T D Castor | PubMed Health

PubMed1995

Low vision: physician screening helps to improve patient function.

Low vision is a common problem of older patients. As a primary care practitioner, you are not expected to treat most ocular problems, but you can play an important role by identifying patients with visual impairment. Familiarize yourself with the normal visual changes that occur with aging as well as the more common age-related ocular diseases, including glaucoma, cataracts, age-related macular degeneration, and diabetic retinopathy. You can identify patients with visual problems with a careful history and basic in-office tests of visual acuity. Refer patients found to have visual impairment to an eye care specialist for further evaluation.

Activities of Daily Living↗

PubMed1995

Ethical aspects of care of the geriatric orthopaedic patient.

Ethical aspects of care of the geriatric orthopaedic patient include respecting patient self-determination as the primary standard of decision making; using advance directives or appropriate surrogate decision makers when patient decisional capacity is lost; and balancing the benefits and burdens of any intervention and its alternatives in arriving at a treatment decision. With an increase in managed care plans, questions of justice in care of the elderly will be raised. Physicians face fiscal incentives that encourage fewer surgical procedures and lower levels of health care particularly in the elderly, a group that notably has benefited from the functional enhancement permitted by modern orthopaedic techniques. Professional vigilance is required of physicians to ensure that appropriate health care services continue to be available to patients.

Advance Directives↗