The Mount Sinai journal of medicine, New York
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Palliative care is a medical specialty that aims to improve the quality of life for patients with chronic and advanced serious illness and their families. It is appropriate throughout all stages of the trajectory of illness, which distinguishes it from hospice care. Hospice care is limited to patients with terminal prognoses. ⋯ Palliative care has been associated with improved outcomes for patients and families and has experienced a rapid expansion in available services. Despite this, palliative care consultation continues to be underutilized. As the number of patients living with complex and serious illness burden continues to increase, palliative care specialists will play an important role in providing timely access to critical supportive services and the provision of high-quality care.
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Delirium is a common neuropsychiatric syndrome in the elderly that can occur in several different settings caused by several different processes. It is common and causes increased morbidity and mortality to those affected. ⋯ Diagnosis of delirium, specifically with the use of objective instruments, is discussed, as is the evidence for pharmacological and nonpharmacological treatment strategies. Discussion of the neurobiology and genetic markers for delirium may elucidate further areas for future research.
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Alzheimer's disease exists along a spectrum, from early memory changes to functional dependence and death. Using a case illustration, we review the evaluation and diagnosis of mild cognitive impairment and the diagnosis and management of Alzheimer's disease at each stage, including the management of both cognitive and behavioral/psychiatric aspects of the disease and end-stage and end-of-life care.