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"I'm not young enough to know everything."

—J. M. Barrie


By the end of this chapter, readers will be able to:

  1. Describe the health conditions that are most common among older adults.

  2. Discuss the implications of those health conditions for function and quality of life.

  3. Describe the ways in which health conditions present differently than they do in younger adults.

  4. Discuss specific common health conditions affecting older adults, including cancer, diabetes and other metabolic conditions, endocrine disorders, urinary tract infections (UTIs), pneumonia, and other infectious diseases.

  5. Discuss the ways in which multiple diseases may overlap, and the consequences of these interactions for function.

  6. Describe relevant issues in use of over-the-counter and prescription medications in later life.

  7. Discuss the ways in which occupational and physical therapy may contribute to treatment of individuals with these conditions.

Clinical Vignette

Mary Ramos is a 78-year-old widow who has macular degeneration, high blood pressure, and arthritis. Until last week, she was active in many community organizations, socialized with friends, and helped with child care for her four grandchildren. She described herself as being in good health and as enjoying her life.

Over the past week, Mrs. Ramos became quite lethargic and then developed a high fever. When her daughter came to her home to pick up the two grandchildren, Mrs. Ramos had been watching, she found her mother lying listlessly on the couch. The daughter was sufficiently concerned to call emergency medical services, and her mother was taken to the hospital. In the emergency department, she was found to be seriously dehydrated and delirious; she was diagnosed with a UTI and put on antibiotics. Since then, her cognitive status has deteriorated: she does not recognize her children and is not oriented to place or time although she is oriented to person.

  1. What are some characteristics of this situation that might be found in an adult of any age?

  2. What are some characteristics of this situation that seem unique to an older adult?

  3. What role do you see for occupational therapist or physical therapist in evaluating Mrs. Ramos's status and development of an intervention plan?

At some point during the aging process, illness or disability will affect most older adults' ability to undertake the activities that give life meaning and sustain well-being. As discussed, some of those conditions are associated with specific systemic changes that occur in later life as well as the many medical conditions that can be seen at any age. "Aging itself is associated with deterioration in health status, and acute hospitalization of the elderly even more so" (Zafrir, Laor, & Bitterman, 2010, p. 10). In the United States, older adults, particularly those older than 85 years, accounted for a disproportionate number of hospitalizations, even though these rates declined somewhat between 2000 and 2010 (Levant, Chari, & DeFrances, 2015). The most common reasons for hospitalization, according to ...

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