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KEY CONCEPTS

KEY CONCEPTS

  • image The population of older adults in the United States is increasing and is expected to become more racially and ethnically diverse.

  • image The primary goal of care for older adults is to maximize the amount of time they can live independently.

  • image Living arrangements of older adults are tied to health and functional status, presence of disabilities, and caregiver ability, rather than chronological age.

  • image Geriatric assessment is a multidisciplinary, multifaceted approach to promote wellness and prolong independence.

  • image Geriatric syndromes are multifactorial clinical conditions that are linked with poor health outcomes.

  • image Pharmacists can play an important role in identifying medications that may be contributing to geriatric syndromes.

  • image Transitions of care are common and risky for older adults.

  • image Optimal care transitions require teamwork, and the pharmacist's primary role on the care transitions team is to identify and address current and potential medication-related problems.

INTRODUCTION

The population of older adults age 65 years or older is growing both globally and in the United States. This is due to increased life expectancy associated with advances in science and technology in early detection of diseases, therapeutic interventions that increase survival, and overall improved healthcare delivery to the general public such as vaccinations, access to care, and treatment options.1

As people are living longer, they are likely to experience multiple chronic medical conditions. The fraction of older adults using healthcare resources will increase, primarily due to the aging of the “Baby Boomer” generation. Despite the development of chronic medical conditions, many older adults lead full, active lives with functional abilities largely preserved. This is contrary to the myth that older age is linked with sickness and disability or poor functional status. Many of these older adults either have few chronic conditions or have them well-controlled. The healthcare needs for an active 65-year-old person are very different from an octogenarian living in a skilled-nursing facility. Additionally, with the advances in cancer treatment, and the emergence of new therapies that have transformed diseases such as hepatitis C and acquired immunodeficiency syndrome into chronic conditions, it is likely that the healthcare resources used by older adults will include treatment of advanced diseases, life-prolonging measures, and general health maintenance.

The goal of providing optimal healthcare to older adults is to promote and maintain independence, which has a direct effect on quality of life. To achieve and maintain independence, healthcare providers can target interventions and approaches to promote and maintain functional status. The functional status of older adults is impacted by disease, accidents, age-related changes (eg, decreased muscle mass or bone density), and frailty; it is independent of chronological age. Because of this, there has been a shift in focus in older adults from managing health conditions alone to incorporating functional status into the assessment of health and wellness. This requires a holistic, multidisciplinary approach.

In addition to the anticipated growth in numbers, the older ...

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