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Older adults represent the most rapidly growing demographic in the U.S. and in many developed countries around the world. The field of geriatric medicine is still relatively young, and is only recently seeing a significant increase in peer reviewed literature. Medicare and Medicaid expenditures related to older adults are nearly a trillion dollars/year in the US. How our healthcare system cares for older adults, and how those older adults navigate an increasingly complex system, is of the utmost importance. According to the Institute of Medicine, physicians and other healthcare professionals receive an inadequate amount of training in geriatric medicine. Geriatric medicine is based on the concept of delivering person centered care with a focus on function and quality of life. It is essential that physicians, nurse practitioners, physician assistants, pharmacists, social workers and other health care professionals all be knowledgeable about thegeriatric approach to care.
Geriatric medicine varies from most other fields in medicine. While many specialties function on the basis of evidence-based literature, geriatricians and other clinicians caring for older adults must integrate relatively limited evidence with variable physiological changes and complex psychosocial determinants. Geriatricians are used to caring for 90 year olds with multiple chronic illnesses. Their variable physiology leads to uncertain responses to pharmacotherapy, and their personal goals and wishes need to be incorporated into any plan of care. Practicing geriatric medicine requires the ability to see patterns. But it goes one step further, as the rules are constantly in flux. Every patient is an individual with particular needs and goals. In order to provide true person centered care to older adults, one has to incorporate these factors into the decision making process.
The proposed handbookis designed to present a comprehensive and state-of the-art update that incorporates existing literature with clinical experience. Basic science and the physiology of aging create a background, but are not the main focus. This is because every chapter has been written through the lens of “person centered care.” This book is about focusing on what matters to the person, and how that is not always about pathology and physiology. The reader generally will not find simple solutions to symptoms, diseases and syndromes. In fact, the key to caring for geriatric patients is the ability to think both critically and divergently at the same time. Geriatrics encompasses multiple disciplines and spans all of the subspecialties. It requires knowledge of working within an interdisciplinary team. It requires an appreciation of how quality of life varies with each individual and creates treatment and care plans that also vary. And most of all, it requires a firm commitment to first learning who the person is so that all of the necessary data can be analyzed and integrated into a true person centered plan of care. This book aims to serve as an unparalleled resource for meeting these challenges. Updated and revised from the previous edition, this text features over 40 new peer-reviewed chapters, new references, and a wide array of useful new tools that are updated on a regular basis by interdisciplinary and interprofessional experts in geriatric medicine.
Pages i-lvi
Front Matter
Pages 1-1
The Geriatrics Approach to Care
Pages 3-12
Pages 13-33
Caring for Patients in an Evidence-Limited World
Pages 35-51
Geriatric Prescribing Principles and Interprofessional Healthcare Team Leadership
Pages 53-76
Pages 77-86
Legal Aspects of Geriatric Medicine
Pages 87-108
Ethical Issues in the Care of Older Adults
Pages 109-120
Policy Issues in the Care of Older Adults
Pages 121-132
Age-Friendly Health Systems in an Ecosystem Perspective
Pages 133-146
Pages 147-167
Pages 169-184
Caregiving (in the Twenty-First Century)
Pages 185-199
Comprehensive Geriatric Assessment
Pages 201-210
Determination of Decision-Making Capacity
Pages 211-227
Pages 229-247
Pages 249-296
Health Maintenance and Prevention
Pages 297-321
Pages 323-340
Front Matter
Pages 341-341
Management of Cardiovascular Disease in the Elderly
Pages 343-383
Pages 385-400
Orthostatic (Postural) and Postprandial Hypotension in Older Adults
Pages 401-409
Pages 411-428
Pages 429-450
Pages 451-473
Thyroid Disorders in Older Adults
Pages 475-494
Infectious Diseases in Older Persons
Pages 495-510
Pages 511-541
Gastrointestinal Disorders in Older Patients
Pages 543-569
Pages 571-596
Pages 597-619
End-Stage Kidney Disease in the Elderly Population
Pages 621-635
Dermatologic and Mucocutaneous Disorders
Pages 637-662
Changes and Diseases of the Aging Eye
Pages 663-689
Otologic Changes and Disorders
Pages 691-708
Pages 709-719
Pages 721-760
Pages 761-779
Front Matter
Pages 781-781
Cancer and Older Adults: The Introduction
Pages 783-799
Cancer Screening in the Older Adult
Pages 801-825
Pages 827-854
Colorectal Cancer in Older Adults
Pages 855-868
Lung Cancer in Elderly: Patient-Centered Approach for Optimal Delivery of Care
Pages 869-884
Pages 885-911
Pages 913-917
Pages 919-932
Front Matter
Pages 933-933
Gynecologic and Urologic Problems in Older Women
Pages 935-958
Pages 959-977
BPH and Male Lower Urinary Tract Symptoms
Pages 979-997
Voiding Problems and Urinary Incontinence in the Geriatric Patient
Pages 999-1024
Front Matter
Pages 1025-1025
Alzheimer’s Disease and Other Dementias
Pages 1027-1046
Cerebrovascular Disease and Stroke
Pages 1047-1072
Parkinson’s Disease and Other Movement Disorders
Pages 1073-1096
Schizophrenia and Other Late-Life Psychoses
Pages 1097-1108
Front Matter
Pages 1109-1109
Depression, Anxiety, and Other Mood Disorders
Pages 1111-1153
Pages 1155-1169
Pain Management in the Older Adult
Pages 1171-1184
Pressure Injury and Chronic Wounds
Pages 1185-1212
Pages 1213-1233
Pages 1235-1249
Pages 1251-1265
Pages 1267-1277
Front Matter
Pages 1279-1279
Pages 1281-1294
Emergency Medicine and the Person-Centered Approach to the Older Adult
Pages 1295-1316
Approach to Acute Hospital Care
Pages 1317-1335
Pages 1337-1372
Pages 1373-1386
Pages 1387-1399
Pages 1401-1410
Pages 1411-1424
Pages 1425-1435
Population Health for Older Adults
Pages 1437-1449
Mechanisms of Paying for Health Care
Pages 1451-1467
Interdisciplinary Care and Care Coordination
Pages 1469-1485
Improving Quality and Safety in the Care of Older Adults
Pages 1487-1510
Front Matter
Pages 1511-1511
The Demography and Biodemography of Aging
Pages 1513-1524
Molecular and Biological Factors in Aging
Pages 1525-1554
Pages 1555-1565
Pages 1567-1584
Pages 1585-1624
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