Current Diagnosis and Treatment: Geriatrics 2E

An authoritative, one-stop source of answers on conditions commonly encountered among older adults

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• Provides a framework for using the functional and cognitive status, prognosis, and social context of patients to guide diagnosis and treatment of medical conditions
• Applies the principles of geriatric medicine in different care settings to address common clinical scenarios and common geriatric conditions
• Includes valuable information on health promotion and disease
• Delivers essential information on important topics such as delirium, cognitive impairment, dementia, falls and mobility disorders, Parkinson and other movement disorders, sleep disorders, and arthritis
• Covers special geriatric considerations in cardiovascular health, cancers, endocrine disorders, skin problems, respiratory disease, and renal disorders
• Concise, practical, and current diagnostic and treatment information on the most common health problems of older adults
• The best quick reference for busy clinicians who provide care for older patients
• Valuable to students, residents, nurses, nurse practitioners, physician assistants, internists, and family physicians.
• Includes guidance on care in all settings – clinic, home, hospital, and long-term care, as well as pre- and post-operative settings

Section I. Principles of Geriatric Care
1. Transforming the Care of Older Adults: Knowledge, Skills, & System Change
Guiding Principles
2. Consideration of Function & Functional Decline
Geriatric Principles
Epidemiology of Functional Limitations
Assessment of Functional Status
Risk Factors for Functional Decline
Prevention of Functional Decline
Rehabilitation: The Treatment of Functional Decline
3. Goals of Care & Consideration of Prognosis
Goals of Care Discussions
A Practical Guide to Goals of Care Discussions
Importance of Surrogate Decision Makers
Prognostication
Prognosis Related to Specific Diseases
Communicating Prognosis to Patient or Surrogate
4. The Social Context of Older Adults
Financial Issues in the Third Age
Food Insecurity and Older Adults
Medicare
Housing and Long-Term Care
Caregiving
Recommendations for Clinicians
5. The Interprofessional Team
Key Definitions and Concepts
Interprofessional Team Innovations in Geriatrics
Evidence of Interprofessional Teams in the Care of Older Adults
Resources and Tools for Teamwork
Barriers to the Advancement of Teamwork
Future Steps
6. Geriatric Assessment
Teams and Clinical Sites of Care
Prognosis
Patient Goals
Functional Assessment
Preventive Services
Falls and Gait Impairment
Vision Impairment
Hearing Impairment
Dementia
Incontinence
Depression
Nutrition
Medication Use
Caregiver Support
Financial, Environmental and Social Resources
Abuse
Geriatric Assessment in Primary Care
7. Atypical Presentations of Illness in Older Adults
Defining Atypical Presentations
Identifying Patients at Risk
8. Prevention & Health Promotion
Screening Issues for the Geriatric Population
Geriatric Syndromes
Health-Related Behaviors
Immunizations
Endocrine Disorders
Cardiovascular Disease
Cancer
9. Principles of Prescribing for Older Adults
Geriatric Principles
Drug Metabolism and Physiologic Effects in Older Adults
Geriatric Therapeutics
Prescribing for Older Adults
Adherence
Managing Complexity
Prescribing Across the Care Continuum
10. Addressing Multimorbidity in Older Adults
Background and Definitions
Multimorbidity and Health Outcomes
Clinician Challenges in the Care of Older Adults with Multimorbidity
General Considerations in the Care of Multimorbid Older Adults
11. Geriatrics & Palliative Care
Overview of Palliative Care
Psychological, Spiritual, and Social Issues
Communication, Decision Making, and Advance Care Planning
Challenges to Providing Palliative Care in Long-Term Care Settings
Caring for Family Members: Grief and Bereavement
12. Ethics & Informed Decision Making
Ethical Issues in the Care of Older Adults
Decision-Making Capacity and Informed Decision Making
Advance Care Planning and Advance Directives
Surrogate Decision Making
Balancing Promotion of Independence and Patient Safety
Section II. Care Settings
13. Transitions and Continuity of Care
General Principles in Older Adults
Definitions
Background
Adverse Events During Transitions
Barriers to Successful Care Transitions
Overcoming the Barriers: Best Practices
Evidence-Based Interventions
Innovations
Conclusion
14. Ambulatory Care & the Patient-Centered Medical Home
General Principles in Older Adults
Personal Physician
Physician Directed Medical Practice
Whole-Person Orientation
Care Coordination and Integration
Quality and Safety
Enhanced Access
15. Providing Quality Care to Older Adults in the Emergency Department
General Principles
Models of Emergency Care
Structural Enhancements
Financing
Clinical Care
Future of Emergency Care
16. Hospital Care
General Principles in Older Adults: Hazards of Hospitalization
Successful Models of Care
Approach to the Hospitalized Older Adult
Therapy
Prevention
Transitioning from Hospital to Home
17. Perioperative Care in Older Surgical Patients
General Principles in Older Adults
Surgical Risk in the Older Adult
Clinical Care
Models of Surgical Care
18. Long-Term Care, Nursing Home, & Rehabilitation
General Principles in Older Adults
Long-Term Care in the Community
Institutional Long-Term Care
Hospice and End-of-Life Care
19. Home-Based Care
Preventive Home Care/ Geriatric Assessment
Medical House Calls
Posthospitalization Case Management & Transitional Care Models
Home Rehabilitation
Hospital at Home
Eligibility Requirements
Payment Denials
Innovations in Care Delivery
Medicaid
Area Agencies on Aging
Postacute Hospitalization & Home Rehabilitation Care
Home Care & Assessments
House Calls & Home-Based Primary Care
20. The Aging Traveler
General Principles in Older Adults
Overview of Travel Problems
Risk of Venous Thromboembolism Due to Travel
Resources About Travel Risks
Ship Travel
Air Travel
Section III. Common Conditions in Geriatrics
21. Delirium
22. Cognitive Impairment & Dementia
23. Cerebrovascular Disease
24. Parkinson Disease & Essential Tremor
Parkinson Disease
Essential Tremor
25. Falls & Mobility Disorders
26. Osteoarthritis
27. Osteoporosis & Hip Fractures
28. Coronary Disease
Acute Coronary Syndrome
Chronic Coronary Heart Disease
29. Heart Failure & Heart Rhythm Disorders
Heart Failure
Bradyarrhythmias
Tachyarrhythmias—Atrial Fibrillation & Atrial Flutter
Ventricular Arrhythmias
30. Hypertension
31. Valvular Disease
Aortic Stenosis
Aortic Insufficiency
Mitral Stenosis
Mitral Regurgitation
32. Peripheral Arterial Disease & Venous Thromboembolism
Peripheral Arterial Disease
Venous Thromboembolism
33. Chronic Venous Insufficiency & Lymphedema
Chronic Venous Insufficiency
Lymphedema
34. Chronic Obstructive Pulmonary Disease
35. Gastrointestinal & Abdominal Complaints
Gastroesophageal Reflux Disease
Dysphagia
Motility Disorders
Peptic Ulcer Disease
Dyspepsia
Diarrhea
Diverticular Disease
Inflammatory Bowel Disease
Fecal Incontinence
Colonic Ischemia
Abdominal Pain
36. Constipation
37. Fluid & Electrolyte Abnormalities
Hyponatremia
Hypernatremia
Potassium Disorders
Hypokalemia
Hyperkalemia
Nocturnal Polyuria
38. Chronic Kidney Disease
39. Urinary Incontinence
40. Benign Prostatic Hyperplasia & Prostate Cancer
Benign Prostatic Hyperplasia
Prostate Cancer
41. Thyroid, Parathyroid, & Adrenal Gland Disorders
Subclinical Hypothyroidism
Subclinical Hyperthyroidism
Hypothyroidism
Myxedema Coma
Hyperthyroidism
Nodular Thyroid Disease & Neoplasia
Acute Adrenal Insufficiency
Cushing Syndrome
Hyperparathyroidism
42. Diabetes
43. Anemia
44. Common Cancers
Breast Cancer
Lung Cancer
Colorectal Cancer
Pancreatic Cancer
Ovarian Cancer
Leukemia
Lymphoma
45. Depression & Other Mental Health Issues
Depression
Suicide
Bipolar Disorder
Anxiety & Stress Disorders
Schizophrenia & Psychotic Disorders
46. Sexual Health & Dysfunction
47. Common Infections
Urinary Tract Infections
Respiratory Tract Infections
Gastrointestinal Infections
Skin and Soft-Tissue Infections
Prosthetic Joint Infections and Osteomyelitis
HIV/AIDS
48. Pressure Ulcers
49. Common Skin Disorders
Seborrheic Keratosis
Epidermal Inclusion Cyst
Warts (Verruca Vulgaris & Verruca Plantaris)
Onychomycosis
Dry Skin, Pruritus, & Asteatotic Dermatitis
Seborrheic Dermatitis
Stasis Dermatitis
Psoriasis
Rosacea
Contact Dermatitis
Drug Eruption (Morbilliform)
Herpes Zoster
Scabies
Bullous Pemphigoid
Actinic Keratosis
Basal Cell Carcinoma
Squamous Cell Carcinoma
Melanoma
50. Sleep Disorders
Insomnia
Sleep Apnea
Periodic Limb Movement During Sleep & Restless Legs Syndrome
Narcolepsy
Circadian Rhythm Sleep Disorders
REM Behavior Disorder
Sleep Problems in Special Populations
51. Oral Diseases & Disorders
Section IV. Common Clinical Scenarios in Geriatrics
52. Evaluating Confusion in Older Adults
53. Addressing Polypharmacy & Improving Medication Adherence in Older Adults
Problems Caused by Polypharmacy
Unprescribing: Intervening to Reduce Polypharmacy
Adherence
54. Managing Persistent Pain in Older Adults
55. Considering Anticoagulation in Older Adults
Available Classes of Anticoagulant Therapy
Management of Bleeding in Older Patients on Anticoagulants
56. Assessing Antiaging Therapies for Older Adults
Antiaging Therapies
Ethical and Legal Issues with Antiaging Therapies
57. Considering Complementary & Alternative Medicines for Older Adults
Massage and Chiropractic Therapy
Herbs & Supplements
Other Forms of Alternative or Complementary Medicine
58. Managing Misuse of Alcohol & Psychoactive Prescription Medications in Older Adults
Health Risks Associated with Hazardous and Harmful Use in Older Adults
Psychoactive Medications
Definitions to Guide Screening and Interventions
Brief Interventions
59. Assessing Older Adults for Syncope Following a Fall
General Approach to the Patient with Falls or Syncope
How Falls and Syncope Overlap
When to Consider Syncope as a Cause of Falls
Common Diagnostic Categories to Consider
60. Treating Headaches in Older Adults
61. Managing Vision Impairment in Older Adults
Normal Changes in the Aging Eye
Cataracts
Age-Related Macular Degeneration
Diabetic Retinopathy
Glaucoma
Systemic Medications and Glaucoma
Visual Symptoms Indicating Need for Urgent Referral to an Eye-Care Specialist
62. Managing Hearing Impairment in Older Adults
63. Addressing Chest Pain in Older Adults
64. Addressing Dyspnea in Older Adults
65. Managing Joint Pain in Older Adults
Gout
Calcium Pyrophosphate Crystal Disease
Polymyalgia Rheumatica
66. Managing Back Pain in Older Adults
67. Determining the Appropriate Use of Exercise for Older Adults
68. Defining Adequate Nutrition for Older Adults
69. Helping Older Adults with Low Health Literacy
Unique Health Literacy Considerations in Older Adults
Screening
Clear Health Communication Strategies
Systems Approaches
70. Understanding the Effects of Homelessness and Housing Instability on Older Adults
Pathways to Homelessness Among Older Adults
Strategies to Prevent Homelessness Among Older Adults
Health Status of Older Homeless Adults
Interaction Between Health Status and Environment
Conclusions & Next Steps
71. Understanding the Effects of Criminal Justice Involvement on Older Adults
Epidemiology
The Clinical Encounter
72. Detecting, Assessing, & Responding to Elder Mistreatment
73. Meeting the Unique Needs of LGBT Older Adults
Definitions
Health Issues for LGBT Older Adults
Biopsychosocial Aspects of Care
Conclusion
Section V. Broadening Clinical Practice
74. Applying Evidence-Based Medicine to Older Patients
The Challenges with Current Evidence
Applying the Evidence to Your Older Patients
75. International Perspectives in Geriatric Care
Challenges for the Future of China’s Aging Population
76. Public Policy Intersecting with an Aging Society
Three Spheres of Aging with Dignity and Independence
Key Programs and Services for Older Adults
Opportunities in the Patient Protection and Affordable Care Act
Where Do We Go from Here?
Index