Scholars@Duke
Gwendolen Toni Buhr

Gwendolen Toni Buhr

Associate Professor of Medicine
Medicine, Geriatrics and Palliative Care
gwendolen.buhr@duke.edu
Duke Box 3003, Durham, NC 27710
201 Trent Drive, Box 3003, 2508 Blue Zone Duke Hospital S, Durham, NC 27710

Selected Publications

Point-of-Care Ultrasound in Post-acute and Long-Term Care: A Scoping Review.

Journal Article J Am Med Dir Assoc · October 19, 2024 OBJECTIVES: Point-of-care ultrasound (POCUS) is an emerging application of ultrasonography that is being integrated into patient care in many medical specialties. The post-acute and long-term care (PALTC) setting has opportunities to adopt POCUS as a diagn ... Full text Link to item Cite

Use of Virtual Interactive Patient Encounters to Prepare First-Year Medical Students for Clinical Practice.

Journal Article Acad Med · October 1, 2023 PROBLEM: With the dissolution of the Step 2 Clinical Skills exam, medical programs have a greater responsibility to teach and assess clinical skills in the preclerkship years. Clinical teaching this early has traditionally been avoided because of insuffici ... Full text Link to item Cite

Hypotension

Chapter · February 18, 2022 Blood pressure is the vital sign reflecting the function of the heart, vascular system, and blood volume and the central nervous system's response to changes in these systems. Hypotension is associated with a full spectrum of symptoms, including dizziness, ... Full text Cite

Geriatrics Scholarly Concentration Programs Among U.S. Medical Schools.

Journal Article J Am Geriatr Soc · September 2020 OBJECTIVES: To identify and describe geriatric scholarly concentration programs (GSCPs) among U.S. medical schools. DESIGN: Survey and interview. SETTING: Allopathic and osteopathic medical schools in the United States. PARTICIPANTS AND METHODS: We used a ... Full text Link to item Cite

Geriatric Resource Teams: Equipping Primary Care Practices to Meet the Complex Care Needs of Older Adults.

Journal Article Geriatrics (Basel) · October 21, 2019 Primary care practices lack the time, expertise, and resources to perform traditional comprehensive geriatric assessment. In particular, they need methods to improve their capacity to identify and care for older adults with complex care needs, such as cogn ... Full text Link to item Cite

Resident learning across the full range of core competencies through a transitions of care curriculum.

Journal Article Gerontol Geriatr Educ · 2018 The authors developed a Transitions of Care (TOC) curriculum to teach and measure learner competence in performing TOC tasks for older adults. Internal medicine interns at an academic residency program received the curriculum, which consisted of experienti ... Full text Link to item Cite

Advancing Geriatrics Education Through a Faculty Development Program for Geriatrics-Oriented Clinician Educators.

Journal Article J Am Geriatr Soc · December 2015 Geriatrician and nongeriatrician faculty need instruction as teachers to provide quality training for a broader community of physicians who can care for the expanding population of older adults. Educators at Duke University designed a program to equip geri ... Full text Open Access Link to item Cite

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

Journal Article Gerontologist · August 2015 PURPOSE OF THE STUDY: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. DESIGN AND METHODS: The study design was a qualitative, observational study of nursing home staff perceptions of the im ... Full text Link to item Cite

Using the jigsaw cooperative learning method to teach medical students about long-term and postacute care.

Journal Article J Am Med Dir Assoc · June 2014 Since many of the frailest and most vulnerable Americans reside in nursing homes, medical students need focused education and training pertaining to this setting. A unique cooperative learning experience utilizing the jigsaw method was developed to engage ... Full text Link to item Cite

Development and assessment of a web-based clinical quality improvement curriculum.

Journal Article J Grad Med Educ · March 2014 BACKGROUND: Understanding quality improvement (QI) is an important skill for physicians, yet educational interventions focused on teaching QI to residents are relatively rare. Web-based training may be an effective teaching tool in time-limited and experti ... Full text Open Access Link to item Cite

An advanced course in long term care for geriatric medicine fellows.

Journal Article J Am Med Dir Assoc · July 2013 Long term care deserves focused attention within a geriatric medicine fellowship curriculum to ensure that graduates are prepared not only for clinical care but also for the leadership, administrative, educational, quality improvement, and health policy as ... Full text Link to item Cite

MDS 3.0 perspective: a better tool for patient care.

Journal Article J Am Med Dir Assoc · March 2013 Full text Link to item Cite

Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities.

Journal Article Ann Longterm Care · April 2012 Urinary tract infections (UTIs) are commonly suspected in residents of long-term care (LTC) facilities, and it has been common practice to prescribe antibiotics to these patients, even when they are asymptomatic. This approach, however, often does more har ... Link to item Cite

Prioritizing culture change in nursing homes: perspectives of residents, staff, and family members.

Journal Article J Am Geriatr Soc · March 2012 OBJECTIVES: To explore the perspectives and priorities of nursing home residents, family members, and frontline nursing staff concerning a broad range of items representing common targets of culture change initiatives. DESIGN: Qualitative study. SETTING: A ... Full text Link to item Cite

Ensuring vitamin D supplementation in nursing home patients--a quality improvement project.

Journal Article J Nutr Gerontol Geriatr · 2012 Randomized controlled trials have shown that adequate vitamin D supplementation in nursing home (NH) residents reduces the rates of falls and fractures. In our NH, review of medication administration records of all patients (n = 101) revealed that only 34. ... Full text Link to item Cite

Update on teaching in the long-term care setting.

Journal Article Clin Geriatr Med · May 2011 Since the advent of the teaching nursing home, made formal in the 1980s, long-term care has been used to teach geriatric medicine. Despite this, national surveys have indicated a need for more training during residency to facilitate the appropriate care fo ... Full text Link to item Cite

Urinary tract infections in long-term care residents.

Journal Article Clin Geriatr Med · May 2011 Urinary tract infection (UTI) is common in long-term care (LTC) residents; however, most infections are asymptomatic and do not require treatment. Differentiating asymptomatic from symptomatic UTI is challenging, because LTC residents typically have chroni ... Full text Link to item Cite

Nutritional supplements for older adults: review and recommendations--Part II.

Journal Article J Nutr Elder · January 2010 The use of nutritional supplements (NS) with the intention of improving health and delaying age-related chronic disease is a common practice among older adults; however, randomized controlled trials have yielded mixed results regarding the likelihood that ... Full text Link to item Cite

Mentoring: a key strategy to prepare the next generation of physicians to care for an aging America.

Journal Article J Am Geriatr Soc · July 2009 Mentoring is an important instructional strategy that should be maximally used to develop the next generation of physicians who will care for a growing population of frail older adults. Mentoring can fulfill three specific purposes: (1) help learners choos ... Full text Link to item Cite

Body mass trajectory, energy balance, and weight loss as determinants of health and mortality in older adults.

Journal Article Obes Facts · 2009 The relationship between body mass (usually measured as BMI in kg/m(2)) and healthy longevity is a major focus of study in the nutrition and aging field. Over-nutrition now rivals frailty as the major nutritional concern; the number of older adults who are ... Full text Link to item Cite

Nutritional supplements for older adults: review and recommendations-part I.

Journal Article J Nutr Elder · 2009 The majority of older adults take nutritional supplements (NS) to prevent deficiencies and/or because they are interested in the potential health promoting effects of these nutrients. This review explores the evidence of benefit for supplements of multivit ... Full text Link to item Cite

Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life.

Journal Article J Am Med Dir Assoc · June 2008 OBJECTIVES: The purpose of this review was to describe the characteristics of late-life obesity, including prevalence, pathophysiology, and influences on morbidity and mortality. A second objective was to systematically review the empiric evidence on the e ... Full text Link to item Cite

Solving the long-term care puzzle: A unique learning experience for medical students.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2007 Link to item Cite

Difficult behaviors in long-term care patients with dementia.

Journal Article J Am Med Dir Assoc · March 2007 Difficult behaviors are relatively common challenges that can occur throughout the natural progression of dementia, but are particularly common in the mid to late stages of disease. These behaviors can be challenging to manage in nursing and assisted care ... Full text Link to item Cite

Providing optimal nutrition in the assisted living environment

Chapter · January 1, 2007 Optimal nutritional status plays a critical role in successful aging, contributing to both health and quality of life.1 One key determinant of dietary intake and thus nutritional status in the later years of life is living situation, since living environme ... Cite

Difficult Behaviors in Long-Term Care Patients with Dementia

Journal Article Journal of the American Medical Directors Association · January 1, 2007 Full text Cite

Quality improvement initiative for chronic pain assessment and management in the nursing home: a pilot study.

Journal Article J Am Med Dir Assoc · May 2006 Featured Publication OBJECTIVES: To improve assessment and management of chronic pain in the nursing home through a method of continuous quality improvement. DESIGN: Quality improvement. SETTING: One nursing home in North Carolina as the primary site and 3 related facilities a ... Full text Link to item Cite

Difficult behaviors in long-term care patients with dementia.

Journal Article J Am Med Dir Assoc · March 2006 Featured Publication Difficult behaviors are relatively common challenges that can occur throughout the natural progression of dementia, but are particularly common in the mid to late stages of disease. These behaviors can be challenging to manage in nursing and assisted care ... Full text Link to item Cite

Caregivers' reasons for nursing home placement: clues for improving discussions with families prior to the transition.

Journal Article Gerontologist · February 2006 Featured Publication PURPOSE: This study identifies the relative importance of reasons for institutionalization endorsed by caregivers of patients with dementia; examines the relationship between caregivers' reasons for institutionalization and indicators of caregiver and pati ... Full text Link to item Cite

When to talk with families about nursing home placement: Evidence for physicians.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2003 Link to item Cite