Geri #

Three M’s:

• What Matters
• Mentation
• Meds
• Mobility

What Matters #

• GOC
  • Prognosis
  • Short term, long term
  • Align recommendations
• Advanced directives
  • MDPOA
  • MOST

Mentation #

• Dementia
• Delerium
• Depression
  • Avoid
    • Paxil → too sedating
    • Prozac → long 1/2 life
  • Caution
    • Celexa → Qtc prolonger
  • Good options
    • Lexapro → lesat drug-drug interactions
    • Zoloft

Can’t diagnose the others if you have depression, must treat first

Mild Cog Impairment (Mild Neurocognitive Decline) #

Prognosis:

• 1/3 get better
• 1/3 stay same
• 1/3 get worse

Meds #

Beers

Mobility #

• Timed Up and Go (TUG)
  • <13s is normal
  • >13s
    • → to PT
      • Balance training
      • Tai-Chi
    • Screen for fall rsik
• Walk Velocity
  • Good predictor of prognosis/mortality