The Role of Family Physicians in Older People Care

This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice.After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed.

Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the "silver tsunami." Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management. This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients.

This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helping them to better understand some features of primary care and to more fruitfully interact with family doctors.

Auteur

Jacopo Demurtas is a Family Doctor, researcher and teacher, based in Capalbio, in the southern part of Tuscany. After pursuing his Medical Degree in 2010, he studied at the Tuscany School of Family Medicine in Pisa, where he completed his Family Medicine/General Practice training in 2014. In 2017 he received his Master of Education in Family Medicine. He has been involved in teaching Family Medicine since 2014. His main research interests encompass telemedicine and triage, medical education, geriatrics, palliative care, metaresearch.

After obtaining his Medical Degree in 2008, Nicola Veronese attended the school of Geriatric Medicine. He is currently senior researcher at the University of Palermo. Dr Veronese is the author of more than 450 articles, mostly on the epidemiology of chronic diseases in older people, published in international, peer-reviewed journals. Finally, he is the scientific director of the Italian society geriatrics hospital and territory (SIGOT) and leader of the SIG in systematic reviews and meta-analysis of the EuGMS.

Contenu

Introduction: Family Doctors and the Silver Tsunami: how to face the storm.- Scales and Scores for comprehensive geriatric assessment in primary care.- Nutritional issues of older people in primary care.- Frailty and sarcopenia in primary care: current issues.- The older patient with cognitive impairment in primary care.- The older patient with psychiatric illness.- The older patient at home.- Managing incontinence.- Intermediate care in older population: the role of the Family Doctor.- The older patient in nursing home.- The role of caregivers in older people.- Red Flags in elderly care.- Vaccinations in older people.- The Geriatric Team: clinical and social aspects.- Elder Abuse and Domestic Violence.- Polipharmacy and overtreatment.- Quaternary Prevention and Deprescribing.- Quality or quantity of life? Supportive and palliative approach to the elderly.- Dying at home.- Dying in 4D (or more).- Integrating spiritual care in the frame.- Dignity Therapy.- Conclusions.