Pharmacological management of chronic constipation in older adults.

Chronic constipation in older adults has multiple etiologies, and many of these factors are interrelated. An initial medical history and physical examination can provide relevant clues to the causes of the problem. The Rome III classification system of functional constipation is useful in clinical practice to help clinicians identify symptoms and confirm a diagnosis.

Crushing or splitting medications: unrecognized hazards.

Given the high use and the cost of medications in the current economy, one way older adults may save money on prescription costs is to split some of their medications in half. However, not all oral medications can be split. Splitting inappropriate medications such as extended-release tablets can be harmful and in some instances very dangerous.

Anticoagulation therapy in older adults newly diagnosed with atrial fibrillation.

Atrial fibrillation (AF) is the most common chronic arrhythmia and the most serious heart rhythm irregularity in individuals older than 70. It is usually not life threatening in and of itself, but it can lead to serious medical problems, including stroke, additional heart rhythm problems, and heart failure. Symptoms of AF vary considerably.

Introducing insulin into diabetes management: transition strategies for older adults.

Many older adults with type 2 diabetes require insulin to supplement or replace oral hypoglycemic control. Overtime, the addition of this more intensive therapy is needed to preserve beta cell function or prevent macrovascular sequelae. This is the result of the natural progression of diabetes and not a failure on the part of the patient.

Travel immunization update for older adults.

Older Americans are among the most widely traveled group in our society. Recent trends point to more international travel, more travel to Third World countries, and more travel by older adults with significant health problems. Regardless of the reason for travel, older adults need to plan for healthy travel.

Pharmacological management of type 2 diabetes in newly diagnosed older adults.

There is clear evidence that effective management of type 2 diabetes includes control of elevated blood sugar, lipids, and blood pressure, along with exercise and lifestyle modifications to prevent both macrovascular and microvascular complications. However, the target goals and aggressiveness of therapy may need to be altered for older adults, depending on the presence of comorbid conditions, differences in life expectancy, and individual functional capacity. This article provides evidence-based and consensus recommendations from the American Diabetes Association and the American Geriatrics Society to guide pharmacological management of type 2 diabetes in newly diagnosed older adults.

Educating advanced practice nurses for collaborative practice in the multidisciplinary provider team.

Purpose: To describe the use of a clinical decision-making work sheet as a tool to teach communication skills to advanced practice nurse (APN) students. Achievement of competencies in communication and documentation that utilize language and communication strategies that are shared with other health professionals promotes effective collaborative practice among members of the multidisciplinary provider team.

Data Sources: Review of the recent Institute of Medicine report on health professions education and other health professional literature.