CMD

  • Describe the scope of and problems associated with detection and management of chronic pain in the elderly, especially nursing facility nursing residents
  • Identify appropriate and inappropriate choices in the pharmacologic approach to management of  pain in the elderly, including the appropriate use of opioids in the era of the “opioid crisis”
  • Formulate an appropriate plan for management of pain in the elderly that encompasses both pharmacologic and non-pharmacologic interventions
  • Discuss potential adverse consequences to elderly nursing facility residents of the CDC guidelines and societal initiative to reduce opioid prescribing
8:30 – 9:30


Diagnosis of Dementia in the Outpatient Setting   

    Milta O. Little, DO, CMD

·         Define and distinguish dementia and mild cognitive


·         Describe the impact dementia has on the patient and


·         Identify the most common types of dementing illnesses

·         Successfully perform brief cognitive screens that can be used

in daily clinical practice

9:30 – 9:50 Break/Refreshments/Vendor Displays
9:50 – 10:50


The Golden Years

    Jason Martin, RN CEN NREMT-P

  • List the patterns of injury found in geriatric trauma patients
  • Distinguish the management principles pertinent to these specific injuries in the geriatric trauma patient
10:50 – 11:50 Should Ms. Daisy Be Driving?

    David B. Carr, MD

  • Describe common age-related medical conditions that can impact driving
  • List the steps in evaluating the medically impaired driver
11:50 – 12:45 pm Lunch  (served on site)
12:45 – 1:45 Patient Optimization: Nutrition is The Key to Better Outcomes

 Troy Morrison DO 

  • Recognize patients at risk for nutritional impairment.
  • Optimize their patient’s nutritional status using an evidence-based approach




(Anne McLester room)

1:45 – 2:45


When Multi-morbidity and Evidence-Based Medicine Collide: Conflict or Opportunity?

  Milta O. Little, DO, CMD

  • Distinguish multi-morbidity from co-morbidity
  • Describe the effects of multi-morbidity on aging physiology
  • Identify multi-morbidity in the clinical setting
  • Apply the current evidence base to improve the quality of care of multi-morbid older adults
Screening Miss Daisy and her limitations

  Peggy P. Barco, OTD/L, SCDCM, CDRS, FAOTA

  • Realize the strengths and limitations of the driving evaluation process in relationship to older adults with cognitive impairment.
  • Apply evidenced based clinical screens (inclusive of the probability calculator) in case study applications of determination of fitness to drive in older adults with dementia
2:45 – 3:45


Nephrology issues in the Geriatric patient

Samir Garcia, MD

  • Analyze and apply evidence based information in caring of the geriatric patient
  • Identify the management of cardio renal syndrome
Physical Therapy Assessment and Intervention in the Medically Complex Geriatric Patient

Jeff Nickle, PT, GCS, CLT

  • Identify factors that limit or contraindicate physical therapy assessment and intervention
  • Describe common disease processes in the medically complex geriatric patient and their impact on intervention
 3:45– 4:00 Break/Refreshments/Vendor Displays Atrium Hallway
4:00 – 5:00


Communication across Generations

  Erin Wehrman, PhD

  • Identify the communication challenges experienced across generations
  • Identify strategies to communicate more effectively across generations
5:00 – 5:30 pm Questions and Answers/Evaluations

We reserve the right to substitute speakers and topics in case of emergency or cancellation. Information presented during this conference represents the views and opinions of the presenters and does not necessarily constitute the opinion, endorsement of, or promotion by CoxHealth.

Planning committee members and speakers have created this activity without bias or influence from all external commercial entities.


No sponsorship or commercial support has been received for this activity.

In an effort to be environmentally friendly and reduce participant fees, no handouts or printed presentation notes will be provided at the conference. Rather, presentations can be obtained here to download to a personal electronic device or print off for your personal use.

Presentations will continue to be posted as they become available.

CoxHealth is accredited by the Missouri State Medical Association to provide continuing medical education for physicians.  CoxHealth designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.


CoxHealth Education Center is an approved provider of continuing nursing education by the Midwest Multistate Division, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

8.5 Contact Hours


This program has been deemed appropriate for chaplains to list 8.0 contact hours of continuing education credit.  Credit should be listed on the Association of Professional Chaplains Annual Summary of Continuing Education Hours Form in the area of “Workshops/Conferences/Seminars/Symposia.”


This program has been approved by the Arkansas Board of Physical Therapy for 8.0 contact hours and is deemed equivalent by the Missouri Board of Healing Arts per 4 CSR 150-3.203-5A.


This program meets the criteria for category 2.3 (attending employer-provided, workplace continuing education) Professional Development Unit activities for NBCOT© and qualifies as 8.0 contact hours (equivalent to 8.0 NBCOT© Professional Development Units).


This program has been approved for 2.0 CoxHealth Trauma hours (The Golden Years and Should Ms. Daisy be Driving)


Credit for nursing home administrators, social workers, and case managers is being planned and submitted.

Requirements of Successful Completion:

  • Please note that attendance of the entire conference is required in order to obtain any credit today.

  • Sign-in at the registration desk

  • Turn in a completed evaluation and Personal Verification of Attendance form at the end of the program.

 Accreditation approval only refers to this educational activity and does not imply endorsement of any commercial products by CoxHealth or any proprietary entity producing health care goods or services.



Assistant Professor

Washington University School of Medicine

St Louis, MO


David B. Carr, MD

Professor of Medicine and Neurology

Washington University School of Medicine

St Louis, MO


Milta O. Little, DO, CMD

Associate Professor of Geriatric Medicine

Saint Louis University

St Louis, MO


Jason Martin, RN CEN NREMT-P

Director of Trauma Education/Prevention

HCA Midwest Health

Kansas City, MO


Troy Morrison DO

Orthopedic Surgeon

Citizens Memorial Hospital

Bolivar, Missouri


Jeff Nickel, PT, GCS, CLT

Staff Physical Therapist


Springfield, MO


Erin Wehrman, PhD

Assistant Professor

Department of Communication

Missouri State University

Springfield, MO


Randall D. Huss, MD, CMD

Geriatric medicine, PA/LTC physician; Nursing Home Medical Director

Mercy Clinic

Rolla, MO


Samir Garcia, MD


Ferrell Duncan

Springfield, MO


All speakers except Dr. Morrison and Jeff Nickel, have indicated they DO NOT have significant interest or affiliation in any pharmaceutical companies whose products he may discuss, nor do any members of his immediate family. All speakers have also indicated that they DO NOT intend to discuss any uses of pharmaceutical products or medical devices not approved by the FDA. All speakers have agreed to give a balanced view of therapeutic options, and will use generic names to contribute to impartiality. Their presentation will be evidence or scientific-based. There was no conflict identified that would exclude them from presenting.


Dr. Morrison has indicated he has relevant relationships with the following companies, he is a stockholder with Revive Medical and Ricochet Nutrition.  Dr Morrison’s conflicts have been reviewed by the committee and they did not have any effect on this conference.   Dr Morrison’s lectures were created without bias or influence from all external commercial entities.


Mr. Nickel has indicated he has relevant relationships with the following companies, he works PRN for Select Hospital.  Mr Nickel’s’s conflicts have been reviewed by the committee and they did not have any effect on this conference.   Mr. Nickel’s lectures were created without bias or influence from all external commercial entities.


Presenters are responsible for obtaining all applicable copyright releases when utilizing proprietary information. The opinions of the presenters are not necessarily those of CoxHealth; attendees should formulate their own opinions based on the evidence/scientific-based information presented.



Lisa Boyer, BSN, RN

Enterprise Educator

Nurse Planner/Conference Coordinator

Education Center


Nancy Cathey, BS Gerontology, MS Health Care Management

Director of Senior Care



Melissa Gaines, MD, FACP

Physician – Cox Senior Health



Robin Grothoff, MSW, LCSW

Clinic Manager

CoxHealth Senior Health Center


Stefanie Hawkins PharmD

Ambulatory Care Pharmacist



Deatrice Kellogg, MD

Physician – Cox Senior Health



William Rosen, MD

Medical Director

CoxHealth Senior Health Center


Keith Steenbergen, LNHA, BS

Nursing Home Administrator

Glendale Gardens Nursing & Rehab


Judee Steward, BS Gerontology

Senior Advocate

CoxHealth Senior Advantage


Kristi Vandeloecht, PTA, GC CDR, MS

Clinical Therapist Educator



All planning committee members, with the exception of Lisa Boyer have indicated they do not have any conflicts of interest or significant financial affiliations with any pharmaceutical or medical device companies that would exclude them from the planning of this activity. Lisa Boyer’s conflict has been reviewed by the committee and did not have any effect on this conference.   Planning committee members and speakers have created this activity without bias or influence from all external commercial entities. There were no conflicts identified that would exclude them from the planning process.

Special rates are available for CoxHealth conference participants at the following hotel. Ask for the CoxHealth negotiated rate of $119.00 plus tax.


Doubletree by Hilton

2431 N. Glenstone

Springfield, MO 65803


Cancellations received in writing to by March 10, 2019 will be entitled to a full refund. After this time, a $25 processing fee will be withheld. No refunds will be made the day of the conference. No shows will be charged the full conference fee.

In the event Education Center cancels or reschedules a course, participants are entitled to a full refund or the participant may transfer registration to the next scheduled activity. All refunds must be received in writing via email or by calling the Education Center. CoxHealth is not responsible for travel, hotel, booking fees, or other cancellation fees for registrants when an activity is cancelled.

The entire cancellation policy can be viewed at under the Continuing Education and Life Support tab.