The Care of the Older Person

365 Pages·2022·7.18 MB·English

by  Ronald Caplan

The Care of the
Older Person
The ffth edition of this widely used book by caregivers brings to you updated and revised
content, built on the basic understanding that medicine does not work in a vacuum, but rather
alongside other disciplines to provide the environment for a healthy and fulflling long life.
Edited by alumni and senior faculty at McGill University, with international contributions, this
book advocates the achievement of better, longer, satisfying, and more productive lives for older
persons. It is a helpful resource for physicians, professional caregivers, therapists, students, and
residents in medical and nursing disciplines who care for our burgeoning older population and
need to know what to look for and when to consult specialists.
Key features:
■ Follows a uniform structure with many chapters having a hypothetical vignette for
instructional purposes and with the clinical chapters detailing the features and diagnosis
of given conditions, along with possible management protocols specifc to afficted older
individuals.
■ Builds on the success of the previous four editions to provide high-quality content from
international experts for physicians and other caregivers in the feld.
■ Provides possible management protocols to pressing problems, including the nursing home
challenge, pandemics such as COVID, and precision therapy for cancer.

T H E
CAR E
O F T H E
OLDER
PERSON
5th Edition
EDITED BY:
RONALD CAPLAN
CO-EDITORS:
JOSÉ A. MORAIS | ABRAHAM FUKS | SERGE GAUTHIER
PHIL GOLD | OLIVIER BEAUCHET | HOWARD BERGMAN
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
Fifth edition published 2023
by CRC Press
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and by CRC Press
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CRC Press is an imprint of Taylor & Francis Group, LLC
Fourth edition published by RMC Publishing, LLC. 2021
© 2023 selection and editorial matter, Ronald Caplan; individual chapters, the contributors
This book contains information obtained from authentic and highly regarded sources. While all
reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the
publisher can accept any legal responsibility or liability for any errors or omissions that may be made.
The publishers wish to make clear that any views or opinions expressed in this book by individual
editors, authors or contributors are personal to them and do not necessarily refect the views/opinions
of the publishers. The information or guidance contained in this book is intended for use by medical,
scientifc or health-care professionals and is provided strictly as a supplement to the medical or other
professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s
instructions and the appropriate best practice guidelines. Because of the rapid advances in medical
science, any information or advice on dosages, procedures or diagnoses should be independently
verifed. The reader is strongly urged to consult the relevant national drug formulary and the drug
companies’ and device or material manufacturers’ printed instructions, and their websites, before
administering or utilizing any of the drugs, devices or materials mentioned in this book. This book
does not indicate whether a particular treatment is appropriate or suitable for a particular individual.
Ultimately it is the sole responsibility of the medical professional to make his or her own professional
judgements, so as to advise and treat patients appropriately. The authors and publishers have also
attempted to trace the copyright holders of all material reproduced in this publication and apologize to
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ISBN: 978-1-032-38318-7 (hbk)
ISBN: 978-1-032-38317-0 (pbk)
ISBN: 978-1-003-34447-6 (ebk)
DOI: 10.1201/9781003344476
Typeset in Palatino
by Apex CoVantage, LLC
Contents
Disclaimer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
About the Editor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Editors/Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
List of Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xv
Part I: Helping
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
José A. Morais
2. Caring for the Older Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Abraham Fuks
3. Frailty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Sathya Karunananthan and Howard Bergman
4. Physical Activity as a Countermeasure to Frailty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Guy Hajj Boutros and Antony D. Karelis
5. Doctor, My Spouse Is Getting Forgetful . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Serge Gauthier
6. Update on Alzheimer’s Disease Diagnosis and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Serge Gauthier
7. Navigating the Journey of Dementia as a Caregiver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Claire Webster
8. How to Diagnose and Manage Delirium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Haibin Yin
9. Why Does My Patient Have Gait and Balance Disorders? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Olivier Beauchet
10. Could My Patient Be Malnourished? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
José A. Morais
11. Dental Care in Older Persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
Michael Wiseman
12. Eating, Drinking and Swallowing Problems of Vulnerable Older Adults . . . . . . . . . . . . . . . . . 48
Heather C. Lambert
Part II: Vulnerability
13. Architecture and the Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Julia Gersovitz and Boris Morin-Defoy
14. Are the Immunizations of My Patient up to Date? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Dominique Tessier
15. Management of Older Patients in the Emergency Department:
This Man Is Old, but Is It an Emergency? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Cyrille Launay
v
CONTENTS
16. Critical Care of the Older Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Astrid F. Pilgrim and Michael R. Pinsky
17. COVID-19 in Long-Term Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Julia Chabot, Philippe Desmarais and Michael Stiffel
Part III: Caring
18. Arthritis in the Older Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Linda Yue, Kevin Yip and Joseph A. Markenson
19. Stroke Prevention in the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Liam Durcan
20. Advances in Cardiac Care for Older Persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
P. David Myerowitz
21. Could My Patient Be at Risk of Orthostatic Hypotension? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Eric T. Hedge and Carmelo Mastrandrea
22. The Care of Chronic Obstructive Pulmonary Disease in Older Adults . . . . . . . . . . . . . . . . . . . 127
Bryan Ross and Jean Bourbeau
23. How Do I Manage my Patient with Peripheral Arterial Disease? . . . . . . . . . . . . . . . . . . . . . . . . 134
Oren K. Steinmetz and Anna Eva Kinio
24. How to Manage Type 2 Diabetes in Frail Elderly Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Young-Sang Kim and José A. Morais
25. Hepatobiliary Considerations, Including Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Erica C. Roth, Sunil Karhadkar and Antonio di Carlo
26. Abdominal Organ Transplantation in the Older Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Antonio di Carlo and Sunil Karhadkar
Part IV: Cancer
27. Cancer in Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Doreen Wan-Chow-Wah
28. Cancer Screening in the Older Adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Catalina Hernandez Torres and Tina Hsu
29. Diagnosis and Management of Bowel Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Jessica Holland and Barry L. Stein
30. Precision Medicine and Care of the Older Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Anne Croudass and Donald White
31. Psycho-Oncology: Living with the Fear of Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Norman Straker
Part V: Considerations
32. Incontinence in Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194
Samer Shamout and Lysanne Campeau
33. Sleep Disorders in Older Persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Shachi Tyagi
vi
CONTENTS
34. Polypharmacy and Deprescribing in the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Louise Mallet
35. After Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Ronald M. Caplan
36. The Senior Adult Eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Peter M. Odell
37. Hearing Loss and Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Joseph J. Montano
38. Skin Care of the Older Person: The Skin and Its Associated Changes . . . . . . . . . . . . . . . . . . . . 233
Aziz Khan and Hao Feng
39. Caring for the Older Person Undergoing Plastic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Subhas Gupta and Erin O’Rorke
Part VI: Understanding, Protecting
40. Elder Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Mark J. Yaffe
41. Late-Life Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Jess Friedland, Paulina Bajsarowicz and Philippe Desmarais
42. An Overview of Late-Life Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
Artin Mahdanian and Silvia Monti De Flores
43. Assessment of Decision-Making Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Catherine Ferrier
44. How Can Older People Be Protected? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Randy S. Perskin
45. Financial Guidance for Seniors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
Karen C. Altfest
46. The Role of Religious Belief in the End-of-Life Care of Older Persons . . . . . . . . . . . . . . . . . . . 287
A. Mark Clarfeld
Part VII: Medical Terms
Medical Terms and Their Meaning: Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Ronald M. Caplan
Bibliography and Supplemental Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
vii

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informational purposes only. The materials and information contained in this book and e-book
are not intended to be a substitute for professional medical advice, diagnosis, or treatment. You
should always seek the advice of your physician or other qualifed health provider if you have
questions regarding a medical condition. Never disregard professional medical advice or delay in
seeking it because of something you may have read in this book and e-book. Medical professionals
should not rely on any drug, drug dosage, or other information in this e-book and book, which is
for informational purposes only.
If you think you may have a medical emergency, call your doctor or 911 immediately. The
authors do not recommend or endorse any specifc tests, physicians, products, procedures,
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