Current Diagnosis and Treatment

Table of Contents Section1. Principles of Geriatric Assessment and Care Introduction to the Care of Older Persons: Knowledge, Skills & System Change Guiding Principles Overview of Geriatric Assessment (6) Geriatric Assessment in Primary Care Teams Patient Goals Prognosis Functional Assessment Falls & Gait Impairment Vision Impairment Hearing Impairment Dementia Incontinence Depression Nutrition Medication Use Caregiver Support Financial, Environmental and Social Resources Abuse Preventive Services The Interprofessional Team (5) Key Definitions & Context Innovations in Geriatric Interprofessional Teams Evidence for Interprofessional Teams Barriers to Teamwork Resources and Tools for Teamwork Goals of Care and Consideration of Prognosis (3) Guide to Goals of Care Discussions Importance of Surrogate Decision Makers Prognostication Prognosis Related to Specific Diseases Communicating Prognosis to Patient or Surrogate Functional Assessment & Functional Decline (2) Epidemiology of Functional Limitations Assessment of Functional Status Risk Factors for Functional Decline Prevention of Functional Decline Treatment of Functional Decline Falls & Mobility Impairment (25) Epidemiology of Falls Assessment of Fall Risk and Mobility Risk Factors for Falls Prevention of Falls Treatment of Mobility Impairment Managing Vision Impairment (61) Normal Changes in the Aging Eye Cataracts Age-Related Macular Degeneration Diabetic Retinopathy Glaucoma Systemic Effects of Eye Medications Visual Symptoms Indicating Need for Urgent Referral to an Eye-Care Specialist Managing Hearing Impairment (62) Age-related Hearing Changes How and when to test for Hearing Impairment Sensory Hearing Impairment Neural Hearing Impairment Conductive Hearing Impairment Treatment for Hearing Impairment Cognitive Impairment & Dementia (22) Age-related Cognitive Changes Screening for Cognitive Impairment Mild Cognitive Impairment Common types of Dementia Dementia-related Behaviors When to refer to subspecialty care Urinary Incontinence (39) Age-related Urogenital Changes Screening for Urinary Incontinence Common Causes, Diagnosis, and Treatment of Male-Sex Urinary Incontinence Common Causes, Diagnosis, and Treatment of Female-Sex Urinary Incontinence Sexual Health & Dysfunction (46) Age-related physiologic changes affecting sexual function Taking a Sexual History Sexually-transmitted Infections Common Causes, Diagnosis, and Treatment of Male-Sex Sexual Dysfunction Common Causes, Diagnosis, and Treatment of Female-Sex Sexual Dysfunction Depression & Other Mental Health Issues (45) Depression Suicide Bipolar Disorder Anxiety & Stress Disorders Schizophrenia & Psychotic Disorders Defining Adequate Nutrition (68) Assessment of Nutritional status in Older Adults Recommendation on Essential Nutrients, Vitamins and Minerals intake Definition and potential causes of involuntary weight loss Obesity in older adults Interaction of food and medications Types of nutrition deficiencies Nutrition in special populations Principles of Prescribing & Adherence (9) General Principles & Polypharmacy Drug Metabolism & Physiologic Effects Geriatric Therapeutics Prescribing for Older Adults Adherence Intervening to Reduce Polypharmacy Prescribing Across the Care Continuum Addressing Multimorbidity (10) Background and Definitions Multimorbidity & Health Outcomes Challenges to Managing Multimorbidity General Considerations in the Care of Multimorbid Older Adults Atypical Presentations of Illness (7) Defining Atypical Presentations Identifying Patients at Risk Caregiving and Caregiving Support (new) Defining Caregiving Caregiving in Context Interventions to support caregivers Caregiver resources Potential Outcomes from Caregiving Assessing for Caregiver Burden Responding to Caregiver Burden The Social Context (4—delete Medicare and include legal issues—conservatorship, etc. ) Financial Issues Facing Older Persons Food Insecurity Legal Issues & Conservatorship (new) General Recommendations for Clinicians Detecting, Assessing & Responding to Elder Mistreatment (72) Detecting and Assessing Elder Mistreatment Responding to Elder Mistreatment Prevention & Health Promotion (8) General Principles of Screening & Prevention in Older Persons Screening for Geriatric Syndromes Assessment of Health-Related Behaviors Immunizations Screening for Endocrine Disorders Screening for Cardiovascular Disease Cancer Screening Ethics & Informed Decision Making (12) Ethical Issues in the Care of Older Persons Decision-Making Capacity & Informed Decision-Making Advance Care Planning & Advance Directives Surrogate Decision-Making Balancing Promotion of Independence & Patient Safety Geriatric Palliative Care (11) General Principles Psychological, Spiritual and Social Issues Aid in Dying (new) Challenges to Providing Palliative Care in Long-Term Care Settings Caring for Family Members: Grief & Bereavement Assessing Therapies for Longevity & the Biology of Aging (56—rename for John N) Add domains here Applying Evidence-Based Care to Older Persons (74) Challenges with Current Evidence Applying the Evidence to Older Persons   Section 2: Care Settings Ambulatory Care & Care Coordination (14—look at content) General Principles Models of Ambulatory Care Care Coordination and Integration Across Health Systems and Services Transitions of Care (13) General Principles Background & Definitions Adverse Events During Transitions Barriers to Successful Care Transitions Evidence-Based Interventions & Best Practices Innovations Future of Care Transitions Emergency Department Care (15) General Principles Mod els of Emergency Care Structural Enhancements Financing Clinical Care Future of Emergency Care Hospital Care (16) General Principles Hazards of Hospitalization Successful Models of Care Approach to the Hospitalized Older Person Therapy Prevention Transitioning from Hospital to Home Perioperative Care for Older Surgical Patients (17) General Principles Surgical Risk in Older Persons Clinical Care Models of Surgical Care Home-Based Care (19) General Principles Models of Medical House Calls (Home-Based Primary Care, Transitional Care, Hospital at Home, Home-Based Palliative Care) Models of Home Nursing & Rehabilitation Eligibility Requirements & Payment Denials Approach to Home Care & Assessments Innovations  Residential Care and Assisted Living Care (new) General Principles Models of Residential Care and Assisted Living Care Nursing Home Care & Rehabilitation (18) General Principles Institutional Long-Term Care Short-stay Rehabilitation (new) Consider Dementia locked unit care? Other domains? Technology to Enhance Geriatric Care (new) New technology for older adults in the community New technology for older adults in institution How to evaluate the efficacy and benefits of these new technology Potential list of reliable sites to rate these devices or services The Geriatric Care Industry Safety Enhancing technology Transportation Enhancing technology   Section 3: Common Conditions & Diseases inGeriatrics Osteoarthritis (26) Osteoporosis & Hip Fractures (27) Delirium (21) Parkinson’s Disease & Essential Tremor (24) Cerebrovascular Disease (23) Coronary Artery Disease (28) Acute Coronary Syndrome Chronic Coronary Artery Disease Heart Failure & Heart Rhythm Disorders (29) Heart Failure Bradyarrhythmias Tachyarrhythmias—Atrial Fibrillation & Atrial Flutter Ventricular Arrhythmias Decision-Making about Implantable Devices (new) Hypertension (30) Valvular Disease (31) Aortic Stenosis Aortic Insufficiency Mitral Stenosis Mitral Regurgitation Peripheral Arterial Disease & Venous Thromboembolism (32) Anticoagulation (55) Classes of Anticoagulant Therapy Management of Bleeding in Older Persons on Anticoagulants Chronic Venous Insufficiency, Stasis Ulcers & Lymphedema (33) Chronic Lung Disease (replaces COPD chap 34) Gastrointestinal Disease (35) Gastroesophageal Reflux Disease Dysphagia Motility Disorders Peptic Ulcer Disease Dyspepsia Diarrhea Diverticular Disease Inflammatory Bowel Disease Fecal Incontinence Colonic Ischemia Abdominal Pain Fluid & Electrolyte Abnormalities (37) Hyponatremia Hypernatremia Hypokalemia Hyperkalemia Nocturnal Polyuria Chr onic Kidney Disease (38) Thyroid, Parathyroid & Adrenal Gland Disorders (41) Subclinical Hypothyroidism Subclinical Hyperthyroidism Hypothyroidism & Myxedema Coma Hyperthyroidism Nodular Thyroid Disease & Neoplasia Acute Adrenal Insufficiency Cushing Syndrome Hyperparathyroidism Diabetes (42) Anemia (43) Common Cancers (44) Breast Cancer Lung Cancer Colorectal Cancer Prostate Cancer (new) Pancreatic Cancer Ovarian Cancer