journal
https://read.qxmd.com/read/38960542/pressure-injuries-and-chronic-wounds
#1
EDITORIAL
Jeffrey M Levine
No abstract text is available yet for this article.
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960541/healing-the-miseducation-about-pressure-injuries-and-chronic-wounds
#2
EDITORIAL
G Michael Harper
No abstract text is available yet for this article.
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960540/the-chronic-wound-related-pain-model-holistic-assessment-and-person-centered-treatment
#3
REVIEW
Kevin Woo
Chronic wound-related pain is a complex biopsychosocial experience that is experienced spontaneously at rest and exacerbated during activities. Tissue debridement, trauma at dressing change, increased bioburden or infection, exposure of periwound skin to moisture, and related treatment can modulate chronic wound-related pain. Clinicians should consider multimodal and multidisciplinary management approach that take into account the biology, emotions, cognitive thinking, social environment, and other personal determinants of pain...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960539/nutritional-aspects-of-wound-care
#4
REVIEW
Nancy Munoz, Mary Litchford
Malnutrition is a collective term that includes both undernutrition and malnutrition. Malnutrition presents with and without inflammation, is reported in underweight, normal weight, and overweight individuals, and is associated with undesirable alterations in body composition, and diminished functional status. Older adults commonly experience dwindling nutritional status as evidenced by insidious weight loss, insufficient dietary intake, loss of muscle mass, quality, and strength, declining functional status, and other physical and emotional decline indicators...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960538/infectious-aspects-of-chronic-wounds
#5
REVIEW
Natalie E Nierenberg, Jeffrey M Levine
The treatment, maintenance, and suppression of infection in chronic wounds remain a challenge to all practitioners. From an infectious disease standpoint, knowing when a chronic wound has progressed from colonized to infected, when to use systemic antimicrobial therapy and when and how to culture such wounds can be daunting. With few standardized clinical guidelines for infections in chronic wounds, caring for them is an art form. However, there have been notable advances in the diagnosis, treatment, and management of infected wounds...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960537/surgical-aspects-of-wound-care-in-older-adults
#6
REVIEW
Lisa J Gould
The physical, emotional, and financial toll of acute and chronic nonhealing wounds on older adults and their caregivers is immense. Surgical treatment of wounds in older adults can facilitate healing but must consider the medical complexity of the patient, the patient's desires for treatment and the likelihood of healing. Innovative approaches and devices can promote rapid healing. By using a team approach, from preoperative planning to postoperative care, with a focus on the needs and desires of the patient, successful outcomes with improved patient satisfaction are possible even in medically complex patients...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960536/other-wounds-encountered-in-clinical-practice
#7
REVIEW
Scott Matthew Bolhack
This chapter delves into uncommon wounds including pyoderma gangrenosum, sickle cell disease ulcers, vasculitic wounds, Martorell hypertensive ischemic leg ulcers, and malignant ulcers. Emphasizing a multidisciplinary approach, it covers diagnostics, treatments, and challenges, with case studies illustrating complexities in managing these conditions. The discussion extends to radiation-related wounds, underscoring the need for patient-centered care, interdisciplinary collaboration, and realistic goal setting...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960535/diabetic-foot-ulcers-in-geriatric-patients
#8
REVIEW
Arthur Stone, Cornelius Michael Donohue
Care for the patient with diabetic foot ulcers (DFUs) entails understanding the epidemiology, pathophysiology, and a systematic approach to diagnosis and treatment. The authors will review elements of DFU in geriatric patients including the pathophysiology of diabetes, epidemiology and management of DFU in the context of developing a Plan for Healing. The authors will discuss comprehensive principles of a Plan for Healing, which applies to all aspects of chronic wounds.
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960534/venous-leg-ulcers-the-need-to-incorporate-age-friendly-4m-s-in-management
#9
REVIEW
Sarwat Jabeen, Elizabeth Foy White Chu
Venous leg ulcers develop due to a complex set of conditions routed in lower extremity edema and inflammation. Even though older adults are disproportionally affected by these wounds, the guidelines discuss best practices without keeping in mind the age-friendly 4M's-what Matters Most, Mobility, Medications, and Mentation/Mood. This article reviews the management and treatment of venous leg ulcers, but with a geriatric medicine focus. Compression therapy, mobility optimization, and social isolation reduction are highlighted for our older adult population...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960533/arterial-leg-ulcers-in-the-octogenarian
#10
REVIEW
Allegra L Fierro, Marnie Abeshouse, Tomer Lagziel, John C Lantis
Arterial leg ulcers are a debilitating sequela of chronic ischemia, and their management, particularly in the octogenarian, is an immense challenge. ALUs are frequently a manifestation of end-stage peripheral arterial disease, and their presence portends a high morbidity and mortality. Management primarily relies on restoration of flow, but in the geriatric population, interventions may carry undue risk and pathologies may not be amenable. Adjunctive therapies that improve quality of life and decrease morbidity and mortality are therefore essential, and understanding their benefits and limitations is crucial in developing a multimodal treatment algorithm of care for the uniquely challenging octogenarian population...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960532/pressure-injuries-and-skin-failure
#11
REVIEW
Jeffrey M Levine, Barbara Delmore
Pressure injuries are a common chronic wound in the older adult. Care of pressure injuries is an interprofessional effort and involves physicians, nurses, registered dieticians, rehabilitation therapists, and surgical subspecialties. Numerous treatment modalities exist but have varying evidence to substantiate their efficacy. All primary and other care providers, particularly geriatricians, need to be aware of current evidence-based prevention and treatment standards. When healing is not expected, palliative care should be considered to avoid futile procedures and preserve dignity and quality of life...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960531/wound-bed-preparation-and-treatment-modalities
#12
REVIEW
Wahila Alam
Wound healing is a highly complex natural process, and its failure results in chronic wounds. The causes of delayed wound healing include patient-related and local wound factors. The main local impediments to delayed healing are the presence of nonviable tissue, excessive inflammation, infection, and moisture imbalance. For wounds that can be healed with adequate blood supply, a stepwise approach to identify and treat these barriers is termed wound bed preparation. Currently, a combination of patient-related and local factors, including wound debridement, specialty dressings, and advanced technologies, is available and successfully used to facilitate the healing process...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38960530/the-challenge-of-chronic-wounds-in-older-adults
#13
REVIEW
Aimee D Garcia, Elizabeth Foy White Chu
Care for the older patient living with a chronic wound comes with challenges not seen in younger patients. The aging skin, impacted by the environment and intrinsic physiologic changes, makes it susceptible to injury and poor healing. Likewise, older adults' goals with regards to wound healing may vary depending on their functional abilities and quality of life. The clinician must pay attention to these nuances and collaborate with the older patient in developing a treatment plan. Careful systematic description, documentation, and communication with the patient/caregiver aids the clinician in tracking the treatment goals and potentially reducing medical liability risk...
August 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38521607/preface
#14
EDITORIAL
Manuel Eskildsen, Carl Henry Burton
No abstract text is available yet for this article.
May 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38521606/individualizing-care-for-lesbian-gay-bisexual-transgender-queer-intersex-and-asexual-older-adults
#15
EDITORIAL
G Michael Harper
No abstract text is available yet for this article.
May 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38521605/federal-and-state-policy-issues-affecting-lesbian-gay-bisexual-transgender-and-queer-older-adults
#16
REVIEW
Sean R Cahill
Anti-lesbian, gay, bisexual, transgender, and queer (LGBTQ) + discrimination is widespread, harming the health of LGBTQ + people and constituting a barrier to care. This contributes to higher rates of poverty among LGBTQ + people, especially among people of color, and lower insurance coverage rates. The Affordable Care Act's expansion of insurance access has reduced uninsurance rates among LGBT people and people living with human immunodeficienc virus (HIV). Systemic improvements in culturally responsive health care have occurred over the past decade, including increased collection and use of sexual orientation and gender identity data to improve quality of care...
May 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38521604/home-based-care-for-lesbian-gay-bisexual-transgender-queer-or-questioning-or-another-diverse-gender-identity-older-adults
#17
JOURNAL ARTICLE
Mariah L Robertson
The home-based medicine ecosystem is rapidly expanding. With this expansion, it is increasingly important to understand the unique needs of homebound older adults. There is likely significant intersectionality across the lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) older adult population and the homebound population. This article begins to outline some strategies and approaches to entering the home of LGBTQ+ older adults in inclusive and trauma-informed ways and encourages home-based care teams, organizations, and health systems to utilize existing resources created by the LGBTQ+ aging community to provide universal skills training for the workforce...
May 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38521603/end-of-life-and-palliative-care-for-lesbian-gay-bisexual-transgender-queer-or-questioning-or-another-diverse-gender-identity-older-adults
#18
REVIEW
Evie Kalmar, Jeffrey Mariano
Palliative care focuses on improving the quality of life for people with serious illnesses and their loved ones. This article introduces considerations including barriers to care, intersectionality, minority stress, microaggressions, and social safety that may impact the experience and openness of people to receive this care. The authors outline tools to address these challenges including trauma-informed care and how to recognize bias and earn trust. The authors conclude by offering a model for incorporating these assessments and tools with sample scripts to provide patient-centered and holistic palliative care...
May 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38521602/postacute-care-and-long-term-care-for-lgbtq-older-adults
#19
REVIEW
Jennifer L Carnahan, Andrew C Pickett
LGBTQ + older adults have a high likelihood of accessing nursing home care. This is due to several factors: limitations performing activities of daily living and instrumental activities of daily living, restricted support networks, social isolation, delay seeking assistance, limited economic resources, and dementia. Nursing home residents fear going in the closet, which can have adverse health effects. Cultivating an inclusive nursing home culture, including administration, staff, and residents, can help older LGBTQ + adults adjust and thrive in long-term care...
May 2024: Clinics in Geriatric Medicine
https://read.qxmd.com/read/38521601/psychosocial-and-financial-issues-affecting-lgbtq-older-adults
#20
REVIEW
Vinita Gidvani Shastri, Erica Joy Erney
Isolation, financial insecurity, incomplete advance care planning, and lack of safe/affordable/inclusive long-term care are challenges magnified in gender and sexual minorities. LGBTQIA+ older adults are disproportionately more likely to live alone and experience financial poverty and social isolation. LGBTQIA+ adults suffering from cognitive impairment are an especially defenseless population due to their lack of social connection and potential lack of financial resources and advance care planning...
May 2024: Clinics in Geriatric Medicine
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