Journal of the American Geriatrics Society
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To determine if an educational intervention aimed at house staff will increase knowledge about and recognition of delirium. ⋯ A simple educational intervention aimed at house staff appears to be effective in changing house staff behavior. Improved recognition of delirium may lead to better patient outcomes.
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To characterize the limitation of care in routine geriatric practice in advance of and at the time of a patient's final episode of illness. ⋯ In one geriatric practice, care is frequently limited before a patient's final illness in the course of routine practice. In contrast to recent discussion focusing on limitation of end-of-life interventions or interventions in the severely impaired, these results suggest that there are multiple points in the course of a community-dwelling elderly patient's illness at which choices about level of care can be made. Given this opportunity, a significant number of elderly patients of their surrogates will choose less intensive therapy.
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To assess the satisfaction of surrogate decision-makers with the decision to place feeding tubes in elderly patients with impaired decision-making capacity. ⋯ Most surrogates we studied would repeat the decision to have a feeding tube after experiencing its effects for 5 weeks. However, almost one-third felt the patient would not want the tube. Physicians and surrogates may need to place greater emphasis on patients' wishes before placing feeding tubes and when reassessing their benefit to the patient after being placed.
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Comparative Study
Cardiopulmonary resuscitation in elderly patients hospitalized in the 1990s: a favorable outcome.
To compare the clinical characteristics and survival of elderly and younger hospitalized patients who sustain cardiac arrest and receive cardiopulmonary resuscitation (CPR) in the 1990's and to assess predictors of survival. ⋯ Elderly patients hospitalized in the 1990's who receive CPR have outcomes similar to younger patients who receive CPR. The favorable outcome in the elderly patients may reflect patient selection: the majority of our patients were functionally active prior to hospitalization, without multiple serious illnesses; many were hospitalized for acute coronary artery syndromes; and, in most cases, the arrest was witnessed with the patient's cardiac rhythm monitored at onset of the arrest.
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To study laxative use among older persons and the association of laxative intake with hypoalbuminemia. ⋯ Laxatives are used by large numbers of older persons, and the investigation on unknown adverse effects is important. Prospective studies are needed to confirm the association of laxative use with hypoalbuminemia found in this study and to assess the mechanisms of this association.