The Keystone for Geriatric Medicine provides expert primary care for seniors in the treasure valley. Our interdisciplinary team of doctors, nurse practitioners, therapist, nurses and pharmacists offers a full range of primary care for seniors, including post-hospitalization visits and referrals, treating falls, frailty, confusion and memory problems. We also coordinate care with other specialists and care providers, family and any in-home healthcare providers. Our comprehensive program eliminates or simplifies stressful decisions for patients and their caregivers, and helps them enjoy their golden years with their family, friends and community.

Why Choose Keystone

The Keystone Center for Geriatric Medicine's highly skilled doctors, nurse practitioners, pharmacists and staff use their rare knowledge and experience to provide unparalleled primary care for elders. Our care providers blend the expertise, and resources to provide a holistic focus on the patient's quality of life, and arrange their schedules to spend more time with patients and their families than most primary care physicians. This extra attention allows for highly individualized care and the ability to understand and help patients with any complicated medical or social situations they may have. In addition, our easy-to-use electronic medical record system allows patients and primary care physicians to send test results and messages to our geriatricians securely from any online computer.

Our Approach to Primary Care

Our geriatricians understand that advancing age comes with its own challenges, which can be complicated and difficult to understand. As one of the pioneering geriatric medicine outpatient practices in Idaho, we have extensive institutional experience improving quality of life for seniors. We specialize in all conditions unique to aging, including: multiple chronic health conditions, Falls, wounds, and Dementia.

Through a thorough review by Geriatricians and specially trained pharmacists We also help patients who take many medications (also known as polypharmacy) by identifying serious side effects or, whenever possible, prescribing fewer medications better suited to the patient's condition.

To ensure high-quality, continuous care, our doctors and nurse practitioners are available for consultations, and also offer an annual wellness visit to identify problems early and prevent future illness for all Medicare enrollees. During this visit, individual patients meet with a geriatrician to review their conditions, medicines and hospitalizations, as well as discuss their risk factors and how to stay healthy and well. If patients require specialty treatment, our geriatricians coordinate treatment and recovery plans with specialists, other caregivers, and the patient's primary care physician, as well the patient and patient's family.

Keystone Health Home-Based Medicine

Many older adults have chronic medical conditions—such as arthritis, heart failure, dementia or other illnesses—that make it difficult or impossible for them to visit a doctor's office. Through Keystone Health Home-Based Medicine, located in the treasure valley physicians and nurse practitioners visit participants at home to ensure that the patient's restricted mobility does not result in disrupted access to medical care.

What You Can Expect

  • Routine medical visits in the home, the frequency of which are determined by the physician or nurse practitioner and based on medical need.
  • Urgent medical visits during business hours, usually within 24 hours; emergencies are sent to local hospitals via emergency medical services (911).
  • Around-the-clock prompt telephone access to a physician or nurse practitioner.
  • Treatment from a team of providers specializing in older adults, including geriatricians (medical doctors with a specialty in older adults), nurse practitioners, geriatricians in training, and internal medicine residents.
  • Reminder calls before appointments. You will be given a window for the visit. Visits usually take place between 8am and 4pm

The program does not offer a full range of specialists or consultants. We do not provide transportation or personal assistance aids, but may be able to connect you with other community services. We only perform procedures that are safely conducted in the home environment. All visits take place in the participant's home. If the participant is in the hospital, inpatient rehabilitation or a nursing facility, we will resume visits when they return home.

Providing Full-Spectrum Geriatric & Dementia Evaluation and Management

Our Center, directed by Dr. Megan Dunay ,a board certified Geriatrician, provides:

  • Comprehensive geriatric assessment and consult
  • Mental competency/capacity examination
  • Evaluation of memory and cognitive functions
  • Medication management and prevention of polypharmacy and drug cascade syndrome
  • Evaluation and treatment of Geriatric Syndromes such as falls, Parkinson Disease, dementia, etc.
  • Evaluation and management of behavioral disorders related to geriatric population such a delirium, depression, anxiety, and dementia
  • Palliative consult
  • Cognitive assessment and diagnosis of dementia
  • Elder abuse assessment
  • End of life care

What is Geriatric Care?

Geriatrics is a health discipline encompassing psycho-social, economic, historical, and physiological factors for adults 65 and older. Geriatrics medicine focuses on two principal goals: preserving or improving quality of life and fostering independence or control over life as long as possible.

Who Are Geriatricians?

Geriatricians are physicians trained in the aging process. They evaluate and manage medical, social, and emotional needs of older adults. Their focus is in diagnosis, treatment, and prevention of disease and disability in older adults. They are specialized in geriatric assessment and rehabilitation, preventive medicine, management of patients in long-term care settings, and psycho-social, ethical, legal, and economic issues pertinent to geriatric patients. They give special attention to patients suffering from frailty, falls, incontinence, cerebrovascular disease, dementia, sensory impairment and other cognitive and affective changes that occur with aging.

What is Comprehensive Geriatric Consult (CGC) or Assessment (GCA)? CGC is comprised of a multidisciplinary diagnostic and treatment process that identifies medical, psycho-social, and functional limitations of an elderly person. It requires evaluation of physical, cognitive, affective, social, financial, environmental, and spiritual components that influence an older adult's health. The elderly person's primary care/hospital physician can send a referral to a geriatrician and request a CGC if she/he believes that based on the patient's medical history (age; medical conditions such as heart failure or cancer; psycho-social disorders such as depression or isolation; specific geriatric conditions such as dementia, falls, or functional disability; high health care utilization; and changes in living situation such as from independent living to nursing home or assisted living), the patient would health-wise benefit from such assessment.

Comprehensive Geriatric Assessment will focus on medical history, social history, and review of systems and includes the following components:

  • Functional capacity
  • Fall risk
  • Cognition
  • Mood
  • Pain
  • Vision & hearing
  • Medication (Polypharmacy & drug cascade)
  • Social support
  • Financial concerns
  • Goals of care
  • Advanced care preferences
  • Nutrition/weight change
  • Urinary/ fecal continence
  • Sexual function
  • Dentition
  • Living situation
  • Assessment of Driving-Related Skills
  • Spirituality
  • Durable power of attorney for healthcare
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