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Geriatric Consultation: A Functional Approach
Author(s) -
LICHTENSTEIN HOWARD,
WINOGRAD CAROL HUTNER
Publication year - 1984
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1984.tb02040.x
Subject(s) - medicine , malnutrition , depression (economics) , delirium , dementia , rehabilitation , geriatrics , nursing homes , physical therapy , intensive care medicine , psychiatry , nursing , disease , economics , macroeconomics
Eighty‐one geriatric consultations conducted on behalf of 71 patients (mean patient age 78 years, range 59–99; M34, F37) at San Francisco General Hospital were analyzed. Seventy‐nine per cent of requests were for medical or psychiatric evaluation; 19 per cent social; and 3 per cent rehabilitation. The authors made 50 new diagnoses, many of which identified conditions that adversely affected patients' functional levels, including cardiovascular disorders (8), medication effects (8), malnutrition (7), misdiagnosis of dementia (7), and gait disorders (4). Recommendations focused on treating those conditions whose alleviation could improve self‐care ability: medication adjustment (62 per cent), management of dementia, delirium, or depression (59 per cent), rehabilitation (32 per cent), and treatment of malnutrition (30 per cent). Geriatric consultations resulted in rerouting 18 patients (51 per cent) from nursing homes to lower levels of care. Fourteen of these eventually returned home. By focusing on reversible conditions that affect patients' functional levels, geriatric consultation can improve the management of elderly patients and prevent unnecessary nursing home placement.