RESUMEN
Little documentation exists concerning the extent of functional disability in the hospitalized elderly and the impact of this disability on the care of these patients. A physician-led survey was conducted in a 400-bed community hospital of 279 patients aged 70 or more years. Considerable age-correlated disability was documented. Fifty-four percent of the patients aged 85 years or older were moderately or severely disoriented. Thirty-four percent had impaired hearing, 40% had impaired vision, and 25% had speech impairments. More than half of the patients 75 years or older needed assistance with activities of daily living. Modern hospital design and services may interfere with functional recovery. Evaluation of special care units to minimize the hazards of hospitalizing the elderly is recommended.
Asunto(s)
Actividades Cotidianas , Anciano , Personas con Discapacidad , Hospitalización , Femenino , Servicios de Salud para Ancianos/estadística & datos numéricos , Humanos , Masculino , Estados UnidosRESUMEN
Fifty elderly patients were assessed at home by physicians trained in geriatric medicine. The patients had been referred by physicians, relatives, or community services. Reasons for referral usually were nonspecific and involved either a request for overall assessment or recommendations about placement. Assessment included medical, psychiatric, social and functional components. Mental impairment and impairment in the activities of daily living were common. New medical or psychiatric diagnoses were contributed in 36 instances. The most frequent previously unnoticed pathologic disorders were mental impairment and depression. Assessment resulted in specialists' advice concerning such matters as the medication program, placement, increased support, further diagnostic work and, in two instances, prompt admission to a hospital.
Asunto(s)
Actividades Cotidianas , Servicios de Salud para Ancianos , Visita Domiciliaria , Anciano , Trastornos del Conocimiento/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
While the need for training programs in geriatric medicine is widely recognized, there are substantial obstacles to developing such training. Obstacles include shortage of faculty members and negative attitudes toward geriatrics on the part of students. For the past two years, family medicine residents have participated in a required rotation in geriatric medicine at the Duke University Medical Center. The program has been successful as measured by regular monthly evaluations of the resident on the rotation, resident acceptance, requests by other learners in the university to participate, and career choices of graduates of the program.
Asunto(s)
Medicina Familiar y Comunitaria/educación , Geriatría/educación , Internado y Residencia , Anciano , Curriculum , Visita Domiciliaria , Humanos , Facultades de MedicinaRESUMEN
The depressed elderly have the highest suicide risk of any group in our society. Thus, depression in late life is a serious mental health problem. The essential goal of the diagnostic work-up is to distinguish a major depressive episode from less severe dysphoric symptoms. The major treatment modalities are properly selected pharmacologic agents, electroconvulsive therapy, psychotherapy and counseling, increased physical and social activity, and attention to underlying medical problems.