Abstract
As people age, they accumulate medical conditions. Geriatric giants comprise a group of conditions that lead to significant mortality and morbidity and contribute to the complexity in treating geriatric patients. They are common and rarely occur in isolation. The 5 Is of geriatric giants are: iatrogenesis, immobility, instability, incontinence and impaired cognition. Consequences for the patient and their caregivers include loss of functional independence, institutionalisation and caregiver burnout. Primary care practitioners are often the first port of call for geriatric patients in South Africa and by asking a few key questions and performing a thorough examination; these conditions can be recognised early. Whilst there are often limitations to cure, the main aim is to maintain the older adult’s functional independence as much as possible, and by following an organised management approach to each of these conditions, the quality of life of patients can be improved.
Highlights
Older people seldom have one medical condition; instead they have multiple problems which impact on one another
It is useful to focus on the geriatric syndromes rather than individual diseases in the more complex geriatric patient
The cornerstone of evaluation and management of older persons is encompassed in comprehensive geriatric assessment (CGA)
Summary
Older people seldom have one medical condition; instead they have multiple problems which impact on one another. In 1965, Bernard Isaacs coined the term “geriatric giants” or the 5 Is to describe these syndromes: instability, immobility, iatrogenesis, impaired cognition and incontinence.[1,2] The cornerstone of evaluation and management of older persons is encompassed in comprehensive geriatric assessment (CGA). CGA is centred in a biopsychosocial model and recognises that older persons are more than an isolated biomedical problem. Their complex psychosocial and environmental situations need to be incorporated into individualised patient-centred contextual care. Such care may frequently be at odds with single disease specific management guidelines. This review article aims to shed light on the important questions to ask during the geriatric patient assessment, as well as to provide a framework for the management of each condition
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
