To Protect the Elderly, UC Doctor Pioneers Programs, Networking Ideas

Dr. Laura Mosqueda says her loving relationship with her grandparents led her to the field of geriatrics.

In the six years Mosqueda has directed the geriatrics program at UC Irvine, healthcare for the elderly in Orange County has advanced on various fronts, from research to forensics.

UCI Medical Center in Orange has built a medical wing for geriatric patients and has increased the number of geriatricians from one to nine.

Three UC Irvine doctors now work with the county agency that deals with elderly welfare issues.

And Mosqueda was responsible for the establishment of Orange County’s Elder Abuse Forensic Center, the nation’s first program to bring together several county agencies to address elder abuse problems.

Mosqueda, 44, recently was appointed to the first Ronald W. Reagan Endowed Chair in Geriatrics at UC Irvine. It is one of six newly endowed chairs in geriatrics in the UC system funded by the state.

“It shows a commitment to improving medical education in geriatrics in the state,” Mosqueda said. “If we want to provide better medical care, we have to start with the medical schools.”

Colleagues speak about Mosqueda in glowing terms.

“She walks on water,” said Dr. Thomas Cesario, dean of the UC Irvine College of Medicine. “Laura has taken [the geriatrics program] to unbelievable heights.”

“She’s my Energizer bunny,” said Jo Marie Escobar, the assistant Orange County district attorney in charge of the Family Protection Unit that investigates elder abuse.

Mosqueda grew up in Los Angeles, the daughter of physicians. Her mother is a retired radiologist, her father a gastroenterologist. Her brother practices pulmonary and critical care medicine. Her husband is a carpenter.

She said UC Irvine was strengthening its geriatrics program because as baby boomers age, most doctors, almost regardless of their specialty, would be treating the elderly.

The emphasis begins in their first year, when UC Irvine med students are teamed with elderly people, meeting individually with them three times a year and starting simply by taking the patient’s medical history.

Additionally, a small group of fourth-year medical students follows patients with dementia for four or five months to understand what the patients’ families are going through -- even sitting in the doctor’s office as they wait for an appointment.

“We’re trying to combine the science and art of medicine,” Mosqueda said.

Among the challenges of treating older patients is connecting symptoms with a possible multitude of maladies, including dementia. Physicians also have to be wary of overmedicating elderly patients, and of drug interactions.

Mosqueda is especially concerned about the physical, emotional and financial abuse of the elderly.

Often, she says, victims remain out of sight, unlike in child abuse cases in which the victim goes to school and abuse is more easily detected. In some instances, older adults are abused by their children and are ashamed to seek prosecution.

Mosqueda testified before the Senate three years ago about elder abuse.

To aid in addressing the problem, Mosqueda received an $850,000 grant last spring from the Archstone Foundation, a senior-advocacy group based in Long Beach, to fund the Elder Abuse Forensic Center in Santa Ana. It brings together physicians, social workers, prosecutors and sheriff’s deputies to discuss cases. The center has trained about 100 police officers statewide in recognizing and prosecuting elder abuse.

Escobar said the number of felony abuse cases her office prosecuted had doubled to more than 30 a year with the opening of the center and assigning an attorney to work there.

Mosqueda also is part of the year-old Orange County Elder Death Review Team, which reviews suspicious deaths.

“I have been educated,” Escobar said. “She has opened my eyes to how easy it really is to cause the death of a very elderly person who is dependent on you for their care, and nobody knows about it. She pounds on us to be aware of what is normal and what is not normal.”

Rebecca Guider, deputy director of adult services for the Orange County Social Services Agency, said Mosqueda’s team had been invaluable to social workers in helping determine if someone had been abused or if they needed help.

“She really has spearheaded so many innovative things in Orange County and the state and the nation,” Guider said. “I feel like we’ve been so privileged to have her at UCI and to take an interest in working with our program.”