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2128 results in Geriatrics

Page 28 of 107

  • Chapter 56 - Caregiving

  • from Section IV - Principles of care for the elderly
  • Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
  • Book:
    Reichel's Care of the Elderly
    Published online:
    05 June 2016
    Print publication:
    23 June 2016, pp 749-755

  • Summary

    Family members have long provided physical, emotional, and financial assistance to relatives in need of support because of frailty, dementia, disability, and other conditions common in late life. As our country faces an enormous increase in the number of older Americans, the role of family caregivers will become increasingly important. Health care professionals, especially primary care physicians, should identify people in the caregiving role and screen for caregiving stress or burden. It is likewise important to screen for health effects including depression, anxiety, and substance abuse. Informal caregivers—friends and family members—often care for chronically ill older adults, including those who have a diagnosis of dementia. Caregiver stress can cause health issues for caregivers; clinicians are encouraged to use available tools to screen for stress and to link caregivers to local and online resources.

  • Chapter 27 - Urinary incontinence and fecal incontinence

  • from Section III - Care of the elderly by organ system
  • Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
  • Book:
    Reichel's Care of the Elderly
    Published online:
    05 June 2016
    Print publication:
    23 June 2016, pp 383-397

  • Summary

    Urinary and fecal incontinence are common problems among older adults, with many not discussing symptoms with providers. Incontinence has a significant negative impact on quality of life and can contribute to caregiver strain. The evaluation of urinary and fecal incontinence should focus on potentially reversible or treatable contributing factors. Treatment often depends on the type of incontinence, and initial treatment should begin with behavioral approaches. Common behavioral treatments include dietary management, timed voiding, pelvic floor muscle exercises, and strategies to control urgency symptoms. Biofeedback should be considered for the treatment of fecal incontinence, along with other behavioral treatments. Pharmacologic treatments differ for urinary and fecal incontinence. Anti-muscarinic and beta-agonist drugs are available for the treatment of urinary incontinence. Pharmacologic treatments for fecal incontinence focus on improving stool consistency. Non-invasive office-based procedures have an important role for treating both types of incontinence.

  • Chapter 33 - Common rheumatologic diseases in the elderly

  • from Section III - Care of the elderly by organ system
  • Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
  • Book:
    Reichel's Care of the Elderly
    Published online:
    05 June 2016
    Print publication:
    23 June 2016, pp 453-461

  • Summary

    Rheumatologic disease is often encountered in the geriatric population. Osteoarthritis, rheumatoid arthritis, and crystal-induced arthritis primarily affect the joints. Osteoarthritis, or degenerative arthritis, is the most common joint disease of the elderly. The most common sites include the hands, spine, hip, knees and feet. Rheumatoid arthritis also occurs in the geriatric population. This autoimmune disorder requires early and aggressive treatment to prevent increased morbidity and mortality. Crystal-induced arthritis, mostly gout and pseudogout, has an increased incidence and prevalence in the elderly. Other rheumatologic diseases seen more commonly in the elderly include polymyalgia rheumatica, giant cell arteritis, remitting seronegative symmetrical synovitis with pitting edema, Sjogren’s syndrome, and inclusion body myositis. Polymyalgia rheumatica, an inflammatory disease primarily involving the shoulders and pelvic girdle, is only found in the elderly. Giant cell arteritis, a vasculitis of large vessels, is also only present in the geriatric population. Remitting seronegative symmetrical synovitis with pitting edema is a disease of patients older than 50 years of age.

  • Chapter 21 - Pulmonary issues in the elderly

  • from Section III - Care of the elderly by organ system
  • Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
  • Book:
    Reichel's Care of the Elderly
    Published online:
    05 June 2016
    Print publication:
    23 June 2016, pp 298-310

  • Summary

    Physiologic changes of the respiratory system occur with aging; for example, the chest wall stiffens, airway size decreases, and the diaphragm becomes less efficient. However, these changes alone should not cause significant breathing difficulties unless there is an underlying disease process. The most commonly encountered pulmonary diseases in the geriatric patient population are obstructive lung diseases, pneumonia, pulmonary embolism, interstitial lung diseases, nontuberculous mycobacterium infections, and sleep disorders. Due to their increased likelihood of comorbidities, older patients have numerous special diagnosis and treatment considerations. Practitioners should focus on utilizing the most effective therapies to optimize lung function while minimizing potential harm to the patient.

  • Chapter 25 - Renal disorders in the elderly

  • from Section III - Care of the elderly by organ system
  • Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
  • Book:
    Reichel's Care of the Elderly
    Published online:
    05 June 2016
    Print publication:
    23 June 2016, pp 357-365

  • Summary

    Kidney function changes with aging. Elderly patients with kidney disease are at increased risk for a number of disorders, including alterations in electrolytes, changes in sodium absorption, and chronic changes in kidney function. Traditional estimations of glomerular filtration rate from serum creatinine, through the use of estimating equations, may not be appropriate for the geriatric population, particularly when results suggest only mild impairment in kidney function without proteinuria or hematuria. Still, as the population ages, kidney disease prevalence grows as well. Also, acute kidney injury (AKI) commonly occurs in this patient population. Anatomic and physiologic changes appear to be contributory. Complexities associated with kidney disease in the elderly include the risks as well as benefits of polypharmacy, the timing and indications of referral for specialist care, and the appropriateness of dialysis initiation, presenting challenges for the clinician.

  • Chapter 37 - Anemia and other hematological problems in the elderly

  • from Section III - Care of the elderly by organ system
  • Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
  • Book:
    Reichel's Care of the Elderly
    Published online:
    05 June 2016
    Print publication:
    23 June 2016, pp 523-536

  • Summary

    Hematologic abnormalities occur commonly in the elderly. The prevalence of anemia appears to increase with age and may be caused by various underlying etiologies, including iron deficiency, anemia of inflammation, or myelodysplastic syndrome. Thrombocytopenia due to underlying comorbidities, medications, or immune thrombocytopenia (ITP) may also occur. Underlying hematologic malignancies such as chronic lymphocytic leukemia (CLL) and multiple myeloma also become more prevalent with age. A systematic approach to the evaluation of these hematologic abnormalities is imperative to help guide diagnosis and management. For acute or progressive conditions, a multidisciplinary team of both geriatricians and hematologists is essential to ensure proper diagnosis, frailty assessment, and initiation of appropriate therapies. Novel therapies for the various hematological malignancies are well tolerated, turning life-threatening illnesses into chronic disease that can be managed while preserving quality of life.

Page 28 of 107