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Throwing granny away.

Efforts to promote health and prevent disease have long been aimed at the young, but the National Academy of Sciences is urging greater preventive care for people fifty years of age and older. The NAS issued a report, written by Dr. Robert L. Berg and Joseph S. Cassells, identifying thirteen risk factors that affect large numbers of elderly people and for which prevention is possible.

Misuse of prescription and over-the-counter drugs was seen as a major problem, often leading to life-threatening complications. Dosages for the elderly are often inappropriately prescribed by extrapolating from studies on younger people. Other areas of prevention include: infections, prevented by immunization against influenza and pneumococcal pneumonia; falls, prevented by energy-absorbing surfaces and research on fractures; depression, often relieved by new drugs that are reaching only a fraction of elderly patients in need of them; cancer, effectively prevented in this age group by the same screening used for younger people.

While the National Academy of Sciences proclaimed that "many older individuals lead satisfying lives and maintain their health well beyond society's expectations," the American College of Emergency Physicians was reporting that between 100,000 and 200,000 geriatric patients are abandoned nationwide in emergency rooms each year. Typically, the patient is brought to the hospital by a member of the family, registered, and then left in the waiting room. As 10 million elderly people visit emergency rooms every year, the rate of abandonment is 1-2 percent.

The problem is worse in urban areas. At San Francisco General, which has the busiest emergency department in Northern California, three to four geriatric patients are abandoned each week. These patients often have organic brain syndrome or Alzheimer's, and require more care than the family is able or willing to provide.

Cutbacks in federal funding for the medically indigent are only part of the problem. More people who used to die now grow old and infirm, while the proportion of younger adults in a position to care for them is shrinking. In addition, fewer women are willing to sacrifice marriage and career to stay at home with frail parents.

Perhaps the National Academy of Sciences can add a fourteenth risk factor to their study: families who abandon Granny.
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Title Annotation:risk factors that affect elderly people, and the abandonment of geriatric patients
Author:Nelson, Hilde L.
Publication:The Hastings Center Report
Date:Jan 1, 1991
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