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Biomedical subjects

J E Schuman

Publications and source records attributed to J E Schuman.

9 recordsLinked to original sources
PubMed1986

Some changes of aging.

Aging is associated with changes in body composition and physiologic function which are important in altering the response to drugs of elderly individuals frequently requiring changes in dosages. Declining abilities to do work can lead to incapacity in the late '70s. Such incapacity can be reduced by reconditioning but is likely to be exacerbated by the deconditioning associated with acute illnesses or surgery. Changes in autonomic function, particularly orthostatic hypotension and bladder atony, are likely causes of disability in the postoperative period. The major increase in mortality in the elderly in the postoperative period is related to co-morbidity rather than physiologic changes. Healthy elderly individuals can be excellent surgical risks with careful management. Those with co-morbid conditions can have their surgical risk substantially reduced by medical management.

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PubMed1982

Clinical assessment of the elderly patient.

The examination of an elderly patient often requires special techniques and attention to the patient's comfort and ease. This paper outlines a reasonable approach to each phase of the interview and discusses the particular medical problems of this age group. Older people are often slow to bring their troubles to medical attention because their symptoms are vague or because they accept their disability as part of old age. Sometimes they have difficulty in communicating effectively with the physician. Simple patience can ease an otherwise frustrating situation.

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PubMed1978

The impact of a new geriatric program in a hospital for the chronically ill.

Reports of the rapidly increasing proportion of persons aged 65 years and more in Canada and the resultant need for changes in the country's health care system prompted experimental changes in the operation and training procedures at St. Mary's of the Lake Hospital, Kingston, Ont. Aimed at better patient care and at better education of medical house staff in geriatrics and long-term care, the revised program is permeated with the philosophy of rehabilitation. It includes full-time staff, a geriatric outpatient clinic, a day hospital, a team approach to patient care (with regular team audits), problem-oriented medical records, a formal physical medicine section with a district inpatient unit, and an intensive inservice education program. After the first year of the program patient outcome had improved and more efficient use was being made of continuing care beds because of larger numbers of patinets being discharged home after shorter stays. This may be one avenue for deceleration of our country's dismal rate of institutionalization.

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PubMed1976

Discharge planning in an acute hospital.

To improve discharge planning on an acute medical ward, a nursing "team system" was initiated with clear delineation of responsibility for discharge planning. The head nurse supervised the nurses' actions and supported their communication with attending physicians. To assess the efficacy of this approach, chart reviews and interviews of 60 consecutive patients were performed before and after the implementation of the plan. A plan was labeled adequate if the following criteria were met: all treatable diagnoses were recognized; appropriate treatment regimens were instituted for each diagnosis; the patient's abilities were sufficient for him to function in the proposed environment; and plans were made for follow-up care. Patient knowledge was stated to be adequate if the patient was aware of his diagnosis, treatment regimen and plans for follow-up care. In addition, the patient was questioned concerning his satisfaction with the plans for further care. Seventy-five percent of the patients admitted to this ward required discharge planning. Of those requiring discharge planning, the plan was judged adequate in 55% prior to the program change and in 83% following that change. Eighty percent of the patients required some teaching during their hospital stay. Of these, by the time of discharge, knowledge was adequate in 53% prior to the program change and 51% subsequent to the change. Initially 68% of the patients were very satisfied with the discharge plans but this figure rose to 86% following the program change.

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