Geriatric Care: General Principles
Basics
Basics
Basics
Description
Description
Description
“First do no harm”; many well-intended diagnostic and therapeutic interventions (with efficacy established in younger patients) may not benefit the elder. Geriatric care, more than many other medical specialties, focuses on preserving and improving function and comfort, rather than on life extension.
Epidemiology
Epidemiology
Epidemiology
The percentage of the U.S. population anticipated to be >65 years old by the year 2050 exceeds 20%, and the percentage of those who are >85 old years may reach 24%.
Etiology and Pathophysiology
Etiology and Pathophysiology
Etiology and Pathophysiology
Physiology of aging
- The aging process is not pathologic but part of the developmental continuum. However, physiologic changes associated with aging tend to diminish the body’s compensatory reserve and increase susceptibility to disease.
- Aging increases body fat and decreases total body water and lean body mass. This results in hydrophilic drugs having a smaller apparent volume of distribution. Lipophilic drugs will have an increased volume of distribution and longer half-life.
- Aging decreases renal elimination of drugs.
- Declines in lung capacity, oxygen uptake, cardiac output, muscle mass, glomerular filtration rate as well as blood flow to the brain, liver, and kidneys are associated with aging and must be considered in the diagnosis and treatment of elderly patients.
Risk Factors
Risk Factors
Risk Factors
Access to care
- Despite Medicare, persistent barriers to care include, but not limited to, lack of provider responsiveness, medical bills, and transportation.
- Barriers tend to be more prevalent in the female population and with increasing age.
- Alternatives to the traditional face-to-face visit have become more possible since the COVID-19 pandemic. These could enhance access to care, and these include:
- Encrypted email or home telehealth for those who are technologically equipped
- Phone visits for those with adequate hearing
- Nurse visits at home to evaluate and plan care by reporting to provider
General Prevention
General Prevention
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