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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
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Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
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Palliative Care and Geriatric Surgery.

Jessica H Ballou1, Karen J Brasel1

  • 1Department of Surgery, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.

Clinics in Geriatric Medicine
|November 5, 2018
PubMed
Summary
This summary is machine-generated.

Many seniors prefer to die at home, but invasive procedures are common near end of life. Palliative care for elderly surgical patients needs early recognition and planning to align goals with outcomes.

Keywords:
Advance directivesGeriatric surgeryGoals of carePalliative carePalliative surgery

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Area of Science:

  • Geriatric Medicine
  • Palliative Care
  • Surgical Oncology

Background:

  • Many older adults prioritize independence and dying at home.
  • Despite this, intensive care unit (ICU) admission and invasive procedures are frequent for seniors nearing end of life.
  • Surgical patients are less likely to receive palliative care compared to those with chronic conditions.

Purpose of the Study:

  • To highlight the importance of palliative care for elderly surgical patients.
  • To emphasize the need for interventions that align patient goals with potential outcomes.
  • To address the gap in palliative care access for this demographic.

Main Methods:

  • Review of current literature on palliative care in elderly surgical patients.
  • Analysis of factors influencing palliative care referrals in surgical settings.
  • Discussion of multidisciplinary approaches for advance care planning.

Main Results:

  • Elderly surgical patients often face end-of-life care that contradicts their stated preferences.
  • Palliative care is underutilized in this population.
  • Effective palliative care requires proactive strategies.

Conclusions:

  • Meeting the palliative care needs of elderly surgical patients is crucial.
  • Early recognition, advance care planning, and multidisciplinary interventions are essential.
  • Aligning care with patient goals can improve end-of-life experiences for seniors.