摘要:

Six hundred fifty‐one psychiatric consultations performed during a one‐year period were reviewed retrospectively. Cognitive impairment was present in 54 per cent and depression in 27 per cent of the elderly patients in the population studied. A second study of the point prevalence of cognitive and emotional disorders in the hospital was carried out using the Mini‐Mental State Exam and the General Health Questionnaire. Emotional disorders had similar prevalences in all age groups but cognitive disorders were more common in the elderly. Twenty‐one per cent of consultations were done on patients over the age of 60, although elderly patients occupied 28.5 per cent of hospital beds. Thus, elderly patients were less often referred for psychiatric consultation than younger patients, although the incidence of psychiatric disorders increases w

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04597.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Geriatric patients often appear unmotivated for rehabilitation, and “poor motivation” is frequently the reason given for excluding them from rehabilitation programs. However, these patients may actually be impeded by specific obstacles to the development of motivation. Appropriate intervention may enable them to make better use of rehabilitation opportunities. In this paper the authors review the concept of human motivation and what is known about aging and motivation. Specific age‐related changes are examined and treatment interventions identified to maximize the patients' participation in rehabilitation toward improved functional ab

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04598.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Nuchal rigidity, which may be a sign of meningitis, was found in 35 per cent of geriatric patients on acute‐care and rehabilitation wards and in 13 per cent of younger patients on an acute‐care ward. It was significantly associated with cerebrovascular disease, confusion, abnormal plantar responses, and primitive reflexes. Elderly patients who have nuchal rigidity with no history of neurologic or cognitive disorders should be investigated for meningi

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04599.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Although hallucinatory experiences may be relatively common among the elderly, isolated, and infirm, their frequency has been the subject of little research. Patient records of admissions to a 12‐bed geriatric psychiatry service over three and a half years were reviewed for documented presence of hallucinatory symptoms. Hallucinations were documented in 15 per cent of the cases. Although acute and chronic brain syndromes and schizophrenic disorders were disproportionately represented in the hallucinating sample, affective disorders were also represented. A significant number of persons in this sample were single and had been living alone prior to admission and were described by family members or others as having “independent” or “reclusive” personality styles. In the majority of cases there was no history of psychiatric illness, and the individuals were distressed by the hallucinatory experiences. Symptom management is discussed in the context of factors that appear to affect occurrences and types of hallucinations and the responses to hallucinations in elderly

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04600.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Deficiency of vitamin D is rare in the general population of the North American continent because of the availability of sunlight, vitamin D‐fortified milk, and over‐the‐counter preparations containing the vitamin. Yet there are among the aged those who are at risk of developing a deficiency of the vitamin because of lack of exposure to sunlight and failure to ingest milk or vitamin supplements containing vitamin D. Four cases of vitamin D‐deficiency osteomalacia are described, demonstrating the various findings in the patient history and the physical, radiologic, and laboratory evaluation. In all cases physiologic doses of the vitamin corrected the abnormality quickly and fully. Vitamin D deficiency can be prevented prophylactically once the gerontologist is alert to the fact that some elderly people, who are easily identifiable by history alone, are likely to develop such defic

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04601.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Although the ethical issues in clinical care of severely impaired elderly nursing home residents may appear to be the same as those encountered in the acute hospital, they are not. In particular, “do not resuscitate” orders are not of central importance in the nursing home. For the individuals being considered, decisions about limiting routine treatments and whether treatment should include hospitalization are crucial. Establishing an ethical issues team is one means of increasing awareness of ethical issues in patient care and of dealing with these difficult issues more successfu

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04602.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The reliability of the Functional Assessment Inventory (FAI) was evaluated using a sample of VA domiciliary and nursing home patients. The interobserver and interrater reliability coefficients of the summary rating scales, based on a single assessment, tended to be higher than their test‐retest reliability coefficients, based on two independent assessments separated by a modal four‐week interval. Validity coefficients, using the OARS instrument ratings as criteria, also based on two independent assessments several weeks apart, were, on the average, as high as the test‐retest reliability coefficients. More specifically, the mental health, physical health, and activities of daily living rating scales, along with the objectively scored Short Portable Mental Status Questionnaire and Short Psychiatric Evaluation Schedule, tended to yield relatively similar scores with repeated measurement, while the social resources and economic resources scales were somewhat less stable, a discrepancy possibly explained by the homogeneous nature of the social and economic status of most of the patients (institutionalized veterans). Thus the reliability and validity of the FAI are satisfactory, but the stability of some of its scales requires further investig

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04603.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

A retrospective descriptive study of the elderly patients served by a respite admission program in a teaching hospital is described. Data were collected by health record review and interviews with the program social worker. In the three years covered by the study there were 28 patients, with a mean age of 80.5 years. Fifty‐seven per cent were male, 68 per cent, married, 29 per cent, widowed, and 3 per cent, single. When first admitted they were all living in their own homes or the home of a child. Seventy‐nine per cent of the patients had moderate or severe dementia, with or without physical disability. Family members were the main caregivers and home care services provided support in 54 per cent of cases. Ninety‐three per cent of the patients attended the geriatric day hospital. The patients received respite admissions for a mean of 10.8 months. At the end of the study more than a third of the patients were still living at home and half had entered long‐term care facilities. By means of respite admissions supplemented by day hospital attendance it has been possible to maintain in the community disabled elderly patients who might otherwise have required immediate institutionalization. The need for more respite care and in‐home services is discussed and a role for long‐term care facilities as major providers of respite car

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04604.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

While the “drop attack” has been described in the British literature as a classic geriatric syndrome accounting for as many as one‐quarter of all falls in their elderly population, it is rarely acknowledged in discussions of falls by physicians in the United States. Is the drop attack a distinct entity that has been overlooked and under‐investigated in this country, or is it perhaps a symptom of a spectrum of diseases? This paper reviews the original descriptions of the drop attack for its characteristic features, and focuses on the epidemiology, etiology and clinical management of this common, but infrequently recognized

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04605.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Contrary to earlier findings, elderly patients are not at significantly greater risk of perioperative morbidity or mortality than younger patients simply because of advanced age. Increased risk, when present, is attributable to pathologic changes that are not uniformly seen in all geriatric patients. Most perioperative morbidity is caused by cardiovascular and pulmonary complications. The author discusses an appropriate preoperative evaluation and recommends selective ancillary tests to screen for high‐risk patient

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1983.tb04606.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY