Glossary • Advance care planning — Discussing and preparing for future decisions about medical care, including code status and goals of care.17 • Code status — Indication of the decision to receive or forgo cardiopulmonary resuscitation in the event of cardiac arrest.18 • Comprehensive geriatric assessment — An interdisciplinary, multidimensional process to develop an integrated plan for treatment, rehabilitation and support for frail or older adults made vulnerable by their health or other circumstances.19 • Frailty — A geriatric syndrome characterized by age-associated declines in physiologic reserve and function across multiorgan systems, leading to increased vulnerability for adverse health outcomes.20 • Geriatric Emergency Department (GED) — The integration of best practices for older adults into an existing ED or separate ED space designated for older adults.21 • Geriatric surgery — A perioperative program that is designed to improve surgical care and outcomes for older adults through implementation of surgical standards.22 • Geriatric syndrome — Multifactorial conditions that are prevalent in older adults.23 • Goals of care conversation — A conversation about the patient’s expressed preferences, values, needs, concerns and/or desires, through clinician-led discussion, professional guidance and support.24 • Medical inflection point — The point at which medical intervention may not yield a therapeutic outcome. • Sleep hygiene — The use of various behavioral and environmental practices to ensure effective and restorative sleep.25 • Vulnerabilities — Characteristics that can influence medical care, access to treatment, and outcomes.26 References 1 Huckfeldt, P. J.; Reyes, B.; Engstrom, G.; Yang, Q.; Diaz, S.; Fahmy, S.; Ouslander, J. G. “Evaluation of a Multicomponent Care Transitions Program for High-Risk Hospitalized Older Adults.” J Am Geriatr Soc. 2019 Dec;67(12):2634–42. DOI: 10.1111/jgs.16189. Epub 2019 Oct 1. PMID: 31574164. 2 Westphal, E. C.; Alkema, G.; Seidel, R.; Chernof, B. “How to Get Better Care with Lower Costs? See the Person, Not the Patient.” J Am Geriatr Soc. 2016 Jan;64(1):19–21. DOI: 10.1111/jgs.13867. Epub 2015 Dec 7. PMID: 26639104. 3 Young, L. J.; George, J. “Do guidelines improve the process and outcomes of care in delirium?” Age Ageing. 2003 Sep;32(5):525–8. DOI: 10.1093/ageing/afg094. PMID: 12958002. 4 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed August 5, 2016. 5 U.S. Department of Health and Human Services. CMS statistics. Washington, D.C.: Centers for Medicare and Medicaid Services; 2004. (publication no. 03445) [Google Scholar]. 6 Inouye, S. K.; Westendorp, R. G.; Saczynsk, J. S. “Delirium in elderly people.” Lancet. 2014;383(9920):911–22. doi.org/10.1016/S0140-6736(13)60688-1 7 www.cdc.gov/aging/publications/features/lonely-older-adults.html 8 Kaiser, M. J.; Bauer, J. M.; Rämsch, C.; Uter, W.; Guigoz, Y.; Cederholm, T.; Thomas, D. R.; Anthony, P. S.; Charlton, K. E.; Maggio, M., et al. “Mini nutritional assessment international group. Frequency of malnutrition in older adults: A multinational perspective using the mini nutritional assessment.” J Am Geriatr Soc. 2010;58:1734–8. 9 www.pubmed.ncbi.nlm.nih.gov/28290264 10 www.sciencedirect.com/science/article/pii/S0167494312001768 11 www.pubmed.ncbi.nlm.nih.gov/28531387 12 Substance Abuse and Mental Health Services Administration (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Service. 13 www.healthline.com/health/depression/elderly 14 www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7224a1-H.pdf 15 www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification 16 www.massgeneralbrigham.org/en/about/newsroom/articles/4-things-to-know-about-prehab 17 www.nia.nih.gov/health/advance-care-planning-advance-directives-health-care 18 Erath, A.; Shipley, K.; Walker, L. A.; Burrell, E.; Weavind, L. “Code status at time of rapid response activation — Impact on escalation of care?” Resusc Plus. 2021 Mar 10;6:100102. 19 Welsh, T. J.; Gordon, A. L.; Gladman, J. R. “Comprehensive geriatric assessment — a guide for the non-specialist”. Int J Clin Pract. 2014 Mar;68(3):290–3. Epub 2013 Oct 7. 20 Chen, X.; Mao, G.; Leng, S. X. “Frailty syndrome: an overview.” Clin Interv Aging. 2014 Mar 19;9:433–41. 21 www.acep.org 22 www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification 23 American Society of Clinical Oncology Educational Book 39 (May 17, 2019) e96–e109. 24 manual.jointcommission.org/releases/TJC2018A/DataElem0708.html 25 www.dictionary.cambridge.org/us/dictionary/english/sleep-hygiene 26 Langmann, E. “Vulnerability, Ageism, and Health: Is it helpful to label older adults as a vulnerable group in health care?” Med Health Care Philos. 2023 Mar;26(1):133–42. DOI: 10.1007/s11019-022-10129-5. Epub 2022 Nov 19. 13
