Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-08T04:50:44.685Z Has data issue: false hasContentIssue false

Chapter 1 - Essential Principles in the Care of the Elderly

from Section I - General Approach to the Care of the Elderly

Published online by Cambridge University Press:  30 June 2022

By
Jan Busby-Whitehead ,
Samuel C. Durso  and
William Reichel
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
Get access

Summary

The core principle that should guide any health professional caring for older adults and their families is that the “secret of caring for the patient is in caring for the patient” (Peabody). Practitioners must understand the most up-to-date biomedical and psychosocial aspects of aging, health, wellness, and disease, and strive to support the older adult to remain as active, functional, and engaged as possible. At the same time, practitioners must recognize and help patients and families understand when a palliative approach will be most effective at meeting their goals. The Choosing Wisely campaign launched by the American Board of Internal Medicine provides targeted guidance to clinicians to provide care that is effective and efficient, consistent with the essential principles. Also, the 4Ms (what Matters, Medication, Mentation, and Mobility) proposed by The John A. Hartford Foundation and Institute for Healthcare Improvement provide a framework for an Age-Friendly Health System through which practitioners can deliver optimal care for older adults.

Keywords

principles of geriatricsgerontologybiopsychosocial modelChoosing Wisely4Ms
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 1 - 11
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Administration on Aging. A profile of older Americans: 2020. US Department of Health and Human Services. https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2020ProfileOlderAmericans.Final_.pdf. Accessed on 6/29/21.Google Scholar
Institute for Healthcare Improvement. Age-Friendly Health Systems: Guide to using the 4Ms in the care of older adults – July 2020. www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Documents/IHIAgeFriendlyHealthSystems_GuidetoUsing4MsCare.pdf. Accessed on 6/29/21.Google Scholar
Engel, GL. The need for a new medical model: A challenge for biomedicine. Science. 1977; 196:129–136.Google Scholar
Fava, GA, Sonino, N. The biopsychosocial model thirty years later. Psychother Psychosom. 2008; 77:1–2.Google Scholar
Braveman, P, Egerter, S, Williams, DR. The social determinants of health: Coming of age. Annual Review of Public Health. 2011; 32:381–398.Google Scholar
American Academy of Family Physicians. Joint principles of the Patient-Centered Medical Home: 2007. www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf. Accessed on 6/29/21.Google Scholar
Ranjit, N, Diez-Roux, AV, Shea, S, Cushman, M, Seeman, T, Jackson, SA, Ni, H. Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Arch Intern Med. 2007; 167:174–181.Google Scholar
Park, M, Katon, WJ, Wolf, FW. Depression and risk of mortality in individuals with diabetes: A meta-analysis and systematic review. Gen Hosp Psychiatry. 2013; 35(3):217–225.Google Scholar
Costanzo, ES, Lutgendorf, SK, Sood, AK, Anderson, B, Sorosky, J, Lubaroff, DM. Psychosocial factors and interleukin-6 among women with advanced ovarian cancer. Cancer. 2005; 104(2):305–313.Google Scholar
Holmes, TH, Rahe, RH. The social readjustment rating scale. J. Psychosomatic Research. 1967; 11:213–218.Google Scholar
Wagner, EH, Coleman, K, Reid, RJ, Phillips, K, Abrams, MK, Sugarman, JR. The changes involved in patient-centered medical home transformation. Prim Care. 2012; 39(2):241–259.Google Scholar
Fulmer, T, Gaines, M. Partnering with patients, families, and communities to link interprofessional practice and education. Proceedings of a conference sponsored by the Josiah Macy Jr. Foundation in April 2014. New York: Josiah Macy Jr. Foundation, 2014.Google Scholar
Reichel, W. The continuity imperative. JAMA. 1981; 246:2065.Google Scholar
Jones, CD, Vu, MB, O’Donnell, CM, Anderson, ME, Patel, S, Wald, HL, Coleman, EA, DeWalt, DA. A failure to communicate: A qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations. JGIM. 2014; 30(4):417–424.Google Scholar
Kim, CS, Flanders, SA. In the clinic: Transitions of care. Ann Intern Med. 2013 (Mar. 5); 158(5 Pt. 1):ITC3-1. doi: 10.7326/0003-4819-158-5-201303050-01003. PMID: 23460071.Google Scholar
Kripalani, S, Jackson, AT, Schnipper, JL, Coleman, EA. Promoting effective transitions of care at hospital discharge: A review of key issues for hospitalists. J Hosp Med. 2007 (Sept.); 2(5):314–323. doi: 10.1002/jhm.228. PMID: 17935242.Google Scholar
Grabowski, DC, Stevenson, DG, Cornell, PY. Assisted living expansion and the market for nursing home care. Health Services Research. 2012; 47(6):2296–2315.Google Scholar
Nkimbeng, M, Roberts, L, Thorpe, RJ Jr., Gitlin, LN, Delaney, A, Tanner, EK, Szanton, SL. Recruiting older adults with functional difficulties into a community-based research study: Approaches and costs. J Appl Gerontol. 2020 (Jun.); 39(6):644–650. doi: 10.1177/0733464818786612. Epub 2018 (Jul. 10).Google Scholar
Meret-Hanke, LA. Effects of the Program of All-Inclusive Care for the Elderly on hospital use. Gerontologist. 2011; 51(6):774–785.Google Scholar
Belle, SH, Burgio, L, Burns, R, Coon, D, Czaja, SJ, Gallagher-Thompson, D, Gitlin, LN, Klinger, J, Koepke, KM, Lee, CC, Martindale-Adams, J, Nichols, L, Schulz, R, Stahl, S, Stevens, A, Winter, L, Zhang, S. Resources for enhancing Alzheimer’s Caregiver Health (REACH) II Investigators: Enhancing the quality of life of dementia caregivers from different ethnic or racial groups – A randomized, controlled trial. Ann of Int Med. 2006; 145(10):727–738.Google Scholar
AARP. Caregiving in the United States, 2020. www.aarp.org/content/dam/aarp/ppi/2020/05/full-report-caregiving-in-the-united-states. doi: 10.26419-2Fppi.00103.001.pdf. Accessed on 6/29/21.Google Scholar
Pinquart, M, Sorensen, S. Correlates of physical health of informal caregivers: A meta-analysis. J Gerontology Series B – Pysch Sci & Social Sci. 2007; 62(2):126–137.Google Scholar
Roth, DL, Fredman, L, Haley, WE. Informal caregiving and its impact on health: A reappraisal from population-based studies. Gerontologist. 2015 (Apr.); 55(2):309–319.Google Scholar
AARP. Valuing the invaluable: 2015 update. www.aarp.org/content/dam/aarp/ppi/2015/valuing-the-invaluable-2015-update-new.pdf. Accessed on 6/29/21.Google Scholar
Family Caregiver Alliance National Center on Caregiving. https://caregiver.org/selected-caregiver-statistics. Accessed on 4/18/15.Google Scholar
Cousins, N. The physician as communicator. JAMA. 1982; 248:587–589.Google Scholar
Frank, JD, Frank, JB. Persuasion and Healing: A Comparative Study of Psychotherapy. 3rd edition. Baltimore, MD: The Johns Hopkins University Press, 1991.Google Scholar
Peabody, FW. The care of the patient. JAMA. 1927; 88:877–882.Google Scholar
Elon, R. Personal communication.Google Scholar
American Geriatrics Society and Beers Criteria Update Expert Panel. Updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Ger Soc. 2019; 6(4):674–694.Google Scholar
Norman, DC. Fever in the elderly. Clinical Infectious Diseases. 2000; 31(1):148–151.Google Scholar
Gibson, SJ, Helme, RD. Age-related differences in pain perception and report. Clinics in Geriatric Medicine. 2001; 17(3):433–456.Google Scholar
Cayea, D, Durso, C. Screening and prevention in geriatric medicine. Clinics in Geriatric Medicine. 2018; 34(1).Google Scholar
Chou, C-H, Hwang, C-L, Wu, Y-T. Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: A meta-analysis. Physical Medicine and Rehabilitation. 2012; 93(2):237–244.Google Scholar
Seegal, D. The principle of minimal interference in the management of the elderly patient. J Chron Dis. 1964; 17:299–300.Google Scholar
Reichel, W. Complications in the care of 500 elderly hospitalized patients. JAGS. 1965; 13:973–981.Google Scholar
Long, SJ, Brown, KF, Ames, D, Vincent, C. What is known about adverse events in older medical hospital inpatients? A systematic review of the literature. International Journal for Quality in Health Care. 2013; 25(5):542–554.Google Scholar
Berwick, DM, Nolan, TW, Whittington, J. The Triple Aim: Care, health, and cost. Health Affairs. 2008; 27(3):759–769.Google Scholar
American Board of Internal Medicine. Choosing Wisely: An initiative of the ABIM Foundation, 2015. www.choosingwisely.org. Accessed on 6/29/21.Google Scholar
American Geriatrics Society. Ten things physicians and patients should question. Choosing Wisely: An Initiative of the ABIM Foundation. www.choosingwisely.org/doctor-patient-lists/american-geriatrics-society. Accessed on 6/29/21.Google Scholar
Zwarenstein, M, Goldman, J, Reeves, S. Interprofessional collaboration: Effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews. 2009; Issue 3. Art. No.: CD000072. doi: 10.1002/14651858.CD000072.pub2.Google Scholar
Hopkins, D, editor. Framework for Action on Interprofessional Education and Collaborative Practice (WHO/HRH/HPN/10.3). Health Professions Network Nursing and Midwifery Office, Department of Human Resources for Health, World Health Organization. Geneva, Switzerland, 2010.Google Scholar
Mather, M, Jacobson, LA, Pollard, KM. Aging in the United States. Population Bulletin. 2019; 70(2). www.prb.org/resources/fact-sheet-aging-in-the-united-states. Accessed on 6/29/21.Google Scholar
Mermin, GB, Johnson, RW, Murphy, DP. Why do boomers plan to work longer? J Gerontology Series B – Pysch Sci & Social Sci. 2007; 625:S286–S294.Google Scholar
Keeler, EB, Solomon, DH, Beck, JC, Mendenhall, RC, Kane, RL. Effect of patient age on duration of medical encounters with physicians. Med Care. 1982; 20:1101–1108.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×