GERIATRIC ASSESSMENT IN THE ACUTE CARE SETTING Acute care geriatric services have been an integral part of acute hospital care throughout the world for more than twenty years . Acute geriatric inpatient units represent an organizational ...

Author: Howard M. Fillit

Publisher: Cambridge University Press

ISBN: 1900151901

Category: Medical

Page: 214

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Geriatric assessment is an integral part of geriatric care throughout the world. The frail elderly often have multiple chronic illnesses, functional disabilities and psychosocial problems, their needs therefore extending far beyond the treatment of a single medical condition. Comprehensive assessment of such patients requires a multidisciplinary team approach and the use of an organized, efficient set of guidelines and procedures with which to identify and address potentially 'reversible' problems. The ultimate goal is then to systematically restore and maintain the functions essential to preserve quality of life. Practical Geriatric Assessment is structured for ease of quick reference. The background to each application of geriatric assessment is given first, and this is then placed in its practical context, thus providing an essential guide to the principles and methods of effective geriatric assessment.

Oxygen therapy is essential in the management of respiratory failure but great care has to be taken if hypercapnia is present because uncontrolled oxygen therapy leads to acute rises in PaCOz with disastrous consequences.

Author: M. Lye

Publisher: Springer Science & Business Media

ISBN: 9789400948907

Category: Medical

Page: 160

View: 561

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Most patients in developed nations with medical problems requiring hospital care are elderly. Increasingly the dividing line between general internal medi cine and acute geriatric medicine is becoming more blurred. It is, nevertheless, apparent that some elderly patients on medical or sub-specialty hospital wards become 'bed blockers'. Why? Also, why are 'bed blockers' less of a problem on an acute geriatric ward? Many clinicians believe this is related to a faster access to the long-stay beds of the geriatric unit. Even a brief study of hospital operating statistics will show this is not and cannot be the case. When geria tricians are asked to see elderly 'bed blockers' on colleagues' wards they approach with anxiety because these patients often have to be placed on a long waiting list for these scarce and very expensive continuing care beds. Do geria tricians see different acute medical problems compared with their colleagues? The answer is not immediately obvious, though geriatricians are likely to receive more potential 'bed blockers' than their general medical colleagues. How is it then, that geriatricians seem to cope better than their colleagues? All geriatricians have experience of general internal medicine but the opposite unfortunately does not hold. This book is written in the hope of redressing the imbalance.

The solution is to go on a 'search and rescue mission', to positively identify those who will benefit from your acute geriatric medicine service and take them away from the ED environment as soon as possible.

Author: Gideon Caplan

Publisher: IP Communications

ISBN: 9780987290540

Category: Medical

Page: 461

View: 498

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Geriatric medicine is one of the youngest medical specialities in Australia but is also one of the fastest growing. Geriatric medicine offers a more holistic approach to patient care than organ-based internal-medicine sub-specialities. Patient-centred interventions aim to allow the patient to function optimally. This textbook has been designed to inspire and inform students of geriatric medicine about the science and art of aged care. The book is structured to follow how geriatric-medicine clinicians approach patients who present with geriatric syndromes and must be assisted by systems of care. In an introductory part, overviews are provided of the biology of ageing, comprehensive geriatric assessment (the cornerstone of geriatric-medicine practice), multidisciplinary teamwork, and community services for older people in Australia. In the second part of the book, over 13 chapters, detailed coverage is provided of the geriatric syndromes, the so-called ‘geriatric giants’, immobility, incontinence, instability, and impaired intellect. In the third part of the book, over 10 chapters, ‘Care in context’ - care of older people in general practice and in residential aged care facilities, rehabilitation, acute and post-acute care, end-of-life issues, legal aspects of geriatric medicine, for example – is the focus; geriatric medicine is placed within the Australian health-care system. Individual chapters are written by specialist contributors. Case studies illustrate key points about assessment and management. Inclusion of three poems, by H W Longfellow, W B Yeats, and Dylan Thomas, will enable readers to ‘feel the heart within geriatric medicine’. Australasian medical students, junior hospital doctors working in geriatric medicine, and other members of aged-care teams (specialist nurses, physiotherapists, occupational therapists, social workers, etc.), will find in this book a succinct, readable, and authoritative introduction to the principles and practice of geriatric medicine.

TABLE 120-2 Recent United Kingdom Policy Documents Relevant to Geriatric Medicine—cont'd Author Outline of Contents ... avoidance and ambulatory care geriatrics Clinical governance lead 6 Acute geriatrics Orthogeriatrics lead 7 Acute ...

Author: Howard M. Fillit

Publisher: Elsevier Health Sciences

ISBN: 9780702063442

Category: Medical

Page: 1100

View: 699

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The leading reference in the field of geriatric care, Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, 8th Edition, provides a contemporary, global perspective on topics of importance to today’s gerontologists, internal medicine physicians, and family doctors. An increased focus on frailty, along with coverage of key issues in gerontology, disease-specific geriatrics, and complex syndromes specific to the elderly, makes this 8th Edition the reference you’ll turn to in order to meet the unique challenges posed by this growing patient population. Consistent discussions of clinical manifestations, diagnosis, prevention, treatment, and more make reference quick and easy. More than 250 figures, including algorithms, photographs, and tables, complement the text and help you find what you need on a given condition. Clinical relevance of the latest scientific findings helps you easily apply the material to everyday practice. A new chapter on frailty, plus an emphasis on frailty throughout the book, addresses the complex medical and social issues that affect care, and the specific knowledge and skills essential for meeting your patients’ complex needs. New content brings you up to date with information on gerontechnology, emergency and pre-hospital care, HIV and aging, intensive treatment of older adults, telemedicine, the built environment, and transcultural geriatrics. New editor Professor John Young brings a fresh perspective and unique expertise to this edition.

One of the challenges is to deliver specialist geriatric care to patients in acute care settings only (i.e. those in hospital for no more than 72 hours). Most of these patients will be managed on an acute medical unit, with variable ...

Author: Margot Gosney

Publisher: OUP Oxford

ISBN: 9780191634437

Category: Medical

Page: 624

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With an ageing population, there is little doubt that the majority of hospital-based consultants and their teams will care for older patients and the many complications this presents. This book provides an evidence-based guide for both trainees and consultants in geriatric medicine and those interested in geriatric medicine. Designed in line with the core Royal College curriculum, it provides a comprehensive and relevant guide to the issues seen in everyday geriatric medicine practice across the world. Presented in an easy-to-use double page spread format, highly bulleted and concise, Oxford Desk Reference: Geriatric Medicine is ideal for quick referral for both trainees and consultants. Contributions from the leading figures in geriatric medicine throughout the world make this book indispensable for all those working in the field, and for all those who have to deal with older patients.

Geriatric. Assessment. Providing quality acute geriatric care is complex [24]. Older persons presenting with acute illness have complex needs and require multidimensional assessment and coordinated multidisciplinary approach to care.

Author: Balakrishnan Kichu R. Nair

Publisher: Springer

ISBN: 9789811032530

Category: Medical

Page: 317

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Written by international experts, this book presents chapters that cover common geriatric conditions including dementia, depression, delirium, falls, polypharmacy, incontinence, immobility, and medication-related issues, as well as neurological, cardiovascular, and endocrine diseases associated with old age. The book also discusses various aspects of ambulatory, residential, and palliative care for the elderly, in addition to ethical aspects of old age care, advance care planning and living wills. Geriatric medicine is a rapidly growing field in internal medicine. The majority of elderly people now live in developing countries, where there is an urgent need to up-skill healthcare professionals. By presenting problems as they arise and then discussing how to solve them, this book offers a valuable resource for all physicians interested in the care of older people.

Effectiveness of acute geriatric units on functional decline, living at home, and case fatality among older patients admitted to hospital for acute medical disorders: meta-analysis. BMJ, 338, b50. Boult, C., Reider, L., Leff, B., et al.

Author: Jean-Pierre Michel

Publisher: Oxford University Press

ISBN: 9780198701590

Category: Medical

Page: 1393

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Over the past two decades there has been a marked change in global age demographics, with the number of over-60s increasing by 82% and the number of centenarians by 715%. This new-found longevity is testament to the success of recent advances in medicine, but poses significant challenges to multiple areas of health care concerning older patients. Building upon its predecessor's reputation as the definitive resource on the subject, this new edition of the Oxford Textbook of Geriatric Medicine offers a comprehensive and multinational examination of the field. Fully revised to reflect the current state of geriatric medicine, it examines the medical and scientific basis of clinical issues, as well as the ethical, legal, and socio-economic concerns for healthcare policy and systems. Over 170 chapters are broken up into 16 key sections, covering topics ranging from policy and key concepts through to infection, cancer, palliative medicine, and healthy ageing. New material includes focus on the evolving concepts of malnutrition, sarcopenia, frailty, and related geriatric syndromes and integration of geriatric principles from public health, primary and specialized care, and transitional stages from home to emergency, medicine and surgery, rehabilitation, and long term care. The Oxford Textbook of Geriatric Medicine brings together specialists from across the globe to provide every physician involved in the care of older patients with a comprehensive resource on all the clinical problems they are likely to encounter, as well as on related psychological, philosophical, and social issues.

Modawal A. Model and systems of geriatric care: "delirium rooms"–but where and at what cost? J Am Geriatr Soc 2004;52(6):1023. Chong MS, Chan MP, Kang J, et al. A new model of delirium care in the acute geriatric setting: geriatric ...

Author: Christopher R. Carpenter

Publisher: Elsevier Health Sciences

ISBN: 9781455771790

Category: Medical

Page: 344

View: 470

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This issue of Clinics in Geriatric Medicine features expert clinical reviews on Geriatric Emergency Medicine which includes current information on topics such as palliative medicine and emergency care, alternative management strategies, transitions of care, the emergency department observation unit and the older patient, generalized weakness, altered mental status, trauma management, acute pain management, acute visual changes, orthopedic emergencies, dizziness, palpitations, acute stroke syndromes, abuse and neglect, and electrolyte and endocrine emergencies.

ACUTE TREATMENT There are three main service patterns that describe the division of the acute medical intake between geriatric medicine and general medicine (Beresford 1993): Needs-related model □ Age-defined model □ Integrated model ...

Author: Gurcharan Singh Rai

Publisher: Elsevier Health Sciences

ISBN: 9780443103025

Category: Medical

Page: 528

View: 441

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This title is directed primarily towards health care professionals outside of the United States. It is aimed at the entire training requirements of Specialist Registrars. It covers both the practice of medicine for the elderly and also generic skills required by all doctors at this stage in their training. The emphasis is on practical advice (backed up by evidence where available) on the common problems of the elderly. Chapters end with references, further reading and self-assessment material. Incorporates implications of the National Service Framework for Older People. Chapter on ethics much changed due to: new GMC Guidelines on consent, confidentiality and withholding treatment; new BMA/RCN Guidelines on "do not resuscitate" decisions. New guidelines on stroke, hypertension and osteoporosis incorporated. Major update to bibliography.

Accordingly, Acute Medicine clinicians working collaboratively with the multidisciplinary team (MDT), acute geriatric medicine or frailty liaison teams, and community partners need to make a holistic assessment to reduce inappropriate ...

Author: Glenn Matfin

Publisher: John Wiley & Sons

ISBN: 9781119672852

Category: Medical

Page: 468

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Lecture Notes discusses the principles of the initial assessment, investigation, diagnosis, and management of adult patients with everyday Acute Internal Medicine (AIM) presentations and conditions. This textbook is wide in scope and covers topics ranging from initial identification of acute medical illness, through to effective discharge planning. Lecture Notes contains the latest developments on the generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions covered in the UK AIM curriculum (2022). In Lecture Notes, readers can expect to find detailed information on: Generic skills relevant to AIM, such as clinical reasoning, safe prescribing, point of care ultrasound (POCUS), resuscitation, and managing the acute medical take AIM across the various acute care settings – home (telemedicine, virtual wards, Hospital at Home), ambulatory (same day emergency care), and in-hospital (acute medical unit, enhanced care, critical care) AIM presentations and conditions in special populations such as older people, pregnancy, people with HIV, LGBTQ+, inclusion medicine, people with learning disabilities, perioperative medicine, people with mental illness and more Common presentations in AIM Standalone chapters can be read in any sequence, making the text perfect for quick reference With its accessible coverage of a wide range of AIM content, Lecture Notes: Acute Medicine is an essential resource for medical students, physician trainees, consultants, and other members of the multidisciplinary team working in acute care, patient-facing settings.