Geriatrics - Wikipedia, the free encyclopedia. Geriatrics. An elderly woman in a residential care home receiving a birthday cake. How to cite this article: Dalal P K, Tripathi A, Gupta S K. Vajikarana: Treatment of sexual dysfunctions based on Indian concepts. Indian J Psychiatry 2013;55, Suppl.
Significant diseases. Dementia, arthritis, palliative care, osteoporosis, osteoarthritis, rheumatoid arthritis, Parkinson's disease, atherosclerosis, heart disease, high blood pressure, high cholesterol. Specialist. Geriatrician. Geriatrics or geriatric medicine. There is no set age at which patients may be under the care of a geriatrician or geriatric physician, a physician who specializes in the care of elderly people. Rather, this decision is determined by the individual patient's needs, and the availability of a specialist. It is important to note the difference between geriatrics, the care of aged people, and gerontology, which is the study of the aging process itself. Medicinal plants based traditional systems of medicines are playing important role in providing health care to large section of population, especially in. The term geriatrics comes from the Greek . However, geriatrics is sometimes called medical gerontology. Differences between adult and geriatric medicine. The aged body is different physiologically from the younger adult body, and during old age, the decline of various organ systems becomes manifest. Previous health issues and lifestyle choices produce a different constellation of diseases and symptoms in different people. The appearance of symptoms depends on the remaining healthy reserves in the organs. Smokers, for example, consume their respiratory system reserve early and rapidly. For example, renal impairment may be a part of aging, but renal failure and urinary incontinence are not. Geriatricians aim to treat diseases that are present and achieve healthy aging. Increased complexity. Multiple problems may compound: A mild fever in elderly persons may cause confusion, which may lead to a fall and to a fracture of the neck of the femur (. Elderly people particularly are subjected to polypharmacy (taking multiple medications). Some elderly people have multiple medical disorders; some have self- prescribed many herbal medications and over- the- counter drugs. This polypharmacy may increase the risk of drug interactions or adverse drug reactions. In one study, it was found that prescription and nonprescription medications were commonly used together among older adults, with nearly 1 in 2. Delirium in the elderly may be caused by a minor problem such as constipation or by something as serious and life- threatening as a heart attack. Many of these problems are treatable, if the root cause can be discovered. Geriatric giants. These include immobility, instability, incontinence and impaired intellect/memory. Impaired vision and hearing loss are common chronic problems among older people. Hearing problems can lead to social isolation, depression, and dependence as the person can no longer talk to other people, receive information over the telephone, or engage in simple transactions, such as talking to a person at a bank or store. Vision problems lead to falls from tripping over unseen objects, medicine being taken incorrectly because the written instructions could not be read, and finances being mismanaged. Practical concerns. Elderly people generally want to live independently as long as possible, which requires them to be able to engage in self- care and other activities of daily living. A geriatrician may be able to provide information about elder care options, and refers people to home care services, skilled nursing facilities, assisted living facilities, and hospice as appropriate. Frail elderly people may choose to decline some kinds of medical care, because the risk- benefit ratio is different. For example, frail elderly women routinely stop screening mammograms, because breast cancer is typically a slowly growing disease that would cause them no pain, impairment, or loss of life before they would die of other causes. Frail people are also at significant risk of post- surgical complications and the need for extended care, and an accurate prediction. Assessment of older patients before elective surgeries can accurately predict the patients' recovery trajectories. A healthy person scores 0; a very frail person scores 5. Compared to non- frail elderly people, people with intermediate frailty scores (2 or 3) are twice as likely to have post- surgical complications, spend 5. As societies aged, many specialized geriatric- and geriatrics- related services emerged. So it can be said that geriatrics was first mentioned in Ayurveda. The term geria is very close to the Sanskrit word jara. Rasayana is defined as . In a chapter entitled . Thesis III of the Canon discussed the diet suitable for old people, and dedicated several sections to elderly patients who become constipated. Using her experiences as a physician in a London Workhouse infirmary, she believed that merely keeping older people fed until they died was not enough; they needed diagnosis, treatment, care, and support. She found that patients, some of whom had previously been bedridden, were able to gain some degree of independence with the correct assessment and treatment. It values all the professions, not just medicine, for their contributions in optimizing the well- being and independence of older people. Another . Geriatricians have developed an expanded expertise in the aging process, the impact of aging on illness patterns, drug therapy in seniors, health maintenance, and rehabilitation. They serve in a variety of roles including hospital care, long- term care, home care, and terminal care. They are frequently involved in ethics consultations to represent the unique health and diseases patterns seen in seniors. The model of care practiced by geriatricians is heavily focused on working closely with other disciplines such as nurses, pharmacists, therapists, and social workers. United Kingdom. While originally a distinct clinical specialty, it has been integrated as a specialisation of general medicine since the late 1. In contrast to the United States, geriatric medicine is a major specialty in the United Kingdom; geriatricians are the single most numerous internal medicine specialists. In Canada, there are two pathways that can be followed in order to work as a physician in a geriatric setting. Medical doctors (M. D.) can complete a three- year core internal medicine residency program, followed by two years of specialized geriatrics residency training. This pathway leads to certification, and possibly fellowship after several years of supplementary academic training, by the Royal College of Physicians and Surgeons of Canada. Medical doctors (M. D.) can opt for a two- year residency program in family medicine and complete a one- year enhanced skills program in care of the elderly. This post- doctoral pathway is accredited by the College of Family Physicians of Canada. Many universities across Canada also offer gerontology training programs for the general public, such that nurses and other health care professionals can pursue further education in the discipline in order to better understand the process of aging and their role in the presence of older patients and residents. In India, Geriatrics is a relatively new speciality offering training and 3 year post graduate residency (M. D) training can be joined for after completing the 5. MBBS. Unfortunately, only four major institutes provide M. D in Geriatric Medicine and subsequent training. Training in some institutes are exclusive in the Department of Geriatric medicine, with rotations in Internal medicine, medical subspecialties etc. Twenty- six (2. 6) Minimum Geriatric Competencies in eight content domains were endorsed by the American Geriatrics Society (AGS), the American Medical Association (AMA), and the Association of Directors of Geriatric Academic Programs (ADGAP). The domains are: cognitive and behavioral disorders; medication management; self- care capacity; falls, balance, gait disorders; atypical presentation of disease; palliative care; hospital care for elders, and health care planning and promotion. Each content domain specifies three or more observable, measurable competencies. Research. The health of the patient will decline as a result of delirium and can increase the length of hospitalization and lead to other health complications. The treatment of delirium involves keeping the patient mentally stimulated and oriented to reality, as well as providing specialized care in order to ensure that her/his needs are being met. The Hospital Elder Life Program (HELP) is an model of hospital care developed at the Yale University School of Medicine. It is designed to prevent delirium and functional decline among elderly individuals in the hospital inpatient setting. HELP uses a core team of interdisciplinary staff and targeted intervention protocols to improve patients' outcomes and to provide cost- effective care. Unique to the program is the use of specially trained volunteers who carry out the majority of the non- clinical interventions. In up to 4. 0% of the cases, incident delirium can be prevented. To that end, HELP promotes interventions designed to maintain cognitive and physical functioning of older adults throughout the hospitalization, maximize patients' independence at discharge, assist with the transition from hospital to home and prevent unplanned hospital readmissions. Customized interventions include daily visitors; therapeutic activities to provide mental stimulation; daily exercise and walking assistance; sleep enhancement; nutritional support and hearing and vision protocols. HELP has been replicated in over 6. Although the majority of the sites are based in the United States located in 2. International sites include: Australia, Canada, the Netherlands, Taiwan and the United Kingdom. Pharmacology. These changes may occur in oral protective reflexes (dryness of the mouth caused by diminished salivary glands), in the gastrointestinal system (such as with delayed emptying of solids and liquids possibly restricting speed of absorption), and in the distribution of drugs with changes in body fat and muscle and drug elimination.
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