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Find and Prevent Problems Early in the Older Adult

This article gives some important reminders about treating the older adult with bone and joint problems. Age-related changes in how the body functions are reviewed. Special problems in older adults are noted. A few simple rules are offered to prevent these problems.

Blood pressure goes up. Body temperature goes down. Skin gets thinner and bruises easier. Changes in vision and hearing occur. All these factors put the older adult at increased risk for problems after an operation.

The older adult is more likely to be taking drugs for various problems. Often patients over 65 years old are taking multiple drugs. They may be taking over-the-counter drugs and herbal remedies, too. This report offers doctors guidelines for how to adjust doses for many drugs used to treat older adults. A general rule in giving drugs to older patients is to "start low and go slow."

Delirium is a common problem during a hospital stay for hip fracture. This problem can be prevented. The article offers some easy-to-follow advice. Keep a calendar and a clock in the patient's room. Make sure the room is well lit during the day, with nightlights during dark hours. Prevent dehydration. Make sure patients have their eyeglasses and hearing aids.

The patient's rights are also reviewed. Patients must be given choices. They shouldn't be forced to choose treatment they don't want. Advice from family members, a team approach, and using a living will help patients decide what care they do want.

The author suggests taking extra time with the older adult needing medical care. Ways to prevent, treat, and manage problems are reviewed in this report.

References: Jane F. Potter, MD. The Older Orthopaedic Patient: General Considerations. In Clinical Orthopaedics and Related Research. August 2004. Vol. 425. Pp. 44-49.

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