THE OLDER PERSON AS A PATIENT
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THE OLDER PERSON AS A PATIENT Dr. Enrique Vega Regional Advisor in Aging and Health PAHO/WHO [email protected]
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THE OLDER PERSON AS A PATIENT . Dr. Enrique Vega Regional Advisor in Aging and Health PAHO/WHO [email protected]. The Problem of Mr. Z:. - PowerPoint PPT Presentation
Transcript of THE OLDER PERSON AS A PATIENT
THE OLDER PERSON AS A PATIENT Dr. Enrique VegaRegional Advisor in Aging and HealthPAHO/[email protected]
The Problem of Mr. Z: Mr. Z is 83 years old and functionally ok. He is the
caregiver of his 62 year old wife who has been diagnosed with dementia. He is a retired business man who is socially active, economically stable and with a good heath insurance program.
In the last three months Mr. Z has lost some strength and fell down two times, and he has arthritis in has right knee. He has taken 6 medications and he is not depressed.
Last week he fell and now he has been admitted to the hospital with two rib fractures and a trauma in his right knee.
JAMA. December 2009. Vol 302 No 24
The Problem of Mrs. Z: Mrs. Z is 62 years old and was diagnosed with Alzheimer
Disease in the last five years. She can not be alone for more than 8 hours due to her limitation in daily living activities, although she is in good economic condition and has a good heath insurance program. She has received support from social services.
She has LDL elevated and high systolic blood pressure and auricular fibrillation. She doesn’t sleep well and takes 8 medications.
Her husband suffered a fall last week and was admitted to the hospital and her two children live in another city.
JAMA, December 2009. 302 No 24
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If Mrs. and Mr. Z were Mrs. And Mr. Thompson:
… with the same heath picture Mr. Thompson would be an informal
worker , without any economic pension and living with his wife with dementia and his single daughter and his adolescent grandson.
Without health coverage and only access to a basic primary health care in the health center.
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Or maybe Mrs. And Mr. Parodi:
… with the same heath picture If Mr Parodi were a retired teacher, he
would have an adequate pension and would be living with his wife with dementia, a nurse, his single daughter and his adolescent grandson.
With health insurance coverage and access to the programs or service available.
Aging in Latin America and the Caribbean: Aging Population Growth IS NOW
Population in Millions
1360-69.
0
50
100
150
200
250
300
350
400
1900 1920 1950
Cardiop. IsquémicaCancerTuberculosisDisenteríaNeumonía
Mue
rtes
/100
.000
-80
-60
-40
-20
0
20
40
1950 1960 1975 1995
Cardiop. IsquémicaACVAMortalidad no CVC
ambi
o (%
)
Braunwald E, N Engl J Med 1997; 337: 1360-9
EPIDEMILOGIC TRANSITION
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Pepe Pancho
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THE NEW PATIENT
Several Patient Types
NEW PROBLEMS
DISABILITY COMORBIDITY
FRAILTY
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NEW WAYS?
I DON’T UNDERSTAND WHAT YOUR PROBLEM IS. TALK MORE CLEARLY
PROPORTIONAL MORTALITY AND USE OF SERVICES
33.366.7
> 60 < 60
77.3
22.7
> 60 < 60
MORTALITY BY CANCER ONCOLOGY CONSULTATION
J Am Geriatr Soc 56:1796 –1801, 2008.
EDITORIAL Leading on Behalf of an Aging Society L Fried, JAGS 2008
EDITORIAL Leading on Behalf of an Aging Society L Fried, JAGS 2008
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MUST BE TEAMWORK BASED
NEVER GIVE UP
