Essentials of Clinical Geriatrics 7/E

by Robert L. Kane, Joseph G. Ouslander, Itamar B. Abrass, Barbara Resnick

Overview

An engaging introductory guide to the core topics in geriatric medicine

“This is a valuable reference for those treating geriatric patients, providing well-reasoned expectations. It offers a common-sense approach in a medical system that is oriented to procedure numbers rather than focused on what a rational outcome is. Medicine owes a debt of gratitude to the authors of this work.”

--Doody’s Review Service

For nearly three decades, the goal of Essentials of Clinical Geriatrics has remained unchanged: to help clinicians do a better job of caring for their older patients. You will find thorough and authoritative coverage of all the important issues in geriatrics, along with concise, practical guidance on the diagnosis and treatment of the diseases and disorders most commonly encountered in an elderly patient.

Features:

• A strong focus on the field’s must-know concepts, from the nature of clinical aging to differential diagnosis of important geriatric syndromes to drug therapy and health services
• Numerous tables and figures that summarize conditions, values, mechanisms, therapeutics, and more
• Thorough coverage of preventive services and disease screening
• An appendix of Internet resources on geriatrics

Recognizing the reality that medical issues interact with other social and environmental issues, Essentials of Clinical Geriatrics includes chapters on Health Services, Nursing Home Care, Ethical Issues in the Care of Older Persons, and Palliative Care. You will also find chapters on the differential diagnosis and management of confusion, depression, incontinence, falls, and immobility and general management strategies on cardiovascular disorders, decreased vitality, and sensory impairment.

There is no better resource to help you effectively address the challenges faced by the upcoming "grey tsunami" than Essentials of Clinical Geriatrics.

Product Details

ISBN-13:	9780071792196
Publisher:	McGraw Hill LLC
Publication date:	07/22/2013
Series:	LANGE Essentials
Sold by:	Barnes & Noble
Format:	eBook
Pages:	608
File size:	43 MB
Note:	This product may take a few minutes to download.

About the Author

McGraw-Hill authors represent the leading experts in their fields and are dedicated to improving the lives, careers, and interests of readers worldwide

Table of Contents

List of Tables and Figures xi

Preface xxi

Part I The Aging Patient and Geriatric Assessment 1

1 Clinical Implications of the Aging Process 3

Changes Associated with "Normal" Aging 4

Theories of Aging 5

Clinical Implications 15

Geriatric Syndrome 19

Atypical Presentation of Common Clinical Problems 20

References 21

Suggested Readings 22

2 The Geriatric Patient: Demography, Epidemiology, and Health Services Utilization 23

Growth in Numbers 26

Disability 30

Social Support 31

Use of Services 33

Nursing Home Use 36

References 40

Suggested Readings 40

3 Evaluating the Geriatric Patient 41

History 45

Physical Examination 50

Laboratory Assessment 55

Functional Assessment 57

Environmental Assessment 63

Assessment for Pain 64

Nutritional Assessment 66

Geriatric Consultation 68

Preoperative Evaluation 71

References 75

Suggested Readings 77

4 Chronic Disease Management 79

Specific Areas of Geriatric Disease Management 82

Special Issues in Chronic Disease Management 87

Role of Outcomes in Assuring Quality of Long-Term Care 93

Technology for Quality Improvement 103

Summary 107

References 107

Part II Differential Diagnosis and Management 109

5 Prevention 111

General Principles 111

Effectiveness of Prevention in Older People 115

Osteoporosis 126

Generic Approaches 129

Preventing Disability 131

Iatrogenesis 133

Special Risks of Hospitals 135

Labeling 140

Summary 141

References 142

Suggested Readings 144

6 Confusion: Delirium and Dementia 145

Confusion 145

Delirium 148

Dementia 154

Evaluation 160

Management of Dementia 165

References 170

Suggested Readings 172

Selected Web Sites(Accessed on March 16, 2008) 173

Tools 173

7 Diagnosis and Management of Depression 175

Aging and Depression 176

Symptoms and Signs of Depression 179

Depression Associated with Medical Conditions 184

Diagnosing Depression 186

Management 194

References 207

Suggested Readings 210

Web References 211

8 Incontinence 213

Normal Urination 215

Causes and Types of Incontinence 219

Evaluation 228

Management 239

Fecal Incontinence 257

References 260

Suggested Readings 262

Selected Web Sites (Accessed on March 16, 2008) 262

9 Falls 265

Aging and Instability 267

Causes of Falls in Older Persons 269

Evidence on Falls Prevention 274

Evaluating the Elderly Patient who Falls 275

Management 287

References 291

Suggested Readings 294

Selected Web Sites (Accessed on March 16, 2008) 295

10 Immobility 297

Causes 297

Complications 299

Assessing Immobile Patients 301

Management of Immobility 304

Pain Management 316

Exercise 320

Rehabilitation 321

References 325

Suggested Readings 329

Part III General Management Strategies 333

11 Cardiovascular Disorders 335

Physiological Changes 335

Hypertension 337

Stroke and Transient Ischemic Attacks 344

Coronary Artery Disease 349

Valvular Heart Disease 351

Arrhythmias 354

Congestive Heart Failure 356

Peripheral Vascular Disease 357

References 359

Suggested Readings 362

12 Decreased Vitality 363

Endocrine Disease 363

Anemia 379

Nutrition 383

Infections 387

Disorders of Temperature Regulation 391

References 395

Suggested Readings 398

13 Sensory Impairment 401

Vision 401

Hearing 408

Taste 418

Polyneuropathy 419

Acknowledgment 422

References 422

Suggested Readings 423

Weblinks 423

14 Drug Therapy 425

Nonpharmacological Factors Influencing Drug Therapy 425

Adverse Drug Reactions and Interactions 429

Aging and Pharmacology 435

Geriatric Prescribing 439

Geriatric Psychopharmacology 439

References 446

Suggested Readings 447

15 Health Services 449

Public Programs 452

Long-Term Care 460

The Nursing Home 468

Assisted Living 477

Home Care 478

Other Services 482

Case Management 483

References 487

Suggested Readings 487

16 Nursing Home Care 489

The Goals of Nursing Home Care 489

Clinical Aspects of Care for Nursing Home Residents 491

Process of Care in the Nursing Home 495

Strategies to Improve Medical Care in Nursing Homes 504

Subacute Care and the Nursing Home-Acute-Care Hospital Interface 516

Ethical Issues in Nursing Home 518

References 519

Suggested Readings 521

Selected Web Sites (Accessed 3/16/08) 521

17 Ethical Issues in the Care of Older Persons 523

Autonomy and Beneficence 526

Competence and Informed Consent 527

Advance Directives and End-of-Life Care 529

Moving from DNR to Acceptance of Natural Death 534

The Health-Care Provider's Role 535

Special Problems with Nursing Home Residents 537

Special Case of Dementia 539

Policy Issues 540

Ethical Issues Concerning Caregivers 542

Summary 543

References 544

Web-Based References (Last Accessed July 2008.) 547

Appendix Selected Internet Resources on Geriatrics 549

Organizations 549

Clinical Topics-for Professionals 550

Clinical Topics-for Patients 552

Index 555

Editorial Reviews

4 Stars! from Doody

This handy-to-carry-and-use paperback is invaluable as a ready source of comprehensive up-to-date geriatric clinical information...richly supplemented by an enormous number of helpful tables, figures, and references.

American Family Physician

Strongly recommended... so well written that the amount of information it contains is deceptive.. easy to read and provides an excellent overview of geriatrics.

Journal of Family Practice

All practicing physicians who care for older persons, medical students, residents, fellows, and the entire interdisciplinary team caring for older persons will derive benefit from this book. (Four Stars)

Doody

This is a compact, comprehensive textbook of geriatric medicine. The purpose is to present the fundamentals of geriatric medicine in an easy to understand format. All practicing physicians who care for older persons, medical students, residents, fellows, and the entire interdisciplinary team caring for older persons will derive benefit from this book. There is a plethora of very useful diagrams, tables, and appendixes of the most commonly used and needed forms as well as assessment tools in geriatric medicine, which greatly enhance the utility of this book. Sections on clinical glidepaths, iatrogenesis, home care, and ethics have been expanded or revised in this new edition. This book is like a good lite beer -- all the important points are highlighted, and the authors are essentially correct in most of what they say; this text could be swallowed whole in a geriatrics rotation. Every medical library should own this excellent book.

David O. Staats

New edition of a guide to problem-based diagnosis, treatment, and follow-up care of all common geriatric disorders. Includes review of important nonclinical issues: environmental factors, documentation issues, ethics, and demographics. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Booknews

Reviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: This book focuses on the specific considerations in treating aging patients. The previous edition was published in 2009.
Purpose: The authors state, "There is a growing appreciation that our medical system is not structured to effectively address complex chronic disease and multimorbidity, which are both common in the geriatric population." The purpose of this book is to provide some structure for the treatment of older patients to address these deficiencies. The authors provide an excellent book on the approach to care of older patients.
Audience: Without exception, this book is appropriate for every clinician who treats geriatric patients and for administrators who develop the infrastructure and insurance processes surrounding their care. The authors are well versed in understanding and caring for the geriatric population.
Features: The first edition of this book was published over 30 years ago and has been refined through the subsequent editions. The first part of this seventh edition gives a historical and pathophysiological basis for the study of geriatrics. It is very easy to read and understand and succinctly outlines the problems. The second part considers the differential diagnoses of some conditions common to these patients, such as delirium, dementia, depression, incontinence, and falls, and provides a preventive medicine perspective. The third part addresses the general management of cardiovascular conditions, sensory impairment, drug therapy, and nursing home and palliative care. The tables are intuitive and the references very helpful.
Assessment: This is a valuable reference for those treating geriatric patients, providing well-reasoned expectations. It offers a common-sense approach in a medical system that is oriented to procedure numbers rather than focused on what a rational outcome is. Medicine owes a debt of gratitude to the authors for this work.

Doody's Review Service