Acute Medicine In The Frail Elderly

Frail older people now contribute the majority of the acute emergency take both medical and surgical. Despite this there is often a lack of confidence and knowledge among doctors and nurses in treating older people in the Emergency Department and on Emergency Assessment Units.From the Preface Emergency care of frail older people is challenging but very rewarding. Older patients tend to be complex and therefore their assessment needs to be more extensive and include comprehensive geriatric assessment. It is the extras in their assessment that are not usually needed in younger patients, such as cognitive, functional and social evaluations that make the difference in achieving a better outcome. This book describes the key features of high quality care for frail elderly patients in acute hospital settings. With chapters on assessment and the characteristic non-specific ways that patients tend to present (such as 'confusion', 'collapse query cause' and 'off legs'), this practical guide is ideal to have on-hand. As well as common medical and surgical conditions, it also covers medication management, elder abuse, pressure ulcers and hypothermia, including the physiological changes seen in ageing and ways to define frail patients. Tables, diagrams and images are ideal for quick reference, and key points are summarised throughout the text to aid comprehension, providing doctors, nurses and therapists with both background and essential information to provide the excellent acute care older people deserve.

Frail older people now contribute the majority of the acute emergency take both medical and surgical. Despite this there is often a lack of confidence and knowledge among doctors and nurses in treating older people in the Emergency Department and on Emergency Assessment Units.From the Preface Emergency care of frail older people is challenging but very rewarding. Older patients tend to be complex and therefore their assessment needs to be more extensive and include comprehensive geriatric assessment. It is the extras in their assessment that are not usually needed in younger patients, such as cognitive, functional and social evaluations that make the difference in achieving a better outcome. This book describes the key features of high quality care for frail elderly patients in acute hospital settings. With chapters on assessment and the characteristic non-specific ways that patients tend to present (such as 'confusion', 'collapse query cause' and 'off legs'), this practical guide is ideal to have on-hand. As well as common medical and surgical conditions, it also covers medication management, elder abuse, pressure ulcers and hypothermia, including the physiological changes seen in ageing and ways to define frail patients. Tables, diagrams and images are ideal for quick reference, and key points are summarised throughout the text to aid comprehension, providing doctors, nurses and therapists with both background and essential information to provide the excellent acute care older people deserve.

The aging of society is a growing concern in all advanced nations, and at the forefront of concern is long-term care for frail older people. Enactment of a new public long-term care insurance program by the Japanese government in 1997 provided an excellent opportunity for a conference focusing on an ideal long-term care system for frail older people. The conference was organized around four major themes: Social aspects, including family dynamics and the role of formal providers; Clinical aspects, including effective treatments for physical and mental disabilities; Macroeconomic and macropolitical settings for public policy; Program design and management issues. With contributions from the fields of medicine, nursing, social work, gerontology, political science, economics, and sociology, this volume provides an overview of key problems and possible solutions in programs for frail older people from a unique international perspective.

This book discusses all important aspects of emergency medicine in older people, identifying the particular care needs of this population, which all too often remain unmet. The up-to-date and in-depth coverage will assist emergency physicians in identifying patients at risk for adverse outcomes, in conducting appropriate assessment,and in providing timely and adequate care. Particular attention is paid to the commonpitfalls in emergency management andmeans of avoiding them. Between 1980 and 2013, the number of older patients in emergency departmentsworldwide doubled. Compared with younger patients, older people suffer from more comorbidities, a higher mortality rate, require more complex assessment and diagnostic testing, and tend to stay longer in the emergency department. This book, written by internationally recognized experts in emergency medicine and geriatrics, not only presents the state of the art in the care of this population but also underlines the increasing need for adequate training and development in the field.

This issue of Clinics in Geriatric Medicine, guest edited by Drs. Michael Malone and Kevin Biese, is devoted to Care for the Older Adult in the Emergency Department. Articles in this outstanding issue include: Approach to the Older Patient in the Emergency Department; Ten Best Practices for Older Adults in the Emergency Department; Delirium and Dementia; Falls and Geriatric Trauma; Older Adults in the Emergency Department with Frailty; Communication Strategies to Better Care for Older Individuals in the Emergency Department; Systems-based Practice to Improve Care Within and Beyond the Emergency Department; Common Medication Management Approaches for Older Adults in the Emergency Department; Elder Abuse and Neglect; Care of those with end-of-life needs / Advanced illnesses in the Emergency Department; Behavioral Health Needs of Older Adults in the Emergency Department; and Pain Management Strategies for Older Adults.

This issue of Emergency Medicine Clinics focuses on Geriatric Emergencies. Articles include: Recent Trends in Geriatric Emergency Medicine, Resuscitation of the Elderly, Pharmacology in the Geriatric Patient, Trauma and Falls in the Elderly, Sepsis and Infectious Emergencies in the Elderly, Evaluation of the Geriatric Patient with Chest Pain, Evaluation of Dyspnea in the Elderly, Abdominal Pain in the Geriatric Patient, Neurologic Emergencies in the Elderly, Evaluation of Syncope, Altered Mental Status and Delirium, and more!

The elderly represent the fastest growing segment of the population in developed countries, reflected in the patient population presenting to EDs and hospitals. These patients more often than not have greater co-morbidities, more complicated workups and utilize more laboratory and radiologic services. This text is designed to teach emergency physicians how best to care for this specific demographic of patients. It addresses physiologic changes, high-risk conditions, and atypical presentations associated with elderly patients in the ED that result in frequent misdiagnosis or delays in diagnosis. It instructs the readers how best to care for elderly patients in order to minimize morbidity and mortality, addressing some of the difficult psychosocial issues that confront health care providers that care for elderly patients, such as psychiatric disease and end-of-life care. The utility of this text is not limited to emergency physicians, but it should be useful to all health care providers involved in the treatment of elderly patients with acute medical or surgical conditions.

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.