11 - Hospital Care

Abstract

Geriatric hospital care should involve an interprofessional group of care providers working together to ensure optimal communication with older adults and their families. A less disruptive hospital environment may help reduce the often-deleterious effects that hospitalization has on the mobility, functional status, and cognition of older adults. The admission process involves an opportunity for vaccine status, medication review, advanced care planning, and alcohol use. The geriatrics syndrome of frailty is associated with functional decline, loss of independence, and increased mortality, and older adults being admitted to the hospital warrant consideration of this syndrome. Surgical procedures are common in older adults, and unfortunately, so are perioperative complications. Collaborative management with surgeons and the use of risk-calculators to facilitate informed decision making are both critically important. The cardiac and pulmonary functional assessment are both important perioperative considerations, and evidence-based guidelines should guide providers in management decisions, especially related to cardiac medications, venous thromboembolism prophylaxis, and postoperative anemia management. Interprofessional hospital management should strive to create a hospital environment that facilitates freedom from falls, delirium, skin breakdown, malnutrition, functional decline, and nosocomial infections.