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Management of Infections in Advanced Dementia - 1 CME Credit

Virtual patient cases designed to merge best practices in infectious diseases and palliative care

Start Date: October 4, 2018
Duration: ~ 1 hour
Price: $49

Course Description

Course registration is currently closed while we upgrade our learning platform with enhanced functionality and self-service options for learners. If you would like to be notified when the course re-opens in March 2020, please click here.

Antimicrobial use is extensive in advanced dementia; however, prior research suggests much of this use may not be appropriate. This interactive, self-directed course employs four virtual patient cases to illustrate how health care providers can improve the management of infections in advanced dementia by merging best practices in infectious diseases and palliative care.

Management of Infections in Advanced Dementia presents consensus-based algorithms for antimicrobial initiation, guidance on how to integrate resident preferences into treatment decisions, and tips for communicating with families about infection management in advanced dementia. Two of the cases focus on the management of suspected urinary tract infections, and the other two focus on suspected lower respiratory tract infections. Each case includes three to four multiple choice questions. Participants receive response-specific, evidence-based feedback to answers, as well as supplemental information. This course also includes videos for three scenarios that demonstrate best practices for communicating with families. Finally, the course includes a 10-item multiple choice knowledge pre/posttest.

This course is designed for primary care and specialty physicians, physician assistants, nurses, and nurse practitioners and takes approximately one hour to complete.

What You'll Learn

  • Recognize when it is appropriate to start antimicrobials for a suspected suspected lower respiratory or urinary tract infection in nursing home residents with advanced dementia
  • Examine the incidence and outcomes of infections in advanced dementia
  • Integrate patient preferences in treatment decisions for infections
  • Interpret urinalysis and urine culture results
  • Manage asymptomatic bacteriuria


Susan L. Mitchell, MD, MPH

Susan L. Mitchell, MD, MPH Professor of Medicine at Harvard Medical School; Senior Scientist at the Hebrew Senior Life Institute for Aging Research

Erika D’Agata, MD, MPH

Erika D’Agata, MD, MPH Associate Professor at Brown University, Division of Infectious Diseases; Associate Professor, Rhode Island Hospital, Providence, Rhode Island


Management of Infections in Advanced Dementia covers the following four case studies:

  • 1. Mrs. Baker—a 90-year-old woman with advanced dementia and lethargy.
  • 2. Mrs. White—an 87-year-old woman with advanced dementia, fever, and a new cough.
  • 3. Mr. Ross—a 95-year-old man with advanced dementia and fever.
  • 4. Mr. Smith—a 98-year-old man with advanced dementia, aspiration, and fever.

    Certificate of Completion
    Participations will complete a post-test and be provided a link to the course evaluation after earning a 75% or higher. After completion of the course evaluation, learners will be provided their certificate of completion (CME or CNE).


    Accreditation Statement

    The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    AMA Credit Designation Statement

     ACCME logo

    The Harvard Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    ANA Credit Designation Statement

    This continuing nursing education activity was approved by the American Nurses Association Massachusetts (ANA MASS), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This activity was approved for 1.00 contact hour for all nurses completing the activity after 1/19/2019.


    Disclosure Policy

    Harvard Medical School has long held the standard that its continuing medical education courses be free of commercial bias.

    In accord with the disclosure policy of the Medical School as well as standards set forth by the Accreditation Council for Continuing Medical Education, course planners, speakers, and content reviewers have been asked to disclose any relevant relationship they, or their spouse or partner, have to companies producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients. In addition, faculty have been asked to list any off-label uses of pharmaceuticals and/or devices for investigational or non-FDA approved purposes that they plan to discuss.

    Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide the course director and participants with information that might be of potential importance to their evaluation of a given presentation.

    Disclosure Statement

    All individuals including course directors, planners, reviewers, faculty, staff, etc., who are in a position to control the content of this educational activity have, on behalf of themselves and their spouse or partner, reported no financial relationships related to the content of this activity.


    Susan Mitchell, MD, MPH, a geriatrician and clinical researcher, is a professor of medicine at Harvard Medical School and senior scientist at the Hebrew Senior Life Institute for Aging Research in Boston. She is a graduate of the University of Ottawa Medical School, and has a Master’s Degree in Public Health from the Harvard School of Public Health. Dr. Mitchell’s research focuses on decision-making, health outcomes, and resource utilization for older persons with advanced dementia. She is currently the principal investigator on several large NIH-funded grants that aim to improve the end-of-life experience for patients with advanced dementia and their families.

    Erika D’Agata, MD, MPH, is an infectious disease specialist and epidemiologist. She is an associate professor at Brown University in the Division of Infectious Diseases and at the Rhode Island Hospital in Providence, Rhode Island. Dr. D’Agata is an expert in infection management and antimicrobial resistance in long-term care settings.


    How long will this course take?

    This course should take approximately one hour to complete. You do not need to complete it all at once. You may come back as often as you like.

    How long will this course be available?

    This self-paced course will close enrollments one year after its start date.

    What web browser should I use?

    The platform works best with current versions of Chrome, Firefox, or Safari, or with Internet Explorer version 11 and above. See our list of supported browsers for the most up-to-date information.

    What if I want to learn more about this topic?

    HMS Continuing Education holds live topic-focused conferences throughout the year. Please see our course catalog for upcoming events.