PPT-Polypharmacy and The Frail Elderly

Brian Steeves MD 1 Partnership between PATH Palliative and Therapeutic Harmonization Drug Evaluation Alliance of Nova Scotia Dalhousie Academic Detailing Service Dr Brian Steeves Dr Cheryl Smith DNP. Walsall Healthcare NHS Trust. The Vision. Integrating (or coordinating) care around the needs of patients. Avoiding unnecessary admissions to Hospital; Finding alternatives to Acute Admissions. Supporting Older People in their own . – Enabling Frail Elders to Live Meaningfully and Comfortably at a Sustainable Cost. June 25, 2014. Joanne . Lynn, MD, MA, . MS. Director. , Center for Elder Care and Advanced Illness. Joanne.Lynn@Altarum.org. Introduction – . Marion Christie, Head of Health. Data Label : Internal. The problem. £. The solution. Whole pathway redesign – across both acute and community. meeting . the health and care needs of frail elderly . An NHS England funded initiative delivered by the Eastern Academic Health Science Network. www.sbrihealthcare.co.uk. @. sbrihealthcare. Agenda. 25. th. June, London . 10.30 . Welcome . from Chair . and. The Rapid Geriatric Assessment (RGA). in Long Term Care. Geriatric Workforce. Decline in Geriatricians in the United States. 1988. 2030. Geriatricians. 7,128. 7,750. Geriatricians per older adult. An NHS England funded initiative delivered by the Eastern Academic Health Science Network. www.sbrihealthcare.co.uk. @. sbrihealthcare. Agenda. 25. th. June, London . 10.30 . Welcome . from Chair . chemotherapy has an emerging role for early and advanced breast cancer treatment. Elisabetta. . Munzone. Discussion Leader. . . Vito . Lorusso. Direttore UOC di Oncologia Medica. Istituto. . Oncologico. Vocabulary Week 16 Root: frail/ fract /frag Meaning: break; shatter Words Organize Suffrage Fragment Fragile Arrange Infraction Frail Refract Fracture Fraction Fragment (n) a broken piece “Because was old” is a sentence fract. /frag. Meaning: break; shatter. Words. Suffrage. Fragment. Fragile. Convey. Synthesize. Infraction. Frail. Refract. Fracture. Fraction. Fragment (n). a broken piece. “Because was old” is a sentence . in . the Management of . HIV: . A Case-Based Discussion. Charles . W. Flexner. , MD. Professor . of Medicine, Pharmacology and Molecular Sciences, and International . Health. The Johns Hopkins University . Action Card for administration of benzodiazepines . The use of sedatives and anti – psychotic medication should be kept to a minimum. . S. edation should only be considered once other strategies have failed to calm the patient such as distraction/diversion strategies, using 1:1 special to care for the patient. . Medication Related Harm. Presents after being found by her daughter Angela at 8am, unable to get off the toilet . Did not push her medical alarm which was around her neck. Angela called the ambulance as Mrs Casey is unable to stand, seems confused, has bruises all over her legs and feels cold to touch. II. Polypharmacy issues. Medications who have limited or no evidence (docusate, ABD gel, low-dose antipsychotics at EOL, many supplements, Alzheimer’s drugs in patients with advanced dementia). Medications with little or no benefit because of time frame (calcium, iron, . Dr Dominic Hart. Consultant Geriatrician. Belfast Trust. Frail?. Frail?. What is Frailty. “A state of increased vulnerability to poor resolution of homeostasis after a stressor event.”. NOT. An inevitable part of aging.