Cover image for Essentials of clinical geriatrics
Title:
Essentials of clinical geriatrics
Author:
Kane, Robert L., 1940-2017.
Personal Author:
Edition:
Fourth edition.
Publication Information:
New York : McGraw-Hill, Health Professions Division, [1999]

©1999
Physical Description:
xxvi, 621 pages : illustrations ; 22 cm
Language:
English
ISBN:
9780070344587
Format :
Book

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Summary

Author Notes

Robert L. Kane, MD: Professor and Minnesota Endowed Chair in Long-Term Care and Aging, School of Public Health, University of Minnesota, Minneapolis
Joseph G. Ouslander, MD: Professor of Medicine and Nursing Director, Division of Geriatric Medicine and Gerontology; Chief Medical Officer, Wesley Woods Center; Director, Center for Health in Aging, Emory University; Research Scientist, Birmingham/Atlanta VA GRECC Atlanta, Georgia
Itamar B. Abrass, MD: Professor and Head, Division of Gerontology and Geriatric Medicine, University of Washington Seattle


Table of Contents

List of Tables and Figuresp. xi
Prefacep. xx
Part I The Aging Patient and Geriatric Assessmentp. 1
1. Clinical Implications of the Aging Processp. 3
Changes Associated with "Normal" Agingp. 4
Biological Agingp. 5
Clinical Implicationsp. 10
Classifying Geriatric Problemsp. 12
Diagnosis versus Functional Statusp. 14
Referencesp. 14
Suggested Readingsp. 15
2. The Geriatric Patient: Demography, Epidemiology, and Health Services Utilizationp. 17
Growth in Numbersp. 18
Disabilityp. 22
Social Supportp. 23
Use of Servicesp. 24
Nursing Home Usep. 26
Referencesp. 33
Suggested Readingsp. 33
3. Evaluating the Geriatric Patientp. 35
The Historyp. 38
The Physical Examinationp. 44
Laboratory Assessmentp. 49
Functional Assessmentp. 49
Environmental Assessmentp. 56
Assessment for Painp. 57
Nutritional Assessmentp. 58
Geriatric Consultationp. 62
Preoperative Evaluationp. 64
Referencesp. 68
Suggested Readingsp. 70
4. Developing Clinical Expectationsp. 71
Clinical Glide Pathsp. 73
Disease Managementp. 75
Benchmarksp. 76
Minimum Data Set for Nursing Homesp. 80
OASISp. 81
Role of Outcomes in Assuring Quality of Long-Term Carep. 81
Technology for Quality Improvementp. 86
Computer Technologyp. 87
Terminal Carep. 89
Summaryp. 90
Referencesp. 90
Part II Differential Diagnosis and Managementp. 91
5. Preventionp. 93
General Principlesp. 93
Effectiveness of Prevention in Older Peoplep. 96
Osteoporosisp. 104
Generic Approachesp. 105
Preventing Disabilityp. 109
Iatrogenesisp. 110
Special Risks of Hospitalsp. 112
Labelingp. 117
Summaryp. 118
Referencesp. 118
Suggested Readingsp. 119
6. Confusion: Delirium and Dementiap. 121
Defining Confusionp. 121
Differential Diagnosis of Confusionp. 123
Deliriump. 124
Dementiap. 129
Evaluationp. 134
Management of Dementiap. 140
Referencesp. 143
Suggested Readingsp. 145
7. Diagnosis and Management of Depressionp. 147
Aging and Depressionp. 147
Symptoms and Signs of Depressionp. 148
Depression Associated with Medical Conditionsp. 153
Diagnosing Depressionp. 157
Managementp. 161
Referencesp. 169
Suggested Readingsp. 171
8. Incontinencep. 173
Normal Urinationp. 175
Causes and Types of Incontinencep. 179
Evaluationp. 188
Managementp. 195
Fecal Incontinencep. 212
Referencesp. 215
Suggested Readingsp. 217
9. Instability and Fallsp. 219
Aging and Instabilityp. 220
Causes of Falls in Older Personsp. 223
Evidence on Falls Preventionp. 228
Evaluating the Elderly Patient Who Fallsp. 231
Managementp. 235
Referencesp. 242
Suggested Readingsp. 244
10. Immobilityp. 245
Causesp. 245
Complicationsp. 247
Assessing Immobile Patientsp. 247
Management of Immobilityp. 250
Pain Managementp. 266
Exercisep. 271
Rehabilitationp. 271
Referencesp. 274
Suggested Readingsp. 275
Part III General Management Strategiesp. 279
11. Cardiovascular Disordersp. 281
Physiological Changesp. 281
Hypertensionp. 283
Stroke and Transient Ischemic Attacksp. 289
Coronary Artery Diseasep. 294
Valvular Heart Diseasep. 296
Arrhythmiasp. 299
Congestive Heart Failurep. 300
Referencesp. 301
Suggested Readingsp. 303
12. Decreased Vitalityp. 305
Endocrine Diseasep. 305
Anemiap. 318
Nutritionp. 322
Infectionsp. 324
Disorders of Temperature Regulationp. 328
Referencesp. 332
Suggested Readingsp. 333
13. Sensory Impairmentp. 335
Visionp. 335
Hearingp. 344
Tastep. 352
Polyneuropathyp. 352
Acknowledgmentp. 353
Referencesp. 353
Suggested Readingsp. 356
14. Drug Therapyp. 357
Nonpharmacological Factors Influencing Drug Therapyp. 357
Adverse Drug Reactions and Interactionsp. 361
Aging and Pharmacologyp. 366
Geriatric Prescribingp. 379
Geriatric Psychopharmacologyp. 379
Referencesp. 387
Suggested Readingsp. 388
15. Health Servicesp. 389
Public Programsp. 391
Long-term Carep. 398
The Nursing Homep. 406
Assisted Livingp. 414
Home Carep. 415
Other Servicesp. 419
Case Managementp. 420
Referencesp. 421
Suggested Readingsp. 423
16. Nursing Home Carep. 425
The Goals of Nursing Home Carep. 425
Clinical Aspects of Care for Nursing Home Residentsp. 427
Process of Care in the Nursing Homep. 429
Strategies to Improve Medical Care in Nursing Homesp. 439
Subacute Care and the Nursing Home--Acute-Care Hospital Interfacep. 451
Ethical Issues in Nursing Home Carep. 452
Referencesp. 452
Suggested Readingsp. 454
17. Ethical Issues in the Care of Older Personsp. 455
Autonomy and Beneficencep. 456
Competence and Informed Consentp. 456
Advance Directives and End-of-Life Carep. 459
The Physician's Rolep. 464
Special Problems with Nursing Home Residentsp. 466
Special Case of Dementiap. 469
Policy Issuesp. 469
Summaryp. 471
Referencesp. 472
Suggested Readingsp. 474
Appendix A Suggested Geriatric Medical Formsp. 475
Katz Index of Independence in Activities of Daily Living (ADL)p. 475
Lawton/Brody Instrumental Activities of Daily Living Scalep. 477
Main Components of the Tinetti Fall Risk Scalep. 479
Reuben's Physical Performance Testp. 480
Mini-Mental State Exam (MMSE)p. 482
The Geriatric Depression Scalep. 483
Key Components of a Comprehensive Geriatric Assessment: The Medical History and Physical Examp. 484
Dementia Assessmentp. 494
Incontinence Assessmentp. 500
Assessment for Patients Who Fallp. 507
Appendix B Selected Internet Resources on Geriatricsp. 511
Organizationsp. 511
Clinical Topics-For Professionalsp. 512
Clinical Topics-For Patientsp. 515
Indexp. 519