Ageing is associated with homeostenosis, a progressive constriction of physiological reserve available to meet homeostatic challenges. This leads to impaired capacity of the older person to successfully compensate for physiological stressors, resulting increased vulnerability to apparently minor perturbations. Homeostenosis per se does not cause symptoms or functional impairments, which are usually attributable to disease.
Providing quality acute geriatric care is challenging. Frail older persons can be viewed as complex systems at the verge of failure. When the system fails, higher order of functions such as bipedal ambulation, thumb opposition, attention and social interactions often fail first [1]. Therefore, older persons are more likely …show more content…
This approach is driven by the concept of parsimony in diagnosis which states plurality must not be posited without necessity. Acutely unwell older persons often have multiple comorbidities and this traditional model fails to recognize the interactions between them. Further, it does not examine psychosocial and behavioural domains that are important in the older person. Our preferred acute care model is based on the principles of Comprehensive Geriatric Assessment (CGA) [3], which involves an interdisciplinary and multidimensional diagnostic approach that leads to development of an integrated care plan taking in to account the older person’s needs and preferences. CGA can be time consuming but cost effective. CGA has been shown to result in improvements in physical and cognitive function sustained at 12 months of follow up, and to reduce inpatient mortality and admission to residential aged care facilities following emergency hospitalisation [3]. In the emergency department, CGA by teams led by physicians with expertise in geriatric medicine can lead to expedited discharge and lower readmission rates
Providing quality acute geriatric care is challenging. Frail older persons can be viewed as complex systems at the verge of failure. When the system fails, higher order of functions such as bipedal ambulation, thumb opposition, attention and social interactions often fail first [1]. Therefore, older persons are more likely …show more content…
This approach is driven by the concept of parsimony in diagnosis which states plurality must not be posited without necessity. Acutely unwell older persons often have multiple comorbidities and this traditional model fails to recognize the interactions between them. Further, it does not examine psychosocial and behavioural domains that are important in the older person. Our preferred acute care model is based on the principles of Comprehensive Geriatric Assessment (CGA) [3], which involves an interdisciplinary and multidimensional diagnostic approach that leads to development of an integrated care plan taking in to account the older person’s needs and preferences. CGA can be time consuming but cost effective. CGA has been shown to result in improvements in physical and cognitive function sustained at 12 months of follow up, and to reduce inpatient mortality and admission to residential aged care facilities following emergency hospitalisation [3]. In the emergency department, CGA by teams led by physicians with expertise in geriatric medicine can lead to expedited discharge and lower readmission rates