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THE OLDER PERSON AS A PATIENT

THE OLDER PERSON AS A PATIENT . Dr. Enrique Vega Regional Advisor in Aging and Health PAHO/WHO vegaenri@paho.org. The Problem of Mr. Z:.

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THE OLDER PERSON AS A PATIENT

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  1. THE OLDER PERSON AS A PATIENT Dr. Enrique Vega Regional Advisor in Aging and Health PAHO/WHO vegaenri@paho.org

  2. The Problem of Mr. Z: • Mr. Zis 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 monthsMr. Zhas 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 admittedtothe hospital with two rib fractures and a trauma in his right knee. JAMA. December 2009. Vol 302 No 24

  3. The Problem of Mrs.Z: • Mrs. Zis 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 admittedtothe hospital and her two children live in another city. JAMA, December 2009. 302 No 24

  4. 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 thehealth center.

  5. OrmaybeMrs. And Mr. Parodi: • … with the same heath picture • If MrParodiwerea 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.

  6. Aging in Latin America and the Caribbean: Aging Population Growth IS NOW Population in Millions

  7. EPIDEMILOGIC TRANSITION 1360 - 69. Muertes/100.000 Cambio (%) Braunwald E, N Engl J Med 1997; 337: 1360-9

  8. Company Logo

  9. Company Logo

  10. Pepe Pancho

  11. THE NEW PATIENT

  12. Several Patient Types

  13. NEW PROBLEMS DISABILITY COMORBIDITY FRAILTY

  14. NEW WAYS? Company Logo

  15. I DON’T UNDERSTAND WHAT YOUR PROBLEM IS. TALK MORE CLEARLY

  16. PROPORTIONAL MORTALITY AND USE OF SERVICES MORTALITY BY CANCER ONCOLOGY CONSULTATION

  17. J Am Geriatr Soc 56:1796 –1801, 2008.

  18. EDITORIAL LeadingonBehalf of anAgingSociety L Fried, JAGS 2008

  19. EDITORIAL LeadingonBehalf of anAgingSociety L Fried, JAGS 2008

  20. MUST BE TEAMWORK BASED Company Logo

  21. NEVER GIVE UP

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