Table of Contents

Acknowledgments xiii Introduction   3   One

Why the Elderly Can’t Get Good Medical Care   9 
by Joseph H. Friedman, M.D.

Doctors and Nurses Have Little or No Training in Geriatrics   9
How the Elderly Differ from the Population at Large   11
Your Loved One Needn’t Always See a Geriatrician   12
Caregivers—An Essential Part of the Caregiving Team   13

Two

Delirium, Dementia, Depression, and Psychosis: The Importance
of the Correct Diagnosis   16 

Delirium: A Commonly Overlooked but Dangerous Problem   20
Distinguishing Delirium from Dementia   25
Distinguishing Delirium from Depression   27
Distinguishing Delirium from Psychosis   27
Psychotropic Medications and Delirium   28
What You Can Do to Help Your Loved One’s Physician Detect Delirium   30

Three

Silent Epidemic: Types and Frequency of Medication
Errors in the Elderly   34
Medication Errors   40
Who Suffers Most from Medication Errors?   44

Four

A Closer Look: Adverse Drug Reactions and How
to Prevent Them   45

Adverse Drug Reactions   48
Who Is Most at Risk?   54
What Can You Do to Help Detect and Manage Adverse Drug Reactions?   58
Prevention of ADRs: Safe Medication Use   61

Five

Falls: A Significant Cause of Harm to the Elderly   66

Falls: A Common Occurrence   67
What Causes Falls?   68
Help Your Loved One’s Doctor Detect the Specific Cause of Falls   72
Intervention: Treatment and Elimination of Causes of Falls   75

Six

Dehydration: Water, Water Everywhere and Not
a Drop to Drink   80 

Dehydration: The Most Common Fluid and Electrolyte Disorder   81
Serious Consequences of Dehydration   82
Recognizing the At-Risk Elderly Patient   83
Detecting Dehydration   86
Treating Dehydration   91
Preventing Dehydration   92

Seven

Malnutrition: A Serious Problem for the Institutionalized Elderly
as Well as Those at Home   95

Malnutrition—An Epidemic   97
What Factors Make Your Loved One at Risk for Malnutrition?   99
Detecting Protein/Energy Malnutrition   104
Resolving Malnutrition   107
Preventing Malnutrition   108
Tube Feeding   111

Eight

Understaffing: A Threat in Those Nursing Homes   115

The Serious Problem of Understaffing   117
How You Can Minimize the Effects of Understaffing for Your Loved One   122

Nine

Facing End-of-Life Issues and Making Choices   127

Advance Medical Directives   133
The Issue of Tube Feeding   135
How to Talk about End-of-Life Care   140
Common Questions Regarding Advance Directives   142

Epilogue   145

Appendices   153

APPENDICES –  These Appendices are available to you online. There is no charge to read, print, or download these valuable tools to your computer. NOTE: Appendices below marked with an asterisk have hyperlinks that will connect you to tools, organizations, and articles available on the Internet to help you. For these appendices, the PDF files, which have no hyperlinks, are less valuable

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	Appendix A *	Choosing a Nursing Home or Other Long-Term Care Alternative   153
	Appendix B *	Government Programs to Keep the Elderly in the Community   155
	Appendix C	Diagnosing Delirium and Its Underlying Causes   157
	Appendix D	Risk Factors for Delirium   159
	Appendix E	Physiological Causes for Behavior Problems  161
	Appendix F *	Finding a Geriatric Care Manager   163
	Appendix G	Common Drug-Drug Interactions   165
	Appendix H	Medical History   170
	Appendix I	Medication Record   179
	Appendix J	Medications and Patient Characteristics That Place Elders at Risk  for Adverse Drug Reactions   181
	Appendix K	Risk Factors Causing Falls   182
	Appendix L *	Tools to Monitor Dehydration, Malnutrition, and Kidney Function   184
	Appendix M	Risk Factors for Dysphagia   187
	Appendix N *	Monitoring Nutritional Status and Managing Protein/Energy  Malnutrition   188
	Appendix O *	Important Websites   190
	Appendix P *	Recommended Readings   196
	Appendix Q *	Prescribing Psychotropic Medications for the Nursing Home Residents

Glossary   203

Endnotes   219  

Index   231

About the Authors   235

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Taking Charge: Good Medical Care for the Elderly & How to Get It. A Caregiver's Manual in How to Detect, Manage, and Prevent Six Common, Fatal Conditions in the Elderly Patient | Home |Table of Contents | Delirium | Medication Errors | Adverse Drug Reactions | Falls | Dehydration | Protein-Energy Malnutrition | How to Avoid Problems Caused by Under-Staffing in Nursing Homes | How to Handle End-of-Life Decision-Making | Appendices |   Disclaimer

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