Issue

CASE PRESENTATION
Mr. G, a 90-year-old practicing attorney, was admitted to a subacute rehabilitation facility following a motor vehicle accident (MVA). Mr. G was involved in a rollover MVA, resulting in C1 fracture, C2 dislocation, T1-2 fracture, and left eye trauma. Surgical pins were placed via an anterior approach prior to surgical fusion of C1-2 via a posterior approach. Complications followed the surgical fusion, resulting in respiratory distress, placement of a tracheotomy tube, and use of a ventilator. A percutaneous endoscopic gastrostomy (PEG) tube was placed at this time, as Mr. G

In this third and final part of our discussion on health promotion/disease prevention in older adults, we focus on these issues as related to the care of those elderly persons who have transitioned into living in long-term care settings. This article rounds out Part I (Clinical Geriatrics 2004;12[11]: 17-25), which dealt with maintaining successful aging in the community-dwelling older person through screening initiatives, and Part II (Clinical Geriatrics 2004;12[12]:18-26), which examined guidelines for counseling as well as use of chemoprophylactic agents and immunizations in such a patient.

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 th

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 “Use of Psychotropic Drugs in Cerebrovascular Disease,” which appears on pages 37-45 in this issue of Clinical Geriatrics.

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education t

I have the distinct pleasure of meeting on a regular basis with a group of outstanding third-year medical students who are doing a medicine clerkship at my hospital. For many years now, I have taken the liberty of incorporating a session on geriatric assessment with a focus on caring for the older hospitalized patient. This past month I decided to try something different. I asked the students to complete two questionnaires that I had previously used when teaching students in a geriatric rotation: Palmore’s “Facts on Aging Quiz”1 and the Dye and Sassenrath quiz on aging.2

For those

CASE PRESENTATION
Mrs. K is a 77-year-old woman with multiple medical problems, including insulin-dependent diabetes mellitus, peripheral vascular disease, peptic ulcer disease, and hypertension. Her cardiac history is significant for idiopathic dilated cardiomyopathy that developed at the age of 55 years, leading to severe congestive heart failure (CHF). After a deteriorating course, Mrs. K underwent a heart transplant in 1991. She has a long but poorly described history of mental illness. She was hospitalized in the 1950s for a “nervous breakdown,” although no records were available, an

Although frailty is not inevitable, its prevalence increases as we age, rising dramatically among the “old-old” population. Frailty has a profound impact on health and well-being; it increases risks of falls, injuries, disability, institutionalization, mood disorders, and other adverse health outcomes. It both makes the management of medical conditions and chronic problems much more difficult and contributes to caregiving needs and resource utilization.

To consider what research to date has taught us about frailty, and to identify what future research should explore, the American Geria