Sarah Hanafi is a Psychiatry Resident (R1) at McGill University
I started my Geriatrics rotation on the Restorative Care unit. Having trained mostly in acute care, I found myself perplexed by this care model. On the surface, many patients seemed to suffer from maladaptive personality traits that hindered their graduation to primary care. It felt like a bizarre blend between an internal medicine ward and a long-term care facility; this mirrored the disorientation I felt in managing patients who had few medical problems, per se, but lacked the means — whether intrinsic or extrinsic — to cope. ...continue reading →
“Medical professionals concentrate on repair of health, not sustenance of the soul”.
Atul Gawande’s recently published book, Being Mortal, discusses the treatment of our elderly population and the various flaws of our health care system. One important point from the book is that health care providers such as physicians and nurses are too focused on physical well-being while forgetting about the less tangible necessities of life.
When an elderly individual is sent to a nursing home, safety is the highest priority. Residents are provided with call bells, ramps, elevators, nurses, and physicians who come directly to their rooms. This seems beneficial, as physical health is maintained. With 24 hour nursing surveillance and living in single rooms, residents are less prone to injuring themselves. It is a situation that seems optimal for both the caregivers and seniors. Why, then, is the rate of depression and sadness so high among the elderly population in nursing homes?
Domhnall MacAuleyis a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK
The newspaper story about our research focused on the proportion of older people without sufficient leg strength to stand up unaided from sitting in a chair. At the time, it irritated me. We had just completed a major country wide health and activity survey with superb data on fitness at all ages....and they picked this one component. It was a huge piece of work. Our team had interviewed 1800 adults up to the age of 70 years old, measured VO2max together with ECGs on a treadmill, undertaken various strength tests in a mobile exercise laboratory that we transported to 14 different hospital sites, and taken fasting blood tests in peoples’ homes. My main interest in sport and exercise medicine was in promoting physical activity and - at the time - I thought I was a bit of an exercise guru. It wasn’t the headline I had hoped for and, furthermore, I was teased for weeks by friends and relatives. Everyone wanted to show me how they could all stand up unaided from sitting in their armchairs!
But, with a bit of hindsight, I can now say that perhaps the journalists were right. ...continue reading →
Interview with Dr. Kevin Pottie, Associate Professor of Family Medicine, and Epidemiology & Community Medicine at the University of Ottawa. Dr. Pottie is also Principal Scientist at the C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute at the University of Ottawa.
As people age, changes to the structure and the function of the brain may result in cognitive decline. These changes, however, do not equally affect all cognitive domains or all people. Should we screen our asymptomatic patients for cognitive impairment? In this evidence-based guideline (open access), the Canadian Task Force on Preventive Health Care recommends that we don’t. Dr. Pottie explains in this podcast.