Name______________________________________
Address____________________________________
E-Mail_____________________________________
Employer___________________________________
Employer Address____________________________
__________________________________________
Preferred Phone #____________________________
Business Phone______________________________
REGISTRATION: Alzheimer’s
PROGRAM FEE:
EDUCATORS
This course is approved for six (6) hours professional
development ACT 48 hours.
Marywood University has been approved by NBCC as an
Approved Continuing Education Provider, ACEP No. 4081.
Programs that do not qualify for NBCC credit are clearly
identified. Marywood University is solely responsible for all
aspects of the program. 6 (CEUs)
•General Fee: $35
• Professional Fee: $60
(No CEU’s issued)
(All related CEU’s)
Program fee includes all related CEU’s, program
handouts, morning refreshments, and lunch.
FUNERAL DIRECTORS
TOTAL AMOUNT DUE: ______________
This activity has been submitted to PA State Nurses
Association for approval to award contact hours. PA State
Nurses Association is accredited as an approver of continuing
nursing education by the American Nurses Credentialing
Center’s Commission on Accreditation. This continuing
nursing education activity has no commercial support or
influencing financial relationships. There are no conflicts of
interest. (6.5 CH’s)
PAYMENT:
Cash
Amount $_______
Check
(Payable to Marywood University)
Amount $_______
Credit Card
Charge to:
Master Card
Visa
Discover
Author. #___________________________________
3-Digit Security Code _______ Exp. Date_________
Signature___________________________________
Bill Agency Authorization letter must be attached.
Agency registrations will not be processed without
letter of authorization.
I understand and agree that if, for any reason, my employer refuses payment,
or if I withdraw from the course after the 100 percent cancellation period, I
will be responsible for the immediate and full payment of registration fees due.
Any cancellation one week or more prior to a program will receive a 100
percent refund. No credit for billed or paid registrations will be given after the
one-week deadline.
HOW TO REGISTER / INQUIRIES
• Register in person with cash or a check at Professional Continuing
Education located at the Swartz Center on University Avenue.
• Register by mail with a check or credit card to Professional Continuing
Education, Marywood University, 2300 Adams Ave, Scranton, PA 18509
• Register by fax. If Agency is paying include an authorization letter to bill
the agency. Fax to 570.961.4798
• Register by phone with credit card by calling 570.340.6060
• NEW! Register online at marywood.augusoft.net
QUESTIONS?
• Jill Schroth, Director 570.340.6061 | [email protected]
• Linda Wrazien, Secretary 570.340.6060 | [email protected]
PRESENTS
COUNSELORS
This activity has been submitted to the
Pennsylvania State Board of Funeral Directors, 6 hours.
Alzheimer’s:
NURSES/NURSE PRACTITIONERS
THE DISEASE, THE PATIENT,
THE CAREGIVER
PHYSICIANS/PHYSICIAN ASSISTANTS
This activity has been planned and implemented in
accordance with the Essential Areas and policies of the
Accreditation Council for Continuing Medial Education
through the joint sponsorship of The Commonwealth Medical
College and Marywood University. The Commonwealth
Medical College is accredited by the ACCME to provide
continuing medical education for physicians. The
Commonwealth Medical College designates this live activity
for a maximum of 6.0 AMA PRA Category 1 Credit(s)TM.
Physicians should claim only the credit commensurate with
the extent of their participation in the activity.
SOCIAL WORKERS
This program is approved for six (6) continuing education
hours for social workers applicable toward NJ/PA LSW
licensure renewal.
NURSING HOME ADMINISTRATORS
This activity has been submitted to the Pennsylvania State
Board of Examiners for Nursing Home Administrators for
approval to award contact hours.
OCTOBER 13, 2015
THE VISITING NURSE ASSOCIATION
OF LACKAWANNA COUNTY
& SURROUNDING COMMUNITIES
301 Delaware Avenue • Olyphant, PA 18447
vnahospice.org
REGISTRANT INFORMATION
CONTINUING
EDUCATION CREDITS
NON PROFIT
ORGANIZATION
U.S. POSTAGE PAID
CLARKS SUMMIT, PA
PERMIT #25
REGISTRATION FORM
Latour Room, Nazareth Student Center
Marywood University
PROFESSIONAL
CONTINUING EDUCATION
SUPPORTED BY:
PRESENTER BIOS
7:30am Registration, Continental Breakfast & Vendor Display
8:00am Welcome by Beth McGuigan, VNA Executive Director,
VNA Hospice and Home Health of Lackawanna County
8:15am Michael Gower, Caregiver
Participants will be able to:
1. Discuss the physical, social and psychological effects on the family and/or caregiver
of caring for a patient with Alzheimer’s Disease.
2. Discuss the role of family dynamics in providing care to the patient with Alzheimer’s disease.
8:45am Teresa Osborne, Secretary, Pennsylvania Department of Aging
As a result of this presentation, participants will be able to:
1. Identify the state initiatives that relate to the care of the patient with Alzheimer’s Disease.
9:45am Dr. Mario Cornacchione, DO, CMD, FAAFP
Participants will be able to:
1. Differentiate Alzheimer’s Disease from other types of dementia.
2. Discuss the diagnostic tools and testing procedures in making the diagnosis of Alzheimer’s
dementia.
3. Discuss treatment modalities utilized in the management of Alzheimer’s Disease.
4. List factors that will effect the extent of end of life care for the patient with
Alzheimer’s Disease.
11:45am Lunch (included)
1-2:30pm Attorney James Gillotti, BS, JD
Participants will be able to:
1. Discuss the importance for patients with dementia to complete a power of attorney (POA) and living
will.
2. List essential contents for a POA and living will.
3. Identify the legal standards for capacity to sign wills, POA and living wills.
4. Explain the guardianship process for incapacitated individuals.
2:30pm Clayton Jacobs, Alzheimer’s Association - Greater PA Chapter
This presentation will allow participants to:
1. Identify key components in engaging staff and colleagues in culturally competent approaches to meet
the needs of patients with Alzheimer’s Disease.
2. Identify ways professionals and families can advocate at state and federal level to increase awareness
and action to assist patients and families in the care of the patient with Alzheimer’s Disease.
4:00pm Closing Remarks/Program Evaluation
Michael Gower, BS
Mario Cornacchione, DO, CMD, FAAFP
Mike is a native of South Scranton, and a graduate of
Mansfield University. He recently retired from Johnson
& Johnson after more than 30 years of dedicated service.
Mike has held several senior management positions within
Johnson & Johnson that include Vice President of Account
Management, Vice President of Sales and Vice President of
Health Care Compliance where he created and implemented
Compliant Business Practices for the Medical Device Market
in China. He was instrumental in creating a China HCC
Compliance Committee that developed policies/procedures
and corrective actions. He is recognized globally as an
innovator in sales and distribution, among other important
roles. On a personal level, Mike shared the responsibility of
caring for his mother, an Alzheimer’s disease patient, with his
siblings during her disease progression.
Serving currently as an Associate Professor in the
Department of Family, Community and Rural
Medicine at The Commonwealth Medical College,
Dr. Cornacchione is Research Program Director of
the Northeast PA Memory & Alzheimer’s Center. A
graduate of Alfred University, Rutgers University,
and New York College of Osteopathic Medicine,
he trained at the University of Rochester, UCLA
School of Medicine, and Mt. Sinai School of
Medicine. Dr. Cornacchione is currently on the
editorial board of Journal of Parkinson’s Disease and
Alzheimer’s Disease, and is President of the Geriatric
Research & Consulting Group, Wilkes Barre. He
is an accomplished presenter and has published
numerous papers and multimedia videos.
Teresa Osborne, Master of Health Services
Administration, BSW
James Gillotti, Certified Elder Law
Attorney, Oliver, Price & Rhodes
Also a native of Scranton, and currently Secretary for the
Pennsylvania Department of Aging, Teresa previously served
as Executive Director of Luzerne/Wyoming Counties Area
Agency on Aging, Chancellor and COO for the Diocese of
Scranton, Executive Director of the Lackawanna County’s
Department of Human Services and Area Agency on Aging,
as well as director positions with the Advocacy Alliance,
United Cerebral Palsy of NEPA, and Serving Seniors.
Secretary Osborne has a long history of working with and
advocating for older Pennsylvanians and other vulnerable
populations, and volunteered with numerous not-forprofit and community organizations focused on improving
conditions for seniors, persons with disabilities and the
marginalized.
Atty. Gillotti, a native of Carbondale, has been in
private practice in Lackawanna County since 1980,
after graduating from the University of Scranton,
and receiving his law degree from Dickinson
School of Law. Jim was certified in 2012 as an
Elder Law Attorney by the National Elder Law
Foundation. He was instrumental in the creation
of the Elder Law Committee of the Lackawanna Bar
Association and serves as Chairman. Atty. Gillotti’s
practice is concentrated in Estate Planning,
assisting families with Medicaid eligibility and
protecting assets from long-term care costs,
administration of estates and trusts, Special Needs
Planning, Business Law and Real Estate.
Clayton Jacobs, BS/Music Education/Psychology
Clay serves as the Vice President of Programs and Services for the Alzheimer’s Association-Greater PA Chapter
in Wilkes Barre. Prior to this role his positions focused on community education, public health outreach and
community mental health services. Mr. Jacobs oversees the programs, services, research engagement and grass
roots advocacy efforts of the Greater Pennsylvania Chapter in 59 of Pennsylvania’s 67 counties. These efforts
include services to 140,000 Pennsylvanians and the mobilization of 13,000 registered advocates. Clay also
serves on the Alzheimer’s Association’s National Quality Assurance & Clinical Engagement workgroups, PSUHershey Medical Center’s CERC Advisory Board, and the Department of Aging Diversity and Inclusion Council.