Orthostatic Hypotension in Older Adults


Book Description

This book provides a comprehensive and practical guide to orthostatic hypotension (OH) for doctors and nurses involved in the care of older adults, together with a state-of-the-art update on OH, covering its epidemiology, pathophysiology, assessment, diagnosis, causes, prevention, management, and relevance for geriatric practice. In addition, it addresses mechanisms of orthostatic tolerance and other orthostasis related conditions, as well as drugs, comorbidities and geriatric syndromes related to OH. The homeostatic ability to maintain blood pressure while standing requires an adequate blood volume and the integrity of the nervous system, heart, blood vessels and muscle pump. However, in older adults, some age-related factors can contribute to the development of OH. For example, decreased baroreflex sensitivity, α-1-adrenergic vasoconstrictor response to sympathetic stimuli, parasympathetic activity, renal salt and water conservation, increased vascular stiffness and decreased ventricular diastolic filling, as well as concentrated capacities of the kidney may be associated with changes in postural blood pressure. It has also been shown that OH is associated with falls, cardiac events, heart failure, stroke, reduced quality of life, and increased risk of overall mortality in these patients. “Orthostatic Hypotension in Older Adults” will be of considerable interest to all professionals working in the fields of geriatrics, geriatric psychiatry, neurology, internal medicine, cardiology, and emergency medicine, or working with older people in hospitals or in their community.




Implementation of Evidence Based Protocol for Orthostatic Hypotension in Older Adults with Advanced Dementia


Book Description

"Orthostatic hypotension (OH) in older adults with dementia is associated with increased confusion, dizziness, syncope, and falls. These problems can be responsible for a negative, downward spiral, high morbidity and mortality. The literature supports that pharmacologic and non pharmacologic treatments are effective in the reduction of symptoms and prevention of orthostasis. The purpose of this quality improvement project was to increase staff knowledge and skill in the assessment of OH and related care for residents in dementia care units. This was accomplished by an in-service program presented to RN's, LPNs, therapists, and unlicensed caregivers using a protocol based on clinical practice guidelines. In-service pre and posttest measures confirmed increased staff knowledge. Pre and post in-service chart audits revealed increased documentation of orthostatic blood pressure measurement and use of care strategies included in the protocol. This evidence based practice will reduce symptoms of OH, increase resident safety and quality of life. Keywords: orthostatic hypotension, postural hypotension, orthostasis, clinical practice guideline, older adults, long-term care, aging, dementia, syncope and falls " -- Abstract.




Diabetes in Old Age


Book Description

This new edition of the popular and market-leading Diabetes in Old Age features up-to-date and comprehensive information about the key aspects of managing older people with diabetes, predominantly type 2 diabetes. With a strong evidence-based focus throughout, the entire range of issues surrounding diabetes and its many complications are covered, each with a clear focus on how they relate directly to the older patient. Varying approaches to optimizing diabetes care in the community, primary care and secondary care health care arenas are presented, and the importance of comprehensive functional assessment is emphasized. Coverage of areas unique to an ageing population of older people with diabetes such as falls management, frailty and sarcopenia, and cognitive dysfunction form a key cornerstone of the book. In every chapter, best practice points and key learning outcomes are provided, as well as published evidence bases for each major conclusion. Diabetes in Old Age, 4th edition is essential reading for diabetologists and endocrinologists, diabetes specialist nurses, primary care physicians, general physicians and geriatricians, podiatrists and dieticians with an interest in diabetes, as well as all health professionals engaged in the delivery of diabetes care to older people.




Geriatric Emergency Medicine


Book Description

This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.




Pathy's Principles and Practice of Geriatric Medicine


Book Description

This new edition of the comprehensive and renowned textbook Principles and Practice of Geriatric Medicine offers a fully revised and updated review of geriatric medicine. It covers the full spectrum of the subject, features 41 new chapters, and provides up-to-date, evidence-based, and practical information about the varied medical problems of ageing citizens. The three editors, from UK, USA and France, have ensured that updated chapters provide a global perspective of geriatric medicine, as well as reflect the changes in treatment options and medical conditions which have emerged since publication of the 4th edition in 2006. The book includes expanded sections on acute stroke, dementia, cardiovascular disease, and respiratory diseases, and features a new section on end-of-life care. In the tradition of previous editions, this all-encompassing text continues to be a must-have text for all clinicians who deal with older people, particularly geriatric medical specialists, gerontologists, researchers, and general practitioners. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from Google Play or the MedHand Store. Praise for the 4th edition: "...an excellent reference for learners at all clinical and preclinical levels and a useful contribution to the geriatric medical literature." —Journal of the American Medical Association, November 2006 5th edition selected for 2012 Edition of Doody's Core TitlesTM




Hypotensive Syndromes in Geriatric Patients


Book Description

As the Baby Boomers age, concerns over healthcare systems abilities to accommodate geriatric patients grow increasingly challenging. The increased life expectancy of the population since the early 1900s had been built on the improvement of living conditions, diet, public health and advancement in medical care. With this we have seen a steady decline in the age-specific prevalence of vascular and heart diseases, stroke and even dementia. In addition, societies worldwide struggle to develop a large enough workforce to treat aging patients, which forces geriatric patients to rely on physicians in a wide array of specialties that are often not trained for their demographic. These trends have created a tremendous need for trustworthy resources, yet with regard to hypotensive syndromes, nothing of this nature exists. Hypotensive syndromes represent a heterogenous group of disease states. Hypotensive syndromes are characterized by low blood pressure following postural changes, meals and neck turning. These are common conditions seen in the elderly and could be due to blood pressure dysregulation. These syndromes frequently cause dizziness, syncope and falls in the elderly as well as a resultant decrease in function, and they are frequently mistaken for other conditions. This is especially true among physicians who are not trained to consider the unique needs of an aging patient. The proposed book is designed to present a comprehensive approach to the management of hypotensive syndromes in the elderly. Currently there are no guidelines or good resource to guide about these conditions. This book will also discuss the challenges of diagnosis and management of these conditions. The text introduces the concepts to set a clear foundation before covering the syndromes as they present in other comorbidities, including diabetes, heart failure, and a wide array of serious conditions that are common in older patients. As the Baby Boomers continue to age, this text will prove a vital resource for a wide array of specialties that will be increasingly critical to meeting their needs.




Principles and Practice of Geriatric Sleep Medicine


Book Description

This is a concise and comprehensive review of geriatric sleep medicine from a multidisciplinary viewpoint.










Guccione's Geriatric Physical Therapy E-Book


Book Description

Offering a comprehensive look at physical therapy science and practice, Guccione’s Geriatric Physical Therapy, 4th Edition is a perfect resource for both students and practitioners alike. Year after year, this text is recommended as the primary preparatory resource for the Geriatric Physical Therapy Specialization exam. And this new fourth edition only gets better. Content is thoroughly revised to keep you up to date on the latest geriatric physical therapy protocols and conditions. Five new chapters are added to this edition to help you learn how to better manage common orthopedic, cardiopulmonary, and neurologic conditions; become familiar with functional outcomes and assessments; and better understand the psychosocial aspects of aging. In all, you can rely on Guccione’s Geriatric Physical Therapy to help you effectively care for today’s aging patient population. Comprehensive coverage of geriatric physical therapy prepares students and clinicians to provide thoughtful, evidence-based care for aging patients. Combination of foundational knowledge and clinically relevant information provides a meaningful background in how to effectively manage geriatric disorders Updated information reflects the most recent and relevant information on the Geriatric Clinical Specialty Exam. Standard APTA terminology prepares students for terms they will hear in practice. Expert authorship ensures all information is authoritative, current, and clinically accurate. NEW! Thoroughly revised and updated content across all chapters keeps students up to date with the latest geriatric physical therapy protocols and conditions. NEW! References located at the end of each chapter point students toward credible external sources for further information. NEW! Treatment chapters guide students in managing common conditions in orthopedics, cardiopulmonary, and neurology. NEW! Chapter on functional outcomes and assessment lists relevant scores for the most frequently used tests. NEW! Chapter on psychosocial aspects of aging provides a well-rounded view of the social and mental conditions commonly affecting geriatric patients. NEW! Chapter on frailty covers a wide variety of interventions to optimize treatment. NEW! Enhanced eBook version is included with print purchase, allowing students to access all of the text, figures, and references from the book on a variety of devices.