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Common urological conditions in older adults include hematuria, urinary tract infections, urological malignancies, and conditions that affect male and female genitalia. The incidence and prevalence of most urological conditions increase with advancing age in both men and women, and approximately 20% of all primary care visits include some type of urological complaint. These conditions can cause significant discomfort and pain, affect quality of life, and some conditions potentially lead to hospitalization and death. Prompt evaluation and treatment are required for effective management.
This eighth edition of Dr Reichel's formative text remains the go-to guide for practicing physicians and allied health staff confronted with the unique problems of an increasing elderly population. Fully updated and revised, it provides a practical guide for all health specialists, emphasizing the clinical management of the elderly patient with simple to complex problems. Featuring four new chapters and the incorporation of geriatric emergency medicine into chapters. The book begins with a general approach to the management of older adults, followed by a review of common geriatric syndromes, and proceeding to an organ-based review of care. The final section addresses principles of care, including care in special situations, psychosocial aspects of our aging society, and organization of care. Particular emphasis is placed on cost-effective, patient-centered care, including a discussion of the Choosing Wisely campaign. A must-read for all practitioners seeking practical and relevant information in a comprehensive format.
Urinary and fecal incontinence are common problems among older adults, with many not discussing symptoms with providers. Incontinence has a significant negative impact on quality of life and can contribute to caregiver strain. The evaluation of urinary and fecal incontinence should focus on potentially reversible or treatable contributing factors. Treatment often depends on the type of incontinence, and initial treatment should begin with behavioral approaches. Common behavioral treatments include dietary management, timed voiding, pelvic floor muscle exercises, and strategies to control urgency symptoms. Biofeedback should be considered for the treatment of fecal incontinence, along with other behavioral treatments. Pharmacologic treatments differ for urinary and fecal incontinence. Anti-muscarinic and beta-agonist drugs are available for the treatment of urinary incontinence. Pharmacologic treatments for fecal incontinence focus on improving stool consistency. Non-invasive office-based procedures have an important role for treating both types of incontinence.
Despite extensive prevention and treatment efforts for pressure ulcers, they remain prevalent in various health care delivery settings. Pressure ulcers are increasingly viewed as public health and patient safety issues, and regulatory pressure exists to prevent ulcer development. Because of the significant morbidity and mortality associated with pressure ulcers and because they are considered, for the most part, preventable, effective pressure ulcer prevention has been included in hospital safety strategies. Treatments include palliative wound care, pressure redistribution and repositioning interventions, nutritional intervention, surgery to close pressure ulcers, and pain management. An interdisciplinary team approach that includes not only interprofessional clinical staff and hospital administration, but also patients and their families, is important for achieving care that supports function, independence, and quality of life.