REICHEL’S CARE OF THE ELDERLY

The sixth edition of Reichel's Care of the Elderly: Clinical Aspects of Aging remains the pioneering text for the practicing physician confronted with the unique problems of an increasingly elderly population. Dr. William Reichel's formative text is designed as a practical and useful guide for health specialists from medical students to practicing physicians. This book is not a collection of subspecialty chapters but rather emphasizes the clinical management of the geriatric patient with simple to complex problems. The editors have reviewed every chapter and have included the most up-to-date advances in the care of the elderly. New topics include hormonal therapy in postmenopausal women, drug therapy for Alzheimer sufferers, alternative medicine, the chronic understaffing of nursing homes, management of delirium, and ethical issues. The targeted audience is not only the geriatric specialist, but also medical and allied health practitioners who need practical and relevant information in a comprehensive format.

Christine Arenson (MD, Jefferson Medical College) is Associate Professor of Family and Community Medicine, Director of the Division of Geriatric Medicine, and Co-Director of the Jefferson InterProfessional Education Center at Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Arenson is also the Director of the Eastern Pennsylvania–Delaware Geriatric Education Center. Dr. Arenson practices family and geriatric medicine at Jefferson Family Medicine Associates at the Philadelphia Senior Center.

Jan Busby-Whitehead (MD, University of Texas Medical Branch at Galveston) is Associate Director for Clinical Affairs and Co-Director of the Carolina Program for Healthcare and Aging at the University of North Carolina School of Medicine. She is also a Professor of Medicine and Director of the Center for Aging and Health there.

Kenneth Brummel-Smith (MD, University of Southern California School of Medicine) is Charlotte Edwards Maguire Professor and Chair of the Department of Geriatrics at Florida State University College of Medicine, Tallahassee, Florida. Dr. Brummel-Smith is past president of the American Geriatrics Society.

James G. O’Brien (MD, University College, Dublin, Ireland) is Professor and Margaret Dorward Smock Endowed Chair in Geriatric Medicine, Chair of the Department of Family Medicine and Geriatrics, and Medical Director of the Geriatric Medicine Center at the University of Louisville School of Medicine, Kentucky.

Mary H. Palmer (PhD, Johns Hopkins University School of Hygiene and Public Health; BSN, University of Maryland School of Nursing) is Professor and Helen W. and Thomas L. Umphlet Distinguished Professor in Aging at the University of North Carolina, Chapel Hill, School of Nursing. Dr. Palmer is also Co-Director of the Interdisciplinary Center for Aging Research: Uniting Scientists at the University of North Carolina.

William Reichel, MD, is Editor Emeritus of Reichel's Care of the Elderly: Clinical Aspects of Aging, 6th edition. Dr. Reichel is an affiliated scholar of the Center for Clinical Bioethics at Georgetown University School of Medicine, Washington, DC. Dr. Reichel has published extensively on geriatric and family medicine and is a pioneer of the study of aging.

Sixth Edition

Christine Arenson

Thomas Jefferson University

Jan Busby-Whitehead

University of North Carolina School of Medicine

Kenneth Brummel-Smith

Florida State University College of Medicine

James G. O’Brien

University of Louisville School of Medicine

Mary H. Palmer

University of North Carolina School of Nursing

William Reichel

Georgetown University School of Medicine

CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo, Delhi

Cambridge University Press
32 Avenue of the Americas, New York, NY 10013–2473, USA

www.cambridge.org
Information on this title: www.cambridge.org/9780521869294

© Cambridge University Press 2009

This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.

First published 2009

Printed in the United States of America

A catalog record for this publication is available from the British Library.

Library of Congress Cataloging in Publication dataReichel's care of the elderly : clinical aspects of aging. – 6th ed. / edited by ChristineArenson…[et al.].p.; cm.Includes bibliographical references and index.ISBN 978-0-521-86929-4 (hardback)1. Geriatrics. 2. Aging. I. Reichel, William, 1937– II. Arenson, Christine, 1964–III. Title: Care of the elderly.[DNLM: 1. Geriatrics – methods. 2. Aging – physiology. 3. Health Services for theAged. WT 100 R349 2009]RC952.C53 2009618.97 – dc22 2008022701

ISBN 978-0-521-86929-4 hardback

Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord with accepted standards and practice at the time of publication. Nevertheless, the authors, editors, and publisher can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors, and publisher therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party Internet Web sites referred to in this publication and does not guarantee that any content on such Web sites is, or will remain, accurate or appropriate. Information regarding prices, travel timetables, and other factual information given in this work are correct at the time of first printing, but Cambridge University Press does not guarantee the accuracy of such information thereafter.

Contents

EDITORIAL ADVISORY COMMITTEE

Danielle Snyderman, MD

B. Lynn Beattie, MD, FRCPC

Barbara Carroll, MD

Veronica Deza, MD

Robert Downie, MD

Julie Ducharme, MD

Dan C. English, MD, MA

Robin Gonzalez, MD

Ami Kapadia, MD

Begabati Lennihan, RN, CCH

Ina Li, MD

Robert Loeb, MD

Arlene Lowney, RN, MBA

Vincent Martarana, DPM

Laura Mosqueda, MD

Benjamin A. Nachamie, MD

Galia Paganelli, MD

C. Sloane Robinson, MD

Maria Rodriquez, MD

Barbara Roehl, MD

Brooke E. Salzman, MD

Rebecca A. Silliman, MD, PhD, MPH

B. Brent Simmons, MD

Robert Smith, MD

David Snyderman, DDS

Laura Stanley, RN, GNP

Martha Swartz, Esq.

Steven Weinstein, PhD

Daisy Wynn, MD

Michele Zawora, MD

CONTRIBUTORS

1. William Reichel, MD

Christine Arenson, MD

Joseph E. Scherger, MD, MPH

2. John D. Gazewood, MD, MSPH

3. Racquel Daley-Placide, MD

Holly Jean Coward, MD

4. Laura Goldman, MD

Thomas C. Hines, MD

Ilona M. Kopits, MD, MPH

5. Elena M. Umland, PharmD

Cynthia A. Sanoski, PharmD, BCPS, FCCP

Amber King, PharmD

6. Jacqueline Lloyd, MD

Randy Huffines, DDS

7. Maria A. Fiatarone Singh, MD, FRACP

8. Lisa B. Caruso, MD, MPH

Rebecca A. Silliman, MD, PhD, MPH

9. Phil Mendys, PharmD, CPP

Ross J. Simpson, Jr., MD, PhD

10. B. Brent Simmons, MD

Daniel DeJoseph, MD

Christine Arenson, MD

11. Joshua M. Stolker, MD

Michael W. Rich, MD

12. Pushpendra Sharma, MD

13. Kerri S. Remmel, MD, PhD

14. Michele Zawora, MD

Tsoa-Wei Liang, MD

Hadijatou Jarra, MD

15. James G. O’Brien, MD

Stephanie Garrett, MD

16. Lauren G. Collins, MD

Barry N. Rovner, MD

Marjorie M. Marenberg, MD, PhD, MPH

17. John M. Tomkowiak, MD

18. Richard D. Blondell, MD

Lynne M. Frydrych, MS

Rita M. Sawyer, MSN

19. Paula M. Minihan, MPH, PhD

20. David Defeo, MD

Shannon S. Carson, MD

21. Christine Hsieh, MD

Cuckoo Choudhary, MD

22. David Alain Wohl, MD

23. Karen Krigger, MD, MEd

Molly Rose, RN, PhD

24. Matthew Russell, MD, MSc

Rebecca A. Silliman, MD, PhD, MPH

James Burke, MD

25. Tomas L. Griebling, MD, FACS, FGSA

26. Jan Busby-Whitehead, MD

Mary H. Palmer, PhD, RN-C, FAAN

Theodore N. Johnson, MD, MPH

27. Carmen Sultana, MD

28. Matthew C. Leinung, MD

Paul J. Davis, MD

Faith B. Davis, MD

29. Karen D. Novielli, MD

30. Beth L. Jonas, MD

31. Joseph D. Zuckerman, MD

Aaron Schachter, MD

32. Arthur E. Helfand, DPM

33. James Studdiford, MD

Brooke E. Salzman, MD

Amber Tully, MD

34. Mary H. Palmer, PhD, RN-C, FAAN

Jan Busby-Whitehead, MD

35. Inna Sheyner, MD

Karen Travis Stover, MPH, MSN, ARNP, CS

36. Danielle Snyderman, MD

Christopher Haines, MD

Richard Wender, MD

37. Omesh P. Gupta, MD, MBA

William Tasman, MD

38. Clarence (Fred) Gehris, MD

Leonard Proctor, MD

Lauren G. Collins, MD

39. Allen D. Samuelson, DDS

40. Susan Galandiuk, MD, FACS

Hiram C. Polk, Jr., MD, FACS

41. Kenneth Brummel-Smith, MD

42. Nasiya N. Ahmed, MD

Randal W. Scott, MSW, MBA

Mindy J. Fain, MD

43. Rebecca D. Elon, MD, MPH

Marshall B. Kapp, JD, MPH

44. Seema Modi, MD

Terri Maxwell, MSN, PhD

45. Jeffrey Philip Spike, PhD

46. Amy R. Ehrlich, MD

Keiko Kimura, MD

Jody Rogers, MD

47. James G. O’Brien, MD,

48. Alice K. Pomidor, MD, MPH

Joanne Schwartzberg, MD

49. Joel S. Edman, DSc, FACN

Bettina Herbert, MD

50. Thomas L. Edmondson, MD, CMD, AGSF

William Dean Charmak, PhD

51. Richard Falvo, PhD

52. Daniel Swagerty, MD, MPH

Jonathan Evans, MD, MPH

53. Fred Kobylarz, MD, MPH

Gwen Yeo, PhD

54. Gordon F. Streib, PhD

55. Lisa Granville, MD

Karen Myers, ARNP

56. Susan Mockus Parks, MD

Laraine Winter, PhD

57. Jeanette Koran, BS, RN

Amy Talati, PharmD

Albert G. Crawford, PhD, MBA, MSIS

58. Peter Hollmann, MD

59. David J. Doukas, MD

Laurence B. McCullough, PhD

Stephen S. Hanson, PhD

60. Brooke E. Salzman, MD

Danielle Snyderman, MD

Robert Perkel, MD