10 Commandments of Care for the Hospitalized Elderly
- Bed rest is for dead people (and a few others). Get people moving!; 1 day in bed = 5% total strength loss, takes 3 days of intense rehab to erase; Hospital Associated Functional Decline → inability to care for self developing during acute illness, affects 30% of older inpatients!
- The fewer drugs, the better. Review & tailor meds daily.
Hospitalization is an opportunity to reduce inappropriate outpatient meds; don’t be shy about talking statins, BP meds! - Curate tethers (legami) : remove IVs, catheters ASAP (aspiration catheter kit). Make a case for adding tethers inthe first place
- Delirium is a medical emergency. Assess cognitive statusdaily ;… prevention is KEY
- Treat with antipsychotics only when necessary; start with low oral doses for dangerous or refractory behaviors.
- Treat restraints as a last resort
- Watch for and address depression
- Pay attention to food & fluids consumed. Ask early if intakedeclines Remember taste and thirst thresholds are higher in older adults!
- Discharge planning starts on admission!
- Be proactive discussing goals of hospitalization
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