Geriatrics Treatment and Care Options

Learn about geriatric treatment approaches and supportive care for healthy aging.

Learn about geriatric treatment approaches and supportive care for healthy aging.

We offer advanced cardiac treatment and care for older adults, including non-surgical procedures, expert surgery, and specialized recovery programs at LIV Hospital.

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The Art of Deprescribing

One of the most impactful treatments in this field is the removal of unnecessary medications. Deprescribing is the systematic process of identifying and discontinuing drugs where potential harm outweighs the benefit.

This reduces the risk of falls, cognitive impairment, and adverse reactions. It simplifies the daily routine and reduces costs.

The process is done gradually and under close supervision. It requires a thorough understanding of the patient’s physiology and goals of care.

  • Removal of unnecessary medications
  • Reduction of adverse drug events
  • Simplification of medication regimens
  • Gradual tapering protocols
  • Alignment with care goals
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Chronic Disease Management

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Managing chronic conditions like diabetes and hypertension in older adults requires a nuanced approach. Strict targets that are appropriate for younger adults may be harmful in the elderly.

For example, overly tight blood sugar control can lead to hypoglycemia, which is a significant fall risk. Blood pressure targets are adjusted to prevent dizziness upon standing.

The focus shifts from “fixing” numbers to preventing symptoms and preserving function. Treatment burdens are weighed against benefits.

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Rehabilitation Services

Geriatrics

Physical Therapy (PT) and Occupational Therapy (OT) are cornerstones of treatment. PT focuses on mobility, strength, and balance to prevent falls and improve gait.

OT helps patients adapt their environment and skills to maintain independence in daily activities. This might include learning to use adaptive devices for dressing or cooking.

Speech therapy assists with swallowing difficulties and communication disorders. Rehabilitation is vital after hospitalization to regain baseline function.

Palliative Care Integration

Palliative care is specialized medical care for people with serious illnesses. It focuses on relieving the symptoms and stress of a severe disease. It is appropriate at any age and at any stage in a serious illness.

In this specialty, palliative care is often integrated early. It addresses pain, shortness of breath, fatigue, and nausea.

It also involves emotional and spiritual support for the patient and family. The goal is to improve the quality of life for both.

  • Symptom relief focus
  • Appropriate at any disease stage
  • Pain and fatigue management
  • Emotional and spiritual support
  • Quality of life improvement
Geriatrics

Care Transitions

Moving between care settings, such as from hospital to home or to rehab, is a high-risk time. Social work and geriatrics teams collaborate closely to manage these transitions.

Social workers ensure the home environment is safe and that necessary equipment is in place. They arrange for home health aides or visiting nurses.

Effective discharge planning prevents readmissions. Medication reconciliation is performed to ensure the patient knows what to take upon leaving the hospital.

  • Management of high-risk transitions
  • Social work collaboration
  • Home safety and equipment setup
  • Prevention of hospital readmissions
  • Medication reconciliation at discharge

Surgical Considerations

Surgery in the elderly carries higher risks. Preoperative evaluation assesses frailty, cognition, and nutritional status to predict outcomes.

“Prehabilitation” programs may be used to strengthen the patient before elective surgery. This improves recovery times.

Postoperative care focuses on preventing delirium and getting the patient moving early. Pain management is tailored to avoid over-sedation.

  • Frailty and risk assessment
  • Prehabilitation programs
  • Delirium prevention protocols
  • Early mobilization strategies
  • Tailored pain management

Cognitive Support Strategies

For patients with dementia, treatment involves creating a supportive environment. This includes establishing routines and simplifying communication.

Medications may be used to manage symptoms, but non-pharmacological approaches are preferred for behavioral issues. Music therapy, pet therapy, and sensory stimulation can reduce agitation.

Supporting the caregiver is a significant part of the treatment plan. Education on how to manage behaviors reduces caregiver burnout.

  • Environmental modification
  • Routine establishment
  • Non-pharmacological behavioral management
  • Sensory and therapy interventions
  • Caregiver education and support

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Table of Contents

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Nutritional Interventions

Treating malnutrition involves more than just “eating more.” It may require changing the texture of food for swallowing safety or adding high-calorie supplements.

Social eating programs can encourage appetite. In some cases, appetite stimulants are considered, though their efficacy is limited.

Hydration strategies are implemented for those who lose their thirst drive. Regular weight monitoring ensures interventions are working.

  • Texture modification for safety
  • Caloric supplementation
  • Social eating encouragement
  • Hydration protocols
  • Regular weight monitoring

Incontinence Management

Treatment for incontinence starts with behavioral changes. Scheduled toileting and fluid management are practical first steps.

Pelvic floor physical therapy strengthens the muscles that control urine flow. Medications can calm an overactive bladder, but must be chosen carefully to avoid cognitive side effects.

In some cases, minimally invasive procedures or surgery can correct structural issues causing leakage.

  • Behavioral and fluid management
  • Scheduled toileting protocols
  • Pelvic floor strengthening
  • Medication selection for safety
  • Surgical correction options

Fall Prevention

Treating the “faller” involves a multifactorial intervention. This includes checking vision, reducing psychotropic medications, and treating foot problems.

Home safety assessments identify hazards like loose rugs or poor lighting. Vitamin D supplementation is often used to support muscle and bone health.

Balance training, such as Tai Chi, is prescribed to improve stability. Preventing falls is a primary treatment goal to preserve independence.

  • Multifactorial risk reduction
  • Vision and podiatry correction
  • Home safety modification
  • Vitamin D supplementation
  • Balance training prescriptions

Pain Management

Pain is often under-treated in older people due to fear of side effects. A “start low and go slow” approach is used with pain medications.

Topical agents like lidocaine patches or NSAID creams are preferred over systemic pills when possible. Acetaminophen is often the first line for osteoarthritis.

Non-pharmacological treatments like heat, ice, massage, and acupuncture are integrated into the pain management plan.

  • “Start low and go slow” dosing
  • Preference for topical agents
  • Acetaminophen as first line
  • Integration of non-pharmacological therapies
  • Avoidance of potent opioids when possible

Addressing Sensory Loss

Treatment includes the prescription and fitting of hearing aids. Cochlear implants are becoming an option for older adults with severe hearing loss.

Vision correction involves cataract surgery, which is highly effective. Low-vision aids, such as magnifiers and talking books, help people with macular degeneration.

Improving sensory input reduces cognitive load and helps maintain social connections.

  • Hearing aid fitting and management
  • Cochlear implant consideration
  • Cataract surgery referrals
  • Low vision aids and tools
  • Cognitive load reduction

Managing "What is a Geriatrics" Assessment

When implementing a care plan, understanding what a geriatrics assessment entails is vital. It means the treatment is not just a prescription but a comprehensive life plan.

It involves coordinating transportation to appointments, ensuring meals are delivered if needed, and managing the logistics of daily life.

The treatment plan is dynamic. It changes as the patient’s functional status evolves.

  • Comprehensive life planning
  • Logistical support coordination
  • Dynamic plan adjustment
  • Functional status monitoring
  • Holistic intervention

Home-Based Primary Care

For homebound patients, the doctor visits them at home. This model, often called “house calls,” provides high-quality care for the frailest patients.

It reduces emergency room visits and hospitalizations. The provider scans the living environment, enabling more effective safety recommendations.

It provides a level of intimacy and understanding that is difficult to achieve in a clinic setting.

  • House calls for frail patients
  • Reduction of ER utilization
  • Environmental safety assessment
  • High-touch personalized care
  • Access for homebound individuals

Advance Care Planning

Treatment includes documenting the patient’s wishes for future care. Living wills and medical power of attorney documents are completed.

Physician Orders for Life Sustaining Treatment (POLST) forms translate these wishes into medical orders.

These discussions ensure that the patient receives the care they want and avoids unwanted invasive procedures at the end of life.

  • Documentation of future wishes
  • Living wills and power of attorney
  • POLST form completion
  • Avoidance of unwanted procedures
  • Respect for patient autonomy

FREQUENTLY ASKED QUESTIONS

What is deprescribing?

Deprescribing is the planned and supervised process of reducing or stopping medications that may no longer be beneficial or could be causing harm.

Yes, physical therapy can help people with dementia maintain mobility, reduce fall risk, and improve mood, although the teaching techniques may need to be adapted.

Palliative care can begin at diagnosis and be given alongside curative treatment. In contrast,e hospice care begins after treatment of the disease is stopped and it is clear the person is not going to survive the illness.

Offer small, frequent meals with high-calorie, nutrient-dense foods, make mealtime a social event, and address any dental pain or swallowing issues that might be hindering eating.

Age alone is not a reason to avoid surgery; the decision depends on the person’s overall health, functional status, and the risks versus benefits of the specific procedure.

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