Care of the Elderly

Management involves:

• multiple medical conditions
• drug interactions
• atypical disease presentation
• neuropsychiatric and behavioural problems

Treatment is complex

• medications, social, environmental
• ethical/legal isues
• caregivers

Focus on quality of life

Support the caregiver

Fine balance between:

• aggressive intervention and palliative
• withdrawal of care
• autonomy and caregivers

Frail people:

loss of physiologic reserve

complex interactions

difficulty communications

lack of consensus in care

 

Review medications; make slow and careful changes

 

 

Frailty and Health Care

Focus on function, mobility, and cognition

Iatrogenic risks:

• polypharmacy
• surgery
• etc
• some fates can be worse than death

Prevention of negative impact: pre-op assessment, PATH clinic

models of care

• problem lists
• one thing at once