Geriatrics focuses on healthcare for the elderly. It aims to promote health and prevent/treat diseases and disabilities in older adults. There are differences between adult and geriatric medicine, as geriatricians focus more on functional ability, independence, and quality of life than physicians for adults. Employment of physical therapist assistants in geriatrics is expected to grow substantially due to the aging baby boomer population and medical advances enabling more trauma survivors who will need therapy. Minimum competencies for geriatric physical therapy include treatment of cognitive/behavioral disorders, medication management, and palliative care.
How can we improve the quality of life of an aging person? How can a geriatric physician and a geriatric counselor can work as a team. Who else are the other professionals to be included in the geriatric care team? What are the problems faced by the elderly? These are some of the questions we are trying to find an answer for. Caring for elder persons is getting more and more importance as the number of old people are increasing these days. Relatives alone can't meet the challenges of caring for the old. You need professional who can understand and render proper help in this regard. So geriatric counseling is getting more and more acceptance. Alzheimer's Syndrome, senile dementia, rheumatic pains, feeling of alienation etc are some of the problems counselor have to cope up with.
Geriatric Population. Geriatric Palliative and End-of-Life Care.Michelle Peck
During your journey through this slide deck Geriatric Population. Geriatric Palliative and End-of-Life Care you will experience what it means to die badly.
After practicing as a Geriatric Clinician for over a decade what I know for sure is: Life is a tremendous gift. 100% of us are going to die. If you don't communicate your end-of-life plan, then you should plan on dying badly.
In The Cost of Dying: End-of-Life Care on CBS 60 minutes Steve Kroft interviews Doctor Ira R. Byock. “Families cannot imagine that there could be anything worse than their loved one dying, but in fact there are things worse, generally it’s having someone you love die badly.” ~Doctor Ira Byock
“Dr. Byock what do you mean dying badly?” ~Mr. Kroft
“Dying suffering, dying connected to machines, denial of death at some point becomes a delusion and we start acting in ways that make no sense whatsoever.” ~Doctor Ira Byock
A majority of Americans say they want to die at home. Why is this not happening?
Place of death should be regarded as an essential goal in end-of-life care.
Let’s explore how the end-of-life decision occurs?
For Doctors
Bernacki & Block (2014) found in their review and synthesis of best practices that physician attitudes, training, and perceptions of feeling inadequate in managing the emotional and behavioral reactions of patients all play a role. A majority of trainees were not taught how to communicate and they express strong desires to learn more. Physician barriers also include not addressing psychosocial concerns, placing focus on diagnoses, treatments, and procedures during discussions about the medical care at the end-of-life.
For Patients
Bernacki & Block (2014) found that patients who do bring up dying concerns with their physicians often meet barriers and often are not aware that they are at the end-of-life. Patients that have not set goals based on meaningful conversations about their desires may overuse life-prolonging treatment and underuse services that support quality of life.
Conclusion
Bernacki & Block (2014) found that there is a large body of evidence demonstrating that early discussions of serious illness care goals are associated with:
♛ beneficial outcomes for patients,
♛ no harmful adverse effects, and
♛ potential cost savings.
Apply & Do
To prevent dying badly start early conversations, enhance your knowledge and establish goals. Dreams are only dreams until you write them down. When you write dreams down then they become goals.
Do ♛ The Conversation Project a collaboration with the Institute for Healthcare Improvement. http://theconversationproject.org/starter-kit/intro/
Do your conversation kit now and make your loved ones aware of your wishes.
Wishing you the very best, Michelle
Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices. JAMA Intern Med. 2014;174(12):1994-2003.
How can we improve the quality of life of an aging person? How can a geriatric physician and a geriatric counselor can work as a team. Who else are the other professionals to be included in the geriatric care team? What are the problems faced by the elderly? These are some of the questions we are trying to find an answer for. Caring for elder persons is getting more and more importance as the number of old people are increasing these days. Relatives alone can't meet the challenges of caring for the old. You need professional who can understand and render proper help in this regard. So geriatric counseling is getting more and more acceptance. Alzheimer's Syndrome, senile dementia, rheumatic pains, feeling of alienation etc are some of the problems counselor have to cope up with.
Geriatric Population. Geriatric Palliative and End-of-Life Care.Michelle Peck
During your journey through this slide deck Geriatric Population. Geriatric Palliative and End-of-Life Care you will experience what it means to die badly.
After practicing as a Geriatric Clinician for over a decade what I know for sure is: Life is a tremendous gift. 100% of us are going to die. If you don't communicate your end-of-life plan, then you should plan on dying badly.
In The Cost of Dying: End-of-Life Care on CBS 60 minutes Steve Kroft interviews Doctor Ira R. Byock. “Families cannot imagine that there could be anything worse than their loved one dying, but in fact there are things worse, generally it’s having someone you love die badly.” ~Doctor Ira Byock
“Dr. Byock what do you mean dying badly?” ~Mr. Kroft
“Dying suffering, dying connected to machines, denial of death at some point becomes a delusion and we start acting in ways that make no sense whatsoever.” ~Doctor Ira Byock
A majority of Americans say they want to die at home. Why is this not happening?
Place of death should be regarded as an essential goal in end-of-life care.
Let’s explore how the end-of-life decision occurs?
For Doctors
Bernacki & Block (2014) found in their review and synthesis of best practices that physician attitudes, training, and perceptions of feeling inadequate in managing the emotional and behavioral reactions of patients all play a role. A majority of trainees were not taught how to communicate and they express strong desires to learn more. Physician barriers also include not addressing psychosocial concerns, placing focus on diagnoses, treatments, and procedures during discussions about the medical care at the end-of-life.
For Patients
Bernacki & Block (2014) found that patients who do bring up dying concerns with their physicians often meet barriers and often are not aware that they are at the end-of-life. Patients that have not set goals based on meaningful conversations about their desires may overuse life-prolonging treatment and underuse services that support quality of life.
Conclusion
Bernacki & Block (2014) found that there is a large body of evidence demonstrating that early discussions of serious illness care goals are associated with:
♛ beneficial outcomes for patients,
♛ no harmful adverse effects, and
♛ potential cost savings.
Apply & Do
To prevent dying badly start early conversations, enhance your knowledge and establish goals. Dreams are only dreams until you write them down. When you write dreams down then they become goals.
Do ♛ The Conversation Project a collaboration with the Institute for Healthcare Improvement. http://theconversationproject.org/starter-kit/intro/
Do your conversation kit now and make your loved ones aware of your wishes.
Wishing you the very best, Michelle
Bernacki RE, Block SD, for the American College of Physicians High Value Care Task Force. Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices. JAMA Intern Med. 2014;174(12):1994-2003.
Theory lecture for first semester RN students about the special needs of older adults. We have a growing older adult population.. we need education patients and family members how to adapt to this aging changes.
Geriatrics is a sub-specialty of medicine that focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
Theory lecture for first semester RN students about the special needs of older adults. We have a growing older adult population.. we need education patients and family members how to adapt to this aging changes.
Geriatrics is a sub-specialty of medicine that focuses on health care of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
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important points regarding ICU psychosis, role of dexmedetomidine in it's treatment, mortality associated with delirium, symptomatic and definitive management
Anthony Holley's fantastic presentation on burns injuries that he gave at the Bedside Critical Care Conference 2012. Go to www.IntensiveCareNetwork.com for the unmissable talk.
Health professionals are experts who keep people healthy by using evidence-based medicine and compassion. They identify and treat illnesses, injuries, and both physical and mental challenges in line with the needs of the communities.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Objectives Define geriatrics History of geriatrics Differences between adult and geriatric medicine Types of geriatric specialties Geriatric giants Surgical geriatric specialties Medical conditions Salary Data Employment outlook Achievement in geriatric physical therapy research and practice. Conclusion
3. Geriatrics is the branch of medicine that focuses on health care of the elderly. It aims to promote healthand to preventand treat diseasesand disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician. Rather, this is determined by a profile of the typical problems that geriatrics focuses on. People over the age of 65 make up one of the fastest growing segments of the population of many industrialized nations. The variation in health, daily function, cognition, social roles, and living conditions among these older adults requires that allied health, medical, social service, social science, health education, health management, and movement science professionals develop the competence to address the unique needs of this age group.
4. History of Geriatrics: “ The Cannon of Medicine” written by Abu Ali IbnSina in 1025 Arabic physician, IbnAl-JazzarrAl-Qayrawani (898-980), addressed sleep disorderssand another one on forgetfulnessand how to strengthen memory The first modern geriatric hospital "Father" of Geriatrics, Dr. Ignatz Leo Nascher "Mother" of Geriatrics, Dr. Marjorie Warren Most pressing issue facing geriatrics is the treatment and prevention of delirium
5. Differences between Adult and Geriatric medicine Geriatrics is the branch of medicine that focuses on health care of the elderly. It aims to promote health and to preventand treat diseasesand disabilities in older adults. The term geriatrics differs from gerontology which is the study of the aging process itself. Disease is a medical condition where an abnormal condition impairs bodily function impairs bodily functions whether it is physically or psychologically. Functional ability, independence and quality of life issues are of greater concern to geriatricians, than to physicians of adults.
6. Geriatric Specialities Geriatric psychiatry or psychogeriatrics (focus on dementia, delirium, depressionand other psychiatric disorders). Cardiogeriatrics (focus on cardiac diseases of elderly) Geriatric nephrology (focus on kidney diseases of elderly) Geriatric Rehabilitation (focus on physical therapy in elderly) Geriatric oncology (focus on tumors in elderly) Geriatric rheumatology (focus on joints and soft tissue disorders in elderly) Geriatric diagnostic imaging Geriatrics dermatology(focus on skin disorders in elderly) Geriatric subspeciality medical clinics (As Geriatric Anticoagulation Clinic Geriatric Assessment Clinic, Falls and Balance Clinic, Continence Clinic, Palliative Care Clinic, Elderly Pain Clinic, Cognition and Memory Disorders Clinic)
7. Medically Treatment Issues Treating an elderly patient is filled with complications with the major difference of treating a geriatric patient is that treating an elderly person sometimes needs to have a guardian or healthy proxy make the medically decision required for the situation or treatment required. The issues of power of attorney, privacy, legal responsibility, advance directives and informed consent must always be considered in geriatric procedure Geriatric pharmacotherapy(medications) Issues with medications often need to be addressed with the elderly because of the multiple over the counter medications and herbs as well as those medications prescribed by their physician. Many of the drugs that are taken by the elderly have many contraindications with other medications they may be taking and react in an adverse way to other medications.
8. The presentation of disease in elderly persons may be vague and non-specific and may also be a secondary symptom to the actual cause of the issue. Description of the disease itself may be the patient not being able to verbalize or explain the symptoms due to confusion or delirium caused by the disease itself.
9. Elderly Disease and the Geriatric Giants Elderly disease and the geriatric giants Immobility Instability Incontinence Impaired intellectual memory functioning Elderly care Delirium Multiple medications Impaired vision Impaired hearing
10. Surgical specialties directly related to geriatrics Orthogeriatrics(close cooperation with orthopedic surgery ) Geriatric Cardiothoracic Surgery Geriatric Urology Geriatric General Surgery/Trauma Geriatric Gynecology Geriatric Ophthalmology Geriatric Anesthesia (focuses on anesthesia & perioperative care of elderly) Geriatric Intensive Care Unit: (a special type of intensive care unit dedicated to citically-ill elderly) Geriatric Nursing(focuses on nursing of elderly patients and the aged). Geriatric Nutrition Geriatric Occupational Therapy(part of Geriatric Rehabilitation) Geriatric Pain Management Geriatric Physical Therapy
11. Medical conditions Dementia. Cancer Diabetes Epilepsy Heartdisease* Osteoporosis Parkinson's disease Sleep disorders Stroke
12. Geriatric Psychology As society continues to age and more information becomes clear as to the way the body reacts to time and the abuse the body takes over time the treatments of aging and its diseases will become more efficient and effective. The process of developmental learning as we age from childhood to adulthood and to the elderly stages of development has begun theories of how the brain reacts to those learned processes or experiences. The experience of physical activity not only proves to be physically helpful but mentally the mylen sheaths continue to be activated in brain and thicken, showing to show a delayed onset of dementia.
13. The College of St. CatherinePhysical Therapist Assistant Program June 2007 Employment/Salary Data:Reported Range of Current Hourly Salaries: Full time Geriatrics = $17.50 – $22.50
14. EMPLOYMENT OUTLOOK FOR PHYSICAL THERAPIST ASSISTANTS Employment of physical therapist assistants expected to grow much faster than the average through the year 2010 The large baby-boom generation is entering the prime age for heart attacks and strokes Medical developments should permit an increased percentage of trauma victims to survive, creating added demand for therapy services. “Physical therapist assistant is listed in the Top 100 Occupation List as number 69th , with a 41.1% increase anticipated between 2000-2010 Job outlook for physical therapist assistants is described as “Very Good”
15. Minimum Geriatric Competencies Cognitive and behavioral disorders Medication management Self-care capacity Falls, balance, gait disorder Atypical presentation of disease Palliative care Hospital care for elders Health care planning and promotion
16. Awards in geriatric physical therapy Adopt-A-Doc Program Clinical Educator Clinical Excellence Consumer Brochure Contest for Students Distinguished Educator Entrepreneurial Loan Excellence in Research Fellowship for Geriatric Research Joan M. Mills; Outstanding Service Lynn Phillippi; Advocacy Outstanding PTA Previous Award Recipients Student Award for Research Student Membership Award Volunteers in Action
17. Conclusion As the population ages, so does the need for those trained in the specialized care of the elderly patient as it applies to the physical therapy and its treatments required for quality of life and independent living activities
18. ^GERIATRICSFOR-SPECIALISTS INITIATIVE (GSI) ^Increasing Geriatrics Expertise in Surgical and Medical Specialties ^ Howell, Trevor H. (January 1987), "Avicenna and His Regimen of Old Age", Age and Ageing16: 58–9, doi:10.1093/ageing/16.1.58, PMID3551552, http://ageing.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=3551552 ^ Howell TH (1972). "Avicenna and the care of the aged". Gerontologist12 (4): 424–6. PMID4569393. ^Pitskhelauri GZ, Dzhorbenadze DA (1970). "[Gerontology and geriatrics in the works of Abu Ali IbnSina (Avicenna) (on the 950th anniversary of the manuscript, Canon of Medical Science)]" (in Russian). SovZdravookhr29 (10): 68–71. PMID4931547.