10 Commandments of Care for the Hospitalized Elderly
- Bed rest is for dead people (and a few others). Get people moving!; 1 day in bed = 5% total strength loss, takes 3 days of intense rehab to erase; Hospital Associated Functional Decline → inability to care for self developing during acute illness, affects 30% of older inpatients!
- The fewer drugs, the better. Review & tailor meds daily.
Hospitalization is an opportunity to reduce inappropriate outpatient meds; don’t be shy about talking statins, BP meds! - Curate tethers (legami) : remove IVs, catheters ASAP (aspiration catheter kit). Make a case for adding tethers inthe first place
- Delirium is a medical emergency. Assess cognitive statusdaily ;… prevention is KEY
- Treat with antipsychotics only when necessary; start with low oral doses for dangerous or refractory behaviors.
- Treat restraints as a last resort
- Watch for and address depression
- Pay attention to food & fluids consumed. Ask early if intakedeclines Remember taste and thirst thresholds are higher in older adults!
- Discharge planning starts on admission!
- Be proactive discussing goals of hospitalization
Post correlati
Le attività del servizio sanitario nazionale regionale dipendono da fattori che si possono così riassumere: RISORSE → PROCESSI E PROCEDURE → RISULTATI La sequenza è [...]
La formazione dei futuri medici-chirurghi competenti si gioverebbe della disponibilità di Tutor e Mentor. Si veda: TUTOR nel corso di laurea di medicina e [...]
I sintomi e gli esiti riferiti dai pazienti nel corso della vita e soprattutto in occasione di malattie e dei piani terapeutici adottati (patient-reported outcomes), [...]
