Abstract:
:In end-of-life care, attending to spiritual needs ensures that a dying patient has the opportunity to find meaning in the midst of suffering and to have the opportunity for love, compassion, and partnership in their final journey. This article summarizes some of the beliefs and traditions from Judaism, Islam, and Christianity that affect people as they face their own dying and mortality. People who do not participate in any formal religion also have a drive to find meaning in the midst of suffering and dying. They may find this in personal ways. This article presents some practical tools to help clinicians address and respect spiritual and religious issues of patients. It is crucial that our culture and our systems of care for the dying include a spiritual approach so that dying can be meaningful and even filled with hope.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
Puchalski CM,Dorff RE,Hendi IYdoi
10.1016/j.cger.2004.07.004subject
Has Abstractpub_date
2004-11-01 00:00:00pages
689-714, vi-viiissue
4eissn
0749-0690issn
1879-8853pii
S0749-0690(04)00065-5journal_volume
20pub_type
杂志文章,评审abstract::Pulmonary embolism (PE) is a difficult diagnosis in patients of all ages, but more so in the elderly. Nonspecific symptoms and laboratory results are often misattributed to common diseases or to age itself, and can delay or even deter the diagnosis and treatment of PE. Advanced age is sometimes mistakenly seen as a co...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(02)00055-1
更新日期:2003-02-01 00:00:00
abstract::The concept of cognitive reserve (CR) was proposed to account for the discrepancy between levels of brain pathologic process or damage and clinical and cognitive function. We provide a detailed review of prospective longitudinal studies that have investigated the interaction between CR and Alzheimer disease (AD) bioma...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2019.11.006
更新日期:2020-05-01 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::Older adults receive care from various settings, including acute care hospitals, skilled nursing facilities, nursing homes, group homes, outpatient primary care, specialty clinics, and home. In these various settings, older adults are exposed to pathogens, which makes them "vectors" that transport pathogens from one s...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2007.02.001
更新日期:2007-08-01 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::Cardiovascular risk factors have been associated with 2 common manifestation of unhealthy brain in older people, cognitive impairment and depression. The evidence for these effects is almost entirely observational, but links hypertension, smoking, hypercholesterolemia, diabetes mellitus, and hyperhomocysteinemia with ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2009.12.005
更新日期:2010-02-01 00:00:00
abstract::Urinary incontinence is a prevalent condition in elderly women with significant associated morbidity. Incontinence can by grouped into several types: stress incontinence, urgency incontinence, overflow incontinence, functional incontinence, and mixed urinary incontinence. Careful evaluation, including history and phys...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2015.07.003
更新日期:2015-11-01 00:00:00
abstract::There is no single definition of polypharmacy. Use of 5 or more medications commonly is used. An alternative, quantitative definition, such as use of more medications than clinically indicated or use of unnecessary or harmful prescribing, has been proposed. Protocols or algorithms to improve polypharmacy and prescribi...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2017.01.007
更新日期:2017-05-01 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::Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer disease. It stems from the formation of Lewy bodies, which contain aggregates of the misfolded protein, α-synuclein. These deposit in areas of the nervous system and brain, leading to neuronal cell death and causin...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.06.007
更新日期:2018-11-01 00:00:00
abstract::Primary malignant brain tumors present a formidable challenge to surgeons, patients, and families. Although the prognosis in elderly patients approaches only 6 months, aggressive resection and adjuvant treatment may be indicated in a select group of patients who have preserved functional status. Subdural hematomas in ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2006.04.002
更新日期:2006-08-01 00:00:00
abstract::Although dementias are defined by their cognitive and functional deficits, psychiatric problems are common, contribute to patient distress and caregiver burden, and precipitate institutionalization. Successful treatment involves understanding that physiologic, psychological, and environmental factors can contribute to...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2014.04.002
更新日期:2014-08-01 00:00:00
abstract::Venous thrombosis is a common disease. As the mean age of the population increases, so does the incidence of venous thromboembolism. Anticoagulant therapy is equally effective in young and older patients, and can reduce substantially the associated morbidity and mortality. When considering long-term oral anticoagulant...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2005.09.004
更新日期:2006-02-01 00:00:00
abstract::The importance of a thorough history and physical examination in conjunction with appropriate laboratory, radiographic, endoscopic, and urodynamic studies is emphasized, with the goal of defining the cause of incontinence in the elderly. Once the pathologic process that is causing the symptom of incontinence is object...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1986-11-01 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::Geriatric hip fracture is a common event associated with high costs of care and often with suboptimal outcomes for the patients. Ideally, a new care model to manage geriatric hip fractures would address both quality and safety of patient care as well as the need for reduced costs of care. The geriatric fracture center...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2014.01.002
更新日期:2014-05-01 00:00:00
abstract::Bone is a complex organ which contains an organic matrix which serves as scaffolding, includes mineral as calcium distributed in a pattern providing structure and serves as an ion reservoir for the body. Throughout life it dynamically changes in response to changes in activity, body mass, and weight bearing. It is imp...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2005.02.002
更新日期:2005-08-01 00:00:00
abstract::This article draws attention to some of the unique aspects of diabetes mellitus in the elderly and outlines the principles of management of diabetes in this age group with emphasis on diet therapy. The implications of the Diabetes Control and Complications Trial for the elderly person with diabetes is also briefly dis...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 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::American health-care practitioners are faced with a rapidly growing, geriatric, Hispanic-American population. This group shares certain cultural links but is largely heterogeneous and comprised of many subgroups, the largest of which are Mexican Americans, Puerto Ricans, and Cuban Americans. Health-care practitioners ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 00:00:00
abstract::Balance disorders are common in the elderly and can lead to falls, with resultant severe morbidity and even mortality. Progressive loss of vestibular function begins in middle age and is affected by multiple disease processes. Polypharmacy impacts many disease processes in the elderly, with balance function being one ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2018.01.002
更新日期:2018-05-01 00:00:00
abstract::The treatment of nonpain symptoms is integral to good palliative care of the terminally ill elder. This article reviews the management of common physical symptoms observed during the dying process, including nausea and vomiting, dyspnea, cough, constipation, diarrhea, bowel obstruction, and xerostomia. Alleviation of ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-05-01 00:00:00
abstract::Efforts toward early detection of Alzheimer disease (AD) have focused on refinement and identification of diagnostic markers, with the goal of preventing or delaying disease progression. Mild cognitive impairment (MCI) has emerged as a potential precursor to dementia. Though not without controversy, MCI has been assoc...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2013.07.008
更新日期:2013-11-01 00:00:00
abstract::This article reviews the clinical manifestations, diagnostic criteria, and treatment strategies for the acute leukemias, the myelodysplastic syndrome, Hodgkin's disease, and the non-Hodgkin's lymphomas in the elderly. These are relatively common diseases in the elderly, and age is traditionally thought to be a bad pro...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1985-11-01 00:00:00
abstract::There is strong evidence supporting the benefit of antihypertensive treatment in older patients. Blood pressure goal and drug selection in the elderly is similar to that in younger populations, but there are a few special considerations in these patients. A number of studies have been conducted to determine the drugs ...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cger.2009.03.001
更新日期:2009-05-01 00:00:00
abstract::Behavioral signs and symptoms in dementia are common, morbid, classifiable, and treatable. The current state-of-the-art approach is to evaluate carefully for social or environmental causes, intercurrent medical conditions, or other triggers of the behavior and attempt to deal with those directly. When these conservati...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(05)70073-2
更新日期:2001-05-01 00:00:00
abstract::This review focuses on studies that pertain to obesity and aging. The prevalence of obesity in the elderly is discussed, with an emphasis on body-fat distribution as it relates to morbidity and mortality rates. Treatment options, such as physical activity, growth hormones, and drug therapy, are briefly mentioned. A se...
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::Lesbian, gay, bisexual, and transgender older adults require a comprehensive medical, behavioral, mental health, and social support evaluation as do all elders. Open communication and minimizing barriers in both the patient-provider relationship and throughout the continuum of care settings offer a safe environment fo...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:10.1016/s0749-0690(02)00108-8
更新日期:2003-08-01 00:00:00
abstract::Elderly patients with cardiovascular disease require slightly different management strategies compared with younger patients. Diagnosis is more difficult. Procedures, both diagnostic and therapeutic, are more dangerous. Despite higher risks, elderly patients have much to gain from aggressive therapies such as angiopla...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::The majority of patients with acute diverticulitis can be managed medically. Some will have a complication of diverticulitis such as free perforation with peritonitis, abscess formation, obstruction, or fistula formation. Perhaps even a larger number will develop recurrent diverticulitis, which is associated with an i...
journal_title:Clinics in geriatric medicine
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00