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A Practical Guide to Caring for Caregivers - American Family Physician

Dec 15, 2000 - Patients who provide care to family members or friends with dementia are likely to be in a family physician's practice. The caregiver role can be stressful, and identifying these patients can give the family physician opportunities to help patients cope with the challenges of the ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1215/p2613.html

Advance Care Planning Increases Execution of Advance Directives and Surrogate ...

Dec 1, 2018 - In this study, an intensive advance care planning intervention dramatically increased the completion of advance directives and the identification of surrogate decision makers.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682a.html

Advance Directives in Patient Care: If You Ask, They Will Tell You - Editorials - ...

Feb 1, 1999 - Advertisement << Previous article Next article >> Feb 1, 1999 Issue Editorials Advance Directives in Patient Care: If You Ask, They Will Tell You DAVID DOUKAS, M.D., University of Michigan School of Medicine, Ann Arbor, Michigan Am Fam Physician. 1999 Feb 1;59(3):530-533. Related...

American Family Physician : Editorials

https://www.aafp.org/afp/1999/0201/p530.html

Advance Directives: Navigating Conflicts Between Expressed Wishes and Best Interests - ...

Apr 1, 2015 - Clinicians and surrogates can be faced with challenging decisions when a patient loses the capacity to participate in medical decision making. A significant number of hospitalized and critically ill adults lose decision-making capacity during hospital stays and cannot make treatment ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0401/p480.html

AGS Releases Guideline for Prevention of Falls in Older Persons - Practice Guidelines -...

Jul 1, 2010 - Recommendations from the American Geriatrics Society (AGS) guide physicians in screening older patients for risk of falling and preventing falls among those at increased risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2010/0701/p81.html

Alcoholism in the Elderly - American Family Physician

Mar 15, 2000 - Alcohol abuse and alcoholism are common but underrecognized problems among older adults. One third of older alcoholic persons develop a problem with alcohol in later life, while the other two thirds grow older with the medical and psychosocial sequelae of early-onset alcoholism. The ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0315/p1710.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Ambulatory Devices for Chronic Gait Disorders in the Elderly - American Family Physician

Apr 15, 2003 - Gait disorders in the elderly are common and in most cases cannot be treated medically or surgically. Therefore, treatment often relies on ambulatory devices such as canes, crutches, and walkers. Before selecting a device, the patient should be evaluated to define whether one or both ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0415/p1717.html

Anemia in Older Adults - American Family Physician

Oct 1, 2018 - Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p437.html

Anemia in Older Persons - American Family Physician

Sep 1, 2010 - Anemia in older persons is commonly overlooked despite mounting evidence that low hemoglobin levels are a significant marker of physiologic decline. Using the World Health Organization definition of anemia (hemoglobin level less than 13 g per dL [130 g per L] in men and less than 12 g ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0901/p480.html

Anemia in the Elderly - American Family Physician

Oct 1, 2000 - Anemia should not be accepted as an inevitable consequence of aging. A cause is found in approximately 80 percent of elderly patients. The most common causes of anemia in the elderly are chronic disease and iron deficiency. Vitamin B12 deficiency, folate deficiency, gastrointestinal ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1001/p1565.html

Antidepressants in Older Persons - Cochrane for Clinicians - American Family Physician

Nov 1, 2006 - In older persons with depression, three classes of antidepressants are equally effective: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and tricyclic-like compounds. More patients taking classic tricyclic antidepressants stopped their medications because of...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/1101/p1503.html

Appropriate Use of Polypharmacy for Older Patients - Cochrane for Clinicians - American...

Apr 1, 2013 - Multidisciplinary interventions that address polypharmacy decrease inappropriate prescribing and medication-related problems in patients 65 years and older, but it is not clear if they reduce hospital admissions or improve quality of life. Most interventions studied were led by ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/0401/p483.html

Appropriate Use of Psychotropic Drugs in Nursing Homes - American Family Physician

Mar 1, 2000 - The Omnibus Budget Reconciliation Act (OBRA) of 1987 limited the use of psychotropic medications in residents of long-term care facilities. Updates of OBRA guidelines have liberalized some dosing restrictions, but documentation of necessity and periodic trials of medication withdrawal ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1437.html

Audiometry Screening and Interpretation - American Family Physician

Jan 1, 2013 - The prevalence of hearing loss varies with age, affecting at least 25 percent of patients older than 50 years and more than 50 percent of those older than 80 years. Adolescents and young adults represent groups in which the prevalence of hearing loss is increasing and may therefore ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0101/p41.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Brief Screening Instruments for Dementia in Primary Care - Point-of-Care Guides - ...

Mar 15, 2009 - In addition to identifying patients who may benefit from pharmacotherapy, early detection of dementia helps families anticipate the patient’s needs and helps physicians identify those in need of additional support.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2009/0315/p497.html

Cancer Screening in Older Patients - American Family Physician

Apr 15, 2016 - Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p659.html

Cancer Screening in the Older Patient - American Family Physician

Dec 15, 2008 - Although there are clear guidelines that advise at what age to begin screening for various cancers, there is less guidance concerning when it may be appropriate to stop screening. The decision to stop screening must take into account patients' age; overall health and life expectancy; ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1369.html

Caregiver Care - American Family Physician

Jun 1, 2019 - Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p699.html

Caring for Caregivers - Editorials - American Family Physician

Dec 15, 2000 - Advertisement << Previous article Next article >> Dec 15, 2000 Issue Editorials Caring for Caregivers JAMES O'BRIEN, M.D., University of Louisville, Louisville, Kentucky Am Fam Physician. 2000 Dec 15;62(12):2584-2587. Related Article Long-term care given by family members is a...

American Family Physician : Editorials

https://www.aafp.org/afp/2000/1215/p2584.html

Caring for Older Patients Who Have Significant Hearing Loss - Curbside Consultation - ...

Mar 1, 2013 - This scenario illustrates issues related to end-of-life care and placement in a long-term care facility for older individuals with significant hearing loss. An analysis of data from the 1999 to 2006 cycles of the National Health and Nutrition Examination Survey, and statistics from the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/0301/p360.html

Cerebrospinal Fluid Biomarkers for Detection of Alzheimer Disease in Patients with Mild...

Jun 1, 2018 - There is insufficient evidence to support the routine use of cerebrospinal fluid (CSF) biomarkers for the detection of progressive dementias in patients with mild cognitive impairment (MCI). These tests carry the risk of overdiagnosis of dementia and, therefore, overtreatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0601/p714.html

Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric Depression - ...

Nov 1, 2015 - Combined treatment with citalopram plus methylphenidate provided faster improvement of depression symptoms in older patients with unipolar depression. Combined treatment was also more likely than either medication alone to lead to remission of depression at four weeks and 16 weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p820.html

Clinical Vignettes in Geriatric Depression - American Family Physician

Nov 15, 2011 - The diagnosis of depression in older patients is often complicated by comorbid conditions, such as cerebrovascular disease or dementia. Tools specific for this age group, such as the Geriatric Depression Scale or the Cornell Scale for Depression in Dementia, may assist in making the ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1149.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

Common Oral Conditions in Older Persons - American Family Physician

Oct 1, 2008 - Older persons are at risk of chronic diseases of the mouth, including dental infections (e.g., caries, periodontitis), tooth loss, benign mucosal lesions, and oral cancer. Other common oral conditions in this population are xerostomia (dry mouth) and oral candidiasis, which may lead to ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1001/p845.html

Common Questions About Pneumonia in Nursing Home Residents - American Family Physician

Oct 1, 2015 - Pneumonia in older adults residing in nursing homes can be challenging to diagnose and treat. Pneumococcal and influenza immunizations decrease the risk of pneumonia and are recommended for all nursing home patients. Older adults with pneumonia may not display classic signs and symptoms...

American Family Physician : Article

https://www.aafp.org/afp/2015/1001/p612.html

Common Questions About Pressure Ulcers - American Family Physician

Nov 15, 2015 - Patients with limited mobility due to physical or cognitive impairment are at risk of pressure ulcers. Primary care physicians should examine at-risk patients because pressure ulcers are often missed in inpatient, outpatient, and long-term care settings. High-risk patients should use ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1115/p888.html

Complex Care: Treating an Older Patient with Multiple Comorbidities - Curbside ...

Mar 1, 2014 - Although there are guidelines for management of single chronic illnesses, the evidence base for management of multiple comorbidities is lacking. The American Geriatrics Society described a clinical approach to managing patients with multiple comorbidities in 2012.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/0301/p392.html

Constipation in the Elderly - American Family Physician

Sep 15, 1998 - Constipation affects as many as 26 percent of elderly men and 34 percent of elderly women and is a problem that has been related to diminished perception of quality of life. Constipation may be the sign of a serious problem such as a mass lesion, the manifestation of a systemic disorder...

American Family Physician : Article

https://www.aafp.org/afp/1998/0915/p907.html

Delirium in Older Persons: Evaluation and Management - American Family Physician

Aug 1, 2014 - Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Assessment for and prevention of delirium should occur at ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p150.html

Dementia - Clinical Evidence Handbook - American Family Physician

Jan 15, 2014 - What are the effects of treatments on cognitive, behavioral, and psychological symptoms of dementia (Alzheimer disease, Lewy body dementia, or vascular dementia)?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0115/p117.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Deprescribing Is an Essential Part of Good Prescribing - Editorials - American Family ...

Jan 1, 2019 - There are four important medication issues to discuss with patients as they get older. Find out more and learn the five steps to individualize deprescribing practices for each patient.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0101/p7.html

Depression in Later Life: A Diagnostic and Therapeutic Challenge - American Family ...

May 15, 2004 - Depression in elderly persons is widespread, often undiagnosed, and usually untreated. The current system of care is fragmented and inadequate, and staff at residential and other facilities often are ill-equipped to recognize and treat patients with depression. Because there is no ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0515/p2375.html

Depression Without Sadness: Alternative Presentations of Depression in Late Life - ...

Sep 1, 1999 - Older adults often deny feeling sad while exhibiting other characteristics of depression. Elderly patients with depression who do not present with sadness often have unexplained somatic complaints and exhibit a sense of hopelessness. Anxiety and anhedonia (a general loss of ability to ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0901/p820.html

Detecting Elder Abuse and Neglect: Assessment and Intervention - American Family Physician

Mar 15, 2014 - Elder mistreatment includes intentional or neglectful acts by a caregiver or trusted person that harm a vulnerable older person. It can occur in a variety of settings. One out of 10 older adults experiences some form of abuse or neglect by a caregiver each year, and the incidence is ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0315/p453.html

Diagnosis of Acute Abdominal Pain in Older Patients - American Family Physician

Nov 1, 2006 - Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1101/p1537.html

Discussing Life Expectancy with Older Patients: Prediction and Patient Preferences - ...

Sep 1, 2019 - Evidence shows that physicians need more training in discussing life expectancy, and there are resources available to support this process for certain conditions.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0901/p265.html

Evaluating and Treating Unintentional Weight Loss in the Elderly - American Family ...

Feb 15, 2002 - Elderly patients with unintentional weight loss are at higher risk for infection, depression and death. The leading causes of involuntary weight loss are depression (especially in residents of long-term care facilities), cancer (lung and gastrointestinal malignancies), cardiac disorders...

American Family Physician : Article

https://www.aafp.org/afp/2002/0215/p640.html

Evaluating Medical Decision-Making Capacity in Practice - American Family Physician

Jul 1, 2018 - Medical decision-making capacity is the ability of a patient to understand the benefits and risks of, and the alternatives to, a proposed treatment or intervention (including no treatment). Capacity is the basis of informed consent. Patients have medical decision-making capacity if they...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p40.html

Evaluation and Management of Delirium in Hospitalized Older Patients - American Family ...

Dec 1, 2008 - Delirium is common in hospitalized older patients and may be a symptom of a medical emergency, such as hypoxia or hypoglycemia. It is characterized by an acute change in cognition and attention, although the symptoms may be subtle and usually fluctuate throughout the day. This ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1265.html

Evaluation of Suspected Dementia - American Family Physician

Oct 15, 2011 - As the proportion of persons in the United States older than 65 years increases, the prevalence of dementia will increase as well. Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p895.html

Exercise Alone and Various Combinations of Interventions Reduce the Risk of Injurious ...

May 1, 2018 - Exercise alone; exercise combined with vision assessment and treatment; exercise combined with vision assessment and treatment, and environmental assessment and modification; and clinic-level quality improvement strategies combined with multifactorial assessment and treatment, calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p606.html

Exercise and Older Patients: Prescribing Guidelines - American Family Physician

Aug 1, 2006 - A combination of aerobic activity, strength training, and flexibility exercises, plus increased general daily activity can reduce medication dependence and health care costs while maintaining functional independence and improving quality of life in older adults. However, patients often ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0801/p437.html

Exercise Effective for Depression in Older Patients - POEMs - American Family Physician

Dec 15, 2013 - An organized exercise program for older patients, which may include strength training, endurance training, or both, may be helpful for some patients with symptoms of depression. The results will not be striking, but exercise is an option for patients willing to participate.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1215/od2.html

Exercise for Older Patients Who Are Acutely Hospitalized - Cochrane for Clinicians - ...

Jul 1, 2007 - The effects of exercise interventions on functional outcomes are unclear, but there is a trend toward functional improvement. Multidisciplinary interventions that include exercise also show several other benefits, including reduction in length of hospitalization and hospital costs; ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0701/p69.html

Exercise Prescriptions in Older Adults - American Family Physician

Apr 1, 2017 - Regular physical activity and exercise are important for healthy aging and are beneficial for chronic disease management. Exercise prescriptions for older adults should account for the individual’s health status and functional capacity. Any amount of exercise is better than being ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p425.html

Falls in the Elderly - American Family Physician

Apr 1, 2000 - Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0401/p2159.html

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