Abstract
Geriatric care focuses heavily on functional assessment, evaluating cognition and mood and enhancing social support networks. Caring for older adults requires special knowledge of conditions commonly seen in that population referred to as the geriatric syndromes. Diagnostic tests and medication management should be performed with careful consideration of the risk and benefit of the intervention and the overall life expectancy of the individual. Care should be given to avoiding ageist assumptions and attitudes. Working within multidisciplinary teams that embrace the patient and his/her family and caregivers is the most effective way to provide comprehensive care. For a select group of homebound older adults, delivering primary care in the home setting can reduce stress on patients and caregivers as well as avoiding unnecessary emergency room visits and hospital admissions.
References
U.S. Department of Health and Human Services. Administration on aging statistics. Administration for Community Living. Last modified 9/8/2014.
Warshaw G, Bragg E, Fried L, Hall W. Consensus among directors of geriatrics academic programs. JAGS. 2008;56(10):1796–801.
Berkman LF, Leo-Summers L, Horwitz RI. Emotional support and survival after myocardial infarction. Ann Intern Med. 1992;117:1003–9.
Pahor M, Guralnik J, Salive M, et al. Disability and severe gastrointestinal hemorrhage. A prospective study of community-dwelling older persons. JAGS. 1994;42:816–25.
Lachs M, Feinstein A, Cooney L, et al. A simple procedure for general screening for functional disability in elderly patients. Ann Intern Med. 1990;112(9):699–706.
Trang V, Farish S, Jenkins M. A meta-analysis of effectiveness of influenza vaccine in persons aged 65 years and over living in the community. Vaccine. 2002;20(13–14):1831–6.
Christenson B, Lundbergh P, Hedlund J, et al. Effects of a large-scale intervention with influenza and 23-valent pneumococcal vaccines in adults aged 65 years or older: a prospective study. Lancet. 2001;357(9261):1008–11.
Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older—advisory committee on immunization practices (ACIP), 2012. MMWR Morb Mortal Wkly Rep. 2012;61(25):468–70.
Kimberlin D, Whitley R. Varicella-zoster vaccine for prevention of herpes zoster. N Engl J Med. 2017;356:1338–43.
Uspstf. Recommendations For Primary Care Practice. https://www.uspreventiveservicestaskforce.org.
Lee SJ, et al. “Eprognosis: estimating prognosis for elders”. Division of Geriatrics at the University of California San Francisco. eprognosis.org. Accessed 29 Sep 2015.
Nelson M, Rejeski W, Blair S, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1094–105.
Uchino BN, Cacioppo JT. The relationship between social support and physiological processes: a review with emphasis on underlying mechanisms and implications for health. Psychol Bull. 1996;119(3):488–531.
Alzheimer’s Association. Alzheimer’s disease facts and figures. Alzheimers Dement. 2016;12(4):459–509.
Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Ann Intern Med. 1990;113(12):941–8. https://doi.org/10.7326/0003-4819-113-12-941.
Taylow W, Aizenstein H, Alexopoulos G. The vascular depression hypothesis: mechanisms linking vascular disease and depression. Mol Psychiatry. 2013;18:963–74.
American Geriatrics Society and British Geriatrics Society. AGS/BGS clinical practice guideline: prevention of falls in older persons: summary of recommendations. New York: American Geriatrics Society.
Mathias S, Nayak USL, Isaacs B. Balance in elderly patients: the “get-up and go” test. Arch Phys Med Rehabil. 1986;67:387–9.
JAGS. American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63:2227–46.
Abrams A, Baron E et al. American Medical Association/American Academy of home care physicians: medical management of the home care patient. In: Ramsdell JW, Joanne G. Schwartzberg; 2007.
Unwin B, Maj MC. The home visit. Am Fam Physician. 1999;60(5):1481–8.
Fardellone P. Predicting the fracture risk in 2008. Joint Bone Spine. 2008;76(6):661–4.
Lachs, M., Berman, J. “Under the radar: New York State elder abuse prevalence study” Prepared by Lifespan of Greater Rochester, Inc., Weill Cornell Medical Center of Cornell University, and New York City Department for the Aging; 2011.
Yaffe MJ, Wolfson C, Lithwick M, Weiss D. Development and validation of a tool to improve physician identification of elder abuse: the elder abuse suspicion index (EASI)©. J Elder Abuse Negl. 2008;20(3):276–300.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
LoFaso, V.M. (2018). Home Care/Care of Elderly. In: Sydney, E., Weinstein, E., Rucker, L. (eds) Handbook of Outpatient Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-68379-9_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-68379-9_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-68378-2
Online ISBN: 978-3-319-68379-9
eBook Packages: MedicineMedicine (R0)