Fundamentals of Geriatric Medicine: A Case-Based Approach

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Rainier P. Soriano
Springer Science & Business Media, May 26, 2007 - Medical - 628 pages
Prior to the evolution of modern medicine, with its superabundance of diagnostic and therapeutic medical technology and the rise of the litigious society, the value of clinical skills was evident in both history taking and the physical examination. Even today, physicians can make a correct di- nosis solely by utilizing their clinical skills in about 90% of patient enco- ters. Furthermore, in the past physicians understood their role as a “psychologist” and were more apt to be familiar with the social context of their patients. House calls were common. The doctor was also a “placebo” who, at his best, inspired hope and probably sped recovery. Geriatricians use both clinical skills and take advantage of modern technology sparingly, for they know they are dealing with the most ch- lenging and frail of patients—older patients who so often present with multiple, complex, interacting behavioral, social, and physical problems. In contrast to medicine for young people, working with the older patient is much more demanding. Furthermore, the complex issue of societal at- tudes toward old people can come into play, speci? cally the physician’s need to deal with natural fears of aging, dependency, depression, dementia, and death. Ageism is the enemy of effective medical treatment. At its best, geriatrics exempli? es ways that medical care for all ages can become more humane, problem-oriented, and holistic.

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Contents

Approach to the Older Adult Patient
1
The Comprehensive Geriatric Assessment
20
Geriatric Pharmacology and Drug Prescribing for Older Adults
39
Sites of Care for Older Adults
56
Medicare and Medicaid
73
Psychosocial Influences on Health in Later Life
80
Medicolegal Aspects of the Care of Older Adults
94
Prevention and Chemoprophylaxis in the Elderly
109
Osteoarthritis
322
Osteoporosis
340
Instability and Falls
356
Hip Fractures
373
Hypertension
386
Cardiovascular and Peripheral Arterial Diseases
403
Diabetes Mellitus
437
Thyroid Disorders
450

Vision and Hearing Impairments
143
Exercise and Rehabilitation
164
Nutrition
177
The Older Surgical Patient
192
Depression Dementia and Delirium
216
Insomnia and Other Sleep Disorders
250
Transient Ischemic Attack and Stroke
267
Parkinsons Disease and Related Disorders
289
Dizziness and Syncope
304
Anemia in the Elderly
470
Benign Prostatic Hyperplasia
485
Erectile Dysfunction
502
Urinary Incontinence
512
Pressure Ulcers
531
Overview of Palliative Care and NonPain Symptom Management
547
Principles of Pain Management
573
Index
601
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