Healing the Miseducation About Pressure Injuries and Chronic Wounds
My great aunt was a career US Air Force nurse who served during World War II. I was in medical school when I encountered my first patient with a pressure injury, and I have a vivid memory of her reaction when I told her about it. She was quite literally shocked, sharing that it would have been scandalous if an injured airman or soldier developed a pressure injury. She said it would have been considered a failure of care. Because most pressure injuries today occur in older adults who often are frail, have multiple chronic conditions and limited mobility, that viewpoint has evolved, and I while I don ’t believe most expert...
Source: Clinics in Geriatric Medicine - April 16, 2024 Category: Geriatrics Authors: G. Michael Harper Tags: Foreword Source Type: research
Infectious Aspects of Chronic Wounds
This article will discuss the pathophysiology of infection in older adults, including specific infections such as cutaneous candidiasis, necrotizing soft tissue infection, osteomyelitis, and infections involving hardware. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - April 12, 2024 Category: Geriatrics Authors: Natalie E. Nierenberg, Jeffrey M. Levine Source Type: research
LGBTQIA+ Health in Aging Adults
CLINICS IN GERIATRIC MEDICINE (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 22, 2024 Category: Geriatrics Authors: Manuel Eskildsen, Carl Henry Burton Source Type: research
Copyright
ELSEVIER (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 22, 2024 Category: Geriatrics Source Type: research
Contributors
G. MICHAEL HARPER, MD (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 22, 2024 Category: Geriatrics Source Type: research
Contents
G. Michael Harper (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 22, 2024 Category: Geriatrics Source Type: research
Forthcoming Issues
Pressure Injuries& Chronic Wounds (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - March 22, 2024 Category: Geriatrics Source Type: research
Individualizing Care for Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual+ Older Adults
“If you’ve seen one 80-year-old, you’ve seen one 80-year-old.” I can’t remember exactly when I first heard this quote, but it has always resonated with me as a reminder of the importance to individualize care for older adults. It harkens to the heterogeneity of adults as they age. We often think about this type of heterogeneity in terms of age-related physiologic changes, but in the case of Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual+ (LGBTQIA)+ older adults, we also need to consider the lived experiences of members of this population. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - February 19, 2024 Category: Geriatrics Authors: G. Michael Harper Tags: Foreword Source Type: research
Venous Leg Ulcers
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. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - February 3, 2024 Category: Geriatrics Authors: Sarwat Jabeen, Elizabeth Foy White Chu Source Type: research
The Chronic Wound –Related Pain Model
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 wou nd–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. Unresolved pain can have a significant impact on wound healing, patients’ adherence to ...
Source: Clinics in Geriatric Medicine - February 3, 2024 Category: Geriatrics Authors: Kevin Woo Source Type: research
End-Of-Life and Palliative Care for Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, or Another Diverse Gender Identity Older Adults
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. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - January 29, 2024 Category: Geriatrics Authors: Evie Kalmar, Jeffrey Mariano Source Type: research
The Challenge of Chronic Wounds in Older Adults
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 goal...
Source: Clinics in Geriatric Medicine - January 24, 2024 Category: Geriatrics Authors: Aimee D. Garcia, Elizabeth Foy White Chu Source Type: research
Arterial Leg Ulcers in the Octogenarian
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 ...
Source: Clinics in Geriatric Medicine - January 24, 2024 Category: Geriatrics Authors: Allegra L. Fierro, Marnie Abeshouse, Tomer Lagziel, John C. Lantis Source Type: research
Surgical Aspects of Wound Care in Older Adults
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 satisfact ion are possible even in medically complex patients. (Source...
Source: Clinics in Geriatric Medicine - January 23, 2024 Category: Geriatrics Authors: Lisa J. Gould Source Type: research
Human Immunodeficiency Virus in Older Adults
As people with HIV live longer, they can experience increased incidence and earlier onset of chronic conditions and geriatric syndromes. Older people are also at substantially increased risk of delayed diagnosis and treatment for HIV. Increasing provider awareness of this is pivotal in ensuring adequate consideration of HIV testing and earlier screening for chronic conditions. In addition, evaluating patients for common geriatric syndromes such as polypharmacy, frailty, falls, and cognitive impairment should be contextualized based on how they present. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - January 20, 2024 Category: Geriatrics Authors: Matthew L. Russell, Amy Justice Source Type: research
