Care of the Elderly Patient

Melissa Stiles and Kathleen Walsh

Chapter contents

Geriatric Assessment

33

Assessment

41

Medical Assessment

34

Management

41

Functional Assessment

35

Reporting Requirement

42

Psychological Assessment

35

Pressure Ulcers

42

Social Assessment

35

Classification

42

Summary

36

Risk Factors

42

Falls

36

Management

43

Epidemiology

36

Rational Drug Prescribing for Elderly Patients

45

Risk Factors

38

Pharmacokinetics and Pharmacodynamics

45

Screening

38

Common Prescribing Issues

46

Falls Assessment

38

Principles of Prescribing

47

Management

39

Urinary Incontinence

47

Elder Abuse

39

Age-Related Changes in Urinary System

48

Definition

39

Presentation

48

Risk Factors

39

Evaluation

49

Screening

40

Treatment

50

Clinical Manifestations

41

Family physicians are responsible for the care of increasing numbers of elderly patients and their unique and complex primary care needs. Older patients often have comorbidities, "polypharmacy," and psychological, social, and functional impairments. These can lead to variability in presentation of health problems and make diagnosis and treatment challenging for the family physician.

This chapter discusses common geriatric syndromes and outlines a process by which the family physician can effectively and efficiently care for the elderly patient. The main goal is to assist elderly persons to maintain function and quality of life with self-respect, preserving their lifestyle as much as possible. The chapter addresses functional assessment, falls, elder abuse, pressure ulcers, rational drug prescribing, and incontinence; geriatric conditions such as dementia, delirium, and depression are discussed in other chapters.

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