GeriPal: Bowel Med Taste Tests and More!
It is well known that hospitalization is a very vulnerable period for older persons. Many elders who are hospitalized for seemingly routine illnesses leave the hospital with a major new disabilty that threatens their ability to live independently. This happens even though the medical problem that resulted in hospitalization is resolved. Most studies suggest that about 1/3 of medical hospitalizations in persons over the age of 70 will result in a major new disability---this risk is over 50% in patients over age 85. Many Geriatricians believe that the type of care provided in the hospital contributes to the development of disability. A chief concern is bedrest. Older people seem to weaken quickly when confined to bed, and a number of studies show rapid loss of muscle mass in elders confined to bed.
Hopefully, recognizing that end stage dementia is a terminal condition will result in improved care---care focused on the quality of life of patients and the needs of their families. Mitchell's findings suggest that communication with families is often poor---It is likely that many families would choose to avoid burdensome hospitalizations and "treatments" such as tube feeding if they understood the burdens and marginal potential for benefit. Even when such therapies are continued, palliative care should generally be offered simultaneously. The difficulty estimating prognosis has often prevented hospice referral in patients with dementia. This study helps by showing that pneumonia seems to signal an average 6 month survival in advanced dementia.
Labels: geriatric care, palliative care
2 Comments:
Thanks for the nice words about GeriPal! I'm happy we are done with the bowel medication taste tests but I have a feeling that more tasting is to come. I think docs forget how important taste is to quality of life (myself included as I had often given some of these medications to my patients and called them "non-compliant" when they refused them.
It's a fantastic site, Eric, and very accessible for those like me who are not in the medical profession. Thanks for commenting!
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