Abstract:
:Advance directives cover a wide variety of situations concerning the advance planning for medical care. Advance directives have existed for approximately 20 years; however, their forms and uses are presently expanding and evolving. This article presents advance directives, their various forms and uses, and reviews the current data on how well they achieve their desired goal. The Patient Self Determination Act, which was designed to promote the acknowledgment and completion of advance directives, is also discussed, as well as practical suggestions for the current and future uses for advance directives.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
Cox DM,Sachs GAsubject
Has Abstractpub_date
1994-08-01 00:00:00pages
431-43issue
3eissn
0749-0690issn
1879-8853journal_volume
10pub_type
杂志文章,评审abstract::Elder abuse and neglect is estimated to affect approximately 700,000 to 1.2 million elderly people a year with an estimated annual cost of tens of billions of dollars. Despite the large population at risk, its significant morbidity and mortality, and substantial cost to society, elder abuse continues to be underrecogn...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2012.09.004
更新日期:2013-02-01 00:00:00
abstract::Constipation and irritable bowel syndrome are very common in older persons. Constipation is over diagnosed and over treated in older persons. Lifestyle changes, osmotic laxatives, and lubiprostone are the approaches of choice for the management of constipation. Irritable bowel syndrome should be considered in the diff...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2007.06.008
更新日期:2007-11-01 00:00:00
abstract::Although the increased need for studies assessing the influence of age on the pharmacokinetics and pharmacodynamics of all drugs has been emphasized, relatively little is known about NSAIDs in the elderly. The pharmacokinetics of some NSAIDs have been examined in elderly subjects; unfortunately, recent data indicate t...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-05-01 00:00:00
abstract::Cancer in the oldest old is a novel problem, due to the recent burgeoning of the population aged 85 and older. This article addresses three critical questions related to cancer in the oldest old: Does the incidence of cancer increase after age 95? Is cancer a common cause of death for the oldest old? Is cancer accurat...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1997-02-01 00:00:00
abstract::New data have shown that sebum secretion is highest in young adults and then declines steadily throughout life in both men and women. This parallels the decline in androgen levels, but this cannot be the sole factor because there is so much overlap in sebaceous gland activity between men and women. The increased occur...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-02-01 00:00:00
abstract::This article presents an up-to-date review of the literature on hormone augmentation in the elderly to help primary care physicians better evaluate and utilize hormone replacement and optimization strategies to benefit their patients. The scientific literature suggests that hormone supplementation with estrogen, proge...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2011.07.013
更新日期:2011-11-01 00:00:00
abstract::Lower intestinal bleeding in the elderly is a common problem with numerous and varied causes. Its diagnosis and treatment require a careful, systematic approach by physicians with special expertise. Under the proper circumstances, elderly patients with lower intestinal bleeding do well, even when surgery is required. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-05-01 00:00:00
abstract::In hematopoiesis, mature blood cells, granulocytes, erythrocytes, and megakaryocytes originate from hematopoietic stem cells. With age, changes in hematopoiesis may have clinical consequences: defective immune responses, cytopenias (most commonly anemia and lymphopenia), hematological malignancy, and effects mediated ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2019.03.001
更新日期:2019-08-01 00:00:00
abstract::Suicide in the elderly is a growing problem. The elderly population is increasing, and elderly patients have multiple issues that place them at higher risk of suicidality. These issues include physical illnesses, mental illness, loss of functional status, isolation, and family, financial, and social factors. Access to...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.08.012
更新日期:2019-02-01 00:00:00
abstract::By most clinical and economic measures, our health care system is not providing effective or affordable care to Medicare beneficiaries with severe chronic illness. Two million elders, constituting most of the 5% who account for nearly half of Medicare costs, have multiple chronic conditions, functional disability, and...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:10.1016/j.cger.2008.11.004
更新日期:2009-02-01 00:00:00
abstract::A large percentage of subjects receiving a normal calcium intake of 800 mg per day was in negative calcium balance and increasing the calcium intake to various levels up to 2200 mg per day showed a plateau of the calcium balance at the 1200 mg per day intake, indicating a threshold of calcium absorption at this intake...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::As knowledge of molecular and cellular mechanisms of development and aging is elucidated, the need to understand the relationships among tissues, organ systems, health habits, nutrition, physical activity, and environmental factors on successful aging becomes more explicit. Progress in our understanding of how the imm...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 00:00:00
abstract::Transitions in care are a vulnerable time period for patients during which unintended errors may occur. This article discusses potential risks that could occur during care transitions, suggested improvements, and the transition from hospital to skilled nursing facilities for patients needing rehabilitation after their...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2014.01.017
更新日期:2014-05-01 00:00:00
abstract::Urinary incontinence (UI) in the older adult is a multisystem health problem that has an impact on the lives of millions of older adults. Advanced practice nurses (APNs) specializing in gerontology,family, and adult practice are equipped educationally with the expertise to prevent, assess, and manage this health probl...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2004.04.015
更新日期:2004-08-01 00:00:00
abstract::This article highlights new developments in assessment and management of pain and delirium. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2004.09.002
更新日期:2005-02-01 00:00:00
abstract::Cardiovascular disorders are a common cause of falls and syncope in older adults. The most common cardiac disorders linked to falls and syncope are carotid sinus syndrome, postprandial hypotension, orthostatic hypotension, vasovagal syncope, and bradyarrhythmias. It is important to recognize these conditions, because ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:10.1016/j.cger.2010.07.006
更新日期:2010-11-01 00:00:00
abstract::Clinical assessment of fitness to drive can be a challenging part of primary care of older adults. There are no guidelines on screening for driver safety, so it falls to provider judgment on when to assess older drivers. This review offers recommendations on when to assess for driver safety based on red flag condition...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2017.09.006
更新日期:2018-02-01 00:00:00
abstract::Quality of life is becoming increasingly important in assessing the impact of therapy for hypertension in elderly persons. Although the concept of quality of life is new and is in need of further definition, good measures already exist to examine the effects of therapy in the major domains of quality of life such as s...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-11-01 00:00:00
abstract::Information derived from the relationship of the primary care physician with an older patient provides the best possible way to eliminate or minimize many ethical conflicts that arise in the care of the very old. The conscientious physician can seek information regarding the patient's personal value scheme and his or ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1986-08-01 00:00:00
abstract::The routine prescription of hormone replacement therapy for elderly women to prevent heart disease is not indicated. Until better data are available, the use of estrogens primarily to prevent heart disease probably should be reserved for women at high risk by virtue of their LDL/HDL ratio or the presence of manifest c...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-02-01 00:00:00
abstract::Most Americans will be afflicted by some form of spine-related pain in their lifetime. In older patients, the most frequent source of back pain is lumbar spinal stenosis or vertebral compression fracture. Although most back pain is self-limited, some patients will require interventional techniques. This article review...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2007.12.006
更新日期:2008-05-01 00:00:00
abstract::Within some parts of the United Kingdom major deficiencies in diabetes care for older adults exist; these include lack of screening for the disorder, failure to evaluate complications, lack of individual management plans, and failure to appreciate the role of informal caregivers. The prevalence of diabetes in the elde...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 00:00:00
abstract::Despite the considerable challenges to providing high-quality rehabilitation in a long-term care facility, growing demographic and fiscal pressures are likely to push the nursing home into the forefront of rehabilitation for the frail elderly. Model programs have been implemented in recent years that present alternati...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract::Delusional depression frequently is encountered in the treatment of older psychiatric patients. Although the pathogenesis of this disorder and its relationship to organic brain lesions remains unclear, somatic treatment, especially with ECT, leads to initial recovery in the majority of cases. High rates of relapse and...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-05-01 00:00:00
abstract::What are the dermatologic needs of aging and skin disease in the elderly in the new millennium? This question may be impossible to answer, but predictions may be derived from current sources of data. Data from the US Census Bureau and the National Ambulatory Medical Care Survey are used to characterize current use of ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:10.1016/s0749-0690(05)70090-2
更新日期:2001-11-01 00:00:00
abstract::Physical activity protects against the development of chronic disease and disability. There appears to be little risk of damage to joints from regular, moderate-level exercise. Patients with arthritis can safely participate in exercise programs and often have relief of pain and disability. The most difficult problem f...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1998-08-01 00:00:00
abstract::This article provides a brief overview of the challenges and opportunities of new technologies in the area of geriatric pain management. It also reviews emerging evidence to demonstrate the role technology may play in improving and advancing assessment and management of pain in older adults. ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2016.06.011
更新日期:2016-11-01 00:00:00
abstract::Improvements in delivery systems for enteral feeding, in formulas, and in the understanding of complications have made the technology for enteral feeding easy to apply. Adequate nutrients can be delivered, and individual tolerance for feeding is acceptable. The remaining question is when to apply the technology. Formu...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(02)00035-6
更新日期:2002-11-01 00:00:00
abstract::Urinary infection is the most common infection in elderly populations. There is a high prevalence of asymptomatic bacteriuria, but this is benign and does not require treatment. A urine specimen for culture should be obtained before initiating antimicrobial therapy for symptomatic infection. Antimicrobial treatment re...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2009.04.005
更新日期:2009-08-01 00:00:00
abstract::Epidemiological data suggests that the prevalence of musculoskeletal and neuropathic pain increases with age until at least late mid-life, though the pattern is somewhat unclear beyond this point. And though the prevalence of some types of pain may peak in late midlife, pain is still a substantial and common complaint...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2016.06.005
更新日期:2016-11-01 00:00:00