The older patient with multiple chronic illnesses and other acute issues superimposed is among the greatest challenges confronting the nation's healthcare system. The Division of Geriatric and Palliative Medicine is committed to providing the highest quality of care to older patients and to all patients who are suffering with pain and with other symptoms that are associated with serious illness.
The Division of Geriatric and Palliative Medicine is educating the next generation of physicians through accredited fellowship programs, and is contributing to research to improve care delivery to people with chronic illness and frailty, and those at the end of life. Through comprehensive programs, the Division of Geriatric and Palliative Medicine provides care to promote longevity, minimize illness, reduce costly and preventable hospitalizations and readmissions, and coordinate care of complicated patients.
Our geriatricians diagnose, treat, and manage diseases and conditions that require a special approach when dealing with older adults. They give attention to situations of special concern, including falls, incontinence, preoperative assessment, and post-operative management, cerebrovascular disease, dementia, sensory impairment, and other cognitive and affective changes that occur with aging.
The palliative care multidisciplinary team of physicians, nurses, social workers, and chaplains provides specialized medical treatment to improve quality of life during a serious illness at North Shore University Hospital and Long Island Jewish Medical Center. The palliative care team has fostered strong relationships with local hospice centers and Northwell Health's home-based palliative care team to provide continuous coordination of care and meet patients' and families' care needs.
The Division of Geriatric and Palliative Medicine provides inpatient, outpatient, primary, and consultative services. The faculty are spread through numerous practices including: Northwell Health Geriatric Medical Group, the ambulatory practice at North Shore University Hospital, Geriatric Medicine Consultation Service at North Shore University Hospital, Palliative Care Unit at North Shore University Hospital, Palliative Care Consult Service at Long Island Jewish Hospital, the Geriatric and Palliative Medicine Consult Service Mobile Medical Van, and Senior Housing Medical Services. The division is committed to:
- Multidisciplinary care of older adults and people with advanced illness as well as their families.
- Educating the next generation of physicians through accredited fellowships in geriatric medicine and hospice and palliative medicine.
- Contributing to research into improved care delivery to people with chronic illness and frailty and to those individuals who are at the end of life.
Geriatric services: Geriatricians often become the primary physician for older adults. If this is not the case, your primary physician might refer you to a geriatrician when a problem associated with aging requires special attention. In some cases, a family member might recognize a need for a geriatrician and suggest you consult one.
- Inpatient Services
- Geriatric Consultation
- Palliative Medicine Consultation
- Geriatric Medical Group
- Primary Care of Older Adults and Advice to their Caregivers
- Memory Disorder Evaluation
- North Shore-LIJ Health System Home Care Network
- Hospice Care Network
- North Shore-LIJ Physician Home Visit Program
Palliative services: Palliative care is not a replacement for a patient’s regular treatment. It can be provided at any time during a patient’s illness — regardless of whether that condition is curable or chronic — but is ideally offered as soon as possible following diagnosis. It includes:
- Treating pain and other symptoms
- Ensuring patients and families are fully informed about treatment options
- Helping patients and families receive the care they need — both during and after their hospital stay
When people have complex illnesses that make accessing traditional ambulatory care difficult, they need high intensity, comprehensive care that comes to the home. At Northwell Health, doctors, nurse practitioners, and social workers do just that.
Advanced Illness Management (AIM) is an advanced care program for patients with complex medical conditions who have functional difficulties with activities of daily living. Care is administered in the home so patients can receive quality service in a familiar environment and reduce unnecessary medical treatments. AIM, a program which is part of Northwell Health's care management organization, Care Solutions, partners with the division of Geriatric and Palliative Medicine to meet the needs of our most vulnerable patients.
House Calls Program
Given the choice between home and a hospital, most patients with advanced illness would prefer to spend their remaining time at home. Northwell Health AIM recognizes the patient’s need for the familiarity and comfort of home, so we offer House Calls.
House Calls is a comprehensive care management program that provides home-based primary care services to patients with complex advanced illnesses, functional impairments, or high rates of hospital and emergency department utilization. House Calls is nationally recognized. It has been featured in Newsday and by the local CBS news affiliate, WLNY TV10/55. In 2012, it was one of 18 programs across the country selected to participate in the Centers for Medicare and Medicaid Innovation’s Independence at Home project, and has received grants from regional and national foundations for trial studies and further program development.
An integrated health care team
Patients in the House Calls program have an interdisciplinary care team that administers comprehensive care tailored to their needs.
- Physicians and nurse practitioners provide primary and palliative care in the patient’s home.
- Social workers ensure patients are safe at home and address psycho-social needs.
- Wound care specialists tend to non-healing abrasions.
- Medical coordinators schedule appointments and manage prescriptions, durable medical equipment orders, and specialty referrals.
Patients in the House Calls program can expect a high level of treatment provided similar to those provided in the doctor’s office, including ultrasounds, radiology, EKG, sleep studies, lab work, physical, occupational and speech therapy, as well as IV fluids and prescription refills.
Compassionate care – On demand
Illness doesn’t stick to a 9-to-5 schedule, so neither does the Northwell Health House Calls program. Medical staff is available around-the-clock to assist patients during emergencies.
- A nurse practitioner is available to answer clinical questions from patients and caregivers, and make urgent same-day visits during normal business hours (Monday-Friday, 9 a.m. – 4:30 p.m.).
- Physicians and nurse practitioners are also available by phone on weeknights and weekends to answer clinical questions from patients and caregivers, or arrange urgent services.
- Community paramedics provide a 24/7 in-person clinical response for patients experiencing unpredictable changes in clinical status who do not have a physician or nurse practitioner immediately available.
Health care is often segmented – with limited communication between providers, hospitals and organizations. Advanced Illness Management wants to eliminate the division between services by working with hospitals and health care providers to ensure coordinated care, even outside the home.
- When House Calls patients are admitted to the hospital, their primary care physician contacts the hospital care team within 48 hours to share information and speed the discharge process.
- Clinicians visit patients at home within 48 hours of discharge from hospitals and rehab facilities to assist with safe transitions back into the community.
- The interdisciplinary care teams work closely with hospice, home care, and several community-based organizations to ensure continuity of care.
Shared decision making
An informed patient is a better patient. Patients need to be equal partners in making decisions about their health. House Calls providers include patients and their caregivers in developing joint care plans and work with subspecialists as needed. From the outset, goals of care are established for every patient, and the majority of patients have a Medical Orders for Life-Sustaining Treatment (MOLST) form completed and entered into the medical record.
The Northwell Health Advanced Illness Management team wants their patients to spend less time doing medically unnecessary procedures and more time with friends and family.
- All House Calls patients are encouraged to document their wishes and appoint a Health Care Proxy for cases when they cannot make health care decisions themselves.
- House Call providers work diligently to reduce unwanted visits to the Emergency Department, as well as hospitalizations through the integrated services provided in the home.
Geriatric Medical Practice
865 Northern Boulevard, Suite 201
Great Neck, NY 11021
(516) 773-8974 (evenings and weekends)
Long Island Jewish Medical Center
270-05 76th Avenue
New Hyde Park, NY 11040
North Shore University Hospital
300 Community Drive
Manhasset, NY 11030
Home-Based Palliative Care
Advanced Illness Management:
Hospice Care Network:
Orzac Center for Rehabilitation
900 Franklin Avenue
Valley Stream, NY 11580
Barbara Tommasulo, M.D. - Medical Director
Orzac Center for Rehabilitation
900 Franklin Avenue
Valley Stream, NY 11580
Phone: (516) 256-6551
Maria Torroella Carney, MD
- Chief of Division - Geriatrics & Palliative Care of Medicine - Internal Medicine, Long Island Jewish Medical Center
- Chief of Division - Geriatrics & Palliative Care of Medicine - Internal Medicine, North Shore University Hospital
- Associate Professor, Hofstra Northwell School of Medicine
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