Skip to main content Accessibility help
×
  1. Home
  2. Browse subjects
  3. Medicine
  4. Geriatrics
  5. Content listing

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

2128 results in Geriatrics

Page 29 of 107

  • Chapter 36 - Pressure ulcers

  • 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 509-522

  • Summary

    Despite extensive prevention and treatment efforts for pressure ulcers, they remain prevalent in various health care delivery settings. Pressure ulcers are increasingly viewed as public health and patient safety issues, and regulatory pressure exists to prevent ulcer development. Because of the significant morbidity and mortality associated with pressure ulcers and because they are considered, for the most part, preventable, effective pressure ulcer prevention has been included in hospital safety strategies. Treatments include palliative wound care, pressure redistribution and repositioning interventions, nutritional intervention, surgery to close pressure ulcers, and pain management. An interdisciplinary team approach that includes not only interprofessional clinical staff and hospital administration, but also patients and their families, is important for achieving care that supports function, independence, and quality of life.

  • Chapter 46 - Aging in adults with intellectual disabilities and severe and persistent mental illness

  • 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 640-650

  • Summary

    Although they are distinct populations, older persons with intellectual disabilities (ID) and older persons with severe and persistent mental illness (SPMI) share a variety of characteristics that affect their clinical needs and, hence, their interactions with community-based health care practitioners. Physical comorbidity is the rule for older persons with intellectual disabilities and serious and persistent mental illnesses. Several promising evidence-based programs such as health education, health screenings, and healthy lifestyle changes through exercise and nutrition have been demonstrated to improve the quality of life of older adults with disabilities and reduce the long-term medical burden of care. Health promotion should be a cornerstone of care for older patients with disabilities. The family provides a safety net of support for older adults with disabilities, as significant numbers of older adults with ID and SPMI live with their families. Even when they live apart, family members provide high levels of support. These families face significant challenge as the caregivers themselves age, and long-term caregiving takes a toll on their health and well-being.

  • Chapter 7 - Frailty

  • from Section II - Geriatric syndromes
  • 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 97-106

  • Summary

    Frailty is an important geriatric syndrome characterized by diminished physiologic reserves and function, and a decreased capacity to withstand stressors. More than a third of people over age 85 are estimated to be frail, and are at higher risk of adverse health outcomes, including dependency, institutionalization, and death. Although advanced age, multi-morbidity and disability are associated with frailty, there is strong evidence that frailty is a distinct entity. It is characterized by diminished strength and endurance, and impaired physiologic function in many organ systems (including musculoskeletal, neuroendocrine, and immune systems) and includes nutritional, cognitive, and psychosocial dimensions. The two main frailty constructs are a biological syndrome model and an accumulation of deficits model. Frailty is an important syndrome to guide clinical care, and several screening tools include combinations of nutritional status, physical activity, mobility, energy, strength, cognition, mood, and social relations and support.

  • Chapter 9 - Evaluation and management of dizziness

  • from Section II - Geriatric syndromes
  • 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 116-124

  • Summary

    Dizziness is a common symptom in the elderly characterized by a distorted sense of spatial orientation. Vertigo, a related symptom, includes the illusion of self-motion. Dizziness (spatial disorientation without an illusion of self-motion) occurs when distorted input to the vestibular system is relatively symmetrical, while vertigo often occurs when the input is relatively asymmetrical. Patients may use terms such as lightheaded, woozy, off-balance, or spinning to describe dizziness or vertigo. Characterizing the experience (e.g., “What do you mean by dizziness?”) is not specific enough to identify the cause. More important is determining the timing, triggers, and associated findings of the experience. ‘Timing’ refers to the continuity and duration of symptoms, with three categories: episodic vestibular syndrome (EVS)—brief, intermittent episodes lasting seconds to hours; acute vestibular syndrome (AVS)—continuous symptoms for days to weeks; and chronic vestibular syndrome (CVS) persisting for months to years. ‘Triggers’ are actions that initiate dizziness (e.g., specific head movements, standing posture, or exercise).

  • Chapter 11 - Recognition, management, and prevention of delirium

  • from Section II - Geriatric syndromes
  • 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 148-156

  • Summary

    Delirium is a serious neuropsychiatric condition characterized by an acute change in cognition and attention that affects a significant proportion of hospitalized older adults and is associated with significant morbidity and mortality. Prevention of delirium is an important part of the care of hospitalized older adults. The Hospital Elder Life Program is a multicomponent intervention that has been shown to reduce the incidence of delirium. As many cases of delirium are overlooked, its diagnosis is important and can be achieved using the Confusion Assessment Method, which relies on four cardinal features of delirium: acute onset, inattention, altered level of consciousness, and disorganized thinking. The etiology of delirium is often multifactorial with contributions from predisposing factors (such as sensory impairment, chronic illness, and cognitive impairment) and precipitating factors (such as infection, polypharmacy, or illness). Once diagnosed, delirium should be evaluated with a thorough history, complete physical, medication review, and targeted tests in an effort to identify these factors.

  • Chapter 41 - Dental care for the elderly patient

  • 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 587-596

  • Summary

    The establishment and long-term maintenance of comfort, function, health, and aesthetics in the oral cavity is important for nutrition, hydration, self-esteem, and survival. Recent research has shown a correlation between oral health and systemic health. The general physician has an opportunity to interview and examine patients to determine whether there is a need for an oral health professional’s services. The timeless value of an emphasis on prevention and patient and caregiver education is particularly germane to oral health. Salivary integrity, diet (processed carbohydrate discipline), oral hygiene, fluoride exposure, and periodic examination by an oral health professional are important to maintain the health of the mouth.

  • Chapter 50 - The mistreatment of older adults

  • 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 685-690

  • Summary

    Elder mistreatment is a surprisingly common and often misunderstood phenomenon. It causes significant pain and suffering and is especially prevalent among those who have a dementing illness. Financial abuse is one of the most common types of mistreatment and often co-exists with other types (such as emotional and/or physical abuse). Sometimes the clinician is called upon to assess capacity for financial transactions. The implications and consequences of such an assessment are significant, and it is often helpful to engage a geropsychologist or neuropsychologist to assist with an accurate determination. It is critically important for the clinician to ask about abuse and to identify high-risk situations. Once abuse is suspected, the clinician must know what the reporting requirements and options are, as these vary among states. In general, suspected abuse in licensed facilities is reported to the Long-Term Care Ombudsman, and suspected abuse in community settings is reported to Adult Protective Services. Health practitioners have an opportunity to prevent and detect abuse at early stages, thus improving the quality of life for their patients and those who love them.

  • Chapter 1 - Essential principles in the care of the elderly

  • from Section I - General approach to the care of 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 1-16

  • Summary

    The core principle that should guide any health professional caring for older adults and their families is that the "secret of caring for the patient is in caring for the patient." (Peabody). Practitioners must understand the most up-to-date biomedical and psychosocial aspects of aging, health, wellness, and disease, and strive to support the older adult to remain as active, functional, and engaged as possible. At the same time, practitioners must recognize and help patients and families understand when a palliative approach will be most effective at meeting their goals. The Choosing Wisely campaign launched the American Board of Internal Medicine provides targeted guidance to clinicians to provide care that is effective and efficient, consistent with the essential principles.

  • Chapter 3 - Comprehensive geriatric assessment

  • from Section I - General approach to the care of 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 28-45

  • Summary

    Geriatric providers must evaluate and manage their patients with a focus on function in order to provide optimal care. The comprehensive geriatric assessment (CGA) is an interprofessional approach to assess function and screen for geriatric syndromes in the heterogeneous older adult population. Components of geriatric assessment include the history and physical, cognitive assessment (such as the widely used Mini-Mental State Exam), assessment of affect to screen for depression, and assessment of functional status. The latter evaluates activities of daily living (ADL), falls, incontinence, nutrition, safety of the environment in which the patient lives, and social situation. This method of evaluation has shown to improve the care of older adults throughout the continuum of care: in the hospital, in primary care, and at home.

  • Chapter 35 - Dermatologic conditions 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 477-508

  • Summary

    The geriatric population seeks care for a variety of skin concerns, which may be common conditions or unique to their age group. Some conditions can be attributed to normal physiologic changes of aging, which include benign skin growths, immunosenescence, and generalized xerosis. Other concerns are pathologic and may be related to a medical comorbidity or medication. Additionally, years of sun exposure may result in a significant burden of cutaneous carcinoma for some individuals. Changes in the structure and function of the skin that are a result of both natural and UVR-induced aging may contribute to skin disease. Common conditions (such as atopic dermatitis, seborrheic dermatitis, and psoriasis) affect the elderly in addition to diseases that are more unique to this population, such as bullous pemphigoid. Appropriate evaluation and management of skin disease require special attention in older adults.

  • Chapter 38 - Cancer 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 537-563

  • Summary

    Cancer is one of the leading causes of mortality and morbidity in the developed world. Age is a primary risk factor for developing cancer, and geriatric oncology is a rapidly emerging field which aims to address the needs of older cancer patients. The four most common solid tumors encountered in elderly patients are breast, prostate, colorectal, and lung cancer. All clinicians who deal with elderly patients should have knowledge of cancer risks, screening, and management principles. When evaluating cancer patients, the first issue to address is life expectancy exclusive of the cancer diagnosis. After estimating life expectancy and completing a geriatric assessment, the goals and options of cancer treatment can be better defined. Final decision-making should be patient-centered, with the patient’s (and the family, if appropriate) choice taking precedence

  • Chapter 53 - Implications of an aging society

  • 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 719-729

  • Summary

    The aging of America, as well as of the entire world, will have wide-ranging consequences on our society, economy, government, and our own lives. Everyone will be affected in some way by this demographic change. Untold opportunities and challenges will present themselves. A shortage of clinicians and paid caregivers will put greater strain on our health care system. Ensuring the health and welfare of our nation, including those who are most vulnerable, will require a reassessment of personal and governmental priorities. It is likely that more of the caregiver burden will be shifted to families and informal caregiving networks and more of the financial burden for long-term care will shift from government onto the private sector. Necessary increases in government spending on Social Security, Medicare, and Medicaid, even if individual benefits decrease, will result in decreased discretionary spending by state and federal governments. There will also be a greater burden on local governments and communities to meet the needs of a growing number of older adults. Nevertheless, the opportunity for many to live longer, better lives is a real possibility.

  • Chapter 28 - Gynecologic 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 398-407

  • Summary

    Gynecologic concerns remain common throughout the lifespan. The most common concerns of elderly females are vulvovaginitis and other vulvar conditions, gynecologic-specific cancers, pelvic floor prolapse, post-menopausal symptoms, and sexual dysfunction. Elderly patients are less likely to report concerns and may have special needs due to underlying comorbidities. Careful attention to risk factors with sensitive history taking is an important part of health and wellness in the aging female. Special adjustments can be made during the physical exam for patient comfort. The approach to the geriatric patient should be based individually on functional status and patient goals. Frail elders should be managed with quality of life and maintenance of function as the top priorities.

  • Chapter 18 - Sleep 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 264-273

  • Summary

    Sleep disorders in late life are typically unrecognized, underdiagnosed, and poorly treated. Epidemiological studies report that more than 50% of older adults meet diagnostic criteria for one or more sleep disorders. These sleep disorders often are associated with negative changes in quality of life and increased health care burden and mortality rates, among other serious consequences. Contextual factors may complicate the diagnosis and management of sleep disorders in late life. Insomnia and sleep apnea are the two most common sleep disorders in older patients. Both psychological interventions and pharmacotherapy are treatments for insomnia and sleep apnea.

  • Chapter 48 - Post-acute care and institutional long-term care for the elderly

  • 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 659-670

  • Summary

    Skilled nursing facilities are continuing to evolve in the services offered and in their role within the health care system. Nursing facilities are increasingly offering care for post-acute, short-stay patients such as those needing rehabilitation after a stroke, medical illness, or surgery. Short-term care may also include respite care and hospice-type care. Typically, over half of the long-term residents in a nursing facility suffer from dementia. The trend toward a variety of assisted living arrangements has left skilled nursing facilities with more medically complex, functionally and behaviorally impaired residents. Issues of informed consent, use of restraints, and medication prescribing and management must all be addressed at both the clinical and administrative levels. Quality improvement efforts must include regulatory and legal requirements in addition to the benchmarks set by the nursing facilities themselves.

  • Chapter 31 - Lipid management in older patients

  • 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 436-445

  • Summary

    Appropriate lipid management in older patients provides an important opportunity to address cardiovascular risk. In light of the recent update in the cholesterol treatment guidelines, clinicians are encouraged to apply both evidence from clinical trials and additional judgment in treating older individuals. Included in this approach to reducing the burden of cardiovascular disease are considerations of combining medical therapy with an important emphasis on lifestyle to assist in care for older individuals. Given the influence of age on cardiovascular risk and associated comorbidities in this population, the balance between risk and benefit is central to appropriate clinical decision making

Page 29 of 107