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Robert L. Kane, MD
.Professor and Minnesota Endowed Chair in Long-Term Care and Aging
.School of Public Health
.University of Minnesota
.Minneapolis, MN
Joseph G. Ouslander, MD
.Director, Institute for Qualty Aging
.Boca Raton Community Hospital
.Professor of Medicine (Voluntary)
.Assistant Dean for Geriatric Education
.University of Miami Miller School of Medicine (UMMSM) at Florida Atlantic University
.Associate Director, Division of Gerontology and Geriatric Medicine
.Department of Medicine, UMMSM
.Miami, FL
.Professor (Courtesy)
.Christine E. Lynn College of Nursing
.Florida Atlantic University
Itmar B. Abrass, MD
.William E. Colson Chair in Gerontology
.Professor of Medicine and Division Head, Gerontology and Geriatric Medicine
.University of Washington Harborview Medical Center
.Seattle, WA
Barbara Resnick, PhD, CRNP, FAAN, FAANP
.Professor
.University of Maryland School of Nursing
.Sonya Gershowitz Chair in Gerontology
.Baltimore, MD
List of Tables and Figures | p. xi |
Preface | p. xxi |
The Aging Patient and Geriatric Assessment | p. 1 |
Clinical Implications of the Aging Process | p. 3 |
Changes Associated with "Normal" Aging | p. 4 |
Theories of Aging | p. 5 |
Clinical Implications | p. 15 |
Geriatric Syndrome | p. 19 |
Atypical Presentation of Common Clinical Problems | p. 20 |
References | p. 21 |
Suggested Readings | p. 22 |
The Geriatric Patient: Demography, Epidemiology, and Health Services Utilization | p. 23 |
Growth in Numbers | p. 26 |
Disability | p. 30 |
Social Support | p. 31 |
Use of Services | p. 33 |
Nursing Home Use | p. 36 |
References | p. 40 |
Suggested Readings | p. 40 |
Evaluating the Geriatric Patient | p. 41 |
History | p. 45 |
Physical Examination | p. 50 |
Laboratory Assessment | p. 55 |
Functional Assessment | p. 57 |
Environmental Assessment | p. 63 |
Assessment for Pain | p. 64 |
Nutritional Assessment | p. 66 |
Geriatric Consultation | p. 68 |
Preoperative Evaluation | p. 71 |
References | p. 75 |
Suggested Readings | p. 77 |
Chronic Disease Management | p. 79 |
Specific Areas of Geriatric Disease Management | p. 82 |
Special Issues in Chronic Disease Management | p. 87 |
Role of Outcomes in Assuring Quality of Long-Term Care | p. 93 |
Technology for Quality Improvement | p. 103 |
Summary | p. 107 |
References | p. 107 |
Differential Diagnosis and Management | p. 109 |
Prevention | p. 111 |
General Principles | p. 111 |
Effectiveness of Prevention in Older People | p. 115 |
Osteoporosis | p. 126 |
Generic Approaches | p. 129 |
Preventing Disability | p. 131 |
Iatrogenesis | p. 133 |
Special Risks of Hospitals | p. 135 |
Labeling | p. 140 |
Summary | p. 141 |
References | p. 142 |
Suggested Readings | p. 144 |
Confusion: Delirium and Dementia | p. 145 |
Confusion | p. 145 |
Delirium | p. 148 |
Dementia | p. 154 |
Evaluation | p. 160 |
Management of Dementia | p. 165 |
References | p. 170 |
Suggested Readings | p. 172 |
Selected Web Sites (Accessed on March 16, 2008) | p. 173 |
Tools | p. 173 |
Diagnosis and Management of Depression | p. 175 |
Aging and Depression | p. 176 |
Symptoms and Signs of Depression | p. 179 |
Depression Associated with Medical Conditions | p. 184 |
Diagnosing Depression | p. 186 |
Management | p. 194 |
References | p. 207 |
Suggested Readings | p. 210 |
Web References | p. 211 |
Incontinence | p. 213 |
Normal Urination | p. 215 |
Causes and Types of Incontinence | p. 219 |
Evaluation | p. 228 |
Management | p. 239 |
Fecal Incontinence | p. 257 |
References | p. 260 |
Suggested Readings | p. 262 |
Selected Web Sites (Accessed on March 16, 2008) | p. 262 |
Falls | p. 265 |
Aging and Instability | p. 267 |
Causes of Falls in Older Persons | p. 269 |
Evidence on Falls Prevention | p. 274 |
Evaluating the Elderly Patient who Falls | p. 275 |
Management | p. 287 |
References | p. 291 |
Suggested Readings | p. 294 |
Selected Web Sites (Accessed on March 16, 2008) | p. 295 |
Immobility | p. 297 |
Causes | p. 297 |
Complications | p. 299 |
Assessing Immobile Patients | p. 301 |
Management of Immobility | p. 304 |
Pain Management | p. 316 |
Exercise | p. 320 |
Rehabilitation | p. 321 |
References | p. 325 |
Suggested Readings | p. 329 |
General Management Strategies | p. 333 |
Cardiovascular Disorders | p. 335 |
Physiological Changes | p. 335 |
Hypertension | p. 337 |
Stroke and Transient Ischemic Attacks | p. 344 |
Coronary Artery Disease | p. 349 |
Valvular Heart Disease | p. 351 |
Arrhythmias | p. 354 |
Congestive Heart Failure | p. 356 |
Peripheral Vascular Disease | p. 357 |
References | p. 359 |
Suggested Readings | p. 362 |
Decreased Vitality | p. 363 |
Endocrine Disease | p. 363 |
Anemia | p. 379 |
Nutrition | p. 383 |
Infections | p. 387 |
Disorders of Temperature Regulation | p. 391 |
References | p. 395 |
Suggested Readings | p. 398 |
Sensory Impairment | p. 401 |
Vision | p. 401 |
Hearing | p. 408 |
Taste | p. 418 |
Polyneuropathy | p. 419 |
Acknowledgment | p. 422 |
References | p. 422 |
Suggested Readings | p. 423 |
Weblinks | p. 423 |
Drug Therapy | p. 425 |
Nonpharmacological Factors Influencing Drug Therapy | p. 425 |
Adverse Drug Reactions and Interactions | p. 429 |
Aging and Pharmacology | p. 435 |
Geriatric Prescribing | p. 439 |
Geriatric Psychopharmacology | p. 439 |
References | p. 446 |
Suggested Readings | p. 447 |
Health Services | p. 449 |
Public Programs | p. 452 |
Long-Term Care | p. 460 |
The Nursing Home | p. 468 |
Assisted Living | p. 477 |
Home Care | p. 478 |
Other Services | p. 482 |
Case Management | p. 483 |
References | p. 487 |
Suggested Readings | p. 487 |
Nursing Home Care | p. 489 |
The Goals of Nursing Home Care | p. 489 |
Clinical Aspects of Care for Nursing Home Residents | p. 491 |
Process of Care in the Nursing Home | p. 495 |
Strategies to Improve Medical Care in Nursing Homes | p. 504 |
Subacute Care and the Nursing Home-Acute-Care Hospital Interface | p. 516 |
Ethical Issues in Nursing Home | p. 518 |
References | p. 519 |
Suggested Readings | p. 521 |
Selected Web Sites (Accessed 3/16/08) | p. 521 |
Ethical Issues in the Care of Older Persons | p. 523 |
Autonomy and Beneficence | p. 526 |
Competence and Informed Consent | p. 527 |
Advance Directives and End-of-Life Care | p. 529 |
Moving from DNR to Acceptance of Natural Death | p. 534 |
The Health-Care Provider's Role | p. 535 |
Special Problems with Nursing Home Residents | p. 537 |
Special Case of Dementia | p. 539 |
Policy Issues | p. 540 |
Ethical Issues Concerning Caregivers | p. 542 |
Summary | p. 543 |
References | p. 544 |
Web-Based References (Last Accessed July 2008.) | p. 547 |
Selected Internet Resources on Geriatrics | p. 549 |
Organizations | p. 549 |
Clinical Topics-for Professionals | p. 550 |
Clinical Topics-for Patients | p. 552 |
Index | p. 555 |
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