Issue

Like many of you, I consider myself lucky to have trained at a medical school that prided itself in having many outstanding professors, some of whom are still considered to be “giants” in their respective areas of expertise. Although the technology available at that time was less precise and at times more invasive, there was particular focus on detail—taking a thorough history and doing a complete physical examination were the hallmarks of good medical practice. I remember gathering around the bed of a patient as my professor described “interesting wave forms” in the neck; maneuvers

Managing the care of older adults at risk for frailty and disability is very complex and time consuming. Preventive care for older adults is the first line of defense in recognizing the potential for developing chronic conditions that can further complicate care and lessen quality of life. In many cases, long-term effective management of these conditions across care settings begins because of thorough preventive care. Geriatric assessment can identify looming health problems early, enabling health care professionals to better devise plans of care and coordinate their delivery.

Because prev

Case Presentation

Mrs. Edna Wilson is an 82-year-old woman with a history of diet-controlled hypertension and osteoarthritis who has not seen a doctor in over 3 years. A retired teacher, she lives in a senior retirement community, where she delivers meals-on-wheels to “shut-ins” and organizes church charity events. She walks her dog twice a day, drives to the local shopping center for groceries, and manages her own household. At a recent health fair, she was told that her cholesterol level is very high. Mrs. Wilson decides to visit her physician for a routine check-up. She inquires what

Case Presentation

An 82-year-old woman brought her 84-year-old husband to his cardiologist for a routine follow-up visit. Mr. J has a 3-year history of Alzheimer’s dementia, and his wife had been caring for him at home. He suffers from coronary artery disease and hypertension, and he had a myocardial infarction 5 years ago. A pacemaker was inserted 4 years ago after he developed sick sinus syndrome. Mrs. J is well-liked by the office staff, and she often brings them home-baked cookies. She looked tired and pale as they arrived for the appointment.

During the examination, Mrs. J compla

The sexual health of aging men and women has long been an area that physicians have not adequately addressed. In recent years, however, more open attitudes from patients and the availability of pharmacologic therapy and psychological counseling have allowed for successful management of older patients with an interest in remaining sexually active. In this article, we present two case studies to illustrate the modern-day concerns of older men and women about their sexuality, and to demonstrate how physicians can best manage issues of sexual dysfunction in this age group.

Case Study 1

A 7

Accreditation
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

Credit Designation Statement

The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1.0 category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit

This continuing medical education activity is sponsored by the Johns Hopkins University School of Medicine, Baltimore, Maryland. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

These examination questions are based on the article “Constipation in the Older Adult,” which appears on pages 44-54 in this issue of Clinical Geriatrics.

Accreditation

The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuin