Clinical Assessment and Management of Older People: What’s Different?

Thyroid disorders are common, especially in older people where 10–20% may have structural abnormalities of the thyroid glan and/or thyroid function tests outside the reference range (1). Evaluation of thyroid function, size, and structure is therefore an important part of any complete history and physical examination of a patient.

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Chapter 3 Clinical assessment of older people

Oxford Handbook of Geriatric Medicine ◽

10.1093/med:hand/9780198530299.003.0003 ◽

2006 ◽

Author(s):

Lesley K. Bowker ◽

James D. Price ◽

Sarah C. Smith

Keyword(s):

Older People ◽

Clinical Assessment

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The value of specialist clinical assessment of older people prior to entry to care homes

Age and Ageing ◽

10.1093/ageing/afh007 ◽

2003 ◽

Vol 33 (1) ◽

pp. 25-34 ◽

Cited By ~ 37

Author(s):

D. Challis ◽

P. Clarkson ◽

J. Williamson ◽

J. Hughes ◽

D. Venables ◽

...

Keyword(s):

Older People ◽

Clinical Assessment ◽

Care Homes

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Specialist clinical assessment of vulnerable older people: outcomes for carers from a randomised controlled trial

Ageing and Society ◽

10.1017/s0144686x06004831 ◽

2006 ◽

Vol 26 (6) ◽

pp. 867-882 ◽

Cited By ~ 7

Author(s):

DAN VENABLES ◽

PAUL CLARKSON ◽

JANE HUGHES ◽

ALISTAIR BURNS ◽

DAVID CHALLIS

Keyword(s):

Randomised Controlled Trial ◽

Older People ◽

Social Services ◽

Clinical Assessment ◽

Service Use ◽

Controlled Trial ◽

Effective Means ◽

Related Factors ◽

Randomised Controlled ◽

Home Placement

‘Caring for carers’ is high on the United Kingdom policy agenda for community care. Although recent policy advocates the provision of services directly to the carer, research suggests that an alternative way of helping carers is through targeting enhanced services towards the cared-for person. This paper reports a randomised controlled trial of the effects on carer distress of an additional specialist clinical assessment for vulnerable older people at risk of residential or nursing home placement. The sample was composed of 142 informal carers of older people, randomly assigned to receive either the additional specialist assessment or the usual social services assessment. Carers were assessed using the modified Social Behaviour Assessment Schedule (SBAS), and data were also collected on older peoples' service use throughout the study period. Regression analyses indicated that changes in older peoples' behaviour, as opposed to carer or service-related factors, predicted changes in carer distress, and that the carers of the older people who experienced depressive symptoms received the greatest benefit from the specialist assessment. The study suggests that an effective means of improving outcomes for carers may be to target services towards the distressing behaviours of the person for whom they care, with symptoms of depression being particularly important.

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Cervical spondylotic myelopathy: what the neurologist should know

Neurology International ◽

10.4081/ni.2016.6330 ◽

2016 ◽

Vol 8 (4) ◽

Cited By ~ 2

Author(s):

Celmir De Oliveira Vilaça ◽

Marco Orsini ◽

Marco A. Araujo Leite ◽

Marcos R.G. De Freitas ◽

Eduardo Davidovich ◽

...

Keyword(s):

Differential Diagnosis ◽

Motor Control ◽

Natural History ◽

Older People ◽

Clinical Assessment ◽

Cervical Spondylotic Myelopathy ◽

Fine Motor ◽

Upper Limbs ◽

Assessment And Treatment ◽

History Presentation

Cervical spondylotic myelopathy is a wellknown cause of disability among older people. A significant amount of these patients is asymptomatic. Once the symptoms start, the worsening may follow a progressive manner. We should suspect of spondylotic myelopathy in any individual over 55 years presenting progressive changes in gait or losing fine motor control of the upper limbs. Despite its frequent prevalence, this condition is still neglected and many times confused with other supratentorial lesions regarding diagnostic. Here we address some of most important aspects of this disease, calling attention to pathophysiology, the natural history, presentation, differential diagnosis, clinical assessment, and treatment.

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