Physician's Perspective

January is….

January marks the beginning of a new year and a new decade. What better time to take stock of our current situation and consider how best to alter our practices, or those we fail to do, in order for us and those around us to lead happier and more productive lives. This month marks the beginning of a rotating litany of Health Observances and Healthcare Recognition Dates that seem almost derived from Hallmark itself.

January has been designated as National Blood Donor Month, Birth Defects Prevention Month, Cervical Cancer Awareness Month, National Glaucoma Awareness Month, and Thyroid Awaren

New Era of Healthcare Reform: Need for Advocacy and Cost Containment

This issue of Clinical Geriatrics features articles that I hope you will enjoy reading as much as I have: “Hyperlipidemia in Older Adults,” “Predicting Survival From In-Hospital CPR,” and “Management of End-Stage Renal Disease in the Older Adult.” As I was reading these articles in sequence, however, I kept thinking of the healthcare debate and the cost of providing care to individuals in their last decade or less of life. Whether someone has hyperlipidemia, end-stage renal disease, cancer, or cardiac arrest, the cost of one’s healthcare is not insubstantial.

We recently have

Common Problems Are Often the Most Perplexing

This issue of Clinical Geriatrics features two articles on topics that are very important in the treatment of the older patient—depression and hyponatremia.

I was recently asked to see Mrs. S, a 65-year-old woman who was thought to be “depressed.” The medical team wanted a recommendation regarding the “right” antidepressant to give her in light of her coexisting medical condition. A few months earlier, she had extensive bowel surgery that left her with what is known as “short bowel syndrome,” and so had less than 30 cm of intestine remaining. Questions surfaced regarding what

Bringing Together the Disciplines of Geriatrics and Developmental Disability

I am pleased that this issue of Clinical Geriatrics contains an article regarding the developmentally disabled elderly.1 I first became personally interested in the special needs of this population over 20 years ago when I noted that persons with developmental disability were often being admitted to long-term care facilities for reasons that at the time I did not understand. Urinary incontinence, mild congestive heart failure, a need to take multiple medications throughout the day, among other reasons, seemed manageable to me with proper support and medical guidance, and should not have result

Improving Trauma Care for Older Persons: A Professional and Personal Journey

For the past few months, I have been focusing my attention, both from an academic and clinical perspective, on the growing problem of the older person who has suffered a traumatic injury. A great deal of this concern and excitement relates to the fact that I have decided, after many years of focusing my efforts more on Medical Education and Medical Administration, to return to my roots and once again devote the majority of my professional life to being a Geriatrician. This summer, I will be assuming a new role as Director of Geriatric Medicine at the University of Maryland Medical Center in Ba

Living Today for a Better Tomorrow

The month of May has been officially designated as “Older Americans Month.” In 1963, President John F. Kennedy met with the National Council of Senior Citizens and agreed that it would be beneficial to designate a month to acknowledge the contributions of past and current older persons, in particular those who defended our country. At that time, there were 17 million persons in the United States age 65 and older, with one-third of them living at or below the poverty level. Medicare was not yet a reality. It originally was called “Senior Citizens Month,” but in 1980 Jimmy Carter changed

Baby Boomers…or Bust!

Periodically, I like to study the Geriatrics Review Syllabus (GRS), published by the American Geriatrics Society. I find it useful to refresh my memory in certain areas and to learn new material in others. The information is always up to date and well worth the time that one devotes to the project. This time, however, in light of the recent drastic changes in the economy, I found myself questioning the validity of a statement contained in Chapter 1 as it relates to “baby boomers” (of which I am one):

“Compared with their parents at the same age, baby boomers typically have higher inc

Primum Non Nocere…First, Do No Harm

Primum non nocere…first, do no harm. These words frequently echo in my mind as I hear about various patients. Physicians are often faced with a dilemma; a patient presents with one problem, and in 15 minutes, a decision must be made regarding what the likely cause is and how best to treat it. While this may work when caring for the younger, healthier person in whom “economy of diagnosis” is usually the case and one problem can explain the presenting signs and symptoms, it is a major flaw in the care of the older person whose medical history and medical conditions are frequently more comp

Weighing the Benefits and Risks of Searching for the Fountain of Youth

“Healthy aging,” “life extension,” “successful aging.” These phrases are frequently used to promote a special lifestyle, diet, medication regimen, or treatment. While the eternal search for the Fountain of Youth remains elusive, it is easy to see how normal aging and age-associated illness can bring thoughts of vulnerability and the need to do something “different.” While some are searching for a prolongation of the lifespan itself, others are merely trying to live healthier and more productive lives for as long as possible.

This issue of Clinical Geriatrics features two ar

Helping Older Patients Thrive Through the Winter Months

As we start the New Year, it is important that we all consider planning ahead. This is particularly true if you are an older person facing what is not only the coldest but also often the loneliest and most difficult time of the year. Winter can be a wonderful time of beautiful fields covered with snow, sleigh bells in the air, snow squishing under our feet, and indoor gatherings of family and friends. It can also be a time when some find themselves isolated, unable to go outside due to the risk of falling on snow or ice, cold beyond endurance, and heating bills that can numb the senses and