Hospitalists’ Guide to the Care of Older Patients

The first book designed specifically for hospitalists and other hospital-based staff who need concise, evidence-based guidance on the vital topic of caring for older hospitalized patients Hospitalists' Guide to the Care of Older Patients is an up-to-date, practical reference in geriatric medicine for hospitalists, as well as other physicians and nurses working in the hospital setting. The book uses numerous tables, figures, and images to highlight the areas of geriatric medicine that are most relevant to hospitalists. Written by nationally recognized experts, chapters broadly follow the course of hospitalization, from admission through daily care and active management of the transition to post-hospital settings, providing practical, evidence-based guidance at each point. Contents include: A systematic approach to the care of older patients, emphasizing clinical skills and daily activities that can be implemented in today's hospital environment Techniques for effective communication with patients and their caregivers Tools and "e;pearls"e; for quickly and accurately assessing the whole patient, including risk for in-hospital complications, function, decision-making capacity, and home support Best practices for prevention and management of the complications of hospitalization, including delirium, falls, pressure ulcers, and hip fractures Specific recommendations in areas with wide practice variation, such as psychopharmacology and nutrition in older hospitalized patients Practical guidance on complex issues, such as establishing goals of care, managing patients who lack decision-making capacity, and managing the discharge transition Methods to improve the daily work and communication of the whole hospital team, including physicians, nurses, and other healthcare providers As the population ages, hospitalists are caring for an increasing number of older patients. This book helps hospitalists expand their knowledge, incorporate key clinical skills into daily practice, build more efficient patient care teams, and teach more effectively in today's fast-paced, complex hospital environment.

The first book designed specifically for hospitalists and otherhospital-based staff who need concise, evidence-based guidance onthe vital topic of caring for older hospitalized patientsHospitalists' Guide to the Care of Older Patients is anup-to-date, practical reference in geriatric medicine forhospitalists, as well as other physicians and nurses working in thehospital setting. The book uses numerous tables, figures, andimages to highlight the areas of geriatric medicine that are mostrelevant to hospitalists.Written by nationally recognized experts, chapters broadlyfollow the course of hospitalization, from admission through dailycare and active management of the transition to post-hospitalsettings, providing practical, evidence-based guidance at eachpoint. Contents include:* A systematic approach to the care of older patientsemphasizing clinical skills and daily activities that can beimplemented in today's hospital environment* Techniques for effective communication with patients and theircaregivers* Tools and "pearls" for quickly and accurately assessing thewhole patient, including risk for in-hospital complicationsfunction, decision-making capacity, and home support* Best practices for prevention and management of thecomplications of hospitalization, including delirium, fallspressure ulcers, and hip fractures* Specific recommendations in areas with wide practice variationsuch as psychopharmacology and nutrition in older hospitalizedpatients* Practical guidance on complex issues, such as establishinggoals of care, managing patients who lack decision-making capacityand managing the discharge transition* Methods to improve the daily work and communication of thewhole hospital team, including physicians, nurses, and otherhealthcare providersAs the population ages, hospitalists are caring for anincreasing number of older patients. This book helps hospitalistsexpand their knowledge, incorporate key clinical skills into dailypractice, build more efficient patient care teams, and teach moreeffectively in today's fast-paced, complex hospitalenvironment.

CONTRIBUTORS viiCHAPTER 1 INTRODUCTION AND OVERVIEW 1Brent C. Williams, Preeti N. Malani, and David H. WesorickCHAPTER 2 THE HOSPITALIZED OLDER ADULT: COMMUNICATION AND PHYSICAL EXAMINATION 5Mark E. WilliamsCHAPTER 3 GERIATRIC ASSESSMENT FOR THE HOSPITALIST 17Brent C. WilliamsCHAPTER 4 INFORMED DECISION-MAKING AND THE EVALUATION OF DECISION-MAKING CAPACITY 31Lisa S. Seyfried, Esther O. Akinyemi, and Scott Y.H. KimCHAPTER 5 CARING FOR PATIENTS WITH LIMITED PROGNOSIS: NEGOTIATING GOALS OF CARE AND PLANNING FOR THE END-OF-LIFE 47Adam D. Marks and Caroline A. VitaleCHAPTER 6 GERIATRIC PHARMACOTHERAPY 65Gabe Solomon, Macgregor A. Montaño, and Paul C. WalkerCHAPTER 7 MANAGING BEHAVIORAL DISTURBANCES WITH PSYCHOACTIVE MEDICATIONS: DOS, DON'TS, AND MAYBES 93David C. Belmonte, Jolene Bostwick, and Amy B. RosinskiCHAPTER 8 ISSUES AND CONTROVERSIES SURROUNDING NUTRITION IN HOSPITALIZED OLDER ADULTS 115Lauren W. Mazzurco, Joseph Murray, and Caroline A. VitaleCHAPTER 9 HIP FRACTURE: MANAGING THE MEDICALLY COMPLEX, OLDER SURGICAL PATIENT 141Paul J. GrantCHAPTER 10 FALLS AND MOBILITY DURING HOSPITALIZATION 165Cynthia J. Brown and Donna M. BeardenCHAPTER 11 PRESSURE ULCERS: A PRIMER FOR THE HOSPITALIST 181Aimée D. GarciaCHAPTER 12 DELIRIUM 203Tia R.M. Kostas and James L. RudolphCHAPTER 13 TRANSITIONAL CARE PLANNING: ASSURING A SAFE DISCHARGE 225Satyen Nichani, Darius Joshi, and Christopher S. KimINDEX 247