This section focuses on the Geriatric Periodic Health Exam (GPHE) in the primary care setting. Learners will become familiar with the GHPE's structure, content and screening process; they will also develop the ability to apply the IPEA framework to GPHE.

Learning Objectives

Frailty is discussed as a potentially remediable contributory factor to morbidity in the elderly. Predictors of frailty, the concept of atypical presentations, the importance of early identification, and the benefits of an interprofessional approach to frailty management are explored. This section also applies the IPEA framework to frailty.

Dr. John Puxty and Susanne Murphy of the Centre for Studies in Aging & Health at Providence Care, gave an overview of the Geriatric Periodic Health Exam in Primary Care in an online presentation health care professionals in South East Ontario via the Ontario Telemedicine Network on February 3, 2010.

Frailty is a dynamic condition experienced by some older adults.  It creates a vulnerability to adverse outcomes resulting from an interaction of physical, socio-economic and co-morbidity factors. When an individual is frail the impact of an “illness” further impairs function and ability to cope.

Living Longer, Living Well: Highlights and Key Recommendations icon

In January 2012, the province launched Ontario’s Action Plan for Health Care. It established a new direction for the province’s health care system, with a focus on equity, quality, access, value, and choice to ensure Ontarians receive the right care, in the right place, at the right time. The Action Plan highlighted the development of a Seniors
Strategy as a way to establish sustainable best practices and policies at a provincial level that could in turn support the local delivery of health, social, and community care services with a focus on helping older Ontarians to stay healthy and stay at home longer.

Senior Friendly Hospital Care : Summary Report & Recommendations

Seeking to continuously improve quality of care and contribute to healthy communities across the province, in September 2010 the Local Health Integration Networks (LHINs) collectively identified the Senior Friendly Hospital (SFH) Strategy as a cross-LHIN priority for province-wide implementation.

Dr. George Heckman -Developing new model for geriatric medicine - Photo

Dr. George Heckman, a physician with the Schlegel-University of Waterloo Research Institute for Aging, has been at the forefront of developing a new model for geriatric medicine. Heckman’s unique role, supported by the University, the Waterloo Wellington Local Health Integration Network (LHIN), the Ministry of Health and Long-Term Care and philanthropist Ronald Schlegel, involves teaching students, treating seniors, conducting research and serving as the geriatric specialist across the LHIN.

The Division of Geriatric Medicine at McMaster University supports a number of outstanding and successful research endeavors & projects, one of which is the Hospital Elder Life Program (HELP). HELP is an innovative and evidence based model of care designed to prevent delirium and functional decline in hospitalized older persons.

“Arthritis” means inflamed joint and is a term used to describe a group of diseases and conditions that cause pain, stiffness and swelling in a person’s joints or other parts of their musculoskeletal (muscle and bone) system (1).  Arthritis is a leading cause of disability in Canada and is most common in older adults (1). 

There are several types of arthritis including osteoarthritis, rheumatoid arthritis and gout (1). Most types of arthritis are characterized by pain, aching, stiffness and swelling, which weaken the structure and functioning of affected joints (1).This can make simple tasks a challenge and disrupt daily routines. Osteoarthritis is the most common type experienced by older adults and is usually present in the joints of the hands, knees, hips and spine (2).

Participation in physical activity is necessary for a healthy musculoskeletal system. Low-impact exercise such as walking, cycling and swimming help keep joints flexible and strengthen the muscles that support them (2). Additionally, maintaining a healthy weight will help protect joints by avoiding excess stress on them during daily tasks. The use of canes, grab bars and larger handles can help those living with arthritis manage their daily activities. As part of an arthritis management strategy, physicians might also recommend medication to reduce pain (1). Discuss your needs with your health care team.

References

(1)  Government of Canada. (2011). Chapter 1: Life with arthritis in Canada: A personal and public health challenge – What is arthritis and how common is it? Retrieved from https://www.canada.ca/en/public-health/services/chronic-diseases/arthritis/life-arthritis-canada-a-personal-public-health-challenge/chapter-one-what-is-arthritis-and-how-common-is-it.html

(2)  Health Canada. (2008). Seniors and aging – Osteoarthritis. Retrieved from http://www.hc-sc.gc.ca/hl-vs/alt_formats/pacrb-dgapcr/pdf/iyh-vsv/diseases-maladies/seniors-aines-ost-art-eng.pdf

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